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The manufacturer of the only vaccine approved by the Food and Drug Administration to protect against monkeypox privately warned senior Biden health officials about their plan to split doses and change how the shots are delivered. “We do have some reservations … due to the very limited safety data available,” Bavarian Nordic CEO Paul Chaplin wrote to Health and Human Services Secretary Xavier Becerra, and Food and Drug Administration Commissioner Robert M. Califf in a letter sent Tuesday and obtained by The Washington Post. (Diamond, 8/10)

This dose-sparing tactic will allow far more people to sign up for doses before summer’s end; if successful, it could help contain the outbreak in the U.S., which currently accounts for nearly a third of the world’s documented monkeypox cases. But this decision is based on scant data, and the degree of protection offered by in-skin shots is no guarantee. ... (Wu, 8/10)

The Biden administration is in talks with multiple companies about bottling millions of new doses of the monkeypox shot, but it could take three to six months to get them ready for distribution, according to two senior administration officials and two other people with knowledge of the matter. The administration on Tuesday recommended providers administer the monkeypox vaccine with one-fifth of the normal amount intradermally — between the layers of the skin — to try and stretch supply without sacrificing efficacy. (Banco and Cancryn, 8/10)

“When you look at the rates of increase, you can see that it’s really approaching an exponential curve. And unfortunately, it’s going to become harder and harder to control the ... higher these numbers get,” said Dr. Peter Chin-Hong, an infectious-disease expert at UC San Francisco. Doctors fear that an increased spread could result in the virus becoming endemic in the wild animal population, meaning it would be virtually impossible to eliminate as a new disease of concern in the U.S. (Lin II, Money and Gutierrez, 8/10)

Tri Vo knew that he had monkeypox before his test came back — what started as painless pimples had turned itchy, then began to feel like glass underneath his skin. It was manageable during the day, but at night, it felt like the glass was vibrating, Vo said. (Gaffney, 8/11)

Since May, nearly 90 countries have reported more than 31,000 cases of monkeypox. The World Health Organization classified the escalating outbreak of the once-rare disease as an international emergency in July; the U.S. declared it a national emergency last week. (Cheng, 8/10)

Back-to-school season is starting, and as kids return to the classroom they will also spread germs. But one infectious disease expert says monkeypox isn’t a major concern and parents should not be alarmed. (Yousry, 8/10)

“I hope they can do it as soon as possible,” said Chin-Hong, noting the injection method has been extensively studied for polio and yellow fever. “We’re on the steep curve of people getting ill, infected and spreading it. On the hospital side where we see the most serious cases, the number of patients has doubled in the last week.” (Vaziri, 8/10)

The Houston Health Department says it is waiting on additional guidance from the Centers for Disease Control and Prevention to begin using the new method. Both health departments will need to retrain healthcare workers — a process that could take days — and obtain different syringes to administer the proper dosage. During a Wednesday Q&A session, Dr. David Persse, Houston’s chief medical officer, said a nationwide scramble for the same type of syringe could lead to supply issues. But “at this point, we’re not anticipating that,” he said. (Gill, 8/10)

New Hampshire health officials are expanding eligibility for the monkeypox vaccine. State officials recently announced that the federal government was sending an additional 1,140 doses of the vaccine to New Hampshire. (Fam, 8/10)

About 600 doses of a monkeypox vaccine have been administered to Wisconsinites as of Tuesday, the state Department of Health Services said in a press conference Wednesday. About 200 doses were given at the start of this week and another 300 over last week. Health officials have confirmed 32 cases of monkeypox in the state as of Tuesday, according to DHS. (Mathew, 8/10)

The World Health Organization is urging the public not to attack monkeys amid the monkeypox outbreak, following reports that primates have been poisoned and killed in Brazil. "What people need to know is that the transmission we are seeing is happening between humans," WHO spokesperson Dr. Margaret Harris said Tuesday at a press briefing in Geneva. (Lenthang, 8/10)