Madagascar forced to divide and share mpox vaccine as epidemic takes off
Madagascar is implementing fractional dosing, splitting single mpox vaccine vials into fifths, to address a severe shortage during its largest-ever outbreak. While this WHO-authorized strategy aims to stretch limited supplies to protect more people, it introduces logistical challenges and requires specialized administration techniques.
Why it matters
The strategy highlights the critical global inequality in vaccine access and the difficult trade-offs developing nations face when managing public health emergencies with insufficient resources.
Madagascar has recorded at least 4,000 mpox cases so far - Simon Townsley Authorities in Madagascar are being forced to split single vaccines into fifths to try to protect as many people as possible during an ongoing mpox outbreak.
The method, known as "fractional dosing", is authorised by the World Health Organization (WHO) in emergencies when there are critical vaccine shortages, but is not routinely recommended and carries a level of risk.
Madagascar, the African island with a population of roughly 33 million people, is currently battling its largest-ever outbreak of the virus formerly known as monkeypox , with at least 4,000 cases recorded so far.
Another one million people are thought to be at risk of contracting clade 1b mpox, a fast-spreading strain of the virus that emerged from the Democratic Republic of the Congo in late 2023.
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