She told a White House briefing that nearly 97% of the shots administered were first doses, and although many people are eligible for a second dose, “very few” have been given so far.

Walensky said the CDC expected to gain more insight into the trend. Vaccine scarcity may have caused delays in second shots previously but that was no longer the case, she said.

More than 207,000 doses of Bavarian Nordic’s Jynneos vaccine were given as of Aug 23 in the 19 jurisdictions reporting data to the CDC, Walensky said.

The vaccine needs to be given in two doses, four weeks apart, to be fully effective.

To expand access to the vaccine, the US food and drug administration (FDA) on Aug 9 authorised giving it intradermally — between the layers of the skin — which would allow providers to get five doses from a single one-dose vial.

Bavarian Nordic has raised doubts about the safety of the method, citing a lack of evidence and the possible increased risk of reactions compared to injecting it into the muscle.

During the briefing yesterday, officials said providers are reporting getting 4.5 to five doses per vial, but several experts told Reuters the figure is lower.

“The vast majority of health departments that I’ve talked to in the last week are feeling fortunate if they can get four doses out of a vial, and in some cases three,” Dr. Michael Osterholm, an infectious disease expert at the University of Minnesota, said in an interview.

Dr Umar Shaw, secretary of health for Washington state, said on Thursday that many providers were getting three or four doses per vial.

Walensky confirmed that some US jurisdictions were reporting a downward trend in monkeypox cases and that health officials were watching this with cautious optimism.