By Monday, New Jersey’s 11 clinics administering monkeypox vaccinations will no longer give the regular, one-shot-per-vial dose deep into the arm. The federal government is making 360,000 more vials of vaccine available. But to qualify, health officials say, New Jersey must reduce each dose to one-fifth the regular dose. “We need to make sure vaccines are going to places that need it more than others … And if that means lowering the dosage so more people can get shots in arms — and we can slow the spread — I think that’s an important step,” said Chris Fuscarino of Garden State Equality.

Clinics will need to get precisely five shots out of each vial of vaccine. They will also now need to administer the shots intradermally — just under the skin. That’s not easy, warns epidemiologist Stephanie Silvera of Montclair State University. “You’re asking for perfection — not only on getting that exact number of doses, but also to administer them perfectly, as well,” said Silvera. In addition, she said, “We cannot pretend that the intradermal dose is as effective as the subcutaneous because so far, the data does not indicate that … but it’s going to provide more people with access to the vaccine.”

“The CDC is under a tremendous amount of political and social pressure to provide something,” Silvera said. “We’re again caught on our heels. We knew this was coming. We did not have sufficient amount of vaccine.”