The Democratic Republic of Congo has struggled to launch an mpox vaccination campaign in the capital, Kinshasa, due to a shortage of doses, as cases continue to surge nationwide, particularly among children, according to the country’s response leader.

The World Health Organization declared mpox a global health emergency in mid-August after a new strain began spreading from Congo to neighboring countries.

However, donors have been slow to convert their pledges into financial support and vaccine deliveries, according to the Africa Centres for Disease Control and Prevention.

Cris Kacita, the head of operations for Congo’s mpox control program, said Tuesday that the country had 53,921 doses of vaccine left for use in prisons – where people are at high risk due to squalid conditions – but needed over 162,000 doses to launch a vaccination program in the capital.

Daphne Von Buxhoeveden from the EU’s Health Emergency Preparedness and Response Authority said Wednesday she expected 100,000 vaccine doses to arrive from Germany on Thursday.

A spokesperson for Bavarian Nordic said 265,000 doses of its mpox vaccine, Jynneos, had been delivered to African countries, adding that 1 million more doses were awaiting shipment to the continent.

"We are simply waiting for Africa to ask or say where they should be sent," the spokesperson said.

"When some people don’t get vaccinated, it can be due to many different reasons. But one thing it’s definitely not due to is a lack of vaccines."

Kacita said that, in addition to not knowing when some of the donations would arrive, the arrival of vaccines was delayed by the administrative process, which includes sending an official request, manufacturing, preparing documents, and obtaining import authorizations.

"As long as we don’t have the necessary quantity, it’s going to be complicated to launch (vaccination) in the 14 health zones," he told Reuters, referring to areas of Kinshasa.

So far, the capital, with nearly 20 million inhabitants, has been less affected than regions elsewhere in the country. Vaccination programs are underway in six other provinces.

The charity Save the Children said Wednesday that targeted vaccinations are needed to stop the virus from spreading rapidly among children.

According to the aid agency’s data, suspected cases among children in Congo have increased by more than 130% since Aug. 14, rising from 11,300 to 25,600 as of Nov. 3.

"Children are especially vulnerable to mpox – they explore by touch and taste, don’t always understand health guidance, and have weaker immune systems than adults," Katia Vieira de Moraes LaCasse from Save the Children said.

Russia’s consumer and health watchdog told Reuters that several African and former Soviet countries had expressed interest in buying Russia’s vaccine against mpox and smallpox.