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“It’s preferable to avoid skin-to-skin contact altogether if someone has monkeypox but at the very least using a condom may reduce that risk”
GENEVA, Switzerland – The World Health Organization (WHO) has advised those at risk to use condoms during sex as monkeypox DNA has now been detected in semen. During the weekly regular press briefing Wednesday, journalist Lynne Peterson, from Trends-in-Medicine asked whether WHO scientists and researchers had learned more about whether monkeypox can be transmitted through blood or semen.
In answer, Dr Rosamund Lewis, WHO’s technical lead for research on monkeypox answered:
“There have not been any reports so far of transmission of monkeypox through blood transfusions. There have definitely been reports of the detection of the monkeypox virus DNA in semen. One study did illustrate that the virus could be isolated from that specimen,” she said.
“However, other studies are still underway. We’re still monitoring this space and still looking to understand it. This is an area where we need to learn more. There’s a lot we don’t know and monkeypox can be transmitted through the close contact that is involved in sexual activity,” she added.
Dr. Lewis then laid out what WHO has learned since the outbreak began this past May.
“There may be a contribution from infection through contact with semen, itself, but we don’t fully know the answers to this question yet, so protecting oneself involves the actions we’ve been talking about from the beginning, which is reducing physical contact with anyone who has monkeypox, reducing number of sexual partners, reducing casual sex or new partners and being more open about one’s risks and having conversations with others that may highlight mutual protection and protection of each other,” Lewis said.
“These are the important features. As long as we don’t have the answers to these questions, the actions to protect oneself remain critically important and some agencies, including WHO, are recommending the use of condoms. That is, in part, as a precautionary measure because we don’t know how much of the infection is transmitted through semen but it is also because it does reduce skin-to-skin contact,” she continued.
Dr. Lewis then pointed out that the health experts advise use of condoms.
“It’s preferable to avoid skin-to-skin contact altogether if someone has monkeypox but at the very least using a condom may reduce that risk while we do more studies to learn more information. This applies, as you highlight, to bisexual and gay men who have sex with men and anyone who has multiple sexual partners. This is not a disease that is limited specifically to a specific group. What is happening is that it is being spread primarily in one risk group. We know that the majority of cases are occurring among men who are gay or bisexual, as they report themselves when their cases are reported to WHO.”
Lewis acknowledged that the WHO has encountered a few cases of women and others who may have acquired monkeypox through a different route of infection, different mode of transmission. “But the vast majority today are still among men who have sex with men, whether they be gay, bisexual or otherwise have contact with other men who have monkeypox,” she said.
She then stressed; “Protect yourself, protect each other, access to testing and vaccine where it’s available and reduction of, of course, any discrimination or stigma, because that prevents people from accessing care.”
The U.S. Centers for Disease Control and Prevention had issued guidelines in dealing with prevention of a monkeypox infection, in addition to obtaining a vaccination early last month:
CDC & HHS expand approach to monkeypox- 1st death reported
CDC & HHS expand approach to monkeypox- 1st death reported
Padilla, 11 Senators urge HHS address MPX vax racial disparities
“I think it’s important to emphasize that deaths due to monkeypox, while possible, remain very rare” a CDC official said
WASHINGTON – At the end of a summer when the number of cases in the monkeypox outbreak rose sharply, the increase in reported infections now appears to be cresting amid increased public messaging and access to vaccines, prompting U.S. health officials to expand their strategy with a new equity-based effort to combat the disease.
Although the reported number of cases, according to most data from the Centers for Disease Control & Prevention, has reached 18,417 in the United States, the number of additional cases decreased from the high at the start of the month, suggesting a downward trajectory in the spread of the disease as vaccines become more readily available.
The numbers are also consistent with a new study finding a significant number of gay and bisexual men, as well as other men who have sex with men, have been limiting contact with casual sex partners, which has been the driving force in the spread of monkeypox. The report from the CDC last week found limiting one-time sexual encounters can significantly reduce the transmission of monkeypox virus, while about half of men who have sex with men are cutting down on sexual activity amid the outbreak, including one-night stands and app hookups.
With the trajectory of monkeypox on the decline, the Biden administration announced a new initiative with the goal of ensuring vaccine distribution is consistent with the value of equity, including on the basis of geographic, racial, and ethnic lines. A total of 10,000 doses of vaccines in the federal government’s supply will be earmarked for localities that have used 50 percent of their allocated supply to support equity interventions, such as outreach to Black and Latino communities, which have been disproportionately affected by the disease or a specific event and celebration for LGBTQ people, health officials announced Tuesday.
Demetre Daskalakis, the Biden administration’s face of LGBTQ outreach for monkeypox and deputy coordinator for the White House monkeypox task force, laid out the details for the new equity-based supplementary initiative in a conference call Tuesday with reporters.
“So what we mean by an equity intervention is what works in your state, county, or city to reach people who we may not be reaching, especially people of color and members of the LGBTQI+ population,” Daskalakis said. “What it means is: It can be working with a specific group or venue that reaches the right people for monkeypox prevention. Once these innovative strategies have been reviewed by CDC, vaccines will be supplied to jumpstart these ideas and accelerate reach deeper into communities.”
The additional equity-based approach to monkeypox vaccine distribution is consistent with the Biden administration’s efforts in recent weeks to distribute additional shots to localities hosting large-scale events for LGTBQ people at the end of the summer, such as Black Pride in Atlanta and Southern Decadence in New Orleans.
Louisiana Gov. John Bel Edwards joined the conference call with reporters on Tuesday and had high praise for the Biden administration for making the additional 6,000 doses of monkeypox vaccine available in time for Southern Decadence, which takes place in the final week of August through Labor Day weekend.
“This is an example — I think a really solid example — of what a federal-state-local partnership and — and then the community providers as well,” Bel Edwards said. “Because the public health folks in New Orleans have been tremendous, but also the community providers.”
Bel Edwards said health officials in the Biden administration have, in addition to providing more vaccines, sent down multidisciplinary teams to New Orleans to help the state organize and prepare as well as set up testing and vaccination sites “that are going to be convenient for the at-risk population.”
A reporter from the New Orleans Advocate on the conference call, however, asked a pointed question on the recent distribution of vaccines to New Orleans in advance of Southern Decadence: The current approach to vaccine administration requires a series of shots, and even with new distribution most people won’t have even had their second shot by that time, so how can Southern Decadence think they will be protected, especially when vaccines take time to become fully effective?
Daskalakis, while promoting the equity-based approach to vaccine distribution, said the Biden administration has been “very clear” that first shot of the monkeypox vaccine “doesn’t mean that you’re protected for the event.”
“We’re going to talk to them about lots of other strategies that they can reduce risk of acquiring monkeypox, but also make it clear that that shot is not for today; it’s for four weeks from now, plus two weeks after that second dose when you get maximum protection,” Daskalakis said.
Although the number of cases is cresting, concern about monkeypox continues as well as the potential danger of the disease. Case in point: The death of a hospital patient in Texas who had monkeypox, but may have to succumbed to other factors, has drawn attention amid a conventional understanding the skin disease isn’t fatal. The case represents the first time in the United States that a patient with monkeypox died while having the condition.
The patient, as confirmed by the Texas Department of State Health Services on Tuesday, was an adult resident of Harris County who was “severely immunocompromised” and state health officials reviewing the case said it is under investigation to determine what role monkeypox played in the death.
Jenny McQuiston, a CDC official who specializes in research on zoological diseases that spread from animals to people, said in response to a question on the casualty that health officials are also evaluating the death and the role monkeypox played.
“I think it’s important to emphasize that deaths due to monkeypox, while possible, remain very rare,” McQuiston said. “In most cases, people are experiencing infection that resolves over time. And there have been very few deaths even recorded globally. Out of over 40,000 cases around the world, only a handful of fatalities have been reported.”
Despite the cresting in the number of cases, many health experts aren’t sold on the new approach to vaccines announced earlier this month by the Biden administration, which sought to expand existing doses of vaccines fivefold as supply hasn’t met demand. The new vaccine approach calls for injecting the JYNNEOS vaccine from the subcutaneous route (delivery of the vaccine under the fat layer underneath the skin) to the intradermal route (delivery of the vaccine into the layer of skin just underneath the top layer).
Bob Fenton, a regional administrator for FEMA and the response coordinator for the White House task force, said about 75 percent of jurisdictions have already adopted the new approach to vaccine injection, while an additional 20 percent are working toward a “fully operational intradermal method.”
“We continue to be laser-focused on doing everything within our power to help jurisdictions and clinicians get shots in arms,” Fenton said. “We’re seeing more and more jurisdictions adopt the intradermal administration.”
Data of this new intradermal approach, critics have said, is insufficient to support the idea it will be as effective as subcutaneous injections, although the Biden administration continues to give assurances the new route for injections is tested and safe. According to a report earlier this month in the Washington Post, the manufacturer of the JYNNEOS vaccine in Denmark, Bavaria Nordic, privately threatened to cut off supply of the shots based on a conversation with health officials on objections the vaccine hasn’t been approved for intradermal use.
McQuiston, in response to a question on whether or not U.S. health officials are collecting newly available real-world information on the results of the new vaccine approach, said U.S. health officials continue to receive data on monkeypox and soon onboard information from additional states.
“CDC operates a system called VAERS — or the Vaccine Adverse Event Reporting System — and we’re actively looking at…different types of events that might be reported post-vaccination,” McQuiston said. ” And we are actively gathering information from the different jurisdictions and states and cities about which vaccines they’re administering — whether it’s subcutaneous or intradermal — and we are gathering those data now, as we speak.”
“Similar to the COVID-19 outbreak, the U.S. monkeypox outbreak is disproportionately affecting Black and Latino Americans”
WASHINGTON – In a letter sent out Monday to U.S. Department of Health and Human Services Secretary Xavier Becerra and Centers for Disease Control and Prevention Director Dr. Rochelle Walensky, U.S. Senator Alex Padilla (D-Calif.), joined by 11 Senate colleagues, asked the agencies to address the growing racial disparities in the federal response to the monkeypox outbreak.
“Similar to the COVID-19 outbreak, the U.S. monkeypox outbreak is disproportionately affecting Black and Latino Americans,” wrote the Senators. “At the beginning of the COVID-19 pandemic, limited data/reporting on cases, hospitalizations, deaths, and tests disaggregated by race or ethnicity made it difficult to assess its implications across communities….Over time, federal, state and local data showed that the majority of COVID-19 cases and fatalities affected people of color, with most illnesses and deaths occurring in regions with higher percentages of Black and Latino populations.”
“The devastating racial and ethnic disparities during the peak of the COVID-19 pandemic underscored the underlying social, economic, and health inequality that has long existed within our health care system due to racial and discriminatory systemic and structural barriers, and the disparities began to narrow with targeted education, outreach, and resource distribution,” continued the Senators.
The Senators stressed that in ways similar to the coronavirus pandemic, racial inequity in health care has become an obvious trend in the circulation of the Monkeypox virus. Multiple health care providers across the United States reported that white men have been receiving a disproportionate amount of vaccinations while making up a smaller percentage of being at risk for Monkeypox.
On Monday the Los Angeles County Department of Public Health published the latest statistics which show that the most significant population of men affected by the outbreak are Black and Latino.
“Vaccine access must be equitable, even in the face of high demand,” urged the Senators. “Any federal targeted response and aid must not inadvertently stigmatize the ongoing public health crisis, but there should be intentional outreach to get resources to impacted communities.The implementation of a rapid and efficient vaccination program is essential to containing and eradicating MPV in communities across the United States. Collecting quality data is crucial to direct our vaccination and testing in the proper directions.”
The letter was cosigned by Senators Cory Booker (D-N.J.), Bob Menendez (D-N.J.), Ben Cardin (D-Md.), Elizabeth Warren (D-Mass.), Ed Markey (D-Mass.), Martin Heinrich (D-N.M.), Dr. Rev. Raphael Warnock (D-Ga.), Tammy Baldwin (D-Wis.), Bernie Sanders (I-Vt.), Sherrod Brown (D-Ohio), and Chris Van Hollen (D-Md..).
“This new agreement solidifies a domestic manufacturing capability that will bring us more vaccine sooner to end this outbreak”
WASHINGTON – The U.S. Department of Health and Human Services announced on Monday that the Biden Administration will provide $11 million in funding to produce JYNNEOS – a vaccine approved to prevent smallpox and monkeypox – at Grand River Aseptic Manufacturing (GRAM) in Grand Rapids, Michigan.
The agreement between the Biomedical Advanced Research and Development Authority (BARDA), part of the HHS Administration for Strategic Preparedness and Response (ASPR), and GRAM aids the company in accelerating the fill and finish manufacturing qualification and production in its recently expanded facility, HHS said in a press release.
The funding will allow GRAM to purchase additional equipment necessary for JYNNEOS production and recruit and train additional staff to operate the line. With BARDA’s support, vaccine production at the facility is expected to be underway later this year, months ahead of the 9-month schedule typical for this type of work, according to HHS.
“We continue to build on our efforts to secure and make safe and effective vaccines readily available,” said HHS Secretary Xavier Becerra. “This new agreement solidifies a domestic manufacturing capability that will bring us more vaccine sooner to end this outbreak.”
“Rapidly increasing the supply and safe delivery of monkeypox vaccine to at-risk Americans is a top priority,” said Assistant Secretary for Preparedness and Response Dawn O’Connell. “BARDA’s support helps ensure success in doubling the capacity available to fill and finish this vaccine, improves preparedness for smallpox bioterrorism, and strengthens the security of the U.S. supply chain. Production of JYNNEOS in the U.S. creates jobs and speeds the availability of the vaccine.”
In July, to support the current monkeypox outbreak and future smallpox preparedness, BARDA placed orders for fill, finish, and delivery of 5 million vials of JYNNEOS from U.S. government-owned bulk vaccine stored in Denmark. In that contract, Bavarian Nordic agreed to complete a technology transfer that would allow a U.S.-based contract manufacturer to fill and finish 2.5 million vials of JYNNEOS.
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