Thread by @donnellymjd

(1/18) We are moving FAR too slowly to stop #monkeypox in the US, esp. considering that summer parties are now in full swing. Here’s a quick recap + some thoughts on a better, faster, fairer response.

(2/18) Last Thursday we saw extreme demand for vaccines among the highest risk demographic, GBTQ men + our sexual networks, as NYC’s single vaccine site was OVERWHELMED w/in minutes. cbsnews.com/newyork/news/s…

(3/18) Just 1,000 doses for a city with 750k GBTQ men+ is NOT NEARLY ENOUGH. Like with other vaccination efforts, we’ll continue to run out of vaccines before we run out of arms.
nbcnewyork.com/news/local/nyc…

(4/18) It is important to understand that there are two vaccines against #monkeypox: a new one (Jynneos) and an old one (ACAM2000). (Both are also labeled for use against smallpox.) cdc.gov/smallpox/clini…

(5/18) Jynneos is the "new one"... a standard modern injectable vaccine. It requires 2 doses, doesn’t leave a scar, and is very safe to use on the vast majority of the population.

(6/18) ACAM2000 on the other hand is OLD. We haven’t used a vaccine like this in generations. It is one dose, uses a percussive administration technique, and is ROUGH on bodies & thus shouldn't be used on immunocomp'd people.

(7/18) The US only has ~70k doses of Jynneos (or half that for 2-dose regimes) on hand right now.
#unconfirmed side note: I've been told that's because of a Trump-era decision to allow ~20M doses to expire without replacing them.

(8/18) The Feds are scrambling to obtain more Jynneos: the Biden admin has reportedly purchased ~2M doses with less than a fifth of them scheduled to arrive by August 1. Those doses are READY TODAY, but are rumored to be held up by a delayed @US_FDA inspection. 😡

(9/18) Tonight the @JoeBiden admin is supposed to announce a new strategy on mpx. Here’s what I hope that includes: washingtonpost.com/health/2022/06…

(10/18) 1. WAIVE THE FDA INSPECTION. There are 100s of thousands of doses ready to take a 7 hour flight from Sweden TODAY. The EU's inspections have been done and are similar to ours. The doses are safe. GET THOSE HERE NOW! AND GET THEM INTO ARMS!

(11/18) 2. IMPLEMENT A BACKUP PLAN W/ ACAM2000. If something happens with the Jynneos doses or the outbreak explodes, we'll need a backup plan. Practitioners need training to use the riskier old vaccine. And, we need to start preparing advice for patients who may have take it.

(12/18) 3. RAMP UP TESTING. We’re testing only 20 people per day in NYC! My friend @reluctantlyjoe has been calling for increased testing for a MONTH!

https://twitter.com/reluctantlyjoe/status/1541586004410191872

(13/18) Testing has recently started to improve but the rate of current testing is still far too slow for ring vaccination of close contacts to be effective. washingtonpost.com/health/2022/06…

(14/18) 4. ORDER MORE JYNNEOS VACCINES. 2M doses is a good start, but we should prioritize a national stockpile that can actually be used in an emergency. We don’t have that today.

(15/18) 5. VACCINE ACCESS AND PRIORITIZATION. As Jynneos vaccines get distributed, we should learn from @nychealthy’s mistakes...

(15/18) ... Prioritize Jynneos for immunocomp’d GBTQs first. Work w/ orgs who can help with outreach to communities of color + GBTQs outside major cities. Not all gays live in Chelsea.

(17/18) 6. VACCINE EQUITY. Finally, we have to start being strategic, not reactive. Get vaccines to countries with endemic monkeypox and in addition to helping people, it will reduce the likelihood of another intl outbreak.

(18/18) 7. RELEASE THE DATA. The public is flying blind in the US right now. We don’t know the demographics of cases nor the number of tests being done. COVID taught us that data is essential: @CDCgov must fix this woeful deficiency.