🧵What @DrArwady says here needs to be shouted from the rooftops. A huge challenge local #PublicHealth departments have is they have virtually no flexibility in how they spend money they receive from the federal government (i.e., most of their funding). chicagotribune.com/news/breaking/… Local health departments receive precious little sustained, year-over-year funding, and only periodically receive large, temporary funding for emergency situations like COVID. (By the way, they've received NOTHING yet to fight monkeypox.)

FDA's new emergency use authorization (EUA) that allows for each vial of our primary #monkeypox/MPV vaccine (Jynneos) to be split into 5 doses is potentially a real game changer to get more vax in arms. But it's important to set some expectations here at the start. For one thing, the new delivery method that FDA calls for requires different kind of needles. Those have to be ordered. Guess how many public health departments, especially big city health departments, are ordering these needles right now.