ウィスパリング同時通訳研究会コミュの08/26/22: Press Briefing by White House Monkeypox Response Team and Public Health Officials

Bob Fenton: (00:00)
Good afternoon. I’m Bob Fenton, the White House monkeypox response coordinator. Today, HHS assistant secretary for preparedness and response, Dawn O’Connell will cover our ongoing work to scale up vaccine supply and distribute vaccine where it is needed. CDC Director Walensky will discuss the initial data we have on vaccinations from a small number of jurisdictions. And deputy White House monkeypox response coordinator, Dr. Demetre Daskalakis will provide an update on our partnership with impacted communities.
(00:36)
From the start, our vaccination strategy has been centered around reaching approximately 1.6 million Americans, including gay, bisexual, and other men who have sex with men and others with a known high risk exposure to monkeypox. To do that, we’ve worked nonstop to scale up access to the JYNNEOS vaccine in the US. In fact, we have made more JYNNEOS vaccine available than any other country in the world. And because of the FDA’s authorization of safe and effective intradural vaccination, we can accelerate the number of shots and arms with the urgency this outbreak warrants.
(01:17)
As of this past Monday, we have made 1.1 million vials of vaccine available jurisdictions. That is the same total number of vials that jurisdictions were expecting before FDA approval of intradermal administration. As administrator, O’Connell will discuss shortly we’re approaching having enough vaccine for everyone in the at-risk community to receive two doses of vaccine. I’m also glad that we’ve seen significant progress in intradermal administration of vaccine in just the last two weeks.
(01:53)
As of today, 75% of jurisdictions are already applying intradermal administration of vaccine. And another 20% are working to move in that direction. This is important progress in a short period of time. As as a cumulative, 1.1 million vials are delivered to jurisdictions. And as we get more supply, we are approaching the point where we can offer two doses of vaccine to the entire high risk population via intradermal administration.
(02:27)
Why we continue to deliver as much vaccine to states and jurisdictions as possible, our focus has to be getting those shots into arms. Over the past couple weeks, CDC has been working closely with jurisdictions and clinicians directly to operationalize the intradermal approach. They’ve hosted webinars with thousands of providers providing video trainings. And our team is in touch with health leaders around the clock. As Don will discuss in detail, we have made clear to jurisdictions.
(02:58)
We stand ready to help in any way we can including providing additional vaccines once a jurisdiction has attested to using more than 85% of their vials. Currently, there are a handful of jurisdictions. Approximately one fifth that have attested to use in 85% of their current supply. So our focus right now is working closely with clinicians and local health departments to get shots into arms. And importantly, we continue to encourage jurisdictions to focus vaccination efforts on getting vaccines out equitably to individuals at highest risk of contacting the virus.
(03:37)
That’s why we are working closely with places like Atlanta and New Orleans to prepare for events like Black Pride and Southern Decadence. And last week, we got hundreds of vaccines out to individuals who participated in pride activities in Charlotte, North Carolina. The bottom line is this. Over the past three months, we have made significant strides in increasing supply of vaccine, accelerating its delivery and strengthening our preparedness for the future.
(04:07)
We have a robust supply of vaccine available for jurisdictions out in the field and we are working hand in hand with jurisdictions to get shots into arms, to help adapt the intradermal approach and to answer their questions. We will also continue to do everything in our power to address needs on the ground and adapt our response as needed so we can get this outbreak under control. Before I turn it over to Assistant Secretary O’Connell, I want to take a moment to recognize the work of jurisdictions. They’re leveling up their operations to get more vaccines in arms. Just this week, our team heard from health leaders here in DC who told us they were getting 900 shots out per day using the intradermal method and getting between 4.5 and five doses on average per vile. Those aren’t just numbers, that’s real action impacting hundreds of people every day. So thank you to all the clinicians, health partners and members of the community for working together to combat this outbreak. With that, let me turn it over to Assistant Secretary O’Connell.

Dawn O’Connell: (05:16)
Bob, thanks so much. At ASPR, we continue to do everything we can to increase the availability and accelerate the distribution of vaccines and treatments nationwide with the goal of first offering vaccines to Americans at highest risk of contracting monkeypox. As Bob mentioned, we are soon approaching the point where most people at highest risk will have access to two doses of JYNNEOS. Our work is far from over, but this is a step in the right direction as we continue to fight the spread of the virus.
(05:46)
Now, I’m happy to walk through the numbers. To date, across all four phases of the national vaccine strategy, we have allocated approximately 1.1 million vials of JYNNEOS vaccine. We shipped about half of that number prior to the FDA issuing their emergency use authorization for JYNNEOS allowing for intradermal administration. So those first 600,000 or so vials were distributed when one vial equaled one dose.
(06:15)
Since the FDA issued the EUA on August 9th, we have shipped approximately 188,000 additional vials of vaccine which represents up to 940,000 doses using the intradermal vaccination method covered by the EUA. Combined, that comes to about 1.5 million doses already distributed and in the field.
(06:38)
Now, on Monday, we launched the fourth phase of our national vaccine strategy making the next 360,000 vials of vaccine available to states and jurisdictions for ordering and distribution. Using the intradermal administration method, jurisdictions can administer up to 1.8 million doses of vaccines from these vials. Taken together by the end of phase four, we will have provided enough vials to states and jurisdictions to provide more than 3 million doses of vaccines. Meaning we have supplied nearly enough vaccine to reach the entire at-risk population.
(07:14)
We’ve got more to do, but this is an important step along the way. Now, as supply continues to increase steadily and we ship out thousands of doses daily, it’s important that we make sure vaccines are going to the people and places that need the most and that shots, like Bob said, are getting into arms, not sitting on shelves. As part of phase four, in order for jurisdiction to order from its allocation, it must attest that it has utilized at least 85% of its current supply.
(07:44)
Since Monday, 14 jurisdictions have attested to 85% utilization. And as soon as the jurisdiction let us know that they have used 85% of their supply, they can order more. The strategic national stockpile team immediately fulfills those orders and ships them out. Of the jurisdictions that have attested to this 85% utilization, since Monday ASPR has shipped nearly 48,000 vials of vaccine, which represents up to 240,000 doses.
(08:14)
Looking ahead, we anticipate another 150,000 vials of vaccine from our supplier, which represents up to 750,000 doses, and all coming in as early as late September. In addition, last week, we announced that Bavarian Nordic reached an agreement with Grand River Aseptic Manufacturing to establish the first US-based fill-and-finish for JYNNEOS in Grand Rapids, Michigan. Once up and running, this facility will fill-and-finish 2.5 million vials we ordered this summer. This is an important step in building our domestic capacity and in providing domestic jobs. (08:50)
In addition to getting vaccines out to those that need it the most, it is also important to us that TPOXX is easily accessible for treatment to those at-high risk for severe disease. That is why last week we announced that we would pre-position up to 50,000 patient courses. That’s three times as many treatment courses as there are monkeypox cases. Jurisdictions were able to start ordering those treatment courses earlier this week, and so far, the SNS has shipped out about 10,000 courses to 19 jurisdictions. That’s in addition to the more than 22,000 courses we’ve already shipped. This approach allows us to pre-position these treatment courses for quick and easy access for patients who qualify for them. So bottom line, our message to states and jurisdictions is if you need vaccines, if you need treatments, or if you need additional support for your local response, please let us know. And with that, it’s my pleasure to turn the program over to Dr. Walensky.

Dr. Walensky: (09:49)
Thank you, Administrator O’Connell. Good afternoon, everyone. Today, I’d like to share with you the latest information and data out of our local health departments and CDC on the current monkeypox outbreak. As of August 25th, over 46,700 cases have been detected globally in 98 countries. In the United States, there have been nearly 17,000 cases of monkeypox identified across all 50 states, the District of Columbia, and Puerto Rico.
(10:16)
Throughout the current monkeypox outbreak, CDC has worked diligently to make data available as quickly as possible to help raise awareness and guide decision making. Earlier this week, CDC posted updated data on our website, providing an in-depth look at monkeypox case demographics and symptoms, the use of TPOXX, an experimental treatment for monkeypox, as well as data from a behavioral survey of gay and bisexual men. The posting of these data on our website prior to its publication in a scientific journal is an example of the way we are working to modernize CDC and share timely and actionable data with all of you.
(10:53)
Today, CDC is posting additional data that provide a picture of monkeypox vaccine administration in the United States. Our plan is to update these data on a weekly basis on the CDC website. It’s important to note that the data we’re releasing today reflect only 19 jurisdictions where data are flowing to CDC for analysis, but the data do provide us with an insight and understanding of where we are in our efforts to administer vaccine to those at risk. We’re actively collaborating with the remaining jurisdictions so that they can upload their data in response to our data-use agreements.
(11:28)
Now I’d like to walk you through the vaccine administration data CDC is releasing today. Data as of August 23rd show that over 207,000 doses of vaccine have been administered in these 19 jurisdictions. The data demonstrate that the vast majority of doses administered, nearly 97%, are first doses with consistent week over week increases in vaccinations. While we are encouraged by this scale-up, there are many people eligible for second doses, and very few of the doses administered so far are recorded as second doses.
(12:02)
I’d like to take this moment to emphasize that this is a two-dose vaccine, and it’s important to receive the second dose in the series. I encourage providers to continue to highlight the importance of the second dose so that all vaccinated people optimize their protection from the vaccine.
(12:18)
Now, the administration data also show that among the first doses given, the majority of recipients have been adults age 25 to 39, with around 53% of first doses administered in this age group so far. The majority of first-dose recipients, 92% have been males, and 6% of doses have been administered to women. Regrettably, we at CDC are not receiving data by gender and are unable to report it as such. Those who are white represent about 47% of administered vaccines. Those who are Hispanic represent about 22%, and those who are black represent about 10%. Recently, we’ve seen a demographic shift in new cases as black and Hispanic men have increasingly and disproportionately represented new cases, which further highlights the importance of equity in vaccine administration.
(13:10)
Given the early evidence of racial and ethnic disparities in monkeypox vaccine administration, CDC remains committed to reducing the impact of health disparities by collaborating with jurisdictions on provision of educational materials and promotion of equitable access to monkeypox vaccines. We’re also working with communities to provide vaccine and harm-reduction education at large events attended by groups at highest risks for monkeypox right now.
(13:37)
States, territories, and large local jurisdictions in the United States have stepped up in the face of this outbreak and agreed to report secure, protected data about monkeypox vaccine administration in their jurisdictions to the CDC. These data are essential to help us understand who the vaccines are going to and critically to make sure vaccines are getting to the communities where they are most needed. The data presented today are from 19 jurisdictions, and as I previously mentioned, we’re actively working with the remaining jurisdictions to get these data flowing.
(14:07)
I want to emphasize that public-health data in the United States are unique. They come from a complex decentralized landscape of state and local health departments with many points of friction that can keep data from coming from local jurisdictions to the CDC. The effort to secure monkeypox vaccine data represents how we at CDC are working hand in glove with our state and local partners and other federal agencies to continually improve our approaches. Our goal is swift, transparent, publicly available, and actionable data, and we will share additional jurisdictional data as they become available.
(14:42)
Finally, as students return to college campuses, I want to highlight that earlier this week, CDC made information on resources readily available on our website about monkeypox for administrators, staff, and students at colleges and universities. We will continue to provide the necessary information and education and conduct outreach to those at risk. As you have heard me say many times before, we remain open to feedback on how and where we can provide tailored information to those at highest risk. Thank you, and I’ll now turn things over to Dr. [inaudible 00:15:14]

Demetre Daskalakis: (15:14)
Thank you so much, Dr. Walensky. Today, I wanted to provide an update on a key element of our response. That’s working closely with gay, bisexual, and other men who have sex with men to provide evidence based behavioral advice, to help reduce the risk of monkeypox as we work to get vaccination and testing to scale. It has been a top priority since the earliest days of the outbreak to communicate in plain and direct language about how monkeypox is transmitted and what actions people, specifically men who have sex with men, can take to avoid exposure to this virus. It has been core to my and our mission to provide this advice in a way that reaches men who have sex with men in places they know and trust and to speak plainly and directly about behaviors associated with monkeypox transmission so that they and transgender and gender-diverse individuals have the tools to navigate this outbreak.
(16:06)
The queer community has been central in developing, adapting, and amplifying these messages as the outbreak has unfolded, and the epidemiology further informed our advice to prevent monkeypox. 94% of cases were associated with sexual activity, and nearly all the cases have been seen in gay, bisexual, and other men who have sex with men. Today, the CDC’s MMWR reports in a special monkeypox survey of participants of the American Men’s Internet Survey, or AMIS, that both reinforce this strategy and highlights the important self-motivated behavioral actions taken by MSM during this outbreak to reduce their personal risk of infection and therefore the spread of monkeypox in the community.
(16:48)
Around 50% of surveyed men report having reduced their number of sex partners, reduced their one-time sexual encounters, and avoided some virtual and real spaces associated with increased monkeypox exposure risk. A second MMWR describes a mathematical model that shows that temporary changes in behavior like the ones reported in the AMIS study would not only lead to reduction in the percentage of people who got monkeypox but would also slow spread in the population, allowing more time for vaccination efforts to reach people who could benefit most. (17:23)
What this means is that the LGBTQAI+ people are doing things that are actually reducing their risk, and it’s working. And it speaks to the resilience and commitment of this community to addressing the challenge of monkeypox using every tool in their toolkit, as well as the need for clear, frank, and community-responsive advice from the partnership of public health and community. This is strong progress and shows that the work we’re doing to engage the community is having results and that the community has mobilized to protect itself. So let me be clear, the advice about how to reduce risk for monkeypox exposure is for now, not forever, and as an important part of our public health and community response, as we urgently surge vaccinations to control this outbreak. I’ll hand the mic back to Kevin for questions.

Kevin: (18:14)Get into a few questions. Please keep your questions to one question. Let’s go to Carla Johnson of the Associated Press.

Carla Johnson: (18:25)Really about what you’re doing to address the disparities we’re seeing in these new numbers about vaccine administration, particularly to the Black and Hispanic community. Tha