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In a recent study published in the Frontiers in Medicine journal, researchers estimated the D-dimer levels and characterized lymphocyte subsets and cytokine profiles in severe coronavirus disease 2019 (COVID-19) patients.
Patients experiencing severe COVID-19 should be prioritized concerning treatment by employing early and timely intervention, with an early diagnosis being the most effective strategy. Therefore, thorough monitoring of the COVID-19 severity and efficient early intervention are essential steps in lowering the associated death rate. In certain investigations, patients with COVID-19 were shown to have several aberrant hematological parameters, such as lymphopenia, neutrophilia, increased D-dimer levels, and fibrinogen. However, the clinical relevance of these biomarkers has not yet been fully clarified.
The present study assessed the relationship between D-dimer levels, cytokines, lymphocyte subsets, and disease severity in COVID-19 patients.
The team searched for publications published up until 1 August 2022 in the databases Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure (CNKI), PubMed/MEDLINE, Scopus, Embase, Web of Science, clinical trials, and Google Scholar. To locate other potentially pertinent publications, the WHO publishing database, New England Journal of Medicine, Lancet, JAMA, and BMJ were examined.
Case-control, cohort, and cross-sectional study designs were all included in the present study. Furthermore, the eligible studies must state that the patients had a COVID-19 diagnosis and tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ribonucleic acid (RNA). Studies that evaluated laboratory parameters associated with patients having non-serious or severe disorders or between survivors and non-survivors were eligible for assessment in the study.
The team obtained variables such as the first author, year of publication, study design, number of participants belonging to the severe and non-severe disease groups, country, and levels of laboratory indices in various groups. The Newcastle-Ottawa scale was used to evaluate the non-randomized study's risk of bias. Scores for the NOS criterion ranged between 0 (high-risk deviation) and 9 (low-risk deviation). Studies were deemed high quality if their NOS score was more than 7.
The team found 32 of the 5561 studies eligible for the present study. Among these, 28 studies categorized the study cohort as severe or not severe, while four studies categorized the study sample as COVID-19 survivors or non-survivors. The D-dimer levels estimated in COVID-19 patients were described in 21 articles, the lymphocyte subset levels in 28 articles, and the cytokine levels were described in 17 articles.
Twenty-one articles revealed that patients in the severe group had greater D-dimer levels than those in the non-severe group. The relationship between COVID-19 severity and the number of patient lymphocyte subsets was examined using a random-effects model. Patients in the severe COVID-19 group had lower levels of lymphocytes, T cells, B cells, natural killer (NK) cells, CD3+ T cells, CD4+ T cells, and CD8+ T cells than those in the non-severe group.
Additionally, patients with severe conditions had greater neutrophil-to-lymphocyte ratios (NLR) than those with less severe conditions. By excluding any one specific research from all of the NLR and lymphocyte subsets comparing non-severe and severe groups, sensitivity analyses showed that the results showed sufficient robustness. Except for NK cells and the neutrophil-to-lymphocyte ratio, no substantial publication bias was found in most studies. The random-effect results showed that patients in the severe group had greater levels of interleukin (IL)-2, IL-4, IL-6, and IL-10 than those in the non-severe group. Sensitivity analysis revealed that the primary finding exhibited robustness.
The study findings demonstrated that patients with severe COVID-19 had greater levels of cytokines (IL-2, IL-4, IL-6, and IL-10), NLR, and D-dimer, and lower levels of lymphocyte subsets, all of which are very important for predicting disease changes. The researchers advise that clinicians regularly monitor D-dimer and cytokines levels as well as lymphocyte subsets in hospitalized patients as potential indicators of illness progression to severe disease.
CLAIM
President Joe Biden told people to get vaccinated to protect themselves from hurricanes
DETAILS
Misrepresents source: Biden didnt tell people to get vaccinated to protect themselves from hurricanes. Instead, he urged people to get COVID-19 vaccines to protect themselves from COVID-19 in the event of a hurricane. This is because disaster-hit areas are prone to disease outbreaks and access to healthcare in such areas can become difficult, creating public health risks.
KEY TAKE AWAY
Disaster areas are prone to disease outbreaks, due to factors such as crowding in shelters and poor sanitation. COVID-19 vaccines mitigate public health risks associated with disaster areas, as they are highly effective at reducing a persons risk of severe illness and death from COVID-19. The U.S. Centers for Disease Control and Prevention recommends that people in affected zones stay up to date on their COVID-19 vaccines, to reduce their likelihood of becoming sick with COVID-19 and needing medical care.
REVIEW In late September 2022, Hurricane Ian hit several parts of the U.S., leaving a trail of destruction, with Florida and South Carolina being the most affected areas. Around the same time, social media posts began to appear, suggesting that U.S. President Joe Biden told people to get COVID-19 vaccines because it would protect them from Hurricane Ian. These posts commonly included a video clip in which Biden is heard saying:
Let me be clear: If youre in a state where hurricanes often strike like Florida or the Gulf Coast or into Texas a vital part of preparing for hurricane season is to get vaccinated now. Everything is more complicated if youre not vaccinated and a hurricane or a natural disaster hits.
Examples of such posts are this Facebook video and this TikTok video.
Others made this claim explicitly, including prominent individuals, such as Anthony Sabatini, a member of Floridas House of Representatives, who tweeted Dont listen to Biden and that Getting a COVID vaccine wont protect you from #HurricaneIan. He also posted a screenshot of this tweet on Instagram.
Contrary to the impression that these relatively new social media posts give, the video clip of Biden isnt recent. Its actually a recording of Bidens remarks dating back more than a year ago to August 2021, given before a briefing from the FEMA Administrator, Homeland Security, and COVID-19 Response Teams. Bidens full remarks can be read here on the White Houses website. Indeed, a simple Google search using Bidens quote turns up the same link to the White House website.
Bidens more recent remarks regarding Hurricane Ian, on 27 September 2022, made no reference to vaccination.
More critically, apart from sowing confusion regarding the timeline of his 2021 remarks and Hurricane Ian, the posts also misrepresented Bidens words. While Biden has been criticized for making numerous verbal gaffes, its not the case in this instance, as these posts claimed or implied. By reading his full remarks, it becomes clear that Biden urged people to get vaccinated because disaster areas tend to be particularly prone to disease outbreaks for several reasons, such as crowding in shelters and poor sanitary conditions.
This, combined with the ongoing COVID-19 pandemic, would have been likely to pose a great risk to public health, if many people in hurricane zones were unvaccinated. Furthermore, people in hurricane zones struggle to obtain adequate nutrition and shelter, and may have little to no access to healthcare services. This means that those who catch COVID-19 and become seriously ill may be at a greater risk of dying.
Studies have shown that the COVID-19 vaccines are highly effective at reducing a persons risk of severe illness and death from COVID-19. Vaccination can also reduce virus transmission to some degree, although its less effective now due to the emergence of new SARS-CoV-2 variants like Omicron. Therefore, COVID-19 vaccines help to mitigate the indirect effects of hurricanes on human health. The U.S. Centers for Disease Control and Prevention recommends that people stay up to date on their COVID-19 vaccines:
Staying up to date on vaccines makes it less likely that you will be sick with COVID-19 while sheltering or evacuating from a hurricane, and less likely to need medical services while hospitals are under strain from the natural disaster.
In summary, social media posts claiming that Biden told people to get COVID-19 vaccines to protect themselves from hurricanes are misleading, as they ignore the context of the quote and misrepresent his words. This claim was also fact-checked by PolitiFact, USA Today, and AFP, which found the claim to be false.
The COVID-19 pandemic has been the worst global health crisis of our time, infecting an estimated 600 million people and causing 6 million deaths, and it continues to be a lingering threat worldwide [1]. What made this pandemic different fromany other that humanity has faced in the past was not just about how potent and virulent the SARS-CoV-2 virus was, but also that it had an ally that waseven more virulent and potent: the infodemic of misinformation. Despite glaringly clear evidence of vaccine and mask efficiency, and the global scientific effort that resulted in making an effective vaccine accessibleall over the world in record time, misinformation related to masks and vaccines has made their global adaption a challenge. With the emergence of effective antivirals, people continued to get affected in large numbers largely due to the misinformation virus playing a crucial role in the pandemic. While there is controversy on whether the COVID-19 pandemic is becoming endemic or not, it is quite clear that the misinformation pandemic is well entrenched in our society even before the COVID-19 pandemic and has just exploded in the past few years, both regarding the spreading of COVID-19 misinformation as well as political issues. It is going to require a sustained global effort to mitigate its ongoing onslaught [1].
Misinformation is defined as "publicly available information that is misleading or deceptive relative to the best available scientific evidence, and that runs contrary to statements by actors or institutions who adhere to scientific principles" [2]. The term disinformation is used to refer to "deliberate, engineered falsehoods circulated with malicious intent or to serve a personal, political, or economic agenda." "Infodemic" is another term defined by the WHO as referring to "false and misleading information that causes confusion, risk-taking behaviors and mistrust of health officials" [2]. The problem becomes compounded since the majority of people now turn to online resources and social media for information about COVID. One study reported that 72% of Americans turned to online news and social media sources for COVID-19 information, with 47% reporting that the source was social media [3]. Cinelli et al., employing epidemic modeling for the dissemination of information, showed high measures of the transmissibility of posts on various social media platforms [4]. This misinformation pandemic led to an erosion of trust in science, and scientifically based expert guidelines, as well as in governmental interventions, and public health responses to COVID-19 [5].
While misinformation has been impactful on a multitude of aspects related to COVID-19, including mask-wearing, use of chloroquine, and ivermectin, among others, the single biggest area where there has been a sustained and relentless misinformation campaign has been on the issue of vaccination; both in terms of efficacy and, much more so, in terms of its safety.Concerns about potential safety aspects particularly the side effects and the rapid pace at which these vaccines were developed are some of the primary reasons for COVID-19 vaccine hesitancy. The WHO has defined vaccine hesitancy as "the reluctance or refusal to vaccinate although the availability of vaccines" [6-7]. Vaccine hesitancy has been the primary culprit in derailing public health vaccination strategies globally and one of the primary drivers of misinformation on social media. The US Surgeon General identified misinformation as the greatest threat to COVID-19 vaccination efforts [8]. Table 1 illustrates common topics of COVID-19 misinformation.
Muric et al. analyzed antivaccine-related tweets from Twitters application programming interface (API) and found that misinformation originated from websites with low and dubious credibility and that many accounts with antivaccination content were right-leaning politically [9]. Bots, short for software robots, are typically automated spam accounts and likely play a critical role in orchestrating the misinformation spread. One study found that up to 66% of bots are discussing COVID-19 [10]. Another potent source of misinformation is "trolls". This term is used for individuals who deliberately misrepresent their identity with the purpose of promoting discord. Amplification is a term used to describe a commonly used misinformation strategy by employing multiple bots and trolls to create impressions of false equivalence or consensus [11]. Similarly, another study [12] by Ferrara et al., found that automated bots tweeted significantly more COVID-19-related content as compared to non-bot accounts, and a content analysis of these tweets revealed that they significantly promoted political conspiracies and divisive content. Figure 1 illustrates the targeted misinformation.
Hughes et al. [13] employed qualitative coding methodology to analyze and identify specific patterns of content that were commonly employed by anti-vaccine media. A framework called "the 5C model of the drivers of vaccine hesitancy" provides five main individual-level determinants for vaccine hesitancy: confidence, complacency, convenience (or constraints), risk calculation, and collective responsibility [14]. A study from the United Kingdom (UK) found that demographic variables associated with COVID vaccine hesitancy included youth, female gender, and low income or education. These subjects also tended to rely heavily on social media for information and lacked trust in science [15]. Wilson et al. were able to demonstrate a significant relationship between social media use to organize offline action and concerns about vaccine safety, and they also found an influence from foreign disinformation campaigns [16].
Social media may help promote disinformation by making use of vivid imagery and content [17]. Betsch et al., describe that based on the fuzz-trace theory, where individuals process new information through verbatim memories which incorporate many precise details and gist memories that only contain a summarized bottom line meaning, they make decisions usually based on the gist memories rather than detail memories [18]. Content on social media that isvagueand anecdotal tendsto be shared more readily and is more likelytogo viral, as opposed to evidence-based information that tends to be duller and more theoretical.
Machine learning-based models have been shown to be effective in detecting misinformation regarding COVID-19 vaccines on social media platforms. Bots and trolls are programmed to spread misinformation. Machine learning can help in detecting and mitigating this misinformation.Artificial intelligence can also utilize several machine learning models to classify fake news and tweets[19].At least two studies have attempted to create datasets of tweets to annotate misinformation about covid vaccines - Covid Lies and Covax Lies [20,21]. As these detection systems are improvised and additional targets of misinformation are added, these efforts may result in developing misinformation inoculation interventions on social media platforms relevant to COVID-19 vaccination.
There is an urgent need for interventions to mitigate the effects of this infodemic, but thus far, the best way to achieve effective solutions has been elusive.
Promoting Accuracy in Information
As the understanding of COVID evolves, separating valid information from misinformation becomes a moving target and hence challenging to actualize. The availability of abundant and unreliable sources of information poses additional challenges. The information chain needs structure, wherein information production needs to be limited and mainly resourced to standardized public health portals (e.g. World Health Organization, Center for Disease Prevention) as reliable sources of information [22]. Artificial intelligence and machine learning models can help in recognizing and mitigating the fake and false information either spread via the algorithm or the trend and help in flagging and mitigating it [19]. This available information should be relayed or promoted by leveraging mass media platforms like social media, television, newspapers, and radio. Implementing this structural differentiation between information source and relay of information is vital to minimize the spread of wrong content and ensure accurate data is available to end users [22].Pennycook et al., in one study, showed that a simple accuracy reminder could help participants in truth discernment and influence their subsequent sharing behavior [23].
Clarifying Misinterpreted Ideas
Eradicating health-related misconceptions is the first key to promoting community health [24]. This can be established by individuals that can best present facts in non-scientific jargon, which for most populations is their trusted community health leaders, which includes physicians, researchers, mental health workers, community health workers, or social workers [25]. Bautista et al. proposed a two-phased conceptual model. An authentication phase as well as a correction phase, which healthcare professionals can use to approach correcting health misinformation on social media (e.g., Twitter and Facebook) [26]. Special campaigns that provide opportunities for them to interact with their patients to clarify doubts and misconceptions through emotive language and imagery can be helpful. This process can be accelerated by health agencies by fostering an increased social media presence that can be utilized in promoting such health events, such as legal consequences and financial penalties for spreading intentional false information either by an act of commission or omission.
Social Media Self-Regulation
Social media plays a big role in influencing the community. Healthcare providers can effectively disseminate useful information through social media platforms. Social media channels can play a proactive role in the continued propagation of pro-health ideas and/or curtailing anti-health ideas. All the major social media companies issued a joint statement on their efforts to minimize misinformation about COVID-19 on their platforms [26]. Pinterest redirected vaccine search results on their site to credible information sources such as the CDC. Facebook or Instagram reduced the ranking and rejected ads of groups and pages that promoted vaccine misinformation [27,28]. Social media can also act as barricades to identify potentially harmful misinformation preachers. Various social media platforms have partnered with government health agencies to link health-related information to official websites to help relay accurate information.
Inoculation
As misinformation may prove resistant to correction, an alternative approach derived from inoculation theory is to proactively prepare people for potential misinformation by explaining the logical inconsistencies and pitfalls inherent in misleading communications beforehand. The rationale for this theory is that "inoculating" people in this manner will enable them to better perceive flaws in the arguments and information presented to them and thereby be able to identify them as being deceptive [29]. Just as how vaccines work, "inoculation" messages introduce counterarguments in peoples minds that can help generate resistance to future misinformation.
Law Enforcement and Community Movement
While social media companies in the United States are subject to US Federal Trade Commission regulations as any other US-based business, they are free of any oversight by the US Federal Communications Commission. More specifically, Section 230 of the Communications Act of 1934 absolves social media companies of an obligation to audit or censor user-generated content on their platforms by not considering them as publishers of information as other media entities. Hence the onus of curbing disinformation is largely a result of internal self-monitoring on the part of these companies, although there is evidence to show that social media platforms may, in many instances, be complicit in disseminating identifiable misinformation [30]. Health misinformation needs to be viewed as a public health crisis, and there is hence an urgent need for federal oversight and regulation of social media companies in the same manner as any other media source. Currently, Congress is actively looking into the security system and details for major companies as Facebook and Twitter. The company has stated that they have become more vigilant in recognizing the fake news and even blocking the accounts of users spreading the fake news [31-32].
The United Nation International Children's Emergency Fund (UNICEF) has created a field guide to target vaccine misinformation which provides a comprehensive structure organized into three phases: Listen, Understand, and Engage [33-36]. The phase listen refers to the creation of an active and dynamic social listening system that includes appropriate monitoring tools, including the use of virality scores and rumor logs. The understand phase proposes a Five Pillars of Verification system: provenance, source, date, location, and motivation for responding to information and creating a "risk evaluation matrix." The phase "engage" explores promoting social media health literacy and inoculation strategies.
The infodemicis here to stay and has potentially more lethal ramifications than even the COVID-19 pandemic. Unlike the hugely successful vaccination development program for COVID-19, inoculation strategies for this infodemic are not as easy to resolve and involve a complex interplay between social media companies, medical professionals, researchers, implementation scientists, and federal agencies.
Overview
00:00:27
MH Hello, everybody. This is Margaret Harris in WHO Headquarters, Geneva, welcoming you today, October 5, to a media briefing on the many major global health issues that WHO is currently responding to. As always, well open with remarks by our WHO Director-General Dr Tedros Adhanom Ghebreyesus, after which we will open the floor to questions from media representatives.
Joining Dr Tedros in the room are, Ill go from left to right, Dr Maria Van Kerkhove, Technical Lead on COVID-19 and on Dr Tedros right is Dr Sylvie Briand, Director, Epidemic and Pandemic Preparedness and Prevention, Dr Abdi Mahamud, Acting Director, Alert and Response, and Dr Soumya Swaminathan, our WHO Chief Scientist.
00:01:17
Online, we also have many experts, including Dr Mike Ryan, our Executive Director, World Health Emergencies, Dr Rick Brenna, our Regional Emergency Director for the Eastern Mediterranean Region, Dr Palitha Mahipala, our WHO Representative in Pakistan, and we have even more, a big range of subject-matter experts whom I will introduce to you as they answer your questions.
I have to apologise in advance. We do not have simultaneous translation today, as we have a number of major global meetings going on at the same time as this press conference and so it was not possible to arrange the simultaneous translation. I apologise for that. But now, without further ado, I will hand over to Dr Tedros. Dr Tedros, you have the floor.
TAG Thank you. Thank you, Margaret. Good morning, good afternoon and good evening. First to Uganda, where WHO is continuing to support the government to respond to an outbreak of Ebola disease in four districts. So far, 63 confirmed and probable cases have been reported, including 29 deaths. Ten health workers have been infected, and four have died. Four people have recovered and are receiving follow-up care.
WHO has released US$2 million from our Contingency Fund for Emergencies, and were working with our partners to support the Ministry of Health by sending additional specialists, supplies and resources. When there is a delay in detecting an Ebola outbreak it is normal for cases to increase steadily at the beginning and then decrease as life-saving interventions and outbreak control measures are implemented.
00:03:19
The vaccines used successfully to curb recent Ebola outbreaks in the Democratic Republic of the Congo are not effective against the type of Ebola virus that is responsible for this outbreak in Uganda. However, several vaccines are in various stages of development against this virus, two of which could begin clinical trials in Uganda in the coming weeks, pending regulatory and ethics approvals from the Ugandan government.
Now to Pakistan. Although the waters have stopped rising, the danger is only increasing. More than 1,500 lives were lost in the floods but many more could be lost to disease in the coming weeks without a massive and urgent international response. WHOs Executive Director for Health Emergencies, Dr Mike Ryan, has just led a team to Pakistan to assess the needs.
Approximately 10% of all of Pakistans health facilities have been damaged, leaving millions without access to health care. Stocks of essential medicines and medical supplies are limited or have been washed away, damaged roads and bridges are impeding access to services and supplies, and disease surveillance and referral mechanisms have been severely disrupted. There are now outbreaks of malaria, cholera and dengue, an increase in skin infections, and we estimate that more than 2,000 women are giving birth every day, most of them in unsafe conditions.
WHOs focus is on supporting people in four groups, those in camps, who we access easily but are a small percentage of the total need, those who are living along the roadside for hundreds of kilometres, those in areas cut off by flood waters, who are very difficult to access, and those in areas where the water is receding, and are returning home to destroyed villages and homes.
00:05:47
In August, WHO released US$10 million from our Contingency Fund for Emergencies but this massive and unprecedented disaster needs a massive and unprecedented response. Today, we have issued an appeal for US$81.5 million to support WHOs work to support the delivery of immunisation and other life-saving health services, to address severe acute malnutrition, to enhance disease surveillance and to strengthen water and sanitation, and we urge our donors and partners to support this effort. In the words of the United Nations Secretary-General Antonio Guterres, this is not about generosity, this is about justice.
Now, to COVID-19. Several countries in Europe are now reporting an increase in COVID-19 cases, hospitalisations and deaths. This is to be expected as the weather cools and people spend more time together inside and most countries no longer have measures in place to limit the spread of the virus. We expect reported cases of COVID-19 to increase but the deaths dont have to, given we have vaccines and therapeutics that can save lives.
Omicron remains the dominant variant globally, and WHO and our partners are tracking more than 300 subvariants but surveillance, testing and sequencing remain weak globally, which makes tracking this virus like chasing shadows. So, we continue to call on all countries to increase surveillance, testing and sequencing, and to ensure the most at-risk groups are vaccinated.
At the same time, the Northern hemisphere influenza season is starting. Measures introduced to curb the spread of COVID-19 during the pandemic also helped to reduce the burden of flu but, with most of those measures lifted, flu is back and should not be taken lightly. Flu vaccines are safe and effective in reducing severe disease and death, especially among the most at-risk groups, so please get your flu vaccine.
00:08:33
Another disease making an unwelcome comeback is cholera. After years of declining cases globally, we have seen a worrying upsurge of cholera outbreaks around the globe over the past year. In the first nine months of this year alone, 27 countries have reported cholera outbreaks. Not only are we seeing more outbreaks but more deadly outbreaks. The data we have, which are limited, show the average case fatality rate so far this year is almost three times the rate of the past five years. In Syria, more than 10,000 suspected cases of cholera have been reported just in the past six weeks.
And in Haiti, after more than three years with no cases of cholera, two cases have been officially reported this week in the capital Port-au-Prince, with 20 suspected cases and seven deaths under investigation in other areas. Its likely the actual number of cases is significantly higher. This outbreak is a particular setback as Haiti was preparing to be certified as cholera-free later this year.
Although cholera can kill within hours, it can be prevented with vaccines and access to safe water and sanitation, and can be treated easily with oral rehydration or antibiotics for more severe cases but the reality is that many people dont have access to these simple interventions.
00:10:33
In 2013, WHO and our partners created an international stockpile of cholera vaccines which last year shipped 27 million doses but, with an increasing number of outbreaks, supply cannot keep up with demand. We urge the worlds leading vaccine manufacturers to talk to us about how we can increase production.
Cholera thrives on poverty and conflict but is now being turbocharged by climate change. Extreme climate events like floods, cyclones and droughts further reduce access to clean water and create the ideal environment for cholera to spread. Cholera is deadly but its also preventable and treatable. With the right planning and action, we can reverse this trend.
Finally, WHO has today issued a medical product alert for four contaminated medicines identified in The Gambia that have been potentially linked with acute kidney injuries and 66 deaths among children. The loss of these young lives is beyond heartbreaking for their families.
The four medicines are cough and cold syrups produced by Maiden Pharmaceuticals Limited, in India. WHO is conducting further investigation with the company and regulatory authorities in India. While the contaminated products have so far only been detected in The Gambia, they may have been distributed to other countries. WHO recommends all countries detect and remove these products from circulation to prevent further harm to patients.
Ebola in Uganda, multiple outbreaks in Pakistan, cholera around the world, the ongoing COVID-19 pandemic, the global monkeypox outbreak, the annual threat of influenza, and contaminated medicines all illustrate why its so urgent that all countries, individually and as a global community, invest in strengthening their defences against outbreaks that can devastate families and communities, and cripple societies and economies.
00:13:37
In particular, it shows why cost-effective investments in disease surveillance and primary health care are so important. Emergencies are an unfortunate fact of life. We might be able to prevent some but we cant prevent them all. But by investing in strong health systems at the local level, we can mitigate the impact emergencies have and save many lives. Margaret, back to you.
MH Thank you very much, Dr Tedros. Now, well open questions to the media. As you know, we need you to raise your hand on the Zoom. We also need you to indicate what your outlet is on the Zoom. We cant take a question from you unless we are very confident you are actually media. Having said that, weve got several questions already and the first goes to Belisa Godinho, from W Magazine, Portugal. Belisa, I know youve submitted two questions but please stick to one question, and I ask that of all journalists, one question at a time. So, Belisa, please go ahead.
BG Thank you. Thank you very much. The W Magazine media issue is about global health and climate. First, I would like to know specifically if and how will the virtual marathon for the design of vaccines on sustainability and the environment be implemented. Thank you.
00:15:25
MH Thank you, Belisa. Thats a very important question. Dr Soumya Swaminathan, our Chief Scientist, will answer.
SS Thank you for that question and, if I understand it correctly, youre asking about how do we prepare in the future for potential outbreaks that will arise, that we expect will come because of the close links between wild animals and the destruction of our forests and environmental hazards.
Weve seen the risk of pandemics continue to increase and spillover events as well. One of the things that we should be doing and we are doing is trying to anticipate where these risks can come from and identify mainly the viral families where we think that a spillover from animals to humans can happen and that can potentially result in epidemics or pandemics.
There are about 25 or so viral families where such a thing could happen. In the past, weve had the R&D Blueprint for Epidemics identify priority pathogens, one of which was a disease X, which SARS-CoV-2 turned out to be, and that was very helpful. The work that the R&D Blueprint has done over the last five years, since it was set up, helped us to prepare very quickly when we had the beginning of the SARS-CoV-2 and then we could move rapidly into developing the countermeasures.
Similar work now needs to be done and the other organisation thats involved in this is CEPI, which is the Coalition for Epidemic Preparedness Innovations, which is investing in platform technologies, mRNA but also other platforms, viral vectors and all the other new platforms that we have in order to prepare what are called prototype vaccines.
00:17:24
So, you pick one virus from a particular viral family and in fact this helped us because there were prototype vaccine candidates that had been developed for SARS-1 and for MERS and these could be quickly repurposed to SARS-2. Potentially, if you had these type or prototype vaccines that had been developed for different virus families you could, as soon as you had the new genetic sequence of the outbreak pathogen, could use that platform and switch over very quickly to a very specific vaccine.
That is the plan and WHOs role here is to develop this list of priority viral families, as I said, about 25, but also to identify priority pathogens or prototype pathogens against which vaccines can be developed. And Im sure that not just CEPI but many agencies and government agencies that have been set up now, like HERA in Europe, and BARDA and DARPA and the NIH in the US, and many others around the world will be investing in this and the whole idea is to be as prepared as possible against potential threats.
Were also seeing now, the DG just mentioned the number of outbreaks and the fact that we do not have tools against diseases like this Sudan Ebola virus even though weve had outbreaks in the past where we dont have enough stocks of cholera vaccines and so on. So, I think that this whole area of R&D, which is directed towards public health, is going to be increasingly important. Thank you.
00:19:02
MH Thank you very much, Dr Swaminathan. The next question goes to Carmen Paun, of Politico. Carmen, could you unmute yourself and ask your question.
CP Thank you so much for giving me the floor. Just on monkeypox, to my knowledge the countries that have been reporting monkeypox outbreaks for a long time still havent secured access to the vaccine and the therapeutic that is used against it. But I was wondering if you see any positive impact of this global outbreak on the countries that have been reporting cases for a long time. Is it increased awareness of the virus, is it more investment in research or so far there are only negative consequences? Thank you.
MH Thank you very much, Carmen. Dr Rosamund Lewis has joined us in the room just in time. Over to you, Dr Lewis. No, its not for you? Oh, sorry, Carmen, Dr Lewis was just coming in. Could you kindly repeat the question?
CP Sure. Very briefly, I was wondering whether she sees any potential positive impact of the global monkeypox outbreaks on the countries that have been reporting outbreaks for a long time. Does she see any increased investment in research? Obviously, theres more awareness. I was wondering if potentially, on the long-term, that could have any positive impact on the countries that have had to deal with the virus for a long time.
RL Thank you very much for that question. The countries in the African region are very much a part of the global response here, so we are working together with them, along with all other countries and all other regions. They are engaged in improving their surveillance. Theyre in engaged in improving detection. They have access to 38,000 test kits that have been provided to the countries for enhancing PCR and they are also engaged in trainings for clinical care and studies, studies on vaccines and studies on therapeutics.
00:21:14
So, we are very hopeful that this will increase the capacity throughout the region and also youve heard that the Strategic Preparedness and Response Plan is being released along with an appeal that we have, so that we can engage even further with the most affected countries. Thank you.
MH Thank you. Dr Briand will add some more on this issue.
SB Thanks a lot for this question. You highlighted this issue of access, inequitable access, and indeed this has been one of our main concerns at the start of this outbreak because there were products available but not everywhere in the world. So, WHO has been working very closely, first with countries who have already access to vaccines and will receive some donation of those vaccines.
We are working out a plan for allocating those vaccines but, of course, this is not an issue that can be dealt from one day to another because there are a number of things that we need to sort out, such as the regulatory aspect and the distribution of doses. We have also received donations from manufacturers and in particular for treatment, and so once those donation agreements are finalised we will be also in a position to allocate those life-saving interventions to countries with more difficulties to access those things.
00:22:50
So, its work in progress. Its not as fast as we would like it to be but its good lessons learned as well for everybody to see that when we have a disease that we didnt anticipate really enough in advance, that we may face outbreaks in multiple counties, we need to have in place a more global mechanism to ensure better access to life-saving intervention. Thank you.
MH Thank you very much, Dr Briand. I now have a written question from Helen Branswell, STAT magazine. Shes on a plane right now so cant actually ask her question on person. But her question is shes looking for an update on the vaccine studies, trials, where we are with assessing the vaccines for Ebola Sudan virus in Uganda. I understand Dr Abdi will answer this question first and then Dr Soumya will add as well.
AM Let me turn first to Soumya. I think weve been working very closely with Ana Maria and Soumya. Please.
SS I think, again, our R&D Blueprint team, led by Ana Maria Henao, has been working very, very closely with the Ugandan Ministry of Health but also with other partners, including CEPI and with the manufacturers. There are about six vaccine candidates available for the Sudan Ebola virus, which are mostly in very early stages of development, but three of them have some human data, some immunogenicity and safety data, and so they can actually proceed to be used in the field in a ring vaccination campaign, similar to what was done in the Ebola outbreak in DRC a couple of years ago.
00:24:55
Its a chimpanzee adenovirus. There are two different candidates, one from the University of Oxford and one from the Sabin Vaccine Institute. There are very limited doses available, unfortunately, of both of them. There is raw material, so there has to be some fill and finish to make the product ready and at the same time, of course, a protocol has already been developed, submitted to the Ethics Review Committee. The principal investigator has been identified, funding is being mobilised, and so all the preparations are ongoing.
Now, which vaccine, which of these two will actually go into the trial may depend on which one actually has doses to deployer sooner. It would be good, of course, to test as many vaccines as possible but at least start with one and then there may need to be a rolling intake. We are hoping that we could get this off the ground as quickly as possible but realistically it may take another four to six weeks and at the same time theres also a plan being made for testing of therapeutics.
As you know, there were several therapeutics tested again at the DRC during the last Ebola outbreak, one monoclonal antibody and remdesivir likely to be in a clinical trial that would test each one of them individually against a combination, but the protocol is still being developed and again were working with partners to do that. Thanks. Abdi, you wanted to add anything to that?
00:26:24
AM Just appreciation of the excellent work and collaboration with the R&D and here, in terms of the collaboration, we have a SAGE meeting on Thursday that will also discuss some of the plenary, and then the approval and the logistic support. Thanks.
MH Thank you both for those answers. Now, we have a question from Christiane Oelrich, from dpw. Christiane, please ask your question. dpa, I apologise.
CO Thank you, Margaret. My question is on corona. There has been some concern raised in Germany and other European countries about the sublineage BQ.1.1. I wonder what your take on this is. Thats basically it.
MH Thank you. I think Dr Maria Van Kerkhove is ready to answer that one.
MK Thanks very much for the question. As the DG said in his speech today, there are more than 300 sublineages of Omicron that were tracking right now and there are several that are on our radar. It sounds a little bit like an alphabet soup with all of these subvariants that were tracking but the bottom line is that this virus continues to evolve.
It's circulating at an incredibly intense level around the world right now. Among the Omicron sublineages, BA.5 is dominant. About 80% of the sequences that are available are BA.5 and its subvariant but surveillance has changed drastically in the last several months and the numbers of sequences that the world and our expert networks are evaluating has dropped by more than 90% since the start of the year.
That limits our ability to really track each of these and exactly the one that youve mentioned today. We have a number of subvariants of Omicron that are on our radar because what were looking at is we will continue to see waves of infection. This is for sure going into the future because we will be living with this virus but we have a lot of tools that can mitigate their impact.
00:28:25
We have diagnostics that can get patients into the clinical care pathway using antivirals and using different therapeutics to prevent severe disease, to prevent death. We have vaccines that continue to be effective against preventing severe disease and death. So, it is absolutely critical that we use these tools.
If we look at all countries and particularly in the Northern Hemisphere right now, we are starting to see an increase in case detection and in some countries were starting to see increases in hospitalisation, increases in admission to ICU and increases in deaths and this is really due to incomplete vaccination coverage, inappropriate or ineffective use of available tools like antivirals. Theyre being used among the populations that need access to them.
Were concerned and in the Northern Hemisphere were entering autumn and the winter months, so we will see co-circulation of other viruses like influenza, also mentioned by the DG today. So, we need health systems to be prepared. We need surveillance systems to be able to detect the known variants and subvariants that are circulating and we need to be able to detect new ones that are out there. But we need strong health systems to be able to deal with patients and provide appropriate clinical care regardless of where they show up within the health care system.
00:29:41
And if you hear anything, please ensure that you get vaccinated. In all countries we are missing people who are at high risk and the highest risk of developing severe disease, either because they have not received a single dose of vaccine or they havent received the full course of dosings that are recommended for them. So, please look at your national guidance, follow national guidance and receive the recommended doses in your area.
But the virus is circulating and theres much more that we need to do to reduce transmission while living our lives safely. Public health measures play a key role, wearing a mask when youre around others, when youre indoor improving ventilation, making sure we have good surveillance and we use the appropriate therapeutics, diagnostics and vaccines to save lives now.
MH Thank you very much, Dr Van Kerkhove. The next question goes to Megha, from Health Policy Watch. Megha, please unmute yourself and ask your question.
ME Thank you so much. My question is just could you please provide an update on what the status of work is at the mRNA hub in Africa? Thank you.
MH Dr Soumya Swaminathan will answer that question.
SS Thank you. Thank you very much for that question. Ill try to provide a brief update. As you know, the mRNA hub in South Africa is based at this company called Afrigen but there are a number of partners supporting, including the Ministry of Science and Innovation, as well as the Medical Research Council and then Biovac is the other company to which the transfer will take place.
00:31:19
At this point we actually have an mRNA vaccine candidate that has been developed by scientists in South Africa using publicly available information. Now this, because its a newly-developed vaccine, needs to go through all the phases of testing that a vaccine normally would.
Right now it is going to go into animal studies, hopefully this month, in October, for all the toxicity studies and so on, and then the technology transfer has to happen and then the GMP doses have to be produced so that it could then go into human clinical trials, which will likely start perhaps towards the end of 2023. And then theres a timeline for going into Phase 2 and 3 trials.
Meanwhile, of course, there is the technology transfer, which has also started happening since the basic methodology and the SOPs for how to develop a vaccine have already been done, even though its yet to be proven efficacious and safe. The spokes, and as you know, we have 15 spokes around the world in different regions of the world. Teams from those companies have already started coming to South Africa for training, for the technology transfer.
00:32:37
Theyre now taking that technology back into their own companies and their countries and beginning work, sometimes to use the technology for other products, for other vaccines. And different spokes are now having discussions about which other diseases they could target and theyre thinking about diseases like tuberculosis and malaria but also about chikungunya and dengue and other infectious diseases.
At the same time, there are two other workstreams which have started. One is the Biomanufacturing Training Initiative with the hub in South Korea. So, well have the second batch of trainees going there in October and were working closely with the WHO Academy team to really build a curriculum for manufacturing training in biologics.
Then, the other workstream is led by our regulatory colleagues, Dr Simo, Dr Rogrio Gaspar, and they are actually now building the regulatory capacity of countries because for countries to be successful producers and exporters of vaccines and health products you need a strong regulatory system. That work is also proceeding. So, all of these parallel activities.
We did start this with a longer-term view really, beyond COVID. So, the idea was not to come up necessarily with a vaccine for COVID, though that would be the proof of principle but its going to take time. So, the idea is to build this network, build the capacity, put the technology in the hands of scientists in these companies who will then make products that are needed for their own populations. Thanks. I hope that answered the question.
MH Thank you, Dr Swaminathan. Dr Maringela Simo would like to add a few points, as you mentioned, about the regulatory aspects. Dr Simo, please. Over to you.
00:34:27
MS Thank you. Thank you for the question. Actually, I want to share good news because this week we finalised the formal assessment of the South African Regulatory Authority, which is now considered by WHO as a functional Maturity Level 3 regulatory authority.
Let me say that the Government of South Africa has invested a lot of effort and training of personnel to be able to achieve WHO standards for a functional regulatory authority. Why is it important? Because South Africa hosting the hub, it needs a strong regulatory authority to oversee the production of vaccines in the country. So, I just wanted to share this news. Thank you.
MH Thank you, Dr Simo and Dr Swaminathan. The next question goes to somebody who has been waiting up very late at night, Mary Ann Benitez, in Hong Kong, from the Hong Kong Standard. Mary Ann, please unmute yourself and ask your question.
MB I would like to ask, because doctors and also the CHP Can you hear me?
MH Very well, Mary Ann. Please, go ahead.
MB Theyve been urging people to get COVID-19 and flu jabs in one go, warning of a possible seasonal, a double whammy of COVID and flu because there have been milder flu winter peaks in the past three years amid the pandemic. So, whats the WHO decision also? Is there a crystal ball that people should be overly worried of, as I said, a double whammy of flu and COVID at the same time? Thank you.
00:36:16
A Merck pill used to combat Covid-19 failed to demonstrate it can lower the risk of hospitalization compared with a placebo among adults at a higher risk from the disease, according to the results of a large study conducted in the U.K.
The preliminary results of the randomized trial, which involved more than 25,000 participants, showed that taking molnupiravir did speed time to recovery by about six days, which means that patients did get some relief. Otherwise, though, the study failed to reach an outcome that had been used late last year by regulators such as those in the U.S. and U.K. to authorize the medicine to thwart the pandemic.
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Why the change of heart on COVID vaccines?
Malhotra wrote that he happily received both doses of a COVID-19 vaccine in early 2021. In fact, he said, he was surprised and concerned at the time about the number of vaccine-hesitant patients he encountered on a regular basis.
When his father tragically died after suffering a cardiac arrest in July 2021, however, he says he started to reconsider his perspective. Malhotras father, Prof. Kailash Chand, OBE, was a celebrated figure throughout England and beyondand, yes, he was vaccinated. His death confused Malhotra, both because his father had been taking great care of his body and because there was no evidence of an actual heart attack. Malhotra ultimately concluded that there is a real possibility the COVID-19 vaccines had played a significant role.
Malhotra explained that this is when he started thinking more and more about the vaccines. After reviewing the data in great detail in his editorials, he shared his conclusion that the numbers suggest there is a greater risk of serious adverse events from the vaccines than being hospitalized from COVID-19.
Pharmacovigilance systems and real-world safety data, coupled with plausible mechanisms of harm, are deeply concerning, especially in relation to cardiovascular safety, he added.
The medical and scientific communities have responded to these editorials rather quickly. Both columns were repeatedly shared once they went live, and groups agreeing withMalhotra and disagreeing withMalhotra have both been quite active.
Health Feedback, a group focused on sorting fact from fiction in health and medical media coverage, provided a thorough rebuttalof the editorials on its website.
Scientific evidence from clinical trials and safety monitoring indicate that the COVID-19 vaccines are safe and effective, the group wrote. While severe reactions to the vaccine can occur, they are rare, and the most common side effects of vaccination are mild and go away within a few days. All available evidence indicates that being vaccinated is safer than not being vaccinated.
The Health Feedback response highlighted the fact that multiple organizations supporting Malhotra have been associated with spreading COVID-19 misinformation in the past. This includes the World Council for Health, the host of the previously mentioned press conference, and Health Advisory and Recovery Team.
A recent blog post from Science-Based Medicine, a website owned and operated by the New England Skeptical Society, focused on the second of Malhotras two editorials. David Gorski, MD, PhD, a professor with Wayne State University, wrote the blog post, describing it as projection, pure and simple.
Hes accusing conventional medical authorities, big pharma, and social media companies of spreading medical misinformation about COVID-19 vaccines by using the very techniques of misinformation that he claims to decry, such as cherry-picked studies and conspiracy theories, to do it," Gorski wrote.
Gorski also shared his doubts about the validity of the Journal of Insulin Resistance, saying the publication does not appear to publish many articlesand when it does, it appears to primarily publish the thoughts of its own editors. Both of these facts, he said, raise red flags for this being an ideology journal disguised as a medical journal.
Many have also fully agreed withMalhotra, sharing his story and commenting on it online. The Epoch Times and other outlets already known for being vocal against COVID-19 vaccines, for example, have highlighted the importance of his story. Also,one quick video of Malhotra from Sept. 27 has already hit 1.1 million views on Twitter.
Cardiovascular Business also reached out to both the American College of Cardiology (ACC) and European Society of Cardiology (ESC) about the content of Malhotras editorials. The ACC has repeatedly supported COVID-19 vaccines, emphasizing that the small risks of these vaccines are not nearly as severe as the risks of a COVID-19 infection.
Instead of a full comment, the ACC highlighted its previous publications on this topic, specifically a 2022 document from its Solution Set Oversight Committee.[3] The ESC has not yet responded.
There was a moment during the COVID-19 pandemic when it became clear how essential child care is to a thriving economy.
This truth long known by working parents came only after a deadly global pandemic, women dropping out of the workforce en masse and parents sequestered at home with their children.
Suddenly, politicians were paying attention and even echoing concerns advocates have raised for years: child care workers are underpaid, yet it remains crushingly expensive for parents.
The government invested billions of dollars in helping parents during the pandemic, but that money is set to expire soon. And there was talk at the federal level of including paid family leave, free preschool and expanded public child care in the Inflation Reduction Act, but the final package was stripped of all three.
In Oregon, although work to build child care capacity is underway, the issue has received relatively little attention from the three women Republican Christine Drazan, Democrat Tina Kotek and Betsy Johnson, an unaffiliated candidate running to be the states next top executive.
(Kotek is traveling to Medford this week to visit a preschool and to talk about expanding access to child care.)
The three major candidates for Oregon governor. From left to right: Tina Kotek, Betsy Johnson and Christine Drazan.
OPB Staff / OPB
Kali Thorne Ladd, the chief executive officer of the Portland-based Childrens Institute, an advocacy group focused on public policies affecting children, said shes been dismayed by how little the three candidates for governor have focused on the earliest years of a childs life.
The next governor has the potential to change the trajectory for early learning in Oregon and by doing so, they have the power to change the trajectory of the state, Thorne Ladd said. The success or failure of our children will determine the success or failure of Oregon.
The next woman to be elected governor will also be charged with overseeing a new state agency: the Department of Early Learning and Care, tasked with focusing on children from birth through the age of 5 starting in July of 2023.
Rep. Karin Power, D-Milwaukie, one of the few working parents in the Legislature with small children, helped spearhead an effort to funnel more money into early childhood care and create the dedicated agency during the 2022 legislative session. Power, who is also a lawyer and a mom to a toddler and a first grader, said she deeply, deeply understands that child care is essential infrastructure.
Oregon remains one of the more expensive states in the country for infant care. And its also difficult to secure care in Oregon; every county in Oregon, for example, is considered a child-care desert, for children 2 and younger, meaning there are not enough affordable and accessible spots for the youngest children who need them.
And since neither the state nor the federal government guarantee paid family leave for workers, many parents are stuck trying to patch together care from friends and family or must quit their jobs to care for their kids.
File photo of preschooler.
Rob Manning/OPB
Although the issue of child care hasnt taken center stage with the three gubernatorial candidates, OPB asked each candidate two specific questions on the issue to gain a better understanding of their thinking. Their answers have not been edited.
PAID FAMILY LEAVE
In 2019, Oregon lawmakers passed House Bill 2005, establishing a paid Family and Medical Leave Insurance program.
The program would allow employees to take up to 12 weeks off to care for a new child, seek medical treatment, address domestic violence issues or deal with illness. While on leave, the program would pay a percentage of the persons wages. The amount would depend on how much the employee earns. The persons job would also be protected if they have been with the company for more than 90 days.
The program has gotten off to a rocky start, delayed by the pandemic and myriad other problems, such as turnover and unhappy employees, highlighted in an investigation by the Oregonian.
Employers and employees are scheduled, however, to start paying into the program beginning January 1, 2023, and the program is scheduled to start paying benefits in September 2023.
Here is what we asked the candidates:
Paid family leave is meant to start in Oregon in 2023, but there are many families it wont cover. What is your stance on state-subsidized leave that would cover people working for very small companies fewer than 25 employees or the self-employed?
Editors note: OPBs question to the candidates contained an error that does not affect the candidates answers. Employees at companies with fewer than 25 employees will pay into and be covered by Oregons paid leave program. Self employed people are not required to contribute, but can opt in. Federal employees and tribal government employees will not be covered.
Christine Drazan, the Republican candidate for governor, wrote:
I crossed party lines to support paid family leave in part because constituents supported provisions which helped victims of domestic violence and because responsibility was shared between employees and employers while not burdening our smallest small businesses with an unaffordable program. In the intervening years businesses across the state have faced workforce shortages which have remained unabated. I have great concern that this program as structured will only exacerbate those challenges. We must provide a balanced program which allows businesses to remain open while providing employees with support when they need it most. I do not support expanding the existing program but believe that the existing program warrants review.
Tina Kotek, the Democratic candidate for governor, wrote:
All Oregon families should have access to paid family leave so they can care for a newborn, themselves, or a loved one. As House Speaker, I led the way to pass one of the nations strongest paid family leave programs. As part of the negotiations to pass the bill, Republicans and the business community pushed for an exemption from the employer contribution for companies with 25 or fewer employees. A broad bipartisan coalition ended up supporting that compromise. As Governor, I will focus first on implementing the current law successfully and would then support expanding it.
Betsy Johnson, the unaffiliated candidate for governor, wrote:
Paid family leave is a great policy that politicians should have left to businesses to implement or not based on their market and employee situation. As it is, politicians in Salem have passed heavy handed mandates that will disparately impact small and growing businesses and ironically keep them from being able to maintain their workforces.
This law desperately needs what the initial proposal needed, which is to work closely with business owners by size and sector to figure out how we get around the absurd one-size-fits-all mandate. I deeply believe our government needs to change its perspective from doing things to business to working with business. The idea that its employers are wrong to try to maintain and grow their businesses does real damage to both jobs and job creators.
UNIVERSAL PRESCHOOL
OPB also asked all the candidates about universal preschool. In 2020, voters in Multnomah County approved a measure that will offer free preschool to all children ages 3 and 4 by 2030. The program which will pay lead preschool teachers in line with kindergarten teachers and provide subsidies for programs offering infant and toddler care was expected to start this month, but understaffing in the Early Learning Division has caused delays. A shortage of child care workers and a backlog of background checks is also causing issues with the rollout.
Here is what we asked the candidates:
Voters in Multnomah County approved a universal preschool measure during the pandemic. Do you feel that the private-public partnership model they plan to use could be a fit for families statewide? As governor, would you support legislation to expand free preschool access in the state?
Christine Drazan, the Republican candidate for governor, wrote:
No. During this time of extraordinary tax burden, the last thing we need to do is grow government and expand it.
Tina Kotek, the Democratic candidate for governor, wrote:
I am a strong supporter of making sure every Oregon child can have access to high-quality, affordable early childhood education. Thats why I made sure the Student Success Act included expanded investments in early childhood programs so more children will be ready for school when they enter kindergarten. Oregons path to achieving this big goal will require significant public-private partnership. As Governor, my initial priorities will be on meeting the growing need for suitable physical space for safe child care, expanding our child care workforce by providing capacity-building grants to communities, and expanding the coverage of Oregons Employment Related Daycare Program (ERDC) to meet the needs of more families.
Betsy Johnson, the unaffiliated candidate for governor, wrote:
Im suspicious of the assumptions behind the question. Of course I would be in favor of expanding preschool access and I understand affordability is everything to giving children a head start, but Multnomah Countys program is a disaster from start to finish. It is only a model for failure. It establishes way too high of a tax rate, giving Multnomah County the dubious honor of having the highest individual tax rates of any county in the country and fails to connect early education to the school system as a whole. There is no curriculum, there is no plan, there are no measurables. It is exactly what I would not do.
Galveston resident Serena Davidson turned out to Galveston Pride on Saturday with her daughter to receive the monkeypox vaccine.
While shes not in a high-risk category, she wanted to get protection as soon as possible because she has mild eczema and worries about exposure to the virus. Her 17-year-old daughter also faced her fear of needles to get her first dose.
Monkeypox seems very scary and if theres something out there that can help you not get it why wouldnt you take it? Davidson said.
The two were among vaccine recipients of the 2,000 doses the Galveston County Health District had to give to anyone over the age of 18 this weekend.
We wanted to make sure that we had enough to have it available for anyone who wants one, said Philip Keiser, CEO of GCHD and associate dean for public health practice at UTMB.
In advance of Galveston Pride, GCHD requested additional vaccine doses from the Texas Department of State Health Services and nearby local health authorities. Fort Bend and Harris counties contributed doses.
The vaccine is available to anyone 18 or older, including non-Galveston County residents, regardless of gender, sexual orientation or pre-existing conditions. Non-residents may return to GCHD for their second dose or contact their local health authority.
Children under 18 may get the vaccine with consent of a parent or guardian.
Initially GCHD had only a few hundred doses, so only people in high-risk groups could get the vaccine.
The majority of reported cases, 94 percent, are in men, nonbinary people and transgender people who have sex with men, according to the Centers for Disease Control and Prevention. People with HIV made up 41 percent of cases. Anyone can contract monkeypox through direct contact with an infected rash or body fluids.
For this event, Keiser wanted to cast a wide net.
Ashley Sciba, director of community health services for GCHD, had become accustomed to mass vaccination events for COVID-19, but this was her first monkeypox vaccination event.
Sciba said most people are surprised by the vaccines placement - under the skin of the forearm. As with COVID-19, the nurses have addressed vaccine hesitancy by explaining the side effects and research behind the vaccination.
GCHD made their own monkeypox vaccination cards based on the CDCs COVID-19 cards. Each person completes a consent form and is given an information packet before getting their dose.
People began lining up in the parking lot at 706 Holiday Drive near the Galveston seawall at 9:30 a.m Saturday. By noon, people were able to get a vaccine without waiting in line.
At Friday nights event at Roberts Lafitte, the oldest running gay bar in Galveston, a team of two nurses vaccinated about 60 people in two hours.
Keiser noted that although hundreds of people came through the bar, only a small portion wanted the vaccine.
Theres a lot of vaccine hesitancy, Keiser said. So many people said they wanted the vaccine, and now were saying here it is, but people dont want it.
Keiser said GCHD will share what they learn from this weekends events with DSHS to improve future outreach efforts.
The next vaccination event will be from 12 to 5 p.m. Sunday at Roberts Lafitte in Galveston. Visit gchd.org/monkeypox for more information.
According to the Centers for Disease Control and Prevention, Texas has had 1,664 confirmed cases of monkeypox, or about 6 cases per 100,000 people.
Galveston County Health District reported four probable cases and one confirmed case of monkeypox in the county.
The virus continues to spread across the Houston region, with new cases reported in schools. Last week, the IDEA Public Schools Hardy campus and Ridge Point High School in Fort Bend ISD both reported a case of monkeypox.
The Harris County Jail reported an inmate tested positive for monkeypox last week.
On Tuesday, the first monkeypox-related death in the United States was recorded in Harris County. The invdividual was severely immunocompromised, according to a statement from DSHS. Deaths associated with monkeypox are rare, with only 15 deaths worldwide, according to the CDC.
Monkeypox is spread through direct contact with an infected animal or person or materials contaminated with the virus. The primary transmission route is through contact with infected lesions, scabs or body fluids. A person with monkeypox is infectious until their rash has fully healed.
The vaccine used to prevent monkeypox is called JYNNEOS and is a variation of the smallpox vaccine. It contains a weakened virus that cannot cause monkeypox or smallpox.
The JYNNEOS vaccine is a two-dose regime, with at least four weeks between doses.
Immunity begins days after the first dose, with maximum immunity developing two weeks after the second dose.
The most common side effects of the vaccine are muscle pain, headache, fatigue, nausea, chills and fever, along with redness and swelling at the injection site.
To schedule a monkeypox vaccination appointment, contact your local health department.
stephanie.lamm@chron.com
