We are NOW offering the Smallpox/Monkeypox Vaccine (JYNNEOS) by Appointment ONLY to those groups who are more likely to have been recently exposed to monkeypox
According to the department of health, walk-ins will not be accepted and appointment eligibility is based on the following criteria:
Known contacts who are identified by public health via case investigation, contact tracing and risk exposure assessmentsPresumed contacts who may meet the following criteria: Know that a sexual partner in the past 14 days was diagnosed with monkeypox and/or had multiple sexual partners in the past 14 days in a jurisdiction with known monkeypoxMSM (men who have sex with men)Laboratory workers who perform diagnostic testing for monkeypox and healthcare providers interacting with patients at high risk for monkeypox
The department of health said it will verify the criteria have been met prior to an appointment.
President Joe Biden’s “loose cough” has returned as he faces a rebound case of COVID-19, his doctor said Tuesday, though he “continues to feel well.”
White House physician Kevin O’Connor provided the update on the president’s condition as he continues to test positive for the virus. He said Biden “remains fever-free,” and that his temperature, pulse, blood pressure, respiratory rate and oxygen saturation “remain entirely normal.”
Still, Biden is required to remain in isolation through at least Thursday under Centers for Disease Control and Prevention guidelines — and perhaps longer under tougher White House protocols if he continues to test positive.
Biden’s rebound case — labeled such because he tested positive on Saturday just three days after being cleared from isolation during his initial bout of the virus with two negative tests last Tuesday and Wednesday — has left him eager to return to a normal schedule.
During his first go-around with the virus, Biden, 79, was treated with the antiviral drug Paxlovid, and his primary symptoms were a runny nose, fatigue and a loose cough, his doctor said at the time.
The Biden administration said Friday it has reached an agreement with Moderna to buy 66 million doses of the company’s next generation of COVID-19 vaccine that targets the highly transmissible omicron variant, enough supply this winter for all who want the upgraded booster.
The order of the bivalent shot follows the announcement last month that the federal government had secured 105 million doses of a similar vaccine from rival drugmaker Pfizer. Both orders are scheduled for delivery in the fall and winter, assuming regulators sign off on their effectiveness.
“We must stay vigilant in our fight against COVID-19 and continue to expand Americans’ access to the best vaccines and treatments,” Health and Human Services Secretary Xavier Becerra said in a statement. “As we look to the fall and winter, we’re doing just that — ensuring Americans have the tools they need to stay safe and help keep our nation moving forward.”
The U.S. orders with Pfizer and Moderna include options to purchase 300 million doses each, but reaching that total will require more funding from Congress, the Biden administration said.
About 261 million Americans have received at least one COVID-19 shot, but only 108 million have received a booster.
President Joe Biden tested positive for COVID-19 for the second straight day, in what appears to be in a rare case of “rebound” following treatment with an anti-viral drug.
In a letter noting the positive test, Dr. Kevin O’Connor, the White House physician, said Sunday that the president “continues to feel well” and will keep on working from the executive residence while he isolates.
Biden tested positive on Saturday, requiring him to cancel travel and in-person events as he isolates for at least five days in accordance with Centers for Disease Control and Prevention guidelines.
After initially testing positive on July 21, Biden, 79, was treated with the anti-viral drug Paxlovid. He tested negative for the virus on this past Tuesday and Wednesday, clearing him to leave isolation while wearing a mask indoors.
Research suggests that a minority of those prescribed Paxlovid to experience a rebound case of the virus. The fact that a rebound rather than a reinfection possibly occurred is a positive sign for Biden’s health once he’s clear of the disease.
“The fact that the president has cleared his illness and doesn’t have symptoms is a good sign and makes it less likely he will develop long COVID,” said Dr. Albert Ho, an infectious disease specialist at Yale University’s school of public health.
President Joe Biden tested positive for COVID-19 again Saturday, slightly more than three days after he was cleared to exit coronavirus isolation, the White House said, in a rare case of “rebound” following treatment with an anti-viral drug.
White House physician Dr. Kevin O’Connor said in a letter that Biden “has experienced no reemergence of symptoms, and continues to feel quite well.” O’Connor said “there is no reason to reinitiate treatment at this time.”
In accordance with Centers for Disease Control and Prevention guidelines, Biden will reenter isolation for at least five days. He will isolate at the White House until he tests negative. The agency says most rebound cases remain mild and that severe disease during that period has not been reported.
Word of Biden’s positive test came — he had been negative Friday morning — just two hours after the White House announced a presidential visit to Michigan this coming Tuesday to highlight the passage of a bill to promote domestic high-tech manufacturing. Biden had also been scheduled to visit his home in Wilmington, Delaware, on Sunday morning, where first lady Jill Biden has been staying while the president was positive. Both trips have been canceled as Biden has returned to isolation.
Biden, 79, was treated with the anti-viral drug Paxlovid, and tested negative for the virus on Tuesday and Wednesday. He was then cleared to leave isolation while wearing a mask indoors. His positive tests puts him among the minority of those prescribed the drug to experience a rebound case of the virus.
White House COVID-19 coordinator Dr. Ashish Jha told reporters on July 25 that data “suggests that between 5 and 8 percent of people have rebound” after Paxlovid treatment.
“Acknowledging the potential for so-called ‘rebound’ COVID positivity observed in a small percentage of patients treated with Paxlovid, the President increased his tested cadence, to protect people around him and to assure early detection of any return of viral replication,” O’Connor wrote in his letter.
O’Connor cited negative tests for Biden from Tuesday evening, Wednesday morning, Thursday morning and Friday morning, before Saturday morning’s positive result by antigen testing. “This in fact represents ‘rebound’ positivity,” he wrote.
Both the Food and Drug Administration and Pfizer point out that 1% to 2% of people in Pfizer’s original study on Paxlovid saw their virus levels rebound after 10 days. The rate was about the same among people taking the drug or dummy pills, “so it is unclear at this point that this is related to drug treatment,” according to the FDA.
While Biden was testing negative, he returned to holding in-person indoor events and meetings with staff at the White House and was wearing a mask, in accordance with CDC guidelines. But the president removed his mask indoors when delivering remarks on Thursday and during a meeting with CEOs on the White House complex.
Asked why Biden appeared to be breaching CDC protocols, press secretary Karine Jean-Pierre said, “They were socially distanced. They were far enough apart. So we made it safe for them to be together, to be on that stage.”
Regulators are still studying the prevalence and virulence of rebound cases, but the CDC in May warned doctors that it has been reported to occur within two days to eight days after initially testing negative for the virus.
“Limited information currently available from case reports suggests that persons treated with Paxlovid who experience COVID-19 rebound have had mild illness; there are no reports of severe disease,” the agency said at the time.
When Biden was initially released from isolation on Wednesday, O’Connor said the president would “increase his testing cadence” to catch any potential rebound of the virus.
Paxlovid has been proven to significantly reduce severe disease and death among those most vulnerable to COVID-19. U.S. health officials have encouraged those who test positive to consult their doctors or pharmacists to see if they should be prescribed the treatment, despite the rebound risk.
Biden is fully vaccinated, after getting two doses of the Pfizer coronavirus vaccine shortly before taking office, a first booster shot in September and an additional dose March 30.
While patients who have recovered from earlier variants of COVID-19 have tended to have high levels of immunity to future reinfection for 90 days, Jha said that the BA.5 subvariant that infected Biden has proven to be more “immune-evasive.”
“We have seen lots of people get reinfected within 90 days,” he said, adding that officials don’t yet have data on how long those who have recovered from the BA.5 strain have protection from reinfection.
Moves by rich countries to buy large quantities of monkeypox vaccine, while declining to share doses with Africa, could leave millions of people unprotected against a more dangerous version of the disease and risk continued spillovers of the virus into humans, public health officials are warning.
“The mistakes we saw during the COVID-19 pandemic are already being repeated,” said Dr. Boghuma Kabisen Titanji, an assistant professor of medicine at Emory University.
While rich countries have ordered millions of vaccines to stop monkeypox within their borders, none have announced plans to share doses with Africa, where a more lethal form of monkeypox is spreading than in the West.
To date, there have been more than 21,000 monkeypox cases reported in nearly 80 countries since May, with about 75 suspected deaths in Africa, mostly in Nigeria and Congo. On Friday, Brazil and Spain reported deaths linked to monkeypox, the first reported outside Africa.
“The African countries dealing with monkeypox outbreaks for decades have been relegated to a footnote in conversations about the global response,” Titanji said.
Scientists say that unlike campaigns to stop COVID-19, mass vaccination against monkeypox won’t be necessary. They think targeted use of the available doses, along with other measures, could shut down the expanding epidemics recently designated by the World Health Organization as a global emergency.
Yet while monkeypox is much harder to spread than COVID-19, experts warn that if the disease spills over into general populations — currently in Europe and North America it is circulating almost exclusively among gay and bisexual men — the need for vaccines could intensify, especially if the virus becomes entrenched in new regions.
On Thursday, the Africa Centers for Disease Control and Prevention called for the continent to be prioritized for vaccines, saying it was again being left behind.
“If we’re not safe, the rest of the world is not safe,” said Africa CDC’s acting director, Ahmed Ogwell.
Although it has been endemic in parts of Africa for decades, monkeypox mostly jumps into people from infected wild animals and has not typically spread very far beyond the continent.
Experts suspect the monkeypox outbreaks in North America and Europe may have originated in Africa long before the disease started spreading via sex at two raves in Spain and Belgium. Currently, more than 70% of the world’s monkeypox cases are in Europe, and 98% of cases are in men who have sex with men.
WHO is developing a vaccine-sharing mechanism for affected countries, but has released few details about how it might work. The U.N. health agency has made no guarantees about prioritizing poor countries in Africa, saying only that vaccines would be dispensed based on epidemiological need.
Some experts worry the mechanism could duplicate the problems seen with COVAX, created by WHO and partners in 2020 to try to ensure poorer countries would get COVID-19 shots. That missed repeated targets to share vaccines with poorer nations and at times relied on donations.
“Just asking countries to share is not going to be enough,” said Sharmila Shetty, a vaccines adviser for Medecins Sans Frontieres. “The longer monkeypox circulates, the greater chances it could get into new animal reservoirs or spread to” the human general population, she said. “If that happens, vaccine needs could change substantially.”
At the moment, there is only one producer of the most advanced monkeypox vaccine: the Danish company Bavarian Nordic. Its production capacity this year is about 30 million doses, with about 16 million vaccines available now.
In May, Bavarian Nordic asked the U.S. to release more than 215,000 doses it was due to receive, “to assist with international requests the company was receiving,” and the U.S. complied, according to Bill Hall, a spokesman for the department of Health and Human Services. The U.S. will still receive the doses, but at a later date.
The company declined to specify which countries it was allocating doses for.
Hall said the U.S. has not made any other promises to share vaccines. The U.S. has ordered by far the most number of doses, with 13 million reserved, although only about 1.4 million have been delivered.
Some African officials said it would be wise to stockpile some doses on the continent, especially given the difficulties Western countries were having stopping monkeypox.
“I really didn’t think this would spread very far because monkeypox does not spread like COVID,” said Salim Abdool Karim, an infectious diseases epidemiologist at the University of KwaZulu-Natal in South Africa. “Africa should procure some vaccines in case we need them, but we should prioritize diagnostics and surveillance so we know who to target,” he said. “Normally, you’re able to get ahead of a disease like monkeypox, but I am concerned (the number of new cases) hasn’t started coming down yet.”
Dr. Ingrid Katz, a global health expert at Harvard University, said the monkeypox epidemics were “potentially manageable” if the limited vaccines were distributed appropriately. She believed it was still possible to prevent monkeypox from turning into a pandemic, but that “we need to be thoughtful in our prevention strategies and rapid in our response.”
In Spain, which has Europe’s biggest monkeypox outbreak, demand for vaccines far exceeds supply.
“There is a real gap between the number of vaccines that we currently have available and the people who could benefit,” said Pep Coll, a medical director at a Barcelona health center that was dispensing shots this week.
Daniel Rofin, 41, was more than happy to be offered a dose recently. He said he decided to get vaccinated for the same reasons he was immunized against COVID-19.
“I feel reassured it is a way to stop the spread,” he said. “We (gay men) are a group at risk.”
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Joseph Wilson and Renata Brito in Barcelona, Spain, Chris Megerian in Washington and Cara Anna in Nairobi, Kenya contributed to this report.
