Press Briefing by White House Monkeypox Response Team and Public Health Officials 8/30/22 Transcript

Bob Fenton: (00:01) Good afternoon. Thank you for joining us. I'm Bob Fenton, the white house monkeypox response coordinator. Today, Secretary Becerra, Deputy Coordinator Dr. Demetre Daskalakis, Assistant Secretary O'Connell, and I will provide an update on the administration's effort to distribute vaccines quickly to places that need them. To help states, localities, and providers get shots in arms. And to partner with jurisdictions and LGBTQ+ leaders on the ground to meet impacted communities where they are with vaccinations and information. We also have Dr. Jenny McQuiston from CDCs monkeypox incident response team on for questions. We're also honored to be joined today by Governor John Bel Edwards of Louisiana, to discuss our work together to surge vaccines, and other prevention resources to Louisiana ahead of Southern Decadence in New Orleans this upcoming holiday weekend. Before I turn over to governor Edwards, let me just take a few key points that make my colleagues, and let me drill down on those. Bob Fenton: (01:09) First, on vaccine supply and distribution, as I said on Friday, we have dramatically accelerated distribution of vaccine supply over the past several weeks. Through a strategy that continues to advance equity, and ensures vaccines are getting to where they are needed. And to be very clear, as a result of our efforts, we have enough supply going out into the field to be in a strong position to get two doses of vaccine to everyone in the at risk community. Namely, gay, bisexual, and other men who have sex with men through intradermal administration. Bob Fenton: (01:45) Second on vaccinations, we continue to be laser focused on doing everything within our power to help jurisdictions and clinicians get shots in arms. We're seeing more and more jurisdictions adopt the intradermal administration. As I said Friday, approximately 75% of jurisdictions have already adopted this safe and effective approach. And an additional 20% are working toward fully operational in the intradermal method. In all, that means more shots in arms, more protection from monkeypox, and a faster, effective way for us to end this outbreak. Bob Fenton: (02:20) As of today, 14 jurisdictions have attested to having used more than 85% of their vials. With all of this progress, it's important to acknowledge that there's more work we must do together with our partners on the ground to get shots in arms in the highest risk communities. Equity is a key pillar in our response, and we recognize the need to put extra resources into the field to make sure we are reaching communities most impacted by the outbreak. This requires hyper localized, and hyper tailored efforts, and a strong partnership of local leaders to understand how we can best reach those communities. Already we made allocations of vaccines to the Ryan White clinics, which are trusted sources of care for about a half million individuals living with HIV, about half of the people diagnosed with HIV in the United States. And that's why we're working closely with state and local leaders like governor Edwards to get vaccines and information to large events that bring together large groups of LGBTQ+ individuals, from Southern Decadence in New Orleans, to Black Pride in Atlanta, to Oakland Pride in California. Bob Fenton: (03:33) And as Dr. Daskalakis will discuss in detail, that's why we're launching a new equity intervention pilot program that aims to directly reach queer communities of color that may face barriers in accessing vaccines currently. Through this new pilot program, we'll provide vaccines to health departments, specifically for smaller scale community-based vaccination efforts that leverage the deep relationships that organizations already have on the ground in these communities. Because we know every shot matters, and we're not going to stop until we can reach at the highest risk of contracting monkeypox with the information and vaccines they need to protect themselves. With that, let me turn over to governor Edwards to talk more about vaccination and prevention plans around Southern Decadence this weekend. Governor Edwards and his team have been strong partners in the fight to end this outbreak, and we've been working closely with them to prepare for this weekend's event. Governor Edwards, over to you. Gov. John Bel Edwards: (04:40) Thank you, Bob. I appreciate it. And you're exactly right. Several weeks ago, I called you to make sure that this event was on your radar. It already was. And in fact, you had already started communications with folks here in Louisiana. And so, I want to thank Dr. Wilensky, because she's personally ... Make calls into Louisiana, and talked to some of our healthcare professionals. But also Dr. Daskalakis as well, who is no stranger to New Orleans, and he's been helping us here for quite some times. And of course, I want to thank Secretary Becerra, too. This is an example, I think a really solid example of what a federal state local partnership, and then the community providers as well, because the public health folks in New Orleans have been tremendous. But also the community providers, and it's manifested itself in several, I think, significant ways. So for example, you all have sent down multidisciplinary teams to the New Orleans, to help us to organize and to prepare, to better communicate, and do outreach, and set up testing and vaccination sites in the community. Gov. John Bel Edwards: (05:47) They're going to be convenient for the at risk population. At our request, you sent down additional doses so that we could administer more vaccines. Both to residents and to visitors around Southern Decadence festival, 6,000 doses. We thank you so much. And with respect to testing, you all are going to pilot a mobile testing facility here around the Southern Decadence festival too. So we really appreciate that. I did want to make sure you know that all of the providers that we're partnering with in Louisiana, they have moved to the intradermal method of vaccinations. And so, now rather than one dose per vial, we're averaging about four-and-a-half doses per vial. And that really helps us an awful lot as we try to administer these vaccinations as widely as possible. And so, we're having good luck there. And just for those people who may not be familiar with the Southern Decadence festival, we haven't conducted it since 2019, because it wasn't done during the first two years of the COVID pandemic. Gov. John Bel Edwards: (06:51) But this festival can attract up to 300,000 individuals. Not just from Louisiana, or not even from the South, but from around the country. And we are expecting tens of thousands of people in New Orleans over this Labor Day weekend. And so being able to prepare for that, and to get a head start on the vaccinations on the testing, on the communications, all extremely important. And I will tell you, my public health officials here at The State of Louisiana have told me as recently as today, that the working relationship that they've enjoyed with our federal partners around this particular effort, is probably as good as they've ever seen. There's no doubt we will learn lessons over the weekend that we can then share with other folks around the country, and help them to do an even better job of preparing for similar events. Gov. John Bel Edwards: (07:44) But I want to, on behalf of The State of Louisiana, thank all of our federal partners, but also our partners in New Orleans, and our community providers as well. And we look forward to having as safe an event as we could possibly have over the weekend. So thank you very much, Bob. Bob Fenton: (08:01) Okay. Thank you, Governor. We're going to go over to Secretary Becerra to speak next. Thank you. Sec. Xavier Becerra: (08:09) Bob. Thank you very much, and Governor Edwards, to you, thank you for joining us. Thanks for your partnership and all the work that you're doing to help the folks in Louisiana. I'm going to start the way I've always started. It is important that we all take monkeypox seriously, and that we do everything we can to keep this virus from spreading, so we can end this outbreak. This means communicating and sharing information, getting vaccines to people most at risk, and ensuring those who are infected have access to treatment. Sec. Xavier Becerra: (08:39) One of the things we've learned from our response to COVID 19, is that it's important to reach people where they are. It's not enough to wait for people to show up at a doctor's office, or a county health department to schedule a vaccination appointment. We need to set up vaccination clinics where people are. And when we do that, there are better health outcomes for all of us. Our focus every day is making sure that those most at risk for monkeypox have the information and resources they need. Vaccines, tests, treatment to keep themselves and their loved ones safe. As Bob mentioned, our latest effort involves working with state and local governments across the country to set up vaccination clinics at key upcoming festivals. This is work that started a few weeks back when we allocated additional supplies of JYNNEOS vials to the pride festival in Charlotte, North Carolina. Sec. Xavier Becerra: (09:33) At that festival, local public health officials were able to vaccinate 540 people. Today, I'm happy to announce that we will be allocating an additional supply of the JYNNEOS vaccine vials to the Southern Decadence festival in New Orleans, Louisiana, and the Black Pride festival in Atlanta, Georgia, which will allow up to 5,000 vaccinations at each event. We'll also be allocating an additional supply of JYNNEOS vials to two festivals in Oakland, California, the pride festival, which is also this weekend, and ... Sec. Xavier Becerra: (19:29) [inaudible 00:19:29] California, the Pride Festival, which is also this weekend and Pride Fest on September 11th. This allocation will allow up to 2,400 additional vaccinations, and we're not stopping there. I'm happy to report that we're working with additional jurisdictions to ensure that we're able to set up vaccination clinics at other key festivals. Since the beginning of this outbreak, we've worked to ensure monkeypox vaccines, tests and treatments are available. We began providing vaccines to states and jurisdictions for free within two days of the first confirmed case of monkeypox in the US back in May. In addition, we increased testing capacity from 6,000 specimens per week to up to 80,000 specimens per week. And we made 50,000 patient courses of TPOXX available to jurisdictions. That's the treatment that people can use if they do have monkeypox. Last week, we launched the fourth phase of the national vaccine strategy. So far we've made over 1 million vials of vaccine available to jurisdictions, which is nearly enough to reach the entire population that's most at risk. Sec. Xavier Becerra: (19:29) And finally, we've worked with Bavarian Nordic and Grand River Aseptic Manufacturing in Michigan to establish a second fill in finish line for the JYNNEOS vaccines in the US. Once the facility is up and running, it'll double our capacity to make more JYNNEOS vaccines. We'll continue to do all we can to stop this virus from spreading. As I've said, we all have a role to play and working together will lead to our collective success. So thank you for everything you're doing and now let me turn it over to Dr. Demetre Daskalakis, the deputy coordinator for the White House National Monkeypox Response. Dr. Daskalakis: (19:29) Thank you, Secretary Becerra. As you outlined with greater supply of vaccine, our goal is to be even more intentional and targeted in how we work with states and cities to reach people who could benefit from vaccination and the core educational messages that round out the full package of a monkeypox prevention toolkit. Given the progress we have made toward making the tools available to end this outbreak, our vaccine strategy is to meet people where they seek services, care or community, especially in communities of color. We know that Prides and other large LGBTQI+ focused events can do just that. Our pilot to provide special vaccine supply and educational resources at these large events started with Charlotte Pride, like you said in North Carolina, with great success. It demonstrates the power of partnership between federal, state and local government with the community to work toward the end of the monkeypox outbreak. As we approached Labor Day weekend, we responded to local governments and the community to provide additional vaccines for Black Pride in Atlanta and Southern decadents in New Orleans. Dr. Daskalakis: (19:29) These events will reach a diverse segment of the LGBTQI+ community and help address some of the equity gaps that we are seeing in vaccination among people of color. But that's not enough. We need to work closely with jurisdictions, advocates, local organizations, and service providers on the ground that really know what may be needed to continuously work together to reach deeper in the community, even when there is no big event in town. So that's exactly why today we're announcing an equity innovation pilot that earmarks an additional 10,000 vials of vaccine for smaller equity interventions that are identified by jurisdictions. This is an exciting new program that is directly based on our conversations and collaboration with local leaders and groups on the ground about what they may need to reach their communities. Jurisdictions that have used more than 50% of their delivered vaccine qualify for an allocation of vaccine to support up to five smaller equity interventions that reach populations that could benefit from monkeypox prevention. Dr. Daskalakis: (19:29) So what we mean by an equity intervention is what works in your state, county or city to reach people who we may not be reaching, especially people of color and members of the LGBTQI+ population. What it means is it can be working with a specific group or venue that reaches the right people for monkeypox prevention. Once these innovative strategies have been reviewed by CDC, vaccines will be supplied to jumpstart these ideas and accelerate reach deeper into communities. We know jurisdictions have already centered equity in their work, but we want to provide additional support to foster even greater innovation in vaccine outreach and education of the communities most at risk. This allows jurisdictions to try out new strategies that will better reach communities of color and others overrepresented in the monkeypox outbreak. So great examples include providing vaccines to clinics and organizations not yet reached by current supply, vaccinating its smaller, high impact events and placing backseat in new places, like pharmacy associated clinics that might be less stigmatizing places for some to walk in to seek vaccine. Dr. Daskalakis: (19:29) So an example that we heard from DC is that using pharmacy associated clinics actually resulted in significant improvements in vaccination equity. This allows others to explore similar innovation, working with new organizations, reaching new communities, leveraging new venues and addressing trends in the local epidemiology of monkeypox through innovative strategies will help states and cities to better place vaccine where people are and address some of the stigma and barriers that have slowed access for some. Bob Fenton: (19:29) We're going to move over to Dawn O'Connell to speak next, Dawn. Dawn O'Connell: (19:29) Thanks so much, Bob. I really appreciate it. At ASPR, we continue to do everything we can to increase the availability and accelerate the distribution of vaccines and treatments nationwide with a focus on making vaccines available to those at highest risk. As the secretary just mentioned, by the end of the current phase four allocation, we will be very near to having enough vaccine to offer two doses to the entire high risk population. We have more work to do, but are making progress. To date, we have allocated approximately 1.1 million vials of JYNNEOS vaccine to states and jurisdictions. Of that, we have shipped approximately 771,000 vials to jurisdictions. As we continue to distribute vaccines, we are making sure and working closely with states and jurisdictions to understand where vaccines are needed the most. As of yesterday, 14 jurisdictions have reported that they have used 85% of their available supply. This is no change from last week. As soon as jurisdictions let us know they have used their 85%, they can order more. And our strategic national thought file team will ship those additional vials out immediately. Dawn O'Connell: (19:29) We are in daily communication with jurisdictions and we continue to work to streamline our operations to help them get vaccines to those that need the most as soon as possible. As we continue with our day to day response, we are also focused on strengthening our future vaccine pipeline in bolstering our domestic supply chain. Less than two weeks ago, Bavarian Nordic reached an agreement with Grand River Aseptic Manufacturing, or GRAM as it is known for short, to establish the first US based fill and finish line for JYNNEOS in Grand Rapids, Michigan. Yesterday, ASPR's biomedical advanced research and development authority announced an 11 million investment in GRAM to purchase additional equipment necessary for JYNNEOS production and recruit and train about 75 additional staff to operate the line. Dawn O'Connell: (19:29) I had the pleasure of traveling to Grand Rapids yesterday, where I met with company officials and saw firsthand the progress being made to stand up the new line. In addition to the financial backing, we are providing technical assistance to the Bavarian Nordic and GRAM teams, making sure they have access to all the necessary materials, facilitating connections where are needed and helping clear any roadblocks or hurdles to getting this capacity online as quickly as possible. We anticipate the Michigan line will be up and running by the end of the year, doubling the current capacity to fill and finish the JYNNEOS vaccine. Our message to jurisdictions continues to be, if you need vaccines, if you need treatments or if you need support for your local response, please let us know immediately. And with that, I'll turn it over to you, Kevin. Speaker 1: (19:29) Thank you so much, Dawn. First question, let's go to Jeannie Baumann at Bloomberg. Speaker 2: (19:29) Hi, thanks so much for taking my question. I was wondering what you're doing at CDC to sort of collect data on vaccine administration. I know you said that the [inaudible 00:19:04] safe and effective, but we're going to have some real world evidence. And I didn't know if at some of these big events you're going to be collecting that data and have a way to do follow up to see if there are any reactions or adverse events. Thank you. Bob Fenton: (19:29) Let me have Dr. Jenny McQuiston from CDC answer that question. Dr. McQuiston: (19:29) Hi, thank you. CDC is certainly interested in looking at vaccine efficacy from the perspective of how well is the vaccine working and also vaccine safety and we have several systems in place that do gather information about that. CDC operates a system called VAERS or the Vaccine Adverse Event Reporting System and we're actively looking at different types of events that might be reported post vaccination. And we are actively gathering information from the different jurisdictions in states and cities about which vaccines they're administering, whether it's subcutaneous or intradermal and we're gathering those data now as... Dr. McQuiston: (20:03) ... subcutaneous or intradermal and we're gathering those data now, as we speak. If you look on the CDC website, you're going to start to see a lot of information about vaccine administration. Right now, we have some states on board and we're actively onboarding the rest. So I think that we'll be up to full state reporting in about a week, but you can start to get information now if you go on the CDC website and look. With respect to the vaccines that are being given out at some of these large venues, I think those systems are going to be in place for people who get vaccinated, whether it's through a special venue or through a normal jurisdictional clinic. So I think those same systems will be capturing data. Bob Fenton: (20:41) Thank you. Kevin, we'll take another question. Speaker 3: (20:44) Let's go to Chris Wiggins at the Advocate. Speaker 4: (20:48) Hi, thank you for taking my question. I have two questions. There's a report from the Houston area of a patient with confirmed monkeypox infection who has died. Do you have any information about that case to share? And now that somebody has died in the US, does that change the messaging to the public at all? And then looking [inaudible 00:21:07], people who attended the events in Charlotte the weekend before last reported not seeing many signs indicating where monkeypox vaccines would be available. And those who did find information had to walk to satellite locations a distance away from the events, making it inconvenient. During a press event at Mecklenburg County, they said that no signage was put out in order to protect people's privacy. And so Virginia also said that they would not be doing onsite vaccination Virginia's pride fest at the end of September. I'm wondering what the administration's message to locality is worried about privacy in regards to onsite vaccination is. Thank you. Bob Fenton: (21:50) Yeah. Let me start with Dr. Jenny McQuiston down in CDC to answer the first question and talk about the second. And then I'll see if Dr. Daskalakis wants to add anything to the second part of the question. So Dr. McQuiston ... Dr. McQuiston: (22:08) Hi, thanks for that. Yeah, CDC has been in touch with Texas and Harris County, and we are aware that they're reporting a death in a patient that did test positive for monkeypox. It's our understanding this patient also had underlying health conditions and had a number of things going on. And I think that additional investigation is needed to know what role monkeypox may or may not have played in their death. So we'll be reporting that out as soon as we have more information. Dr. McQuiston: (22:36) I think it's important to emphasize that deaths due to monkeypox, while possible, remain very rare. In most cases, people are experiencing infection that resolves over time, and there have been very few deaths even reported globally. Out of over 40,000 cases around the world, only a handful of fatalities have been reported. It's serious and our hearts certainly go out to this family who have lost a loved one. And while we are doing further investigations to find out what role monkeypox may have played, it's important to focus that we have mitigation measures in place to prevent monkeypox. Get vaccinated. If you're sick, go to a doctor, get tested, and if you have severe illness, there are treatments that are available. Bob Fenton: (23:18) And then- Dr. McQuiston: (23:19) I think if, if you want me to talk a little bit about the Charlotte event, I'll start and then I'll pass it on to Dr. Daskalakis. I think that feedback that you provided is actually really extraordinarily helpful. Charlotte was a pilot project, so only about 540 vaccines were administered during the Charlotte event. And I think some of it was trying to see what might be possible, what might be best practices. So the information you provided about signage and making sure privacy was considered I think will be really important to inform some of these other events. Bob Fenton: (23:51) Let me see if Dr. Daskalakis would like to add- Dr. Daskalakis: (23:54) I would love to add a bit to Dr. McQuiston. So I'll start by saying that public health is a local experience and it's really important that jurisdictions make their plans based on what they expect in their jurisdiction and what's appropriate for their population. So I think it's important to also respect the strategy that Charlotte may have had in terms of how to get the word out. And so 500 plus vaccines is a great success. It's not a clinic. And so really going to pride and getting vaccinated, any number, especially that high, I think is remarkable. Dr. Daskalakis: (24:21) But I'll say I've also spoken to the folks in Atlanta and the folks in New Orleans, and I think their strategy is a bit different. And so I think that New Orleans event is going to be right in Armstrong Park. So you're going to be very clearly in the middle of the French Quarter, very clear where testing as well as vaccines will be available. They have multiple events. Same with Atlanta. They've promoted, already, through the networks of Black Gay Pride, and they're actually building on some great success in Atlanta. Fulton county just put out data that actually almost 70% of their vaccines so far in their vaccination effort have actually been given to people who are Black and brown. So I think that this is going to be another great experience where the local public health officials work with their community to identify what's the best way to get the word out at these big events. So I think it'll be really exciting to see how it plays out in different venues. Thank you. Bob Fenton: (25:15) Take another question, Kevin. Speaker 3: (25:18) Emily Woodruff at the New Orleans Advocate. Speaker 5: (25:21) Hi there. This is Emily Woodruff. I'm with the advocate in [inaudible 00:25:25]. Thank you for taking my question. So I'm wondering if you can tell me about the decision to send vaccines to New Orleans for the event rather than in advance. I know our state officials advocated for more vaccines as far back as July. And so most people here won't probably have even had their second shot by the time the event happened this weekend. So can you tell me about that decision and just how people should think about their level of protection going into this? Bob Fenton: (26:01) Yeah. Well, let me start with Dr. Daskalakis to talk about the different pride events and also the pilot that we've talked about and the importance of reaching out to people to use them to vaccinate those at risk to monkeypox. Dr. Daskalakis: (26:17) Great. I'll start and I'll make sure Dr. McQuiston doesn't have anything else to add, so I'll hand the Baton to her after. So I think the decision to send vaccines to New Orleans, specifically for Southern Decadence was responsive to the community and the local government. And so I think we heard loud and clear that given this event and the fact that it does attract many gay, bisexual, other men who have sex with men and others in the queer community to that space, it was a great opportunity to get folks ready for the event in terms of getting some vaccines on the ground early, but also a great opportunity to reach people who won't go to a clinic or a vaccine effort, but will feel comfortable in, frankly, less stigmatizing spaces that can occur in the events. Dr. Daskalakis: (27:01) I think one of the really important things that CDC has done in terms of setting this up, along with having people on the ground, as you heard from the governor, is being very clear about what guidance is to people after they get their first shot. So that first shot doesn't mean that you're protected for the event. We're going to talk to them about lots of other strategies that they can reduce risk of acquiring monkeypox, but also make it clear that shot's not for today. It's for four weeks from now, plus two weeks after that second dose when you get maximum protection. Dr. McQuiston not sure if you have anything to add. Dr. McQuiston: (27:31) I think the only thing I would add is, yes, we certainly had a request from Louisiana with asking for large amounts of vaccine some time ago, but I think it was actually the inter-agency decision to move to intradermal dosing that freed up enough doses that we could begin to plan a much larger strategy and knew that we had enough to provide. And so I think that is one of the reasons why perhaps the vaccine is coming out now for Louisiana rather than in July. So I just wanted to flag that. Bob Fenton: (28:04) Thank you. Kevin, we'll take another question. Speaker 3: (28:07) Let's go to [inaudible 00:28:08] with the Washington Post. Speaker 6: (28:11) Hi, can you hear me? Bob Fenton: (28:13) Yeah, we hear you. Speaker 3: (28:15) Dimitri, can you expand more on how this equity focused vaccine distribution is going to work? You mentioned how it would apply for up to five interventions. What kind of interventions are we talking about here? Dr. Daskalakis: (28:33) Great question. So it's going to be very similar to the allocations for the large events. It just will allow jurisdictions to work with their community, to identify a handful, a little package of interventions and inequity strategies that may work for them. So I gave some examples. It can be really in the eye of the beholder. Again, what happens on the jurisdiction level really involves that important community engagement in figuring out what will work in their space. So it means letting the CDC know what that plan is, having them review it and then providing an allocation to address what the vision is. Dr. Daskalakis: (29:09) So there are lots of examples. So it can be working in specific venues, specific communities. For instance, thinking about the house and ballroom community is one example, is one strategy that could be great. It attracts a lot of younger folk who are Black and brown, so it could be a great strategy to connect with that community. Those tend to be smaller events and won't hit the threshold of 50,000. So it's really a way to extend the equity plan to not only look at these larger events, but also more local smaller events. Bob Fenton: (29:42) Kevin, we'll take another question. Speaker 3: (29:45) Got MJ Lee at CNN. Speaker 7: (29:50) Hi, thank you for taking my question. I had two, the first is on funding. I was wondering if you could give us an estimate on how much funding the administration estimates that it needs to do everything that it needs ... Speaker 7: (30:03) The Administration estimates that it needs to do everything that it needs to do to try to contain monkeypox and whether there is going to be an official request that is made to Congress and whether that's also just sort of complicated by the outstanding request for COVID funding. And then I had a followup on Southern Decadence and particularly I'm interested in hearing from the governor, you had talked about actions being taken to get vaccines to some of the attendees. But obviously as you've talked about, there are two doses that are necessary. There's a lag time before you get full immunity from the vaccine. So just wondering if you could talk to us a little bit about what went into going ahead with the event anyway, and risk in outbreak, and whether there was any consideration given to canceling the event this year. Thank you. Bob Fenton: (30:49) Yeah. Thank you for those questions. We always want to ensure that we have the resources needed to respond to this event and continue discussions to ensure that those resources will be there through ongoing discussions with Congress and the Administration. Let me turn it over to Secretary Becerra to speak specifically to HHS and anything he wants to add around that area. And then we'll turn over your second question to both CDC and Dr. Daskalakis. Sec. Xavier Becerra: (31:23) Thanks, Bob. And may I ask for Administrator Dawn O'Connell to add a little bit as well. But what I'll tell you is that we continue to try to stay at pace, stay ahead of what is needed in the various jurisdictions so we can make sure that distribution works for them in partnership. And what we've done is stayed in communication with our congressional partners to try to keep them abreast of the needs, to keep this effort going, to be able to stop the spread and end the outbreak. And so what we're going to do is continue to communicate with Congress. We have different scenarios that have been played out. You can discuss the pool of individuals who might benefit from the vaccine, that could be any large number of different types of populations. Obviously those highest at risk are those that we're targeting first and foremost. But what we're doing in conversations with Congress is trying to make sure that we can stay ahead of the monkeypox outbreak. But let me see if Dawn wants to add anything to that. Dawn O'Connell: (32:27) Thank you so much, Secretary. So our focus and priority remains making sure that we have the tools to end this outbreak as quickly as possible. And if we were to receive additional funding, among the things that funding might go to are additional purchases of vaccines, additional purchases of TPOXX, making sure that we have the antivirals and the vaccine available for those populations that might need it. And we can use these tools to end the outbreak as quickly as possible. So we're continuing to look across what those budget numbers might be and plan accordingly. Bob Fenton: (33:00) Thank you. Let's go to CDC to talk about Southern Decadence and I'll see if Dr. McQuiston could add to the decision to support that effort. And obviously it's a local decision to put on Southern Decadence. What we're doing is supporting it, but she could talk about more of the risks there and our efforts to support. Dr. McQuiston: (33:29) Thanks so much. Yeah, it is definitely a local decision whether or not to put on an event like this. And unfortunately I think the governor was not able to be on for the full press conference. But what I can speak to is that from a CDC perspective, we really look at this as an opportunity to reach individuals that need information about monkeypox, how to keep themselves and their loved ones safe. And so that's the spirit in which we're leaning into the engagements that we're having here. So not only getting vaccines to people who might not have had it yet and would benefit from it, but making sure that the educational measures, all of the information that they need to stay safe is something that can be provided along with it. So it's an opportunity to meet people where they are. And one of the things that was discussed, it's also an opportunity to reach those who might not have equitable access to a vaccine where they live and where they're able to access care normally. So, Demetre, I'm sure you have something to add to this. Dr. Daskalakis: (34:23) Thanks, Jenny. I'll just add that I think clear messaging is really the cornerstone of how this outbreak has been approached specifically to gay, bisexual, and other men who have sex with men. And regardless of the event, knowledge is the power to allow them to make decisions that will help them prevent transmission or acquisition of monkeypox. And so I think we have really good evidence as an example, from a morbidity and mortality weekly report that was released last week that showed that gay, bisexual, other men who have sex with men are actually taking steps in their behaviors to reduce risk. Dr. Daskalakis: (34:59) And so it's less about the event and about the people and their dedication to really trying to keep themselves and their community safe. And we're seeing clear signals that this community is doing that. Plus with vaccine availability, this is a fabulous opportunity for individuals to get their first dose. So all in all, I think that the decision is local. But at the end of the day, I think that the community, I think is speaking with their feet, asking for a vaccine as well as with their actions, reducing some of the behaviors that could lead to acquisition in monkeypox. Bob Fenton: (35:32) Kevin, we'll take another question. Kevin: (35:34) Last question. Let's go to Sabrina Wilson at Fox in New Orleans. Sabrina Wilson: (35:43) Do you hear me? Bob Fenton: (35:44) Yeah, we hear you. Sabrina Wilson: (35:45) Yeah. So with all vaccines, of course, you guys know better than I do that there's a lot of hesitancy. So how do you get people to embrace taking the shots? Bob Fenton: (35:58) Let me first start with CDC and Dr. McQuiston, and then I'll ask Dr. Daskalakis to add to that. Dr. McQuiston: (36:07) No, I appreciate that. The monkeypox vaccine experience has been one that has been quite surprising to me personally, at CDC. There has been no shortage of individuals lining up wanting vaccine from the very first moment that monkeypox was reported here in the United States. It's been keeping up with that demand that I think has been the challenge. We've not really seen a lot of vaccine hesitancy. I think as more vaccine gets in arms and people become protected, we'll be able to focus in on maybe who is elected to not get vaccinated and what information could we provide to them that might help change their minds. And so I'm sure Demetre has some ideas on this as well. Dr. Daskalakis: (36:44) I mean, I think you covered it great, Jenny, but I'll say that really looking at what we are seeing in terms of vaccine administration, I want to raise up that Fulton County finding where really taking steps to address equity means that their story is a lot different than other parts of the country. So like I said, they actually just put out data that almost 69% of their vaccines that have been given so far are in people of color. And it just shows that really the way that you build confidence is by really making vaccine accessible and making sure that we elevate voices of people who are getting vaccine and speak to the community. So I think that really our next chapter here is not about vaccine hesitance, but about vaccine confidence and making sure that we build in systems that really improve equity and make sure vaccines are getting not only in arms, but in arms of people who really need it. Bob Fenton: (37:36) With that, I want to thank you for joining us today and especially thank Governor Edwards for joining us today and all the questions as we work together through federal state and local government, to ensure that we vaccinate those at highest risk and today's briefed equity events will also do that. So thank you. Have a good day.