Monkeypox a new worry for gay and bi men

[Jim_n_NYC]

Just now, KeepItReal said:

New York will start providing 2nd dose shots tomorrow - Sept 2.  Just posted a notification on Twitter.  It sounds like they are opening it up initially for those that have had a 1st dose 10 or more weeks ago.  When they catch up, that timeline will probably shorten down to the recommended 4 weeks between shot. 👍 

Are they notifying people or do you have to snag an appointment on your own?

Edited September 1, 2022 by Jim_n_NYC
Bad typing

[Cooper]

On Long Island when you get your 1st shot they give you an appointment for your 2nd. Is that not the same in NYC? 

[Monarchy79]

On 8/28/2022 at 7:37 PM, Quincy_7 said:

https://news.sky.com/story/health-authorities-warned-about-the-risk-of-monkeypox-and-covid-co-infection-12681085

 

What an unlucky fella.

Not an issue of luck. 
He must have had the time of his life before the symptoms arose. 

[Kevin Slater]

1 hour ago, Jim_n_NYC said:

Are they notifying people or do you have to snag an appointment on your own?

The website specifically says you have to make an appointment, so I would guess they're going to get through that surge before reaching out.

Kevin Slater

[Kevin Slater]

1 hour ago, Cooper said:

On Long Island when you get your 1st shot they give you an appointment for your 2nd. Is that not the same in NYC? 

No, in NYC they said they'd reach out to folk to schedule their second dose, but they were prioritizing first doses. 

Kevin Slater

[JUWS]

2 hours ago, KeepItReal said:

New York will start providing 2nd dose shots tomorrow - Sept 2.  Just posted a notification on Twitter.  It sounds like they are opening it up initially for those that have had a 1st dose 10 or more weeks ago.  When they catch up, that timeline will probably shorten down to the recommended 4 weeks between shot. 👍 

I got the same notification. But strange as they had initially said one needs to get 2nd dose 4-5 weeks no longer. And this is just now taken from CDCwebsite https://www.cdc.gov/poxvirus/monkeypox/vaccines/jynneos.html

Says 28 days apart or at least within 35 days... so 10 weeks? huh?

Edited September 2, 2022 by JUWS

[SirBillybob]

This preprint on MVA-BN immunogenicity should generate some attention and controversy. You can probably find a blurb on the gist of it on Bloomberg or other current media.

https://www.medrxiv.org/content/10.1101/2022.08.31.22279414v1.full.pdf

Edited September 2, 2022 by SirBillybob

[EZEtoGRU]

24 minutes ago, SirBillybob said:

This preprint on MVA-BN immunogenicity should generate some attention and controversy. You can probably find a blurb on the gist of it on Bloomberg or other current media.

https://www.medrxiv.org/content/10.1101/2022.08.31.22279414v1.full.pdf

Could you help us non-medical folks with a brief executive summary?

[Luv2play]

I took from the extract that protection from Monkeypox by the vaccine being used is still being assessed but it seems that having received smallpox vaccinations in the past and now this vaccine help raise the antibodies needed to fight possible infection.  

[Luv2play]

I saw a review yesterday on RM where the client blamed the provider for giving him Monkeypox. Viewers in the US may not see this comment but only the negative two star rating. It was an LA provider.

[SirBillybob]

50 minutes ago, EZEtoGRU said:

Could you help us non-medical folks with a brief executive summary?

The manuscript abstract is a good summary and I don’t know how I would word it differently, but I will try to find time to read the paper more attentively and make sense of the figures. I am particularly interested, like @Luv2play, in the SPXV vaccination history advantage as I received it as a child and 12 weeks ago (already!) one full MVA-BN dose.  I believe the research team has high and credible stature in the Infectious Diseases science realm.

Edited September 2, 2022 by SirBillybob

[SirBillybob]

3 hours ago, SirBillybob said:

The manuscript abstract is a good summary and I don’t know how I would word it differently, but I will try to find time to read the paper more attentively and make sense of the figures. I am particularly interested, like @Luv2play, in the SPXV vaccination history advantage as I received it as a child and 12 weeks ago (already!) one full MVA-BN dose.  I believe the research team has high and credible stature in the Infectious Diseases science realm.

Well it’s extremely detailed and geared to the Immunology/Virology academic crowd. It also focuses on Vaccinia Virus and Modified Vaccinia Ankara neutralization by MVA-BN vaccine in addition to the antibodies generated against Monkeypox Virus by the MVA-BN vaccine. The sample numbers are low. 

I take from it that immunity for all MVA-BN vaccine recipients falls short of the immunity conferred by actual Monkeypox infection. There may be some advantage to current vaccination for those that have a history of Smallpox vaccination but the degree of protective immunity lacks equivalency to acquiring and recovering from currently circulating Monkeypox. The apparent “strikingly” worrisome finding is poor MPXV antibody yield among MVA-BN recipients (ie, generally born later than early 1970s) with no history of Smallpox vaccination. There is lacking research data on comparative infection risk for younger vs older. The results do not say anything conclusively one way or another about withholding of 2nd dose for childhood vaccinees. 

The article further underscores the imperative of fractional dosing research. It may also support the agenda of randomized control trials for efficacy, a concept so far avoided, wherein cohorts will be divided between vaccination and placebo, given the suggestion of poor vaccine immunogenicity that itself overrides ethical objection to the type of gold standard approach usually employed including for COVID vaccine development. One such trial has been registered in Spain.

Edited September 2, 2022 by SirBillybob

[EZEtoGRU]

Thanks for the summary SBb.  There seem to be a lot of questions around the usefulness of the current vaccine...particularly among younger folks that didn't get the smallpox vaccine years ago.  Also questions about the dosage regimen.

[SirBillybob]

I tried to pick the slide out of many dizzying figures that will generate the most buzz. The Monkeypox neutralizing antibody titres (though very small therefore non-representative samples), as you can see, are much lower for the younger recipients of MVA-BN (aka Imvanex as it’s Europe). I do believe that the time series is not within-group, but based on a random selection of 33 samples across the vaxx trajectory. In other words, for the older folks on the left, for example, the 3 samples at baseline are not from the same 3 people as measured at 8 weeks. But it shows the trend. 

Edited September 2, 2022 by SirBillybob

[+ newatthis]

3 hours ago, Luv2play said:

I saw a review yesterday on RM where the client blamed the provider for giving him Monkeypox. Viewers in the US may not see this comment but only the negative two star rating. It was an LA provider.

Wait...he caught monkeypox from the provider and still awarded him 2 stars?  Must be one hell of a provider.  Can we have his name 😉?

Edited September 2, 2022 by newatthis

[Luv2play]

1 minute ago, newatthis said:

Wait...he caught monkeypox from the provider and still awarded him 2 stars?  Must be one hell of a provider.  Can we have his name 😉?

Well he said he matched his pics ( and he was a good looking stud in the RM ad). And said somewhat relaxing as I recall. 

As I think about it, it's only the client's allegation and not proved. There is the other side and maybe the provider will respond.

Also the provider may not have realized his condition at the time of the meeting.

I am reluctant to identify the provider on this forum. Anyone can look him up on RM if they can read the comments.

[Kevin Slater]

8 minutes ago, Luv2play said:

I am reluctant to identify the provider on this forum. Anyone can look him up on RM if they can read the comments.

Good call, as that would likely be a violation of the no personal information rule.

Kevin Slater (qua moderator)

[Luv2play]

2 minutes ago, Kevin Slater said:

Good call, as that would likely be a violation of the no personal information rule.

Kevin Slater (qua moderator)

Also I feel there are two sides to every story and we only had one side. I understand the review may have been deleted.

[SirBillybob]

21 minutes ago, Luv2play said:

Also I feel there are two sides to every story and we only had one side. I understand the review may have been deleted.

There’s a potential indirect upside advertising advantage as he has, or will have, cleared infection, rendering further transmission remote to nil. 

[+ nycman]

6 hours ago, SirBillybob said:

This preprint on MVA-BN immunogenicity should generate some attention and controversy. You can probably find a blurb on the gist of it on Bloomberg or other current media.

https://www.medrxiv.org/content/10.1101/2022.08.31.22279414v1.full.pdf

Holy crap that article hurt my brain.

My 2 second "Hooboy Journal Club" analysis:

The “n" values used in these studies were incredibly small.

They didn’t control for the HIV status of the subjects. Which we all know has a huge impact on antibody response to vaccination. I’m actually assuming that I must have missed that somewhere in the article, because without that information, their data is basically worthless. 

They make the assumption that everyone born before 1974 was vaccinated for smallpox and that every born after 1974 wasn’t. Which we know not to be true. 

That previously smallpox vaccinated patients have a more robust response to the monkeypox vaccine is a surprise to no one. Dog bites man. It’s not news. 

We have no idea what titer of neutralizing antibodies is required to make someone "immune". Furthermore, we have no idea if complete "immunity" is crucial to containing the pandemic. (spoiler alert, I don’t think it is).

From their own mouths:  "At this moment it is unclear what the relatively low MPXV neutralizing titers mean for protection against disease and transmissibility."

At the end of the day, the proof is in the pudding. Vaccination is having a huge impact on decreasing the incidence of Monkeypox in the current outbreak. And the vast majority of Monkeypox cases in the current outbreak were born after 1974. Yes, there are other factors (e.g. change in sexual behaviors, Monkeypox may be burning it self out in the ‘slut" population, etc.) but I’m betting it’s 95% due to vaccination. 

I don’t find this weak study to particularly useful in the real world. 

(How did I do prof?)

Edited September 2, 2022 by nycman

[+ nycman]

2 hours ago, SirBillybob said:

But it shows the trend. 

Now you’re just showing off and trying to get @Kevin Slater horned up.

grin

[Luv2play]

I imagine the frequency one has sex with multiple partners is a huge determinant of who is likely to come down with Monkeypox. And men who have sex with men in the under 50 crowd, those born after 1974, have been the majority of cases.

It is my experience over more than four decades going back to before AIDS. that younger men in group settings, gravitate to other younger men. Et voila, more cases.

[SirBillybob]

2 hours ago, nycman said:

Holy crap that article hurt my brain.

My 2 second "Hooboy Journal Club" analysis:

The “n" values used in these studies were incredibly small.

They didn’t control for the HIV status of the subjects. Which we all know has a huge impact on antibody response to vaccination. I’m actually assuming that I must have missed that somewhere in the article, because without that information, their data is basically worthless. 

They make the assumption that everyone born before 1974 was vaccinated for smallpox and that every born after 1974 wasn’t. Which we know not to be true. 

That previously smallpox vaccinated patients have a more robust response to the monkeypox vaccine is a surprise to no one. Dog bites man. It’s not news. 

We have no idea what titer of neutralizing antibodies is required to make someone "immune". Furthermore, we have no idea if complete "immunity" is crucial to containing the pandemic. (spoiler alert, I don’t think it is).

From their own mouths:  "At this moment it is unclear what the relatively low MPXV neutralizing titers mean for protection against disease and transmissibility."

At the end of the day, the proof is in the pudding. Vaccination is having a huge impact on decreasing the incidence of Monkeypox in the current outbreak. And the vast majority of Monkeypox cases in the current outbreak were born after 1974. Yes, there are other factors (e.g. change in sexual behaviors, Monkeypox may be burning it self out in the ‘slut" population, etc.) but I’m betting it’s 95% due to vaccination. 

I don’t find this weak study to particularly useful in the real world. 

(How did I do prof?)

I think yours is the 1st critique. I didn’t think I was analyzing the article. Rather, I was responding to a request to try to summarize key points. But you can always go on Twitter where the article is being discussed somewhat and add your ‘two cents’, a colloquial expression not a commentary on your opinions’ value. 😉

I think “healthy” (in title) usually means no confounding by an underlying medical condition such as HIV.

I thought they pointed out the lack of evidence of vaccination history based solely on age, and that it was an inference. But I think testing for Vaccinia titres was one way that inference was supported. But also look again at the slide and the pre-MVA-BN baseline titres for older age that seem to be explained by Smallpox vaccine cross-reactivity wrt to Monkeypox. 

I may be wrong, but I wasn’t aware of previous evidentiary support for an expected more robust response among Smallpox vaccinated relative to non-vaccinated. I thought there was evidence of an immunogenic response to Smallpox  (not MPXV) from MVA-BN investigated in another article earlier in this thread looking at 1 versus 2 doses among older Smallpox vaccinated but that the antibody titres, as you yourself and others will say, had yet to be correlated with immunity to an exposure. And in Africa (DRC) MPXV outbreaks the attack rate was less. But no previous comparison of MPXV-specific humoral response to MVA-BN between the older presumably vaccinated and younger Vaccinia-naïve. Perhaps the recent unsurprising difference doesn’t nullify the value in exploring it. 

I didn’t think that the authors alluded to uptake rates for achieving control. If the not unreasonable idea that lower levels of uptake may adequately suppress incidence and spread, unlike say for CoV, then the fractional dose strategy for aiming for hypothetical coverage of 100% of MSM may be overkill in the interest of getting it to all of this sub-population but at the expense of immune response. But who can know the ideal sweet spot of dose frequency/quantity and uptake percentage? Again, about 20% targeted uptake in Canada at one dose for the ‘immunocompetent’ and two doses for immunocompromised category seems to have an effect on incidence, though an uptick of reported cases past few days. 

Edited September 3, 2022 by SirBillybob

[xavier32]

I got my first vax shot in SD. Very good experience at Sharp hospital via the Myturn California sign-up site. No invasive questions and really friendly and professional staff.  The itch is annoying but not a big deal. Hope the numbers continue to go down!

[+ Axiom2001]

On 7/21/2022 at 7:31 PM, glutes said:

For those who have been vaccinated re. Monkeypox, is any documentation given to you?

At the agency in San Francisco, I had to complete a brief questionnaire electronically while awaiting my appointment.  It was rather innocuous.