Mpox resurges — with a new, deadlier strain

Oct 11, 2024

PROGRAMMING NOTE: We’ll be off this Monday for Indigenous Peoples Day but will be back in your inboxes on Tuesday.

Driving The Day

A box of Jynneos monkeypox vaccine vials by Danish vaccine developer Bavarian Nordic.

Despite the availability of the mpox vaccine, Jynneos, a new strain has claimed the lives of hundreds of children in Africa. | Pascal Guyot/AFP via Getty Images

A MORE LETHAL MPOX — Two years after containing the first global mpox outbreak, the world faces a new challenge: a more virulent strain that’s already killed more than 900 people, mostly African children, our Carmen Paun reports.

Missteps by the World Health Organization, a vaccine manufacturer and an African country led to another health emergency, experts say.

U.S. federal authorities responded to the first outbreak with a vaccination campaign targeted at those most at risk. In 2023, it offered some doses of the vaccine it used, Jynneos, to some African countries where mpox is endemic. Until recently, leaders of the Democratic Republic of the Congo, the epicenter of this year’s outbreak, refused to accept donated vaccines that the World Health Organization hadn’t yet endorsed.

Now, federal government officials believe the new strain could arrive in the U.S. at any time.

“There’s plenty of blame to go around in terms of what could be done and how things could be done differently. But every single one of us needs to be asking that question,” said Maria Van Kerkhove, the WHO’s incident manager for the global mpox response.

The WHO and the producer of the mpox vaccine are pointing fingers at each other for the delay in reassuring the DRC and other developing countries that the shot is safe and effective. The WHO signed off last month.

DRC officials didn’t respond to repeated requests for an interview, but a leading African health official said it was part of the legacy of mistrust between Africa and the West that the WHO, an arm of the United Nations, could have done more to relieve.

Paul Chaplin, CEO of the Danish maker of Jynneos, Bavarian Nordic, said the company asked the WHO for approval in March 2023. That would have allowed countries that hadn’t yet approved it on their own, such as the DRC, to import it.

But Van Kerkhove said the WHO didn’t receive all the needed information from Bavarian Nordic until late August. Chaplin said nearly a year had passed before the WHO asked for the additional details.

Van Kerhove rejected that assertion.

What’s next: Dr. Jean Kaseya, director-general of Africa CDC, said DRC officials were waiting for the WHO’s assurance that the vaccine was safe and effective.

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Medicare Advantage

A UnitedHealthcare Group Medicare Advantage PPO card rests on top of a Medicare card

The percentage of Medicare Advantage plans with high-quality ratings has significantly decreased for 2025. | Jenny Kane/AP

MA STAR RATINGS DIP — Fewer older Americans are in Medicare Advantage plans with a high-quality rating of four or more stars, according to new federal data.

CMS released 2025 star-ratings data Thursday for Medicare Advantage and drug plans ahead of MA open enrollment, which starts Oct. 15. The agency rates MA plans on a scale of one to five stars based on how well they meet several quality measures such as customer service, POLITICO’s Robert King reports.

But the agency tweaked the star-rating formula starting this year, which has led to overall declines in the number of plans with high ratings. Other factors include prior plan performance on quality measures.

Approximately 62 percent of MA members are in a plan with a rating of at least four stars in 2025, down from 74 percent for this year.

There will also be far fewer five-star plans for 2025, with only seven available, down from 38 this year.

Why it matters: The ratings don’t just help older Americans pick a plan, but they also determine the amount of quality bonuses that plans get.

UnitedHealth Group is taking legal action to avoid what it calls an unfair decline in its ratings. Several of the insurer’s subsidiaries filed a federal lawsuit in Texas last week, arguing that CMS erred in the calculation.

VETERANS' HEALTH

ISSUES PERSIST WITH VA TECH OVERHAUL — The lone facility not subject to the VA’s pause of new rollouts of its electronic health record overhaul saw improvements from previous missteps but still encountered difficulties, a report obtained by POLITICO said, Ben reports.

The backstory: The implementation at Captain James A. Lovell Federal Health Care Center — a Chicago joint-VA/Defense Department facility — began in March. VA officials have said continuing with the Oracle Cerner software at other facilities will partly hinge on the Lovell transition.

The project is billions over budget and has been linked to at least four veterans' deaths. It’s been on pause since April 2023.

The findings: The VA report found the transition was “much less negative” than previous ones, but patient safety issues persisted, as well as problems with usability, training and increased wait times.

“Lovell also had a tremendous amount of national support and support from other centers; this level of support is most likely unsustainable as multiple sites simultaneously undergo [modernization],” the report from a VA research arm found.

VA press secretary Terrence Hayes would not comment on the document but told Pulse that the agency is “committed to getting this implementation right and ensuring the delivery of high quality, safe — and efficient health care to our nation’s Veterans — we will never settle for anything less.”

Oracle Cerner didn’t respond to requests for comment.

2024 ELECTION

YOUNG WOMEN TUNE INTO HARRIS’ ABORTION MESSAGE — Since Vice President Kamala Harris became the Democratic presidential nominee, abortion has become the most important issue for women under 30 — surpassing inflation for that age group, according to a new survey out today.

KFF, a nonprofit health policy research group, followed up with a sample of more than 1,300 nationally represented women they had polled in June before President Joe Biden exited the race — and saw a significant shift in voting issues. Just over 670 women participated in the second survey.

Four in 10 women voters now say abortion is the most important issue, doubling the share from June. Inflation remains the top issue for women overall, as well as Black and Hispanic women.

Among their findings:

— Democratic women under age 50 are twice as likely to say they trust Harris “a lot” to discuss issues related to abortion.

— 3 in 4 women voters say they believe former President Donald Trump, if elected, would sign a national abortion ban. Trump has said on social media he would veto a ban, favoring a leave-it-to-the-states approach. Two-thirds of women voters say they would oppose a national ban, while 6 in 10 Republican women say they’d support one.

— 9 in 10 Democratic women and 3 in 4 Republican women say they believe Harris, if elected, would sign a law restoring Roe v. Wade.

— 58 percent of women voters say they trust Harris “to do a better job” on deciding abortion policy compared with 29 percent for Trump.

Public Health

EARLY COVID IMPACTS LINGER — Unvaccinated people who got Covid-19 early on in the pandemic have a heightened risk of heart attack, stroke and death three years later, according to a new NIH-funded study.

Why it matters: Prior research has shown that people who became infected with Covid are at a higher risk of a cardiovascular event, but this is the first to show impacts lingering years later.

The study of more than 10,000 European patients found that, compared with people who had no infection history, those who got sick when the original virus strain was circulating had double the risk of cardiovascular events — and those with severe cases had nearly four times the risk. All patients tested positive for Covid between February and December 2020. None had been vaccinated.

Other details: The study also suggests that blood type might play a role: Hospitalized patients who had severe Covid before vaccine availability tended to have A, B or AB blood types. Patients with type O blood appeared to be associated with less severe cases.

“Given that more than 1 billion people worldwide have already experienced COVID-19 infection, the implications for global heart health are significant,” study leader Hooman Allayee, professor of population and public health sciences at the University of Southern California Keck School of Medicine in Los Angeles, said in a statement. “The question now is whether or not severe COVID-19 should be considered another risk factor for cardiovascular disease, much like type 2 diabetes or peripheral artery disease, where treatment focused on cardiovascular disease prevention may be valuable.”

Names in the News

Ivy Weng is now OMNY Health’s first chief commercial officer. Weng joins the health data-sharing company from Komodo Health, where she was group vice president of life sciences.

WHAT WE'RE READING

The Atlantic reports on how vaping might lead to smoking cessation.

POLITICO’s Claudia Chiappa reports on how vaccines can prevent deaths related to antibiotic resistance.

The Associated Press reports that a Florida IV fluid factory was spared the brunt of Hurricane Milton amid a fluid shortage.

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