WASHINGTON—U.S. Senator Chris Murphy (D-Conn.) spoke on Wednesday at a U.S. Senate Health, Education, Labor, and Pensions Committee hearing on the federal response to the spread of Monkeypox with Centers for Disease Control and Prevention (CDC) Director Dr. Rochelle Walensky and Director of the National Institute of Allergy and Infectious Diseases (NIAID) Dr. Anthony Fauci.

Murphy highlighted the challenges the CDC faces in access to data, including data related to Monkeypox: “[O]utside of emergency authorities, you’re stuck in a position today in which you have to negotiate fifty different data sharing agreements with states all over the country. And we expect a lot of the CDC, but it's hard to expect too much of the CDC when you don’t have the authorities, as I understand it, to get the data you need absent an emergency. And when we look at what’s happening today with Monkeypox — you’re getting data, but it’s patchy. For instance, you’re not getting full demographic data. So there’s a lot of states that aren’t reporting to you, for instance, breakdowns of cases on race or ethnicity, and that really hurts our ability to target who gets the vaccine, who gets resources.”

“I would just much rather have you be in the business of fighting the public threats presented to the country than in constant negotiation over data sharing agreements. It just seems like an essential function of the federal government to set up a uniform way in which you get data, rather than putting you in the position of negotiating over, and over, and over again these data use agreements,” Murphy added.

In a question to Dr. Fauci, Murphy asked about how to best communicate information regarding the Monkeypox vaccine: “I just want to talk a little bit about what we learned, what you learned over the course of the information distribution campaign for the COVID vaccine, and how that relates to what we are communicating about JYNNEOS [an approved Monkeypox vaccine]. Because there’s been some amount of information regarding questions about the level of protection, the duration of the immunity when it comes to the Monkeypox vaccine.”

Murphy, along with U.S. Senators Time Kaine (D-Va.) and Tammy Baldwin (D-Wis.) introduced the Improving Data Accessibility Through Advancements Act, legislation to modernize our nation’s public health data infrastructure at the CDC. This bill would increase timely and accurate information sharing between local, state, and federal public health departments and other health care entities like hospitals and laboratories to improve our preparedness and response to emerging public health threats.

You can read Murphy’s full exchange with Walensky and Fauci:

MURPHY: “I’ll recognize myself for questions. I have two, one for you Dr. Walensky, and one for Dr. Fauci.

“Dr. Walensky, one of the things I panic about is your access to data. And you’ve talked to this committee about it, we’ve talked personally about it, but outside of emergency authorities, you’re stuck in a position today in which you have to negotiate fifty different data sharing agreements with states all over the country.

“And we expect a lot of the CDC, but it's hard to expect too much of the CDC when you don’t have the authorities as I understand it, to get the data you need absent an emergency. And when we look at what’s happening today with Monkeypox — you’re getting data, but it’s patchy. For instance, you’re not getting full demographic data. So there’s a lot of states that aren’t reporting to you, for instance, breakdowns of cases on race or ethnicity, and that really hurts our ability to target who gets the vaccine, who gets resources.”

“So, certainly in the context of Monkeypox, but maybe more broadly, what position does it leave you in when you don’t have the authorities to be able to compel states in a uniformed way to get you good data?”

WALENSKY: “Thank you senator, and thank you for the question and for your leadership in working with Senator Kaine, Senator Baldwin in trying to get us the authorities so that we can provide these data to you. We have been working closely, tirelessly, with state and local public health staff who have been doing the same to extract data on this outbreak specifically.

“We’ve actually negotiated now 61 data use agreements. We’ve navigated bureaucratic approvals for data to get flowing. We’ve set up voluntary arrangements directly with large commercial labs to send their data, but it's been hard, and it should not be this hard and if we can’t make informed decisions based on the best possible data coming into us, we’re not making the best decisions for the American people.

“The existing patchwork of data systems is not working. It’s not working to the best ability of the American people. For Monkeypox specifically, I can tell you that I don’t know the total number of people hospitalized with Monkeypox, the data on laboratory testing in the United States, complete demographic data, as you noted, which people with Monkeypox have been vaccinated. We can’t link the Monkeypox vaccine to the laboratory data. And demographic data, as you noted, we get 27% of our demographic data on testing, we’ve received 47% of our demographic data on cases, and 91% of our demographic data because of these data use agreements on vaccination.

MURPHY: “I would just much rather have you be in the business of fighting the public threats presented to the country than in constant negotiation over data sharing agreements. It just seems like an essential function of the federal government to set up a uniform way in which you get data, rather than putting you in the position of negotiating over, and over, and over again these data use agreements, and my hope is that soon, we’ll be able to find a consensus on that here. It’s scary that you don’t know how many are hospitalized for the Monkeypox today because of your inability to get that data.

“Dr. Fauci, in the minute and a half remaining, I just want to talk a little bit about what we learned, what you learned over the course of the information distribution campaign for the COVID vaccine, and how that relates to what we are communicating about JYNNEOS. Because there’s been some amount of information regarding questions about the level of protection, the duration of the immunity when it comes to the Monkeypox vaccine.

I don’t know if this was necessarily your fault, but in the euphoria of the sort of early news of the COVID vaccine, we probably got out a little bit ahead of ourselves in terms of what level of protection it could provide. So, what did we learn about how to talk about a vaccine in its early distribution stages? And how does that inform how we should talk about the Monkeypox vaccine?”

DR. FAUCI: “Well, first of all, they are two entirely different pathogens and the response and the durability of response to each is really quite different.

“It was a rather unique situation with COVID vaccine where there was no doubt that the initial protection against symptomatic disease, as well as severe disease, was well into the 90s. That was the really good news. The sobering news was the durability of protection, particularly against infection and symptomatic disease.

“Fortunately, the durability against severe disease lasted. But if you look at coronaviruses in general, which is usually a good parameter of what the response to a vaccine is, even with a coronavirus infection, the durability of protection against reinfection long before COVID came along, just the typical common coronaviruses, did not last very long and we see instances of reinfection with the same coronavirus.

“That poses a very different situation, which leads to the need for and the importance of updating vaccines and giving the boosters that are part of the regimen in addition to the primary regimen.

“When you’re dealing with a pox virus, inherently pox viruses have a much greater durability of protection. We know that because smallpox itself once you get infected, you’re essentially protected for life against reinfection. Once you get vaccinated with the standard smallpox vaccination, you can be sure that the durability is measured at least in decades and maybe lifetime.

“What we’re dealing with now with JYNNEOS is that it likely is going to have durability of protection if you get the two doses. Not just one. We want to make sure people get their two doses. The durability very likely is going to be much greater than that shortened durability of the COVID, because they are really fundamentally two different viruses.”

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