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The particular vaccine (MVA-BN / Imvanex / Jynneos) that has been shown to be effective for monkeypox is administered via injection[1] not scarification. Stored frozen, it has an approved shelf life of 36 months[1]. In 2014 the US had 24 million doses stockpiled[2]; As far as I can tell, the stockpile is around 1 million doses now[3]. 

There are also 100 million doses[3] of the scarifying (ACAM2000) vaccine that hasn't been studied for monkeypox; Stored dry, that has an approved shelf life of 18 months[4]. It is not currently clear to me how much of the stockpile is beyond its expiration date.

If the FDA requires EUAs for the expired vaccines[5], how long that regulatory process will take and how useful vaccination will be by that point are open questions.






The good news is that nurses rarely actually spend as long as that paper suggests for alcohol surface prep. The bad news is that it's short enough to further call the effectiveness into question. At least they aren't using iodine for it any more; I never saw a nurse wait the full 2 minutes that calls for. I don't have the references at hand, but I wonder if chlorhexidine has a fast enough disinfection time to be practical; I know it is at most the same time-frame as alcohol, maybe shorter.

I used to use the same mask that Zvi's friend recommends, but switched to 3M's model 7502 respirator with model 7093 P100 filters. The mask I use is made of silicone and because of that is more comfortable for extended wear and easier to securely fit. The filter cartridges are less visually obtrusive than the pink 'pancake' filters and last longer before clogging (more of a concern for construction work than general covid wear).

I don't have first-hand experience with the GVS Elipse series, but the most compact model looks easier to fit a surgical mask over, should you go somewhere that enforces that bit of theater.

I expect the 1.17x transmission advantage among unvaccinated to mainly be immune evasion as well. One might be able to get a sense of this from existing data by accounting for the proportion previously infected and the degree of protection that conferred toward delta.

I am surprised this writeup didn't mention physical aspects of geophagy. I always thought that tooth-wear was the main hazard of eating dirt. There's plenty of research on geophagy and tooth-wear, both direct like kaolin, and indirect like stone-milled grains which has a big impact in dental specimens in archeology.

40% of whitetail deer had a SARS-CoV2 infection by March 2021. I'd expect it to be predominantly Delta in them too by now. Given the population and reproduction rate of deer, I'd expect the virus to keep circulating in deer indefinitely.

Interested to see a historical analysis of luminous efficacy. Spans 3 orders of magnitude, similar timeframe to other topics covered, and also like other topics here includes many sequential innovations as opposed to mere iteration on a particular technology.

Consider helminthic therapy. Hookworm infection down-regulates bowel inflammation and my parasitology professor thinks it is a very promising approach. NPR has a reasonably good popularization. Depending on the species chosen, one treatment can control symptoms for up to 5 years at a time. It is commercially available despite lack of regulatory approval. Not quite a magic bullet, but an active area of research with good preliminary results.

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