Regional public health experts are fine-tuning their approach to getting the monkeypox vaccine into the arms, even as DC reports a steady decline in new cases.
Monkeypox DC cases decline but public health experts advise caution
“There’s light at the end of the tunnel when it comes to monkeypox in DC,” Mangla said. However, he said officials were “erring on the side of caution” with an aggressive vaccination effort and close monitoring of universities, which could see an increase in cases as students return to campus.
As demand for the vaccine waned in the district, authorities last month expanded eligibility and changed procedures in a bid to reduce stigma associated with a virus that has massively affected men who have sex with men. but can infect anyone. Virginia expanded eligibility guidelines shortly after DC, despite a national vaccine shortage and federal approval of an intradermal injection method to stretch doses.
Several months later a global outbreak of monkeypox, federal data shows nearly 20,000 people had tested positive in the United States as of Thursday. There were 436 cases in the district on Thursday, and 534 in Maryland and 353 in Virginia on Friday, the data showed.
The district, which has received more vaccines than its neighbors, administered nearly 24,000 doses of Jynneos, the only vaccine approved to treat monkeypox.
At one of three walk-in clinics held every Friday, the lunchtime crowd was thin. Over the course of an hour, two men – who both spoke to the Washington Post on condition of anonymity to protect their privacy — received the first doses of the two-dose regimen.
“I was a bit sad not to see more people here,” one man said. He was asked to make an appointment after pre-registering online, but said it was just easier to come to a walk-in clinic on his own schedule.
He praised the smooth process, but wondered if demand was down because people didn’t know where to get vaccinated or couldn’t access sites.
CC public health has removed intrusive questions from the registration process and made the vaccine available to all people of any sexual orientation or gender who have had multiple sexual partners in the past two weeks, in accordance with guidelines from the CDC.
In an effort to learn from their experiences rolling out the coronavirus vaccine, they also quickly recruited community partners to run clinics for those underserved by the medical facility. Blacks also make up a significant portion segment of people who tested positive for monkeypox in the region.
In the District, whites represent approximately 37% of cases and blacks 36%; 55% of those vaccinated are white and 20% are black, according to city data. Maryland case data shows blacks account for 58% of cases and whites for 16%, of which 20% do not report. In Virginia, 39% of reported cases are in blacks and 26% in whites, but whites are much more likely to be vaccinated.
The Biden administration on Friday asked Congress for more than $4.5 billion in emergency funds to respond to monkeypox as part of a broader request for $47 billion.
The National Black Gay Men Advocacy Coalition, which includes Us Helping Us, a DC-based organization that provides medical, behavioral health and social services to black gay and bisexual men and black transgender women, applauded federal efforts to step up the public health response.
“The US public health response has been slow to recognize the impact of MPV in gay and bisexual black men. Our community is paying the price for this inaction,” NBGMAC said in a statement this week. “NBGMAC applauds and honors the resilience of black gay and bisexual men across the country who actively seek testing, vaccination and treatment for MPV, despite unacceptable shortages and other structural barriers.”
Public health officials in Maryland launched a pre-registration system for the monkeypox vaccine this week. The state received 14,539 doses of vaccine and administered 3,470 doses, leaving more than 11,000 doses unaccounted for.
Although infection rates are slowing in some states with larger outbreaks and DC, the CDC reported this week that some states, including Virginia, are “experiencing accelerated growth.”
Virginia distributed 7,741 doses, mostly in Northern Virginia, which has the highest population and highest concentration of cases, according to state data.
Stuart Ray, a professor of medicine in the division of infectious diseases at Johns Hopkins, noted that more vaccines are needed across the country and there aren’t enough tests to catch all the cases.
“When people are worried about getting monkeypox at the grocery store, I say they’re probably fine if they don’t hug or kiss sick customers,” he said. “It’s not a highly transmissible virus, but there are ways to control the risk.”
Monkeypox is transmitted primarily through close skin-to-skin contact.
Although places like DC may see a reduction in cases and demand for vaccines, he said — as with the coronavirus — monkeypox can spread in unprepared communities.
“That’s one of the reasons I wouldn’t want to be the CDC director,” Ray said. “Great preparation makes this look like a non-event. The challenge here is that it could burn out, but it could also kick into high gear and we don’t know which direction this virus is heading.
