A group of public health academics is urging Baltimore leaders to speak up and act quickly to curb the rise of monkeypox, warning that the virus already is disproportionately harming the city’s LGBTQ community.
Anyone can get monkeypox, an infectious disease that causes painful lesions, fever, chills, swollen lymph nodes and more. It is painful and can require multiple weeks of quarantine and isolation, but is rarely fatal. Monkeypox spreads through direct or close contact with an infected person and so far in the U.S. has been affecting predominantly men who have sex with other men.
The latest data from the U.S. Centers for Disease Control and Prevention showed nearly 3,000 confirmed cases of monkeypox nationwide, including at least 71 in Maryland. The CDC has acknowledged that supply of a monkeypox vaccine is limited right now, but it’s unclear how many vaccines Baltimore has — and who’s been getting it.
Public health academics and researchers met Monday morning with Mayor Brandon Scott and members of his administration, including Health Commissioner Dr. Letitia Dzirasa and the city’s director of LGBTQ affairs, Londyn Smith-De Richelieu.
In a statement, Dzirasa said the state allocated over 200 doses of monkeypox vaccine for the city of Baltimore so far, though she did not say how many had been administered or how many remain. Dzirasa said equity is at the core of the city’s approach to handling monkeypox.
“We understand the frustration of city residents who do not have equal access to vaccines as those in neighboring states and territories, and we have been working with our state and federal partners for weeks to increase supply here in Maryland and more specifically Baltimore,” the statement said. “As has also been noted publicly, allocations were determined by the CDC based on a formula for each state. We anticipate additional supply in the coming weeks. However, until that happens, we must work to match equity with access to such an extremely limited supply of vaccine.”
Tom Carpino, a doctoral student at Johns Hopkins Bloomberg School of Public Health who is researching stigma, sexually transmitted infections and HIV in LGBTQ communities, said it was an informative meeting but lacked transparency.
As a gay man and a public health professional, Carpino said he felt compelled to speak up and raise awareness about monkeypox. He’s the lead author of a letter signed by 12 researchers and academics connected to Johns Hopkins University and the Bloomberg School that calls for equitable vaccine access — especially within the LGBTQ community.
“Across the country, monkeypox has been met with a lack of urgency, coordination, and challenges for testing, vaccination, and treatment. We see Baltimore as uniquely poised to lead in how to best combat this outbreak,” they wrote. “Baltimore’s awareness of its own deep-seated inequities positions the city to preempt the inequities existing in other cities’ efforts, where vaccines are disproportionately accessed by white, higher-income, cisgender men.”
In order to design an equitable vaccine program, Carpino said the public needs to know how many vaccines are being administered and who is receiving them.
“I think the first step in talking about equity is understanding the scope of what the supply is,” Carpino said.
Carpino said city officials offered no clarity on how or when Baltimore will receive more vaccines, and while they pledged to advocate for more doses, there were few details on what that would look like.
Carpino said the city health department held a pop-up site Saturday night at the Central Bar where 20 people signed up for vaccination appointments.
“That’s wholly insufficient,” Carpino said. “That’s nowhere near where we need to be.”
Arinze Ifekauche, a spokesperson for the Baltimore City Health Department, said there were three pop-up sites at bars Saturday night and that 60 people total signed up for vaccine appointments.
Dzirasa, the health commissioner, responded to the letter written by Carpino and the academics, urging the authors to reach out to officials at the state-level.
The health department issued a release Monday afternoon saying Dzirasa will hold a briefing at Chase Brexton Health Care’s Mt. Vernon Center Tuesday morning about the city’s response to monkeypox. Chase Brexton Health Service, a longtime provider of health care for the LGBTQ community, is holding an appoint-only vaccine clinic on Tuesday and Wednesday, and every slot has already been filled.
According to Chase Cook, spokesperson for the Maryland Department of Health, the state has received 3,363 doses of the Jynneos vaccine for monkeypox. Cook said Maryland is following federal guidance and has distributed 3,000 of those vaccines to local health departments, saving the remaining 363 doses for “other jurisdictions as needed.”
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While Maryland, like other states, expects to get more doses from the federal government, Cook said the state does not know when that will be.
Federal health officials said in a news briefing last month that they are using a tiered allocation system for hundreds of thousands of vaccine doses that prioritizes places with the most cases, which includes California, Florida, New York and Washington, D.C.
They expect to deploy 1.6 million doses of Bavarian Nordic’s Jynneos vaccine, which can be used before or after exposure, before the end of the year. Some are already in the national stockpile, but most are not yet packaged or produced, The Baltimore Sun reported earlier this month.
Keri Althoff is an epidemiologist at the Johns Hopkins Bloomberg School of Public Health and also signed the letter to city officials. According to Althoff, Maryland had a “sputtering” start to its testing availability, but many local hospitals are now doing in-house testing.
“It is concerning that there is not more transparency about where the vaccine doses are,” Althoff said.
The disease is starting to spread more widely, but Althoff said advocates are trying to highlight the experiences of people in the LGBTQ community who continue to be impacted disproportionately by monkeypox. City and county health departments need to do far more to raise awareness about the disease, she said.
“It’s here. It’s spreading,” Althoff said. “We’re starting to see signals it’s spreading to other communities as well.”