Early data shows monkeypox disproportionately affecting Black men

Monkeypox vaccines continue to arrive but can’t keep up with demand.
Getting ready for Friday morning's monkeypox vaccination at the North Dekalb Health Center in Chamblee on August 5, 2022. Steve Schaefer / steve.schaefer@ajc.com)

Credit: Steve Schaefer

Credit: Steve Schaefer

Getting ready for Friday morning's monkeypox vaccination at the North Dekalb Health Center in Chamblee on August 5, 2022. Steve Schaefer / steve.schaefer@ajc.com)

Monkeypox in Georgia is infecting an overwhelming number of Black people compared to other races — a disproportionate effect not anticipated just a few weeks ago, new data from the Georgia Department of Public Health show.

Dr. Jonathan Colasanti, an infectious disease specialist, says it’s important people know the virus is most heavily affecting communities of color — and that those already infected have access to testing, treatment, and vaccines.

“A few weeks ago when this was circulating in Europe, this wasn’t even being talked about in our communities of color. And I think there was an initial perception that this was in, largely white communities and white, gay and MSM (men having sex with men) communities,” said Colasanti, who is also the medical director of Grady Memorial Hospital’s Ponce De Leon Center, a comprehensive program dedicated to serving those living with or affected by HIV.

“But I just want our folks here at home to know that that’s absolutely not the case. ... And at this point in Atlanta, (monkeypox is) very heavily concentrated within communities of color, based on the early epidemiologic data we have.”

By Wednesday, confirmed cases in Georgia had climbed to 749 and includes eight women, according to DPH. The actual number is likely far higher.

Data from DPH, available for 74% of the cases, shows this racial breakdown: 82% Black people, 14% white, under 1% Asian; multiracial and “other” accounted for a total of about 3%. The total includes 6% Hispanic people.

Nathan Townsend, manager of prevention services for NAESM, an organization that works to address health issues of gay Black men, has been working to get individuals vaccinated against monkeypox. For him, it was no surprise that most of the state’s monkeypox patients are Black.

“We see that kind of disparity across all health outcomes when it comes to African Americans. Health equity is just not there. It’s because we don’t access services for a myriad of reasons, we’re distrusting of the health community. So, even with the vaccinations, there are people who are undecided,” said Townsend, who is Black.

He says that because of this, local health departments have taken steps to ensure that at-risk populations receive vaccines.

“They have isolated certain days for community-based organizations who have access to high-risk populations to enroll their people, so they don’t have to go to mass vaccination clinics or go on-site and not be able to enroll … which ensures that we’re reaching high-risk populations,” said Townsend.

Different patterns are taking shape across the country. Overall in the U.S., according to a CDC report based on available monkeypox case data, more than half of the cases (54%) were among Hispanic and Black people, a group that represents about a third of the general U.S. population. In New York City, according to the city health department, 30% of cases are among white people, 19% among Hispanic people, and 11% are among Black people. In 35% of cases, the race is unknown.

In Georgia, the overwhelming majority of cases are in metro Atlanta, but cases have been diagnosed in 25 counties outside metro Atlanta. Nearly 99% of the cases are among men, and the majority of the cases are among men who have sex with men, according to DPH. The age range is 18 to 66, with a median age of 34.

The racial breakdown is “unacceptable but unfortunately not surprising,” said Dr. Felipe Lobelo, an epidemiologist at Kaiser Permanent of Georgia and an associate professor at the Emory University School of Public Health.

Lobelo said the data spotlights longstanding racial and ethnic disparities in access to care for everything from HIV to COVID-19.

“But as with COVID, social determinants of health are going to continue to drive racial disparities with every new emerging public health threat,” he said.

He said the DPH data on the racial breakdown of cases, “should underscore even more that the public health and medical response to the (monkeypox) outbreak in Georgia and the country needs to be anchored on equitable care.”

While nearly all cases to date have been among men who have sex with men, according to the CDC, health authorities emphasize anyone can catch monkeypox. The health officials also say the virus could begin to spread more broadly.

Last month, the CDC confirmed the first U.S. cases of monkeypox in children: a toddler in California, and an infant whose family was traveling in the District of Columbia. The children, who are in good health, have symptoms and are receiving antiviral treatment according to the CDC. The pediatric cases are likely the result of household transmission, according to the agency.

The virus is spread primarily through prolonged skin-to-skin contact. Touching items that previously touched the infectious rash or body fluids is one way monkeypox spreads, but DPH said in a statement that that has not been identified as a meaningful or common mode of transmission in this outbreak or for monkeypox in general.

Meanwhile, monkeypox vaccines continue to trickle into Georgia but the availability can’t keep up with soaring demand. Georgia DPH has added more information about county health departments offering the vaccine on its website, but available appointments are filling up within hours, sometimes minutes.

The U.S. Department of Health and Human services says Georgia has ordered 25,782 vaccines of the 47,996 it has been allocated. DPH spokeswoman Nancy Nydam said the state is not allowed to order its entire allocation at once and must wait until Aug. 15 to place its next order, which will be for 10,236 doses. After that, Nydam said, Georgia will have to wait for the go-ahead from HHS to order the remaining doses.

Meanwhile, Nydam said a centralized scheduling system is in the works, and is expected to be ready by Monday. She also said a telephone hotline will be available for people to make appointments in addition to online requests.

Staff writers Donovan Thomas and Ariel Hart contributed to this article.

Monkeypox cases in Georgia

749 confirmed cases, including 8 women. Up from 48 cases less than a month ago on July 13.

Racial and ethnic breakdown of Ga. monkeypox cases

82% — Black people

14% — white

under 1% — Asian

3% — multiracial and “other”

6% — Hispanic people

Provided by the Georgia Department of PublicHealth and based on available race and ethnicity data, which was provided for74% of the cases.