Racial disparities revealed in monkeypox vaccination data

State numbers show 71% of virus cases among Black men, but they received only 44.5% of vaccines

State data posted Wednesday shows that the monkeypox epidemic continues to disproportionately affect Black men, even while Black men are vaccinated at a rate that lags far behind their rate of infection.

According to state Department of Public Health data posted Wednesday, 71% of all monkeypox cases to date have been among Black men.

Meanwhile, DPH indicated that 13,049 people have been vaccinated and 5,803 or 44.5%, were Black.

The data also shows that 44.7% of all vaccines have gone to white people, while only 12% of cases were among white people.

The gap — 44.5% vs. 71% — “says we’re not meeting the needs of Black men — and because we’re not meeting the needs of Black men, we’re not meeting the needs of public health as a whole,” said Dr. Melanie Thompson, an HIV physician and researcher. “It shows we need a better strategy to make the vaccine available to Black men.”

The numbers are “jarring but not surprising,” said Larry Walker, executive director of ThriveSS, an organization serving Black men living with HIV, the virus that causes AIDS. ThriveSS is one of the community organizations the state, Fulton and Dekalb counties have partnered with to target the limited supply of the vaccine to the population most in need of protection from the virus.

“We need to go harder, to make sure the distribution of access for Black and brown people is improved,” said Walker.

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The equity issues in the vaccination response to monkeypox come to light as Georgia’s total number of cases topped 1,000 Tuesday -- the fifth-highest amount in the nation, and the second-highest number of cases as a share of the total population.

Similar disparities have been seen in other states, including North Carolina, where 70% of cases have been among Black people, while only 22% of vaccine doses have reached this population.

Monkeypox can affect anyone, according to DPH, but so far mostly affects men who have sex with men. It can spread through prolonged skin-to-skin contact, respiratory droplets, and handling bedding or clothing of an infected person. DPH advises that, while contact with fabric or surfaces that have previously touched the monkeypox rash or body fluids is one way the virus spreads, that avenue of exposure has not been identified as a common mode of transmission in this outbreak or for monkeypox in general.

Dr. Thompson, who has overseen hundreds of HIV research studies, said the equity issues highlighted by the state monkeypox data are “the same story” as seen in HIV, where new cases disproportionately occur among Black and brown people, and treatment disproportionately goes to white people. “We have health disparities in Georgia in almost everything you look at. There’s no safety net ... and a long-standing system of inequities.”

Credit: Steve Schaefer

Credit: Steve Schaefer

One thing that’s needed is “to meet people where they are,” said Dr. Jonathan A. Colasanti, medical director at Grady Health System’s Ponce De Leon Center. At Grady, the majority of patients are Black; since the hospital obtained the monkeypox vaccine July 27, 78% of 582 shots have gone to Black people, he said.

“If you put the vaccine in places where the population is, you’ll vaccinate the population you’re after,” said Dr. Colasanti.

Walker said that ThriveSS has been working with the state, Fulton and Dekalb counties to link people to vaccination events, and has maintained a waiting list that grew to 1,000 people until several hundred were able to obtain vaccines earlier this week.

Public health authorities have been speaking with ThriveSS and other community organizations to figure out how to get medically-trained personnel and vaccine doses into those organizations, and so remove additional barriers that may exist for people who can’t or won’t go to public health facilities, he said.

The nonprofit director also said that many more partnerships between state, county and community should be made, including religious institutions, club promoters and others, to spread information about the virus itself and how to obtain the vaccine. “There are huge networks out there that far exceed any one agency,” he said.

DPH has also launched a scheduling tool on its website to help people access the vaccines: dph.ga.gov/monkeypox, and a number to schedule vaccinations: 888-457-0186.

Meanwhile, Dr. Thompson hailed the state for releasing caseload and vaccination data, including race and ethnicity, which the DPH said would be posted every Wednesday moving forward. This will allow “public health leaders to act on data in real time,” she said.

“You have to reach the most impacted population with the greatest amount of resources,” she said. “Black men do not exist in a bubble, and this matters to the wider population.”

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