Although 60% of people who have had monkeypox in Michigan so far have been black, 70% of the vaccine doses that can prevent infection or limit symptoms after exposure have gone to people Michigan whites.
Black residents have received only 17 percent of the doses administered so far in Michigan, new data from the state health department show.
And when the first doses of Tecovirimat, the antiviral treatment better known as Tpoxx, arrived in Michigan, Oakland and Washtenaw counties, not Detroit, a predominantly black city that has 38 percent of Michigan’s known smallpox infections, say Dr. Shira Heisler. , a physician at Wayne Health and medical director of the Sexually Transmitted Disease Clinic at Detroit Public Health.
“There is no way to physically get” viral treatment for patients in need
These are among the inequities fueled by an underfunded public health system already battered by the COVID-19 pandemic, a growing number of sexually transmitted diseases and recently stressed by the world’s largest monkeypox outbreak, Heisler said.
In those early weeks of the monkeypox outbreak, Heisler said he received calls from people worried they might have the virus. Because his clinic was so short-staffed, he had no one else to pick up the phone. He was also testing and treating patients with the virus and administering vaccines.
Tpoxx doses “were only physically available at two neighboring county health departments,” said Heisler, whose STD clinic is the largest in the state. “I had a patient who was immunosuppressed, HIV positive, in significant pain from monkeypox…However, there was no way to physically get the Tpoxx to the patient.”
“I physically couldn’t get it for him.” The patient had no access to transportation and no courier service was available.
“So I was going to drive over there. Me and the epidemiologist were on the phone (early) evening to find out. … There’s no infrastructure, no organizational infrastructure to be able to do that.”
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The state health department told the Free Press in an email Wednesday that providers initially ordered doses of Tpoxx directly from the strategic national stockpile.
“When the state eased the product into (Michigan), that product was allocated to (local health departments) that currently had cases. That included the health departments in the city of Detroit and doctors in the city that were treating positive patients,” said Chelsea Wuth. , spokesman for the Michigan Department of Health and Human Services.
Doses of the Tpoxx treatment are now available, he said, “at all local health departments in Michigan and at select providers who have encountered a large number of Tpoxx patients. We also maintain a stock of product in Lansing to replenish the ‘Tpoxx inventory for those running. low.”
Funding for smallpox response ‘is unsustainable’
Even as the monkeypox outbreak begins to subside (the rate of new cases is slowing in Michigan and nationally), Heisler was among a group of doctors from the National Coalition of STD Directors to call on Congress on Wednesday more federal funding to support the monkeypox response to ensure more equitable access to care and to shore up a crumbling public health infrastructure.
“The Senate has rejected a request from the Biden administration for $4.5 billion to support the MPV response, also called monkey pox,” said David Harvey, executive director of the National Coalition of Directors of std.
“Let me be clear, this is unacceptable and our community will continue to fight for the resources we need… We will not rest until we get it.”
Clinics like Heisler’s haven’t seen increased funding despite increased demand for monkeypox and a growing number of sexually transmitted infections like syphilis, gonorrhea and herpes.
There is no money for overtime to reach the vulnerable population
Without more money, clinics like hers can’t hire more staff, she said. And without more workers, they can’t do the kind of outreach needed to stop the virus from spreading to the most vulnerable communities.
“Something that we’ve seen in the last couple of months … is the disparities that are already happening in monkeypox,” Heisler said. “People of color have lower vaccination rates and higher case rates. One of the ways to combat that was pop-up vaccine clinics, so you meet the people most affected where they are: gay bars, events of salon, pride events.
“All these events happen at night. Well, we don’t have any funding for staff. I can’t pay overtime.”
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So Heisler and others partnered with an LGBT clinic and sought volunteers recently to organize a pop-up clinic, vaccinating 37 people, 95 percent of whom were people of color.
While it was a success, “it’s unsustainable,” Heisler said. “We all worked our time without compensation… When STIs continue to rise, and now we have the monkey pox outbreak on the ground, we’re stretched thin.
“Myself and my staff are doing all of this because if we don’t, our community won’t get adequate care and health disparities will continue to grow. And that’s not a tolerable outcome. So just because we’re a community. that they take care of each other, that doesn’t take away from the federal government’s responsibility to take care of us.”
Who Gets Monkey Pox Infections in Michigan?
Since the U.S. smallpox outbreak began in May, 265 cases have been identified in Michigan, according to state data, and 97 percent of the cases have been identified in men. The city of Detroit has had the most cases, with 102 infections.
Of the men who have been infected with the virus, 94% reported having sex with men and 55% are HIV positive.
New demographic details on the state’s outbreak also show that of people who have been infected in the state:
- 60% are black
- 34% are white
- 6% reported being Hispanic or Latino (who may also identify with another race)
- 2% are Asian or Pacific Islander
- Less than 1% are American Indian or Alaska Native
- 3% identify as “other”
Who Gets Monkey Pox Vaccines in Michigan?
Although the majority of people with monkeypox in Michigan are black men, doses of the Jynneos vaccine, which is approved for use against smallpox and monkeypox, have gone disproportionately to white residents of Michigan.
Of the 8,775 doses of Jynneos vaccine administered in Michigan for which racial and ethnic data are known:
- 70%—or 5,213 doses—were given to white people.
- 17%, or 1,240 doses, have gone to Black Michiganders.
- 9% (or 656 doses) were given to people who chose “other” for a racial/ethnic designation.
- 8%—or 624 doses—were given to Hispanic or Latino people.
- 3%, or 246 doses, were to Asian or Pacific Islander people.
- 1% (or 67 doses) were administered to Alaska Natives or American Indians.
Closing the monkeypox health disparities gap
The state health department is working to address disparities around monkeypox infections and access to vaccines and treatments, Wuth said.
“These disparities are not unique to Michigan and are being seen across the country in relation to cases and vaccine uptake,” Wuth said.
“Helping Michigan residents make the most informed decisions to protect their health and the health of their community from monkeypox (MPV) requires a combination of providing key prevention information to the public and working with partners and messengers of trust to ensure that information reaches affected communities.”
The U.S. Centers for Disease Control and Prevention launched the Monkeypox Vaccine Equity Pilot Program earlier this month in an effort to close the gap in health disparities from monkey
The agency is offering up to 50,000 doses of the Jynneos vaccine to agencies that can deliver it in non-traditional ways to people who are disproportionately affected by the virus and face barriers to health care.
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They are eligible to apply to state and local health departments; cities that already receive vaccines from the National Strategic Stock; tribal governments and tribal health centers funded by the government. They must be willing to report case and vaccination data to CDC.
The Michigan Department of Health and Human Services requested additional vaccine doses from the CDC to host five events as part of the equity initiative. Four of the five were approved this week, Wuth said.
“None of the events have taken place yet. We are not aware of any events presented by other organizations in Michigan,” he said.
The vaccines will be available, Wuth said, at the following events:
- The PrEP Rally Ball in Detroit on October 1st.
- Gigis Nightclub in Detroit on October 21 and November 19.
- Liberty Leather Bar in Pontiac in two separate leather-themed events scheduled for October 15th and 29th.
- Michigan Leather Pride in Detroit on October 21st.
Harvey, executive director of the National Coalition, said the CDC’s Vaccine Equity Pilot Program is making a difference.
“We’re seeing the numbers go down,” he said, in terms of new cases. But the successes have been largely due to the willingness of volunteers and workers at local STI and sexual health clinics that are already underfunded to lend a hand to the effort.
“It’s a solid initiative, but there’s not enough money,” he said.
Editor’s note: The state Department of Health and Human Services changed the dates of monkeypox vaccine events at Gigi’s Nightclub in Detroit. The story has been updated to reflect this change.
Contact Kristen Jordan Shamus: [email protected] Follow her on Twitter @kristenshamus.
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