Fairness of monkeypox vaccine in Philadelphia challenged by dose scarcity and funding

JaBaris Swain paced a gymnasium at a monkeypox vaccination clinic this week, assessing whether he had received enough shots to meet the needs of a vulnerable community in North Philadelphia.

Forty-seven people had already come for their first shot of a two-dose vaccine that was missing in an outbreak that is significantly impacting black men who have sex with men.

With at least five more appointments scheduled, Swain wouldn’t be able to vaccinate them all and also secure a second shot. He decided to dip into the supplies to be held back for the second doses anyway.

“If you look at it from a utilitarian perspective, you make sure most people have at least a line of protection,” said Swain, medical director of Dr. Ala Stanford Center for Health Equity.

More than half of Philadelphia’s monkeypox cases have been reported in black residents, but they only received 24% of the vaccine doses. White residents received 56% of injections and account for 24% of infections.

Monkeypox can be spread through close physical contact. Although the current national epidemic primarily infects men who have sex with men, cases have also been reported in women and children. Wednesday’s clinic was among the first in Philadelphia to be hosted in a predominantly black neighborhood in response to the current outbreak.

READ MORE: Black Philadelphians at higher risk for monkeypox, but only get a fraction of vaccine doses

Similar disparities have occurred during the COVID-19 pandemic, which has taken the most toll on black Philadelphians. But the initial rollout of the vaccine saw more white residents getting vaccinated. Black residents continue to have lower vaccination rates.

Advocates say awareness has been lacking in neighborhoods where many at-risk Philadelphians live. Increased efforts are needed, said Elle Lett, who created Philly MPX Action with a small group of medical professionals to raise awareness around the virus.

“We need to have vaccination clinics in Kensington, North Philly, the Northeast, in Southwest Philadelphia,” said Lett, a medical student and social epidemiologist. at the University of Pennsylvania, who is a black trans woman. “Philly is a very strange city of colored people.”

City health officials said their efforts have been hampered by a lack of federal funding which has been expected when monkeypox was declared a health emergency last month.

The health department said Thursday it was seeking local applicants for 10 grants of $50,000 or $25,000 to improve access and awareness. The Ministry of Health relies on $375,000 from its budget to fund the grants, hoping to eventually be repaid with federal money.

Community partners can play an important role in closing the immunization equity gap, according to the health department, and the grants are meant to “kickstart” the effort.

The vaccine is currently available from Bebashi — Transition to Hope, a healthcare provider focused on people living with HIV, health officials noted. Black patients received the majority of their doses, said Nackea Bachman, a physician assistant who attends the provider’s weekly immunization clinics held Thursdays in the center building near 13th and Spring Garden streets.

The health department is also working with Philly Pride to reach gay black men and is planning clinics in West Philadelphia through September with Action Wellness, a health center for people living with HIV and other illnesses. chronicles.

Fewer new cases of monkeypox have been reported in Philadelphia in recent weeks, according to data kept by the Philadelphia Department of Public Health, but city officials say it’s too early to determine whether the spread of the epidemic is under control. So far, 327 cases of the virus have been reported in Philadelphia.

About 53% of the doses administered at the pop-up clinic at Ala Stanford Health Center on Monday and Wednesday went to black patients, according to the clinic’s medical director.

Staff are careful to protect the anonymity of people who go there to receive doses of monkeypox vaccine. A complicating factor for the monkeypox vaccination effort is that some men who have sex with men may be less likely to identify as gay, experts note, and they may be reluctant to visit a clinic. established specifically for the monkeypox vaccine.

“We are low key,” said Doris Cush, director of nursing. “It’s total anonymity.”

The clinic strives to reach deeply in the local LGBTQ community. For example, he’s coordinating with a party planner to share vaccination information at an alternative lifestyle party this weekend.

A local resident who was vaccinated this week, Sarah Craig, said getting vaccinated there added to their comfort.

“They’re very friendly and informative here,” said Craig, who is black and non-binary. They wanted to get vaccinated because working as an acupuncturist involves close contact with other people.

READ MORE: Philadelphia sex workers finally have access to monkeypox vaccine

But supplies are still tight in Philadelphia. Federal authorities allocating the vaccines had suggested the new strategy could produce up to five doses from each vaccine vial, but Cush said she had struggled to get more than four. The city the Ministry of Health said three to four doses per vial is typical.

On Wednesday afternoon, Swain learned he could order more shots, although he didn’t know when, and decided to dip into the second dose to give shots to everyone with an appointment.

Later Wednesday, he received confirmation that the health center would receive an additional 200 doses.

If supplies hold up, he expects hold monkeypox vaccination clinics at least once a week at the centre. Just this week, shots were fired at mostly black gay men, transgender women and sex workers.

“We have to keep reminding the city that there are pockets of the city that don’t have access to it,” he said.