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Our picks for the top national and international stories of 2013



mass wedding, same-sex marriage, gay marriage, Supreme Court, Proposition 8, Defense of Marriage Act, Prop 8, DOMA, gay news, LGBT, Washington Blade, marriage equality
mass wedding, same-sex marriage, gay marriage, Supreme Court, Proposition 8, Defense of Marriage Act, Prop 8, DOMA, gay news, LGBT, Washington Blade, marriage equality, year

(Washington Blade file photo by Michael Key)

It was perhaps the biggest year yet for the LGBT rights movement in the United States, as the Supreme Court made history by striking down Prop 8 and part of the Defense of Marriage Act. More states legalized marriage in its wake. Elsewhere in the world, the Catholic Church got a new pope who seemed to break with his predecessor over gay rights, among other issues.

Here are the Blade staff’s picks for the year’s top 10 national and international stories.

#1 Supreme Court strikes down DOMA, Prop 8


Proposition 8, Supreme Court, gay marriage, same-sex marriage, marriage equality, gay news, Washington Blade

The plaintiffs in the Proposition 8 case at the Supreme Court emerge victorious with lawyer David Boies, Human Rights Campaign President Chad Griffin and American Foundation for Equal Rights Executive Director Adam Umhoefer. (Washington Blade file photo by Michael Key)

The U.S. Supreme Court issued a pair of historic decisions against the Defense of Marriage Act and California’s Proposition 8 in a news event we have dubbed the story of the year.

In a 5-4 decision, the court struck down Section 3 of DOMA, the 1996 Clinton-era law that prohibited the federal government from recognizing same-sex marriage. In a separate 5-4 decision issued at the same time, the court ruled the proponents of Prop 8 couldn’t defend the initiative in court, allowing a district court ruling to stand that determined the 2008 amendment was unconstitutional.

Writing for the majority in the decision against DOMA, U.S. Associate Justice Anthony Kennedy emphasized the harm the anti-gay law causes married same-sex couples.

“The federal statute is invalid, for no legitimate purpose overcomes the purpose and effect to disparage and to injure those whom the State, by its marriage laws, sought to protect in personhood and dignity,” Kennedy wrote. “By seeking to displace this protection and treating those persons as living in marriages less respected than others, the federal statute is in violation of the Fifth Amendment.”

The DOMA lawsuit was brought by New York widow Edith Windsor as a result of having to pay $363,000 in estate taxes in 2009 upon the death of her spouse, Thea Spyer. Windsor became a symbol of the marriage equality movement and was named by Time magazine as its No. 3 pick for “Person of the Year” after her victory at the Supreme Court.

The ruling against Prop 8 restored marriage equality to California. Thousands of same-sex couples — beginning with plaintiffs Kris Perry and Sandra Stier, who were wed by California Attorney General Kamala Harris at San Francisco City Hall — began to marry after the U.S. Ninth Circuit Court of Appeals gave the go-ahead weeks after the decision.

Immediately after the ruling against DOMA, the Obama administration pledged to work toward implementing the decision to allow for the recognition of same-sex marriage by the federal government. At a news conference during a trip to Africa, President Obama pledged to make the federal benefits of marriage as widely available as possible.

“It’s my personal belief — but I’m speaking now as a president as opposed to as a lawyer — that if you’ve been married in Massachusetts and you move someplace else, you’re still married, and that under federal law you should be able to obtain the benefits of any lawfully married couple,” Obama said.

Then-Secretary of Homeland Security Janet Napolitano issued guidance saying bi-national same-sex couples would be able to apply for marriage-based green cards to enable them to stay in the United States. The U.S. Office of Personnel Management announced that spousal benefits, including health and pension benefits, would begin to flow to gay federal employees. Perhaps most significantly, the Internal Revenue Service announced it would recognize the marriages of same-sex couples for tax purposes — even if they file tax returns while living in a non-marriage equality state.

Defense Secretary Chuck Hagel also announced that service members in same-sex marriages would be able to receive spousal benefits, including health, pension and housing benefits. Several national guards with state constitutional amendments banning same-sex marriage said they would be unable to process these benefits, but after a second edict from Hagel saying they must comply, each of those states fell in line.

Within a few short months, the ruling against DOMA also helped accelerate the path toward marriage equality throughout individual states. In Ohio, a federal judge recognized the marriage of a same-sex couple that married at BWI airport because one of the partners in the relationship was dying of Lou Gehrig’s disease. Later, a New Jersey superior court ruled the state’s civil union law was insufficient — a decision the State Supreme Court let stand upon appeal from New Jersey Gov. Chris Christie, who later the dropped the lawsuit.

Doug NeJaime, a gay law professor at the University of California, Irvine, said this movement so soon after the Windsor ruling “was anticipated” given the language that Associate Justice Anthony Kennedy used in his opinion.

“Given the flurry of activity, and the quick decisions coming out of places like Ohio, this may mean that the Supreme Court may not be able to avoid the question regarding the constitutionality of state marriage bans as long as some of the justices may hope,” NeJaime said.


#2 States, countries extend marriage rights 


Neil Abercrombie, Hawaii, Washington Blade, gay

Hawaii Gov. Neil Abercrombie on Nov. 13, 2013, signed his state’s same-sex marriage bill into law. (Photo courtesy of State of Hawaii/Office of the Governor)

The movement for marriage rights for same-sex couples made significant advances in the U.S. and around the world in 2013.

In addition to Maryland and Delaware, gays and lesbians began to legally marry in California, Rhode Island, New Jersey, Minnesota and Hawaii. Illinois’s same-sex marriage law that Gov. Pat Quinn signed last month will take effect in June.

New Zealand and Uruguay also extended marriage rights to same-sex couples in 2013.

Brazil’s National Council of Justice in May nearly unanimously ruled that registrars in the South American country cannot deny marriage licenses to same-sex couples.

Gays and lesbians in England and Wales on March 29 will begin to exchange vows after the British Parliament over the summer approved a same-sex marriage bill. An identical measure cleared its first hurdle in the Scottish Parliament last month.

The legal process to extend marriage rights to same-sex couples in Mexico continued to gain ground in Baja California, Guanajuato, Jalisco and other states in 2013. A handful of gays and lesbians have exchanged vows in Colombia, but the country’s attorney general has challenged some of them.

Croatian voters on Dec. 1 approved a constitutional amendment that defines marriage as between a man and a woman. The Australia High Court on Dec. 11 ruled a law that extended marriage rights to same-sex couples in the country’s capital is unconstitutional.


#3 Senate passes ENDA; House version stalls 


Tammy Baldwin, gay news, Washington Blade, Employment Non-Discrimination Act, United States Senate, Democratic Party, Wisconsin, religious exemptions

Sen. Tammy Baldwin (D-Wis.) spoke in a press conference following the passage of the Employment Non-Discrimination Act in the U.S. Senate. (Washington Blade photo by Michael Key).

For the first time in history, the U.S. Senate approved with bipartisan support this year a long sought piece of legislation that would bar employers from discriminating against or firing workers based on their sexual orientation or gender identity.

By a vote of 64-32, the Employment Non-Discrimination Act passed the Senate, marking the first time that either chamber of Congress has passed a version of the bill with protections for transgender workers. A total of 10 Republicans joined the entire Democratic caucus present in voting for the bill.

Prior to the vote, Sen. Jeff Merkley (D-Ore.), ENDA’s chief sponsor, delivered a speech on the Senate floor recognizing the historic nature of the moment.

“I look forward to this vote, this vote for liberty, this vote for freedom, this vote for opportunity, this vote for a fair and just America,” Merkley said.

Despite a push to bring up the legislation in the House, momentum on ENDA seems to have stalled as the legislation has capped out at 201 sponsors and House Speaker John Boehner (R-Ohio) has continually said he opposes it.

“I understand people have differing opinions on this issue, and I respect those opinions,” Boehner said in response to a question from the Washington Blade. “But as someone who’s worked in the employment law area for all my years in the State House and all my years here, I see no basis or no need for this legislation.”

#4 Russia’s LGBT crackdown sparks outrage


Russia, anti-gay, gay news, Washington Blade

Activists protested in front of the Russian embassy several times throughout the year following the passage of anti-gay laws in the country. (Washington Blade photo by Damien Salas)

The Kremlin’s LGBT rights crackdown sparked widespread outrage this past year amid preparations for the 2014 Winter Olympics that will take place in Sochi, Russia, in February.

Russian President Vladimir Putin in June signed a broadly worded bill into law that bans gay propaganda to minors. A second statute that bans foreign same-sex couples and any couple from a country in which gays and lesbians can marry from adopting Russian children took effect in July.

LGBT rights groups and other organizations that receive funding from outside Russia could face a fine if they don’t register as a “foreign agent.”

“These laws are aimed at driving LGBT people back into silence, back underground, back to the invisibility,” Polina Andrianova of Coming Out, a St. Petersburg-based LGBT advocacy group, told the Washington Blade during an August interview.

Playwright Harvey Fierstein is among those who have called for a boycott of the Sochi games in response to Russia’s LGBT rights crackdown. The International Olympic Committee and the U.S. Olympic Committee have also faced criticism from those who feel they have not done enough to publicly criticize the Kremlin over the gay propaganda law.

“The U.S. Olympic Committee has been complicit in this act of aggression because they say we respect Russia’s right to do this,” U.S. Rep. Ileana Ros-Lehtinen (R-Fla.) told the Washington Blade in late September before the USOC added sexual orientation to its anti-discrimination policy. “That is not worthy of Olympic standards.”

Retired Olympic diver Greg Louganis on Dec. 13 told the Blade that gay MSNBC anchor Thomas Roberts should not have co-hosted the Miss Universe 2013 pageant in November in Moscow. The four-time gold medalist also said gay singer Elton John should not have performed in Russia earlier this month.

“It just seems like all they’re doing is lending credibility to what’s going on there,” said Louganis.


#5 LGBT Catholics welcome Pope Francis


Pope Francis, Catholic Church, gay news, Washington Blade

‘If a person is gay and seeks the Lord and is of good will, who am I to judge him,’ said Pope Francis. (Photo by Agência Brasil; courtesy Wikimedia Commons)

LGBT Catholics in 2013 welcomed Pope Francis’ more moderate tone toward gays.

The College of Cardinals on March 16 elected the former archbishop of Buenos Aires to succeed Pope Benedict XVI who abruptly resigned in February.

The Argentine pontiff said during a September interview with an Italian Jesuit newspaper that the Roman Catholic church has grown “obsessed” with nuptials for gays and lesbians, abortion and contraception. These comments came roughly two months after he told reporters as he returned to Rome after a weeklong trip to Brazil that gays and lesbians should not be judged or marginalized.

“If a person is gay and seeks the Lord and is of good will, who am I to judge him?” said Francis in response to a question about gay priests.

LGBT rights advocates in Argentina noted to the Washington Blade the pontiff categorized the same-sex marriage bill the country’s president, Cristina Fernández de Kirchner, signed in 2010 as “the work of the devil” that would “spark God’s war.”

Dignity USA Executive Director Marianne Duddy-Burke acknowledged Francis’ anti-LGBT statements after his election. She remains optimistic the new pontiff will welcome LGBT Catholics back into the church.

“We find much to be hopeful about, particularly in the Pope’s firm desire that the church be a ‘home for all people,’ and his belief that God looks on lesbian, gay, bisexual and transgender people with love rather than condemnation,” said Duddy-Burke in a September statement.


#6 Obama names gay ambassadors, judges


John Berry, Australia, gay news, Washington Blade

John Berry was named U.S. Ambassador to Australia. (Washington Blade file photo by Michael Key)

The U.S. Senate approved this year several openly gay appointees — including the first openly gay federal appeals judge — in confirmations that were historic both in number and significance.

Among the confirmed appointees were five openly gay ambassadors, including former U.S. Office of Personnel Management Director John Berry as U.S. ambassador to Australia. The confirmation made him the first openly gay U.S. ambassador to a G-20 country.

Also among the gay confirmations were Daniel Baer as U.S. ambassador to Organization for Security & Cooperation in Europe; Rufus Gifford as U.S. ambassador to Denmark; James Costos as U.S. ambassador to Spain; and James “Wally” Brewster as U.S. ambassador to the Dominican Republic.

Additionally, the Senate confirmed Eric Fanning as under secretary of the Air Force. After the departure of his immediate boss shortly after the confirmation, Fanning became acting secretary of the Air Force, making him the highest-ranking openly gay civilian in the U.S. military.

Chai Feldblum, the lesbian member of the U.S. Equal Employment Opportunity Commission, was confirmed for a second term after leading the way for a ruling instituting transgender workplace non-discrimination protections.

The Senate also confirmed openly gay judicial nominees. The highest-ranking among them was Todd Hughes, who was confirmed as circuit judge for the U.S. Court of Appeals for the Federal Circuit. He’s the first openly gay person to serve a federal appeals court.

The other confirmations were Pamela Ki Mai Chen as U.S. District Judge for the Eastern District of New York; Michael McShane as U.S. District Judge for the District of Oregon; and Nitza Quiñones Alejandro as U.S. District Judge for the Eastern District of Pennsylvania.



#7 Trans protections recognized under Title IX


The Obama administration made a historic ruling for transgender rights this year by applying existing law to protect students in school on the basis of their gender identity.

The Departments of Education and Justice announced the resolution as a result of a complaint filed by the National Center for Lesbian Rights on behalf of a transgender student in California’s Arcadia Unified School District. The resolution requires the school district to treat the student as male in all respects and keep his transgender status private.

NCLR Staff Attorney Asaf Orr commended the Obama administration for taking the step “to ensure that schools are safe and supportive environments where all students can thrive, including transgender students.”

The resolution represents a growing legal and administrative trend to interpret existing law — in this case, Title IX of the Education Act of 1972 — to ban discrimination against trans people.

Prior to the ruling, the student was required to sleep in a cabin by himself on an overnight field trip instead of being allowed to room with his male peers. The school district also excluded the student from the boys’ restroom and locker room, insisting that he use the nurse’s office.

The student, who remained anonymous, said he’s glad his school district agreed to put in place the resolution proposed by the Obama administration.

“Knowing that I have the school district’s support, I can focus on learning and being a typical high school student, like my friends,” the student said.


#8 Obama references Stonewall in inaugural speech


Barack Obama, Michelle Obama, inauguration 2013, gay news, Washington Blade

In a first, President Obama made two references to gay rights during his inaugural address in January. (Washington Blade file photo by Michael Key)

President Obama stirred passions in the LGBT community by making an unprecedented reference to LGBT rights during his second-term inaugural address and saying he believes gay people deserve equal treatment under the law.

“Our journey is not complete until our gay brothers and sisters are treated like anyone else under the law – for if we are truly created equal, then surely the love we commit to one another must be equal as well,” Obama said.

The words marked the first time that any U.S. president mentioned gay rights during an inaugural address and sent shockwaves through the LGBT community.

Also during the speech, Obama made a reference to the 1969 Stonewall riots, which are considered the start of the modern LGBT rights movement.

“We, the people, declare today that the most evident of truths – that all of us are created equal – is the star that guides us still; just as it guided our forebears through Seneca Falls, and Selma, and Stonewall; just as it guided all those men and women, sung and unsung, who left footprints along this great Mall, to hear a preacher say that we cannot walk alone; to hear a King proclaim that our individual freedom is inextricably bound to the freedom of every soul on Earth,” Obama said.


 #9: Gay mayors in Seattle, Houston; Quinn loses in New York


Christine Quinn, New York City, gay news, Washington Blade

Lesbian Christine Quinn started her mayoral campaign a heavy favorite but ultimately lost in New York’s primary. (Washington Blade photo by Michael Key)

Lesbian Annise Parker won election to her third and final term as mayor of Houston, on Nov. 5, receiving a decisive 57 percent of the vote in a nine-candidate race.

In Seattle, Washington State Sen. Ed Murray defeated incumbent Mayor Mike McGinn by a margin of 56 percent to 43 percent to become that city’s first openly gay mayor.

And in Atlantic City, N.J., gay Republican Don Guardian shook up the political establishment by winning an upset victory over incumbent Mayor Lorenzo Langford, a Democrat, in a city where Democrats outnumber Republicans among registered voters by a nine to one margin. Guardian ran as a socially progressive reform candidate with a record as a highly competent administrator of services for the city’s tourist district.

Meanwhile, New York City Council Speaker Christine Quinn lost her race to become New York’s first openly gay and first female mayor, finishing third in a hotly contested Democratic primary in September. A New York Times exit poll showed pro-LGBT candidate Bill deBlasio, who won the primary and the general election in November, beat Quinn among LGBT voters by a margin of 47 percent to 34 percent in a four candidate race.

Most political observers said LGBT voters joined the majority of their straight counterparts in backing deBlasio, who emerged as more progressive on economic issues than Quinn and who was perceived as an outspoken critic of incumbent Mayor Michael Bloomberg, who is highly unpopular among Democratic voters. Quinn had long been viewed as a Bloomberg ally.


# 10 Manning gets 35 years, comes out as trans


Bradley Manning, wikileaks, gay news, Washington Blade

Manning announced she is transitioning one day after being sentenced for leaking classified documents. (Public domain photo)

One day after a military judge sentenced former U.S. Army Private Bradley Manning to 35 years in prison for leaking classified documents to Wikileaks, the 25-year-old soldier released a statement through her attorney coming out as transgender.

“As I transition into this next phase of my life, I want everyone to know the real me,” Manning said. “I am Chelsea Manning. I am a female.”

Manning’s dramatic announcement shifted the media focus from that of her conviction in an Army court martial proceeding of violating the U.S. Espionage Act for leaking an unprecedented amount of classified information to the issue of who transgender people are and whether they should be entitled to equal rights.

Some transgender rights advocates said Manning’s case would hurt efforts to lift the military’s ban on transgender service members by casting transgender people in a negative light. Transgender activists Brynn Tannehill and Autumn Sandeen, who served in the military before transitioning, said they were especially troubled by arguments by Manning’s attorney that Manning’s struggle over her gender identity created stress that played some role in her decision to leak classified information.

“In my last four years in the Navy I was grappling with gender identity yet I did my job” and didn’t release classified information,” Sandeen said.


By Lou Chibbaro Jr., Chris Johnson and Michael Lavers

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Over 100 LGBTQ-themed books in a Florida school district labeled with advisory warning

They warn: “this book has been identified by some community members as unsuitable for students.”



Advisory Notice (via Twitter)

A southwest Florida district put parental “advisory notice” on over 100 books, many of which are race or LGBTQ-themed. 

A great number of books in Collier County Public Schools, either digital or physical, now have warning labels writing “Advisory notice to parents,” according to an NBC report,

The label, tweeted by nonprofit free-speech-promoting group PEN American, states, “This Advisory Notice shall serve to inform you that this book has been identified by some community members as unsuitable for students. This book will also be identified in the Destiny system with the same notation. The decision as to whether this book is suitable or unsuitable shall be the decision of the parent(s) who has the right to oversee his/her child’s education consistent with state law.” 

Stephana Ferrell, co-founder of the Florida Freedom to Read Project, which means to fight book banning, told NBC that she had a call from Elizabeth Alves, the associate superintendent of teaching and learning for Collier County Public Schools. In the call, Alves told her that the district added the labels starting in February. 

These measures, which Alves described as a “compromise,” happened after the district’s legal representative talked with the Florida Citizens Alliance, a conservative group which initiated a “Porn in Schools Report” project last year. The report included a list of books that “promote gender self-identification and same-sex marriage” as well as titles that include “indecent and offensive material,” as the group explained. 

Chad Oliver, the Collier County Public Schools spokesperson, on the other hand offered a different story. 

Oliver sent an email to NBC News and said, “Based upon advice from the General Counsel, we placed advisory notices on books about which parents and community members had expressed concern and in accordance with the recently passed Parents’ Bill of Rights Law (HB 241).” 

The law referred by Oliver is also known as the “Don’t Say Gay” law.

According to PEN America, there are 110 labeled books in total, and the list greatly overlaps with the one Florida Citizens Alliance inquired about with Collier County Public Schools. 

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Rep. Sean Patrick Maloney introduces bill to make monkeypox testing free

Health insurers would be required to cover costs



Rep. Sean Patrick Maloney has introduced legislation to make monkeypox testing free to the public. (Blade file photo by Michael Key)

Rep. Sean Patrick Maloney (D-N.Y.), amid the ongoing monkeypox affecting gay and bisexual men, has introduced legislation in the U.S. House seeking to make testing for disease free to the public.

Maloney, one of seven openly gay members of Congress and chair of the Democratic Congressional Campaign Committee, said in a statement the measure, called the No Cost for Monkeypox Testing Act, would testing amid the monkeypox outbreak would be accessible to all.

“It is critical that we eliminate cost as a barrier to testing for monkeypox to ensure we can identify cases and prevent further spread,” Maloney said. “This legislation takes the lessons we learned from past public health emergencies and protects those at risk of contracting monkeypox by making tests accessible to everyone.”

The legislation would require private health insurers as well as Medicare and Medicaid to cover the costs of monkeypox testing at no expense to the patients, either through deductibles, co-payments, and co-insurance.

The bill introduction comes the week after the Biden administration declared the monkeypox outbreak a public health emergency and the same it has issued new guidance to enhance to the accessing of existing vaccines doses amid criticism federal officials were too slow in distributing shots.

The Washington Blade has placed a request in with the Centers for Disease Control seeking comment on the legislation. Secretary of Health & Human Services Xavier Becerra said Tuesday the federal government has the capacity to conduct an estimated 80,000 tests each week.

Maloney has been representing New York’s 18th congressional district, but after redistricting is now seeking re-election in the 17th district. Amid controversy over a potential showdown between Maloney and Rep. Mondaire Jones (D-N.Y.), who’s Black, another openly gay member of Congress and the current representative of that district, Jones has since opted to run for re-election in the New York’s 10th congressional district. Maloney is now running unopposed in the 17th.

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Biden administration shifts monkeypox vaccine approach amid shortage

Health experts sees new guidance as mixed bag



The Biden administration has changed its guidance on monkeypox vaccines to enhance availability amid the shortage.

The Biden administration, amid criticism it was slow to act on the monkeypox outbreak and still not meeting the demand for vaccines as the number of cases continues to grow, has announced a shift in guidance for implementation of the shot in an effort to enhance availability.

As the estimated number of monkeypox cases in the United States reaches 8,900, top health officials announced the new move on Tuesday as part of a decision by Secretary of Health & Human Services Xavier Becerra to issue a determination under Section 564 of the Federal Food, Drug and Cosmetic Act to justify emergency use authorization of vaccines. The announcement follows up on the Biden administration’s announcement last week declaring the monkeypox outbreak a public health emergency.

Becerra said in a conference call with reporters the 564 determination and change in approach to vaccines would “boost and strengthen” the Biden administration’s response to monkeypox, which has overwhelmingly affected gay and bisexual men, and “safely accelerates and multiplies our supply of effective vaccines by up to fivefold.”

“Today’s action also reaffirms HHS and this administration’s commitment to using all available resources and capabilities to end the monkeypox outbreak and provide the best possible care to those suffering from the virus,” Becerra added.

The new vaccine approach, which may may be considered minor to non-medical observers, would change injections of the JYNNEOS vaccine from the subcutaneous route (delivery of the vaccine under the fat layer underneath the skin) to the intradermal route (delivery of the vaccine into the layer of skin just underneath the top layer). In theory, that would allow for greater accessibility of monkeypox vaccines as it increases the number of doses from each vial of vaccine.

The change was made amid criticism the Biden administration failed to meet the demand for vaccines during the outbreak and geographic inequity as certain metropolitan areas of the country have more access to vaccines than other places.

As The New York Times reported last week, the Biden administration has faced criticism for not moving quickly enough in acquiring and distributing vaccines, including bulk stocks already owned by the U.S. government manufactured in Denmark by Bavaria Nordic now being given to other clients.

“The government is now distributing about 1.1 million doses, less than a third of the 3.5 million that health officials now estimate are needed to fight the outbreak,” the Times reported. “It does not expect the next delivery, of half a million doses, until October. Most of the other 5.5 million doses the United States has ordered are not scheduled to be delivered until next year, according to the federal health agency.”

Biden officials, nonetheless, touted the numbers of vaccines and tests in response to monkeypox as a positive, acknowledging the 1.1 million vaccines being made available as well as delivery of more than 620,000 of those doses, deployment more than 15,000 courses of the monkeypox treatment and increasing the country’s capacity to administer tests on a weekly basis to around 80,000. Meanwhile, officials also promoted the change in approach in vaccines as means to allow greater accessibility to the shots.

Rochelle Walensky, director of the Centers for Disease Control & Prevention, promoted during the conference call the use of intradermal injections and said they’re “often used for TB skin tests and have been used for other types of vaccines.”

Although Walensky conceded some health care providers “may not be as familiar with intradermal administration” as they are with subcutaneous injection, she said CDC would make additional guidance materials available, including a clinician alert message to the Association of State & Territorial Health Officials, outreach to key clinician partners and an education resource video. The change in guidance, Walensky said, is for vaccine implementation in adults, but children — where single digit monkeypox cases have been reported — would continue to receive vaccination in the traditional subcutaneous approach.

But health experts aren’t responding with overwhelming praise to the decision to change the guidance on vaccine implementation from subcutaneous injections to intradermal injections, expressing concerns the new approach may be insufficient.

Jennifer Kates, director of global health & HIV policy at the Kaiser Family Foundation, was among those saying the change in guidance on vaccine approach was a mixed bag and told the Blade more data is needed to evaluate the effectiveness.

“As we saw with COVID, using these authorities in the context of public health emergencies is an important strategy,” Kates said. “In this case, this step will significantly expand access to vaccines for those most at risk. However, there remain questions about the effectiveness of this approach — real world studies are needed — and challenges to translating vaccines into vaccinations.”

Peter Marks, director of the Center for Biologics Evaluation & Research (CBER) at the Food & Drug Administration, was asked during the conference call with reporters to respond to concerns the change in guidance was insufficient and downplayed the novelty of implementing the vaccines through the intradermal route as “not at all new.”

“In fact, the reason why the Bavaria part of this equation comes from the fact that in Germany, this vaccine was given intradermally originally, in an effort to replicate the original version of the smallpox vaccine,” Marks said. “It’s been given to thousands of people intradermally, so this isn’t the first time it’s been done.”

Walkensky said the intradermal vaccine approach has been implemented amid policies among localities to implement a one-dose approach to the JYNNEOS vaccine through the subcutaneous route. (The D.C. government is one of the jurisdictions that had enacted a one-dose approach amid a vaccine shortage.) There is not data, Walkensky said, to support that approach and “in fact, if anything, there are data saying that that is not protective enough.”

“So by using this alternative strategy of intradermal dosing, not only do we have more doses, but we actually allow people to get two doses in a way that shows immunologic response that’s superimposable from the subcutaneous dosing,” Walkensky said. “So we have more doses, and in fact, we have the ability to doubly vaccinate people so that they get the protection that they need.”

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