National
Biden administration shifts monkeypox vaccine approach amid shortage
Health experts sees new guidance as mixed bag
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.”
Tennessee
Charlie Kirk Act advances in Tenn.
Bill would limit protests, protects speakers opposing ‘transgender’ identities
The Tennessee legislature has passed Senate Bill 1741 / House Bill 1476, dubbed the “Charlie Kirk Act,” which, if signed by Republican Gov. Bill Lee, would reshape how public colleges and universities regulate speech on campus.
The measure targets all public higher education institutions and requires them to adopt a “free expression” policy modeled on the University of Chicago’s framework. That framework emphasizes that universities should not shield students from controversial or offensive ideas and requires state schools to formally embrace institutional neutrality — meaning they do not publicly take a stance on political or social issues.
Under the legislation, publicly funded schools cannot disinvite or cancel invited speakers based on their viewpoints or in response to protests from students or faculty. Student organizations, however — like Turning Point USA, an American nonprofit that advocates for conservative politics on high school, college, and university campuses, founded by Charlie Kirk, and often lack widely represented liberal counterparts — would retain broad authority to bring speakers to campus regardless of controversy.
The law includes broad protections for individuals and organizations expressing religious or ideological beliefs, including opposition to abortion, homosexuality, or transgender identity, regardless of whether those views are rooted in religious or secular beliefs. It further prohibits public institutions from retaliating against faculty for protected speech or scholarly work.
The bill, which has been hailed by supporters as an effort to “preserve campus free speech,” ironically also limits protest activity. Shouting down speakers, blocking sightlines, staging disruptive walkouts, or physically preventing entry to events are now considered “substantial interference” under the legislation, making those who engage in such actions subject to discipline.
Some of those disciplinary consequences include probation, suspension, and even expulsion for students, while faculty who protest in ways deemed to violate the policy could face unpaid suspensions and termination after repeated violations.
Supporters of the bill argue it strengthens free expression on campus. State Rep. Gino Bulso (R-Brentwood), the bill’s sponsor, said it reinforces a commitment to “civil and robust” debate at public universities.
“The Charlie Kirk Act creates critical safeguards for students and faculty and renews the idea that our higher education institutions should be centers of intellectual debate,” Bulso told Fox 17. “This legislation honors the legacy of Charlie Kirk by promoting thoughtful engagement and defending religious freedom.”
Critics, including Democratic lawmakers, have raised concerns that the legislation effectively elevates certain ideological viewpoints — particularly those tied to religious objections to LGBTQ identities — while exposing students and faculty to punishment for protest or dissent.
“It’s ironic that this body is talking about free speech when we had professors in Tennessee schools expelled and suspended when they did not mourn the death of Charlie Kirk — when they said that his statements were problematic and that the way he died did not redeem the way he lived,” state Rep. Justin Jones (D-Nashville) told WKRN.
Kirk, the right-wing activist and founder of Turning Point USA, for whom the bill is named, was assassinated in September 2025 at a public event at Utah Valley University. His legacy and rhetoric remain deeply polarizing, particularly among LGBTQ advocates, who have cited his history of anti-LGBTQ statements in opposing his campus appearances.
The bill now heads to Lee’s desk for his signature.
National
Demonstrators disrupt OMB director hearing over PEPFAR
Capitol Police arrested five protesters
A group of protesters interrupted Office of Management and Budget Director Russell Vought during his testimony before Congress on Wednesday.
Vought was at the Cannon House Office Building to give testimony to the House Budget Committee.
Committee Chair Jodey Arrington (R-Texas) began the hearing by touting what he described as economic accomplishments of the Trump-Vance administration’s economic accomplishments. Ranking Member Brendan Boyle (D-Pa.) disputed those claims in his opening statement.
Boyle went on to admonish Vought for not attending a committee hearing in the previous year.
Vought, the “Project 2025” architect, was invited to speak after Arrington and Boyle made their statements.

Shortly after Vought began reading his statement, Housing Works CEO Charles King stood up in the gallery and began shouting, “PEPFAR saves lives: spend the money!”
The U.S. Capitol Police moved quickly to escort King from the room. Other activists began chanting with King as they unfolded signs bearing a picture of Vought’s face and statements such as, “Vought’s cuts kill people with AIDS,” and “Protect PEPFAR from Vought.”
The group of HIV/AIDS activists included independent activists, former U.S. Agency for International Development and PEPFAR staff, members of Health GAP, Housing Works, and the Treatment Action Group. Six activists were escorted from the hearing and the U.S. Capitol Police detained five of them.

The HIV/AIDS treatment activists protested at the hearing in response to the dismantling of global health programs, including PEPFAR, a federally-funded program credited with saving millions of lives from HIV/AIDS, particularly in sub-Saharan Africa.
“Russell Vought is directly responsible for illegally withholding Congressionally appropriated funds for PEPFAR and related global health initiative,” King said in a statement provided to the Washington Blade. “These funding disruptions have already contributed to preventable deaths and threaten to reverse decades of progress in the fight against HIV worldwide. Enough is enough. Congress must ensure Vought stops this deadly sabotage.”
National
HIV/AIDS group NMAC is ‘destabilized’ and in financial crisis: sources
Organization disputes allegations of mismanagement by new CEO
A statement sent to the Washington Blade by an anonymous source claiming to be a current staff member at NMAC, formerly known as the National Minority AIDS Council, alleges that the prominent HIV/AIDS advocacy organization is facing “a rapid and systemic collapse of leadership, governance, and ethical standards.”
The three-page detailed statement sent on April 4 by someone identifying himself only as “John Doe” includes multiple specific allegations that NMAC CEO Harold Phillips, who began his position in October 2025, “has destabilized the organization at every level,” including hiring nine new high-level appointees with salaries of $220,000 each who are performing “duplicative and unjustifiable roles.”
The Blade was able to corroborate some of the allegations by talking to two other knowledgable sources who spoke on condition of anonymity. Those sources said they had received the John Doe statement and believed many, if not most, of its allegations were accurate.
With a total staff of about 30 to 35 employees, the John Doe statement claims the high salaries of the nine new staff members have added to financial problems NMAC has been facing in recent years. It says that at least two NMAC staffers who raised concerns about Phillips’s actions were terminated on grounds of insubordination.
One of the two anonymous sources who spoke to the Blade said one of the dismissed staff members was considering filing a lawsuit against NMAC in response to the firing.
“An external firm was recently brought in to assess the organizational health,” the John Doe statement to the Blade says. “The findings were staggering — more than 50% of staff reported they are actively seeking employment elsewhere,” it says.
The Blade sent the John Doe statement to NMAC this week and asked for a response to the allegations.
NMAC spokesperson Jennifer Moore Phillips, who serves as chief strategy officer and who is not related to Harold Phillips, sent the Blade a short statement calling the John Doe allegations “false and purposefully misleading,” but which did not comment on each of the specific allegations.
“A recent anonymous letter containing unfounded allegations about NMAC makes claims that are simply false and purposefully misleading,” the NMAC statement says. “Evidenced by our new strategic plan and recent successful Biomedical HIV Prevention Summit in Chicago, NMAC’s new leadership is laser focused on delivering on our mission serving the HIV community with renewed energy and vision,” the statement concludes.
The Biomedical HIV Prevention Summit referred to in the statement, which took place in Chicago April 8-10 of this year, is one of the two largest HIV/AIDS related conferences that NMAC organizes each year. Jennifer Phillips said more than 1,400 people attended the event.
The largest NMAC event, the United States Conference on HIV/AIDS, the most recent of which was held in D.C. Sept. 4-7, drew more than 2,400 participants and was hailed by AIDS activists as a highly successful gathering of a diverse group of experts seeking to push for the end to the HIV/AIDS epidemic.
One of the keynote speakers at that conference was Paul Kawata, who served as executive director and CEO of NMAC for 36 years and who delivered his farewell address at the conference following the announcement that he would retire on Oct. 7, 2025.
Many of the conference speakers praised Kawata, who became NMAC’s leader two years after its founding in 1987, as the leading force behind its growth and evolution into one of the nation’s leading HIV/AIDS advocacy organizations with a special outreach to people of color.
It was at that time that Harold Phillips, who served as director of the White House Office of AIDS Policy under then-President Joe Biden and who later joined NMAC as deputy director before the NMAC board named him Kawata’s successor as CEO, emerged as NMAC’s next leader.
“The Board has exuberantly elected Harold Phillips as our new CEO,” said Lance Toma, chair of the NMAC Board of Directors at the time Phillips’s appointment was announced. “In this unprecedented moment, there is no one more strategically positioned and experienced to lead our movement through what we know will be some of the most tumultuous and complicated times ahead,” the statement said.
The John Doe statement raising questions about Phillips’s actions and leadership says NMAC staff members formally appealed to the board of directors to intervene.
“The Board has remained silent, while Harold arrogantly told the staff that ‘the board has my back,’” the statement says.
The Blade has also attempted to reach out to Kawata by email for comment on how he feels NMAC is doing six months after his retirement. As of April 14, Kawata had not responded to the Blade’s inquiry.
According to the John Doe statement, NMAC officials have recently “sought external financial rescue,” including a visit by an NMAC official to California to request assistance from the pharmaceutical company Gilead Sciences. “Without such intervention, layoffs seem imminent,” the statement says.
“This is not a functioning nonprofit,” the John Doe statement concludes. “It is an organization in crisis – bleeding resources, hemorrhaging staff, and operating without transparency, accountability, or governance,” it says, adding, “The communities NMAC serves, the donors who fund its mission, and the public at large deserve to know what is happening behind closed doors.”
By contrast, the NMAC website describes the organization as a highly functioning nonprofit continuing to lead the fight against HIV/AIDS.
“Launched in 1987 during the early years of the HIV/AIDS crisis in the United States, NMAC is a national HIV organization that offers capacity building, leadership development, policy education, and public engagement to end the HIV epidemic among communities most impacted in the United States,” a statement on the NMAC website says.
“In 2026, we mark 45 years of the HIV movement,” the statement adds. “NMAC continues to pivot to center the needs of people of color impacted by HIV by responding to political challenges that threaten federal funding and programs that have provided an essential survival safety net,” it says. “Simultaneously, as HIV treatment allows people to age with HIV, our whole-person approach extends to achieving optimal quality of life beyond attaining viral suppression.”
In its most recent action, NMAC issued a detailed press release on April 14 criticizing President Donald Trump’s proposed fiscal year 2027 budget provisions that call for cutting more than $1.5 billion in HIV prevention, substance use, housing and other programs. The release provides details on how the cuts would negatively impact important HIV prevention programs and urges Congress to reject the proposed cuts.
