National
U.S. health officials expand approach to monkeypox vaccines as cases crest
At the end of a summer when the number of cases in the monkeypox outbreak rose sharply, the increase in reported infections now appears to be cresting amid increased public messaging and access to vaccines, prompting U.S. health officials to expand their strategy with a new equity-based effort to combat the disease.
Although the reported number of cases, according to most data from the Centers for Disease Control & Prevention, has reached 18,417 in the United States, the number of additional cases decreased from the high at the start of the month, suggesting a downward trajectory in the spread of the disease as vaccines become more readily available.
The numbers are also consistent with a new study finding a significant number of gay and bisexual men, as well as other men who have sex with men, have been limiting contact with casual sex partners, which has been the driving force in the spread of monkeypox. The report from the CDC last week found limiting one-time sexual encounters can significantly reduce the transmission of monkeypox virus, while about half of men who have sex with men are cutting down on sexual activity amid the outbreak, including one-night stands and app hookups.
With the trajectory of monkeypox on the decline, the Biden administration announced a new initiative with the goal of ensuring vaccine distribution is consistent with the value of equity, including on the basis of geographic, racial, and ethnic lines. A total of 10,000 doses of vaccines in the federal government’s supply will be earmarked for localities that have used 50 percent of their allocated supply to support equity interventions, such as outreach to Black and Latino communities, which have been disproportionately affected by the disease or a specific event and celebration for LGBTQ people, health officials announced Tuesday.
Demetre Daskalakis, the Biden administration’s face of LGBTQ outreach for monkeypox and deputy coordinator for the White House monkeypox task force, laid out the details for the new equity-based supplementary initiative in a conference call Tuesday with reporters.
“So what we mean by an equity intervention is what works in your state, county, or city to reach people who we may not be reaching, especially people of color and members of the LGBTQI+ population,” Daskalakis said. “What it means is: It can be working with a specific group or venue that reaches the right people for monkeypox prevention. Once these innovative strategies have been reviewed by CDC, vaccines will be supplied to jumpstart these ideas and accelerate reach deeper into communities.”
The additional equity-based approach to monkeypox vaccine distribution is consistent with the Biden administration’s efforts in recent weeks to distribute additional shots to localities hosting large-scale events for LGTBQ people at the end of the summer, such as Black Pride in Atlanta and Southern Decadence in New Orleans.
Louisiana Gov. John Bel Edwards joined the conference call with reporters on Tuesday and had high praise for the Biden administration for making the additional 6,000 doses of monkeypox vaccine available in time for Southern Decadence, which takes place in the final week of August through Labor Day weekend.
“This is an example — I think a really solid example — of what a federal-state-local partnership and — and then the community providers as well,” Bel Edwards said. “Because the public health folks in New Orleans have been tremendous, but also the community providers.”
Bel Edwards said health officials in the Biden administration have, in addition to providing more vaccines, sent down multidisciplinary teams to New Orleans to help the state organize and prepare as well as set up testing and vaccination sites “that are going to be convenient for the at-risk population.”
A reporter from the New Orleans Advocate on the conference call, however, asked a pointed question on the recent distribution of vaccines to New Orleans in advance of Southern Decadence: The current approach to vaccine administration requires a series of shots, and even with new distribution most people won’t have even had their second shot by that time, so how can Southern Decadence think they will be protected, especially when vaccines take time to become fully effective?
Daskalakis, while promoting the equity-based approach to vaccine distribution, said the Biden administration has been “very clear” that first shot of the monkeypox vaccine “doesn’t mean that you’re protected for the event.”
“We’re going to talk to them about lots of other strategies that they can reduce risk of acquiring monkeypox, but also make it clear that that shot is not for today; it’s for four weeks from now, plus two weeks after that second dose when you get maximum protection,” Daskalakis said.
First death of monkeypox patient reported
Although the number of cases is cresting, concern about monkeypox continues as well as the potential danger of the disease. Case in point: The death of a hospital patient in Texas who had monkeypox, but may have to succumbed to other factors, has drawn attention amid a conventional understanding the skin disease isn’t fatal. The case represents the first time in the United States that a patient with monkeypox died while having the condition.
The patient, as confirmed by the Texas Department of State Health Services on Tuesday, was an adult resident of Harris County who was “severely immunocompromised” and state health officials reviewing the case said it is under investigation to determine what role monkeypox played in the death.
Jenny McQuiston, a CDC official who specializes in research on zoological diseases that spread from animals to people, said in response to a question on the casualty that health officials are also evaluating the death and the role monkeypox played.
“I think it’s important to emphasize that deaths due to monkeypox, while possible, remain very rare,” McQuiston said. “In most cases, people are experiencing infection that resolves over time. And there have been very few deaths even recorded globally. Out of over 40,000 cases around the world, only a handful of fatalities have been reported.”
Despite the cresting in the number of cases, many health experts aren’t sold on the new approach to vaccines announced earlier this month by the Biden administration, which sought to expand existing doses of vaccines fivefold as supply hasn’t met demand. The new vaccine approach calls for injecting 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).
Bob Fenton, a regional administrator for FEMA and the response coordinator for the White House task force, said about 75 percent of jurisdictions have already adopted the new approach to vaccine injection, while an additional 20 percent are working toward a “fully operational intradermal method.”
“We continue to be laser-focused on doing everything within our power to help jurisdictions and clinicians get shots in arms,” Fenton said. “We’re seeing more and more jurisdictions adopt the intradermal administration.”
Data of this new intradermal approach, critics have said, is insufficient to support the idea it will be as effective as subcutaneous injections, although the Biden administration continues to give assurances the new route for injections is tested and safe. According to a report earlier this month in the Washington Post, the manufacturer of the JYNNEOS vaccine in Denmark, Bavaria Nordic, privately threatened to cut off supply of the shots based on a conversation with health officials on objections the vaccine hasn’t been approved for intradermal use.
McQuiston, in response to a question on whether or not U.S. health officials are collecting newly available real-world information on the results of the new vaccine approach, said U.S. health officials continue to receive data on monkeypox and soon onboard information from additional states.
“CDC operates a system called VAERS — or the Vaccine Adverse Event Reporting System — and we’re actively looking at…different types of events that might be reported post-vaccination,” McQuiston said. ” And we are actively gathering information from the different jurisdictions and states and cities about which vaccines they’re administering — whether it’s subcutaneous or intradermal — and we are gathering those data now, as we speak.”
Federal Government
RFK Jr.’s HHS report pushes therapy, not medical interventions, for trans youth
‘Discredited junk science’ — GLAAD
A 409-page report released Thursday by the U.S. Department of Health and Human Services challenges the ethics of medical interventions for youth experiencing gender dysphoria, the treatments that are often collectively called gender-affirming care, instead advocating for psychotherapy alone.
The document comes in response to President Donald Trump’s executive order barring the federal government from supporting gender transitions for anyone younger than 19.
“Our duty is to protect our nation’s children — not expose them to unproven and irreversible medical interventions,” National Institutes of Health Director Dr. Jay Bhattacharya said in a statement. “We must follow the gold standard of science, not activist agendas.”
While the report does not constitute clinical guidance, its findings nevertheless conflict with not just the recommendations of LGBTQ advocacy groups but also those issued by organizations with relevant expertise in science and medicine.
The American Medical Association, for instance, notes that “empirical evidence has demonstrated that trans and non-binary gender identities are normal variations of human identity and expression.”
Gender-affirming care for transgender youth under standards widely used in the U.S. includes supportive talk therapy along with — in some but not all cases — puberty blockers or hormone treatment.
“The suggestion that someone’s authentic self and who they are can be ‘changed’ is discredited junk science,” GLAAD President and CEO Sarah Kate Ellis said in a statement. “This so-called guidance is grossly misleading and in direct contrast to the recommendation of every leading health authority in the world. This report amounts to nothing more than forcing the same discredited idea of conversion therapy that ripped families apart and harmed gay, lesbian, and bisexual young people for decades.”
GLAAD further notes that the “government has not released the names of those involved in consulting or authoring this report.”
Janelle Perez, executive director of LPAC, said, “For decades, every major medical association–including the American Medical Association and the American Academy of Pediatrics–have affirmed that medical care is the only safe and effective treatment for transgender youth experiencing gender dysphoria.
“This report is simply promoting conversion therapy by a different name – and the American people know better. We know that conversion therapy isn’t actually therapy – it isolates and harms kids, scapegoats parents, and divides families through blame and rejection. These tactics have been used against gay kids for decades, and now the same people want to use them against transgender youth and their families.
“The end result here will be a devastating denial of essential health care for transgender youth, replaced by a dangerous practice that every major U.S. medical and mental health association agree promotes anxiety, depression, and increased risk of suicidal thoughts and attempts.
“Like being gay or lesbian, being transgender is not a choice, and no amount of pressure can force someone to change who they are. We also know that 98% of people who receive transition-related health care continue to receive that health care throughout their lifetime. Trans health care is health care.”
“Today’s report seeks to erase decades of research and learning, replacing it with propaganda. The claims in today’s report would rip health care away from kids and take decision-making out of the hands of parents,” said Shannon Minter, legal director of NCLR. “It promotes the same kind of conversion therapy long used to shame LGBTQ+ people into hating themselves for being unable to change something they can’t change.”
“Like being gay or lesbian, being transgender is not a choice—it’s rooted in biology and genetics,” Minter said. “No amount or talk or pressure will change that.”
Human Rights Campaign Chief of Staff Jay Brown released a statement: “Trans people are who we are. We’re born this way. And we deserve to live our best lives and have a fair shot and equal opportunity at living a good life.
“This report misrepresents the science that has led all mainstream American medical and mental health professionals to declare healthcare for transgender youth to be best practice and instead follows a script predetermined not by experts but by Sec. Kennedy and anti-equality politicians.”
The White House
Trump nominates Mike Waltz to become next UN ambassador
Former Fla. congressman had been national security advisor
President Donald Trump on Thursday announced he will nominate Mike Waltz to become the next U.S. ambassador to the U.N.
Waltz, a former Florida congressman, had been the national security advisor.
Trump announced the nomination amid reports that Waltz and his deputy, Alex Wong, were going to leave the administration after Waltz in March added a journalist to a Signal chat in which he, Defense Secretary Pete Hegseth, and other officials discussed plans to attack Houthi rebels in Yemen.
“I am pleased to announce that I will be nominating Mike Waltz to be the next United States ambassador to the United Nations,” said Trump in a Truth Social post that announced Waltz’s nomination. “From his time in uniform on the battlefield, in Congress and, as my National Security Advisor, Mike Waltz has worked hard to put our nation’s Interests first. I know he will do the same in his new role.”
Trump said Secretary of State Marco Rubio will serve as interim national security advisor, “while continuing his strong leadership at the State Department.”
“Together, we will continue to fight tirelessly to make America, and the world, safe again,” said Trump.
Trump shortly after his election nominated U.S. Rep. Elise Stefanik (R-N.Y.) to become the next U.S. ambassador to the U.N. Trump in March withdrew her nomination in order to ensure Republicans maintained their narrow majority in the U.S. House of Representatives.
U.S. Federal Courts
Second federal lawsuit filed against White House passport policy
Two of seven plaintiffs live in Md.
Lambda Legal on April 25 filed a federal lawsuit on behalf of seven transgender and nonbinary people who are challenging the Trump-Vance administration’s passport policy.
The lawsuit, which Lambda Legal filed in U.S. District Court for the District of Maryland in Baltimore, alleges the policy that bans the State Department from issuing passports with “X” gender markers “has caused and is causing grave and immediate harm to transgender people like plaintiffs, in violation of their constitutional rights to equal protection.”
Two of the seven plaintiffs — Jill Tran and Peter Poe — live in Maryland. The State Department, Secretary of State Marco Rubio, and the federal government are defendants.
“The discriminatory passport policy exposes transgender U.S. citizens to harassment, abuse, and discrimination, in some cases endangering them abroad or preventing them from traveling, by forcing them to use identification documents that share private information against their wishes,” said Lambda Legal in a press release.
Zander Schlacter, a New York-based textile artist and designer, is the lead plaintiff.
The lawsuit notes he legally changed his name and gender in New York.
Schlacter less than a week before President Donald Trump’s inauguration “sent an expedited application to update his legal name on his passport, using form DS-5504.”
Trump once he took office signed an executive order that banned the State Department from issuing passports with “X” gender markers. The lawsuit notes Schlacter received his new passport in February.
“The passport has his correct legal name, but now has an incorrect sex marker of ‘F’ or ‘female,'” notes the lawsuit. “Mr. Schlacter also received a letter from the State Department notifying him that ‘the date of birth, place of birth, name, or sex was corrected on your passport application,’ with ‘sex’ circled in red. The stated reason was ‘to correct your information to show your biological sex at birth.'”
“I, like many transgender people, experience fear of harassment or violence when moving through public spaces, especially where a photo ID is required,” said Schlacter in the press release that announced the lawsuit. “My safety is further at risk because of my inaccurate passport. I am unwilling to subject myself and my family to the threat of harassment and discrimination at the hands of border officials or anyone who views my passport.”
Former Secretary of State Antony Blinken in June 2021 announced the State Department would begin to issue gender-neutral passports and documents for American citizens who were born overseas.
Dana Zzyym, an intersex U.S. Navy veteran who identifies as nonbinary, in 2015 filed a federal lawsuit against the State Department after it denied their application for a passport with an “X” gender marker. Zzyym in October 2021 received the first gender-neutral American passport.
Lambda Legal represented Zzyym.
The State Department policy took effect on April 11, 2022.
Trump signed his executive order shortly after he took office in January. Germany, Denmark, Finland, and the Netherlands are among the countries that have issued travel advisories for trans and nonbinary people who plan to visit the U.S.
A federal judge in Boston earlier this month issued a preliminary injunction against the executive order. The American Civil Liberties Union filed the lawsuit on behalf of seven trans and nonbinary people.
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