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U.S. health officials expand approach to monkeypox vaccines as cases crest

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With Southern Decadence coming up, Biden health officials have given an additional 6,000 monkeypox vaccines for New Orleans. (Blade file photo by Michael Key)

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 number of additional monkeypox cases in beginning to crest, per CDC data.

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.”

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U.S. Supreme Court

Trump asks Supreme Court to allow restrictions on gender-affirming care in prisons

SCOTUS could further restrict rights of trans inmates

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The U.S. Supreme Court with an LGBTQ Pride flag flying in front of it. (Washington Blade Photo by Michael Key)

The Trump administration has asked the Supreme Court to allow its policy limiting gender-affirming treatment for federal inmates to take effect while a legal challenge plays out in court.

U.S. District Judge Royce Lamberth ordered the government to continue providing gender-affirming care, such as hormone therapy, which had become policy nearly a decade ago for inmates who were transitioning.

The Trump administration argues in its application that its policy restricting transgender rights was properly adopted and that the judge overstepped, posing nationwide “security and prison-administrative concerns.”

If allowed, the policy would halt surgeries, hormones and social accommodations such as wigs while allowing mental health therapy to continue as the legality of the policy reversal is litigated.

The government also argues in the application that the Bureau of Prisons had “determined that sex-trait-modification surgeries, hormone interventions in general, and social accommodations could no longer be justified as treatment for gender dysphoria.”

American Civil Liberties Union attorneys for the inmates said the policy is “a direct threat to the well-being of transgender people in federal custody and an open violation of their fundamental rights,” and said withholding necessary gender-affirming healthcare constitutes cruel and unusual punishment.

The Blade has covered the ongoing developments surrounding changes to Federal Bureau of Prisons transgender inmate policy that went into effect earlier in Trump’s term. The changes primarily focus on rolling back Biden-era protections for trans inmates.

Earlier this year, the Blade published a joint letter from multiple senators in response to the rollback of the policy. Multiple senators — including Edward Markey (D-Mass.), Jeffrey A. Merkley (D-Ore.) and Mazie K. Hirono (D-Hawaii) — sent a letter to Attorney General Todd Blanche and Federal Bureau of Prisons Director William Marshall III calling for them to reverse the policy change, saying it endangers inmates’ health and safety.

The senators described how the policy shift, along with President Trump’s Executive Order 14168, titled “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government,” is forcing policy changes they argued are rooted more in political rhetoric than in medical research or evidence-based correctional practices.

Federal Bureau of Prisons responded to the Blade’s request for comment in May, declining to reconsider its transgender inmate policy.

The Blade reached out to the Federal Bureau of Prisons once again over the application to the Supreme Court, but did not hear back before publication.

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Federal Government

Education Department rolls back protections for LGBTQ students under Title IX

The DoE policy rescinds Biden-era protections

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U.S. Education Secretary Linda McMahon (Washington Blade photo by Michael Key)

The Department of Education rolled back a Biden-era Title IX interpretation on Monday that secured sex-based discrimination protections for students on the basis of sexual orientation and gender identity.

Title IX was established in 1972 as landmark civil rights law. It prohibits sex-based discrimination in any school or any other education program that receives funding from the federal government.

Education Secretary Linda McMahon spoke about the revision of the policy, claiming the decision would explicitly help “women and girls.”

“Thanks to today’s action, the published Title IX regulations faithfully reflect court orders and congressional intent — reducing confusion for parents, students, and educational institutions. We will continue to relentlessly champion equal opportunity for all Americans and hold accountable any school or college that violates the rights, privacy, or athletic opportunities of our women and girls,” McMahon said via press release.

Prior to her work under the Trump-Vance administration, McMahon was a World Wrestling Federation/World Wrestling Entertainment executive before resigning to pursue a career in politics. She was appointed to the Connecticut State Board of Education by then-Gov. Jodi Rell in January 2009, but resigned from her role shortly afterward to run what ultimately became two failed campaigns for Connecticut’s U.S. Senate seat in 2010 and 2012.

A “fact sheet” provided by the Department of Education also called the inclusive sexual assault and gender identity protections expanded under the Biden-Harris unlawful, saying, “This change is necessary to provide clarity in the Code of Federal Regulations so that institutions, administrations, students, and families can see the rules that are actually in force and to help eliminate public confusion about the Biden administration’s unlawful attempt to stretch Title IX’s legal protections to cover ‘sexual orientation’ and ‘gender identity.’”

This is not the first time this policy has faced judicial hurdles. While Biden was still in office, the plan was struck down in multiple courts in Republican states.

Opponents of the move say it will harm transgender athletes and weaken protections for sexual assault victims.

“Sexual harassment and assault continue to be pervasive in schools and, to the fullest extent possible, we should be working to enforce the laws that protect student survivors of sexual violence. Yet, Education Secretary Linda McMahon and the Trump administration have decided to ignore what survivors need, instead weaponizing Title IX to attack trans students,” said Shiwali Patel, senior director of education justice at the National Women’s Law Center.

This is a return to a first Trump term policy after Biden issued an executive order to attempt to curb discrimination for all — especially those with different sexual orientations and gender identities — that had been given a pass during Trump’s first term. Much of Title IX’s policy has a narrow vision of what sex protections look like that often and enthusiastically leave gender-diverse and non-heterosexual people out.

In March 2021, President Joe Biden signed Executive Order 14021, “Guaranteeing an Educational Environment Free From Discrimination on the Basis of Sex, Including Sexual Orientation or Gender Identity,” to attempt to undo some of the flagrantly anti-LGBTQ policy the Trump-Pence administration had set forth relating to Title IX protections for LGBTQ students and sexual assault survivors.

The secretary focused this “win” for the administration as one more step toward restricting transgender students from competing in women’s sports, but the 2020 rule, completed under former Education Secretary Betsy DeVos, didn’t explicitly ban trans students from participating on sports teams consistent with their gender identity. It did limit the types of sexual harassment and assault complaints that schools had to investigate and required live hearings so male students could respond to accusations.

McMahon didn’t discuss those aspects in her statement or in requests for comment. The 2020 rule drew praise from conservatives and intense opposition from advocates who said it downplayed sexual abuse and left victims unprotected.

In a statement, U.S. Rep. Tim Walberg (R-Mich.), who chairs the House Education Committee, said, “Returning to the 2020 regulations restores longstanding protections for women and girls that the Biden-Harris administration attempted to dismantle and realigns Title IX policy with court precedents.”

LGBTQ activists have called this decision a direct attack on LGBTQ safety — particularly for trans students who continue to face a barrage of legislative, executive, and judicial attacks in recent years from the Trump-Vance administration.

Kelley Robinson, president of the Human Rights Campaign, the largest LGBTQ advocacy group in the world, released a statement following the DoE’s announcement.

“Title IX is, quite simply, about protecting students and ensuring that they are safe from abuse, harassment, and discrimination while they pursue their education. But Donald Trump and his cronies aren’t interested in any of that,” Robinson said. “Donald Trump’s Department of Education has completely lost sight of that mission. Instead of enforcing protections for students, they’re rescinding them. They don’t care if sexual harassment and assault go unaddressed. And they’re happy to strip funding away from school districts and states that are actually trying to keep students safe.

“We know who will be hurt: women, girls, and others who are vulnerable to sexual harassment, assault and abuse — including LGBTQ+ students. The fact that they’re dropping this rule into place abruptly, without a comment period, denying families, educators, loved ones, and the students themselves a say in how they should be treated, shows how little they care about the safety of our students.

“This is a monstrous injustice, and it drives home how essential it is that we take action at the polls this November to start bringing some accountability to an administration that has turned its back on the very students Title IX was written to protect,” she added.

The Washington Blade reached out to the DoE for comment and questions on whether Title IX protections still included LGBTQ students, and received this email response from Education Spokesman Sabin Sidney:

“Your questions indicate you are clearly missing the entire point of this Final Rule. The Biden Administration illegally rewrote Title IX to include ‘sexual orientation’ and ‘gender identification’ in the definition of sex-based discrimination. The Trump Administration is rescinding this rule—only after every federal court that heard legal challenges rejected it as unlawful.

“Since January 2025, the Department has been enforcing Title IX consistent with the President’s Executive Order grounded in biological truth that there are only two sexes. The Trump Administration is restoring the original promise of Title IX and providing clarity to students, parents, and educational institutions. We will vigorously defend equal opportunity consistent with the law’s intended purpose.”

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National

Dr. Fauci ‘honored to be part of’ LGBTQ history

Equality Forum presents pioneering AIDS researcher with Int’l Role Model Award

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Dr. Anthony Fauci (Washington Blade file photo by Michael Key)

PHILADELPHIA — Dr. Anthony Fauci accepted an award from the Equality Forum on Sunday in which he told the audience that he is honored to be part of the LGBTQ community’s history.

“Over these many decades I have not simply admired the community — I have genuinely enjoyed being part of the conversation with it,” Fauci said. “I’ve enjoyed the arguments, debates, disagreements, the humor, the friendship and above all the extraordinary commitment to alleviate suffering and prevent premature death for persons living with HIV.” 

Fauci continued, “I am grateful to the Equality Forum for this award. I am grateful to the LGBTQ community for allowing me throughout these many years to become part of your struggle and I am deeply honored to be part of your history.”

Fauci traveled to Philadelphia to accept the Equality Forum’s International Role Model Award. Longtime HIV/AIDS activist Peter Staley presented Fauci with the award, recalling the early days in the fight against the disease and that activists in the 1980s frequently clashed with Fauci, director of the National Institute of Allergy and Infectious Diseases at the time. In his remarks, Staley recalled the message on one sign from an ‘80s protest, “Fuck Fauci.” But activists warmed up to Fauci and he ultimately befriended his former gay critics, including Larry Kramer. 

Dr. Anthony Fauci speaks at the Equality Form event on Sunday. (Washington Blade staff photo)

Also at Sunday’s event, the Equality Forum honored Erica Deuso, the first out transgender mayor in Pennsylvania; she was elected mayor of Downington, Pa., and sworn in last January. Ben Garcia, executive director of the American LGBTQ+ Museum in New York presented Deuso with the Frank Kameny Award. 

The event also served as the kickoff of LGBT History Month, which Equality Forum honors by naming 31 LGBT Icons, one per day in October. Visit equalityforum.org for a full list of its more than 600 queer Icons. This year’s honorees include designer Calvin Klein, Rep. Chris Pappas, and President Abe Lincoln. 

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