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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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Federal Government

Lambda Legal praises Biden-Harris administration’s finalized Title IX regulations

New rules to take effect Aug. 1

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U.S. Secretary of Education Miguel Cardona (Screen capture: AP/YouTube)

The Biden-Harris administration’s revised Title IX policy “protects LGBTQ+ students from discrimination and other abuse,” Lambda Legal said in a statement praising the U.S. Department of Education’s issuance of the final rule on Friday.

Slated to take effect on Aug. 1, the new regulations constitute an expansion of the 1972 Title IX civil rights law, which prohibits sex-based discrimination in education programs that receive federal funding.

Pursuant to the U.S. Supreme Court’s ruling in the landmark 2020 Bostock v. Clayton County case, the department’s revised policy clarifies that discrimination on the basis of sexual orientation and gender identity constitutes sex-based discrimination as defined under the law.

“These regulations make it crystal clear that everyone can access schools that are safe, welcoming and that respect their rights,” Education Secretary Miguel Cardona said during a call with reporters on Thursday.

While the new rule does not provide guidance on whether schools must allow transgender students to play on sports teams corresponding with their gender identity to comply with Title IX, the question is addressed in a separate rule proposed by the agency in April.

The administration’s new policy also reverses some Trump-era Title IX rules governing how schools must respond to reports of sexual harassment and sexual assault, which were widely seen as imbalanced in favor of the accused.

Jennifer Klein, the director of the White House Gender Policy Council, said during Thursday’s call that the department sought to strike a balance with respect to these issues, “reaffirming our longstanding commitment to fundamental fairness.”

“We applaud the Biden administration’s action to rescind the legally unsound, cruel, and dangerous sexual harassment and assault rule of the previous administration,” Lambda Legal Nonbinary and Transgender Rights Project Director Sasha Buchert said in the group’s statement on Friday.

“Today’s rule instead appropriately underscores that Title IX’s civil rights protections clearly cover LGBTQ+ students, as well as survivors and pregnant and parenting students across race and gender identity,” she said. “Schools must be places where students can learn and thrive free of harassment, discrimination, and other abuse.”

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Michigan

Mich. Democrats spar over LGBTQ-inclusive hate crimes law

Lawmakers disagree on just what kind of statute to pass

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Members of the Michigan House Democrats gather to celebrate Pride month in 2023 in the Capitol building. (Photo courtesy of Michigan House Democrats)

Michigan could soon become the latest state to pass an LGBTQ-inclusive hate crime law, but the state’s Democratic lawmakers disagree on just what kind of law they should pass.

Currently, Michigan’s Ethnic Intimidation Act only offers limited protections to victims of crime motivated by their “race, color, religion, gender, or national origin.” Bills proposed by Democratic lawmakers expand the list to include “actual or perceived race, color, religion, gender, sexual orientation, gender identity or expression, ethnicity, physical or mental disability, age, national origin, or association or affiliation with any such individuals.” 

Democratic Gov. Gretchen Whitmer and Attorney General Dana Nessel have both advocated for a hate crime law, but house and senate Democrats have each passed different hate crimes packages, and Nessel has blasted both as being too weak.

Under the house proposal that passed last year (House Bill 4474), a first offense would be punishable with a $2,000 fine, up to two years in prison, or both. Penalties double for a second offense, and if a gun or other dangerous weapons is involved, the maximum penalty is six years in prison and a fine of $7,500. 

But that proposal stalled when it reached the senate, after far-right news outlets and Fox News reported misinformation that the bill only protected LGBTQ people and would make misgendering a trans person a crime. State Rep. Noah Arbit, the bill’s sponsor, was also made the subject of a recall effort, which ultimately failed.

Arbit submitted a new version of the bill (House Bill 5288) that added sections clarifying that misgendering a person, “intentionally or unintentionally” is not a hate crime, although the latest version (House Bill 5400) of the bill omits this language.

That bill has since stalled in a house committee, in part because the Democrats lost their house majority last November, when two Democratic representatives resigned after being elected mayors. The Democrats regained their house majority last night by winning two special elections.

Meanwhile, the senate passed a different package of hate crime bills sponsored by state Sen. Sylvia Santana (Senate Bill 600) in March that includes much lighter sentences, as well as a clause ensuring that misgendering a person is not a hate crime. 

Under the senate bill, if the first offense is only a threat, it would be a misdemeanor punishable by one year in prison and up to $1,000 fine. A subsequent offense or first violent hate crime, including stalking, would be a felony that attracts double the punishment.

Multiple calls and emails from the Washington Blade to both Arbit and Santana requesting comment on the bills for this story went unanswered.

The attorney general’s office sent a statement to the Blade supporting stronger hate crime legislation.

“As a career prosecutor, [Nessel] has seen firsthand how the state’s weak Ethnic Intimidation Act (not updated since the late 1980’s) does not allow for meaningful law enforcement and court intervention before threats become violent and deadly, nor does it consider significant bases for bias.  It is our hope that the legislature will pass robust, much-needed updates to this statute,” the statement says.

But Nessel, who has herself been the victim of racially motivated threats, has also blasted all of the bills presented by Democrats as not going far enough.

“Two years is nothing … Why not just give them a parking ticket?” Nessel told Bridge Michigan.

Nessel blames a bizarre alliance far-right and far-left forces that have doomed tougher laws.

“You have this confluence of forces on the far right … this insistence that the First Amendment protects this language, or that the Second Amendment protects the ability to possess firearms under almost any and all circumstances,” Nessel said. “But then you also have the far left that argues basically no one should go to jail or prison for any offense ever.”

The legislature did manage to pass an “institutional desecration” law last year that penalizes hate-motivated vandalism to churches, schools, museums, and community centers, and is LGBTQ-inclusive.

According to data from the U.S. Department of Justice, reported hate crime incidents have been skyrocketing, with attacks motivated by sexual orientation surging by 70 percent from 2020 to 2022, the last year for which data is available. 

Twenty-two states, D.C., Puerto Rico, and the U.S. Virgin Islands have passed LGBTQ-inclusive hate crime laws. Another 11 states have hate crime laws that include protections for “sexual orientation” but not “gender identity.”

Michigan Democrats have advanced several key LGBTQ rights priorities since they took unified control of the legislature in 2023. A long-stalled comprehensive anti-discrimination law was passed last year, as did a conversion therapy ban. Last month the legislature updated family law to make surrogacy easier for all couples, including same-sex couples. 

A bill to ban the “gay panic” defense has passed the state house and was due for a Senate committee hearing on Wednesday.

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Indiana

Drag queen announces run for mayor of Ind. city

Branden Blaettne seeking Fort Wayne’s top office

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Branden Blaettner being interviewed by a local television station during last year’s Pride month. (WANE screenshot)

In a Facebook post Tuesday, a local drag personality announced he was running for the office of mayor once held by the late Fort Wayne Mayor Tom Henry, who died last month just a few months into his fifth term.

Henry was recently diagnosed with late-stage stomach cancer and experienced an emergency that landed him in hospice care. He died shortly after.

WPTA, a local television station, reported that Fort Wayne resident Branden Blaettne, whose drag name is Della Licious, confirmed he filed paperwork to be one of the candidates seeking to finish out the fifth term of the late mayor.

Blaettner, who is a community organizer, told WPTA he doesn’t want to “get Fort Wayne back on track,” but rather keep the momentum started by Henry going while giving a platform to the disenfranchised groups in the community. Blaettner said he doesn’t think his local fame as a drag queen will hold him back.

“It’s easy to have a platform when you wear platform heels,” Blaettner told WPTA. “The status quo has left a lot of people out in the cold — both figuratively and literally,” Blaettner added.

The Indiana Capital Chronicle reported that state Rep. Phil GiaQuinta, who has led the Indiana House Democratic caucus since 2018, has added his name to a growing list of Fort Wayne politicos who want to be the city’s next mayor. A caucus of precinct committee persons will choose the new mayor.

According to the Fort Wayne Journal Gazette, the deadline for residents to file candidacy was 10:30 a.m. on Wednesday. A town hall with the candidates is scheduled for 6 p.m. on Thursday at Franklin School Park. The caucus is set for 10:30 a.m. on April 20 at the Lincoln Financial Event Center at Parkview Field.

At least six candidates so far have announced they will run in the caucus. They include Branden Blaettne, GiaQuinta, City Councilwoman Michelle Chambers, City Councilwoman Sharon Tucker, former city- and county-council candidate Palermo Galindo, and 2023 Democratic primary mayoral candidate Jorge Fernandez.

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