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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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National

DOJ seeks to dismiss some claims in gay FBI employee’s bias lawsuit

David Maltinsky was fired after displaying Pride flag at desk

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A gay FBI trainee was fired after displaying a Pride flag at his desk. (Washington Blade photo by Michael Key)

Attorneys for gay former FBI employee David Maltinsky, who was fired from his job as a non-agent employee at the FBI’s Los Angeles Field Office in October 2025 after more than 16 years of service for displaying an LGBTQ Pride flag at his workstation, filed court papers on July 15 opposing a motion by government attorneys to dismiss some but not all of the provisions in his unlawful discrimination lawsuit seeking to overturn the firing.

Maltinsky’s lawsuit, filed in federal court in D.C. on Nov. 19, 2025, states that FBI Director Kash Patel acted illegally by violating Maltinsky’s First Amendment constitutional rights and the U.S. Civil Rights Act of 1964 by ordering his firing on grounds that he “exercised poor judgement with an inappropriate display of political signage” by displaying the Pride flag.

The firing came at a time when Maltinsky successfully completed 16 weeks of the FBI’s 19-week training program at the FBI training academy in Quantico, Va. to become an FBI Special Agent, according to the lawsuit.

In addition to Patel, who took office as FBI director in February 2025 under the Trump administration, the lawsuit names as defendants the FBI itself, Acting U.S. Attorney General Todd Blanche, and the U.S. Department of Justice, which oversees the FBI.

“Defendants discriminated against Maltinsky for engaging in protected speech, for his sexual orientation, and for opposing discrimination – a clear and brazen violation of federal law and the Constitution,” the lawsuit states in an amended complaint filed May 5, 2026.

The Department of Justice, which is representing the FBI in its response to the lawsuit, did not immediately respond to a request from the Washington Blade for comment on the lawsuit and why it is seeking dismissal of some but not all of the lawsuit’s multiple allegations, including its claim that the firing violated Maltinsky’s First Amendment rights.

In its “Partial” motion filed on June 15, 2026, to dismiss some provisions in the lawsuit, the Justice Department through Assistant Attorney General Brett A. Shumate and Associate Branch Director Christopher Hall, stated that the lawsuit fails to provide sufficient evidence that Maltinsky was fired because he is gay.    

“The Amended Complaint contains no factual allegations that Director Patel or any other decisionmaker expressed hostility toward gay employees, relied on Plaintiff’s sexual orientation in making employment decisions, even knew Plaintiff’s sexual orientation or otherwise indicated that Plaintiff’s status as a gay man played any role in the challenged actions,” the motion states.

Based on that, among other things, the motion says the lawsuit’s claim that the firing violated the U.S. Civil Rights Act of 1964 should be dismissed. A 2020 U.S. Supreme Court decision ruled that the 1964 law bans employment discrimination based on sexual orientation and gender identity along with its other categories including race, religion, and gender.  

In its arguments that the decision to fire Maltinsky was illegal, unconstitutional, and unjust, the lawsuit’s amended complaint points out that FBI officials at the Los Angeles Field Office where Maltinsky worked presented the Pride flag to him and gave him full permission to display it at his workstation.  

“The FBI encouraged and honored Maltinsky’s work by awarding him the 2020 Director’s Award For Excellence-Outstanding Service in Diversity and Inclusion,” the lawsuit says. “In 2022, the Attorney General for the Department of Justice awarded Maltinsky the Attorney General’s Award for Equal Employment Opportunity, DOJ’s highest award for performance in support of the Equal Employment Program,” it says.

“In special recognition of Maltinsky’s efforts to improve the FBI, in June 2021 LAFO [Los Angeles Field Office] leadership entrusted to Maltinsky two Pride flags that had been flown from the flagpole located in front of the LAFO,” the lawsuit complaint continues. “Maltinsky displayed one of those flags at his workstation.”

Although the lawsuit doesn’t say so directly, all of that happened during the administration of President Joe Biden and previous FBI Director Christopher Wray, who held the director’s position from August 2017 to January 2025, when Donald Trump took office as president.

Nathaniel Zelinsky, one of the attorneys representing Maltinsky regarding the lawsuit, told the Blade that because the Justice Department did not contest the lawsuit’s First Amendment provisions, the case will move forward to the discovery stage, in which he and fellow attorneys can seek and obtain government documents, and most likely go to trial. He said that regardless of whether the judge approves the dismissal of the lawsuit provisions the government has asked for, the other provisions and the case as a whole  will continue.

“And those First Amendment claims are extremely serious,” he said. “The government, by its admission, fired David Maltinsky because they did not like the speech he displayed when he put up the Pride flag that was gifted to him by the FBI,” Zelinsky said. “The federal government cannot discriminate against its workers based on their speech.”      

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North Carolina

Authorities investigate officer-involved shooting outside Asheville gay bar

Incident took place near Shakey’s on Wednesday

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(Photo by chalabala/Bigstock)

An officer-involved shooting outside of a gay dive bar, Shakey’s, in downtown Asheville, N.C., left one man dead Wednesday.

The bar released a statement the following morning regarding the incident, stating that bar staff had asked a patron to leave earlier in the night citing concerning behavior. The bar said that later the man was spotted with a gun in the parking lot.

The bar proceeded to call 911, locked the doors to the establishment, and followed dispatcher instructions on how to keep patrons of the bar safe while officers arrived. These protocols included getting patrons away from the windows and staying low to the ground.

According to Shakey’s, shots were fired outside of the business. When the Asheville Police Department officers arrived, they fired back. The individual died from their injuries, according to the police.

“Because of everyone’s quick actions, cooperation, and concern for one another, every customer and every employee inside Shakey’s made it home safely. We are incredibly thankful,” Shakey’s said on their Instagram page. They thanked Asheville police, emergency dispatchers, EMS, and all first responders who were on scene.

On Thursday, a spokesperson for the North Carolina State Bureau of Investigation, Chad Flowers, stated that the suspect involved in the shooting was Arturo Castillo Palomar.

The Washington Blade reached out to the North Carolina State Bureau of Investigation for a comment regarding the possibility of the event being considered a hate crime. They said the issue is currently under investigation and that the findings would be turned over to the district attorney for review.

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Pentagon

Hegseth announces testosterone initiative as trans troop ban continues

SPARTA Pride criticized Pentagon policy

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Defense Secretary Pete Hegseth (Washington Blade photo by Michael Key)

The U.S. military will begin testing and treating service members with hormone therapy despite banning similar medical care for transgender service members.

Defense Secretary Pete Hegseth said Wednesday that troops ages 30 and older will be subject to annual testosterone screenings, while younger service members will have the option to voluntarily opt in. Some troops may then be recommended for hormone therapy, he explained in a video posted to social media.

“Under the supervision of our world-class medical professionals, warfighters age 30 and older are going to be tested annually as part of their periodic health assessment,” Hegseth said in a video posted to X, captioned “The High-T Department of War.”

This push to test testosterone levels, as the hormone is commonly referred to as “T,” runs counter to current medical guidelines. Physicians are generally advised to discuss testosterone therapy only with men who have symptoms consistent with low testosterone and documented low hormone levels on two separate blood tests.

Testosterone is a vital sex hormone that all humans naturally produce. It helps regulate muscle mass, bone density, and sex drive. In men, it is primarily produced in the testicles, while in women it is produced in the ovaries and adrenal glands.

Natural testosterone levels in men decline with age and have long been associated with issues such as erectile dysfunction, low libido, mood changes, and weight gain. However, experts continue to debate whether these conditions should routinely be treated with testosterone therapy.

Hegseth’s announcement aligns with other actions taken by the Trump-Vance administration — including efforts by Health Secretary Robert F. Kennedy Jr. — to make testosterone therapy more accessible for men, particularly those assigned male at birth.

Last month, the Food and Drug Administration proposed easing prescribing restrictions on testosterone gels, pills, patches, and injections following a December advisory panel that recommended reducing regulatory hurdles to expand access to testosterone therapy.

Currently, FDA labeling specifies that these medications are approved only for men with hypogonadism, a medical condition that causes abnormally low testosterone levels.

The announcement came as a shock to many LGBTQ advocates because Hegseth and the Defense Department have cited the use of hormone therapy by trans service members as justification for their dismissal under President Donald Trump’s 2025 executive order, “Prioritizing Military Excellence and Readiness.

The Pentagon continues to pursue implementation of the trans military ban as litigation proceeds. As a result, many trans service members have had their gender-affirming medical care halted, even as similar hormone therapy is now being expanded for cisgender service members. Under the executive order, the military currently disqualifies individuals diagnosed with gender dysphoria and has begun formal administrative separation proceedings for trans personnel.

SPARTA Pride, a nonpartisan nonprofit organization made up of trans service members, veterans, and their allies, issued a statement to the Washington Blade following Hegseth’s announcement.

“If hormone therapy helps warfighters perform at their best, then it cannot simultaneously be used as evidence that transgender service members are unfit to serve,” said Kara Corcoran, executive director of SPARTA Pride. “The same class of evidence-based medical treatment cannot be characterized as readiness-enhancing for one group and readiness-destroying for another.”

The legal fight over trans military service remains ongoing.

On June 1, the U.S. Court of Appeals for the D.C. Circuit ruled that trans service members already serving in the military could continue to do so, while allowing the armed services to continue refusing to enlist new trans recruits.

The Blade reached out to the Pentagon to ask why cisgender service members could receive hormone therapy while trans service members could not, but did not receive a response by the time of publication.

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