PRESS RELEASE: More than 300 Health Care Workers, Scientists, Academics, and Community Members Urge the Biden Administration to Address Domestic Needs in the United States Mpox Response
Read full letter here: Mpox 2024 Letter and Signatories – Final.
For Media Inquiries Contact Joseph Osmundson at jo58@nyu.edu or 646-457-1764
June 14, 2024
New York, NY – PrEP4All, a New York-based HIV prevention organization, and STICKITIN, a Los Angeles-based mpox vaccination initiative under the UCLA Hub for Health Intervention, Policy and Practice coordinated a letter urging the Biden administration to take essential and immediate steps to blunt a growing mpox epidemic in the country and to address pernicious disparities in access to mpox vaccine, testing, and treatment.
Mpox is a skin infection caused by a virus closely related to the vaccinia and smallpox viruses. Infections are lengthy and painful, and can be severe or even deadly in individuals with compromised immune systems, especially those with untreated HIV.
Because of the similarity to smallpox, a vaccine, JYNNEOS, that is highly effective at mpox prevention is widely available. However, due to the recent commercialization of the vaccine by its maker, Bavarian Nordic, free access for those without insurance is set to expire in the coming weeks or months. We request that the federal government immediately restore free access for all regardless of insurance before the current batch available via city and state governments runs out. Disparities in mpox vaccination show that Black and Brown Americans are less likely to be vaccinated, with less than a quarter of all eligible individuals having received two doses of JYNNEOS. Black and Latinx Americans are also less likely to be insured.
The letter has been signed by 30 organizations and over 300 individuals, including clinicians and professors at Harvard, Boston University, Columbia University, Duke University, NYU, UCLA, and UCSF, and city and state health workers from across the United States.
Other requests in the letter include:
- Initiating high quality randomized controlled clinical trials of a booster dose of Jynneos due to multiple studies indicating waning vaccine efficacy over time
- Increasing mpox surveillance, with built-in ties to impacted communities, for upticks in mpox cases or the introduction of the more virulent and deadly strain of mpox currently causing an epidemic in the Democratic Republic of the Congo
- Combining data from the American and European clinical trials of the mpox drug tecovirimat to more quickly determine its efficacy, including against secondary end points such as pain and lesion number
These requests are essential for immediate research and implementation steps identified in community organizing in collaboration with city and state health agencies across the United States. Without meeting these requests, the United States government once again risks falling behind the needs of the global mpox epidemic and maintaining limited tools for when, not if, mpox vaccination efficacy wanes or more virulent strains spread globally.
“This letter is a starting point,” said co-organizer Joseph Osmundson, Clinical Associate Professor of Biology at NYU. “These are immediate needs that the government should already have identified and be acting upon. Given the atrocious disparities in mpox cases and deaths, with 90% of mpox deaths being specifically in Black queer men with advanced HIV, the notion of letting vaccine access for the uninsured expire is beyond comprehension. Beyond even this letter, the needs for global intervention for a global epidemic are great.”
After a large global epidemic in 2022 spread mostly in queer sexual networks, cases of mpox have remained and, in 2024, increased in number. Currently, a large outbreak of a more severe strain of mpox is spreading unchecked in the Democratic Republic of the Congo, and South Africa recently reported its first death from the virus as cases there also appear to be growing.
“PrEP4All has been inspired by the Administration’s dedication to a National PrEP Program for un- and underinsured populations over the past two years,” said Jeremiah Johnson, Executive Director at PrEP4All. “But even as we fight for that vision of unfettered access to comprehensive HIV prevention to become a reality, we’re now facing unnecessary barriers to mpox vaccine access for the same communities for whom the Administration is trying to provide PrEP. We need for President Biden and HHS to ensure broad access to vaccination regardless of insurance status, particularly as we face the possibility of a renewed mpox crisis in the US.”
“Recently there has been a spike in rumors and reports around mpox vaccine booster as soon as this year, and we know black and brown LGBTQ individuals are the most vulnerable populations to this next wave of potential infection,” said Jennifer Barnes-Balenciaga, Commissioner of the NYC commission on Gender Equality. “Those in positions of power and influence must make sure others receive the adequate information and care to avert another impending pandemic.”
“We have learned from our experience with HIV, COVID-19, mpox, and other infectious disease epidemics that addressing structural issues, such as those related to financing and coordinated R&D, are essential for robust and equitable production, access, and uptake of life-saving prevention and treatment options in the U.S. and globally,” said Judith Auerbach, Professor of Medicine at UCSF. “This can best happen with strong leadership from the federal government—in partnership with public health scientists, activists, communities, and industry—in the specific ways this letter details.”
“I cannot stress enough the urgency for the Biden administration to prioritize mpox research and address the specific needs of transgender, gender expansive, and intersex communities, which have historically been underserved in healthcare and underrepresented in mpox treatment research. This is an opportunity to ensure equity, enhance awareness, and deliver targeted interventions that can promote public health,” said Matt Inouye, Manager of Policy and Community Engagement.
“As a health equity advocate and a black same gender loving man, I witnessed the impact of the 2022 mpox outbreak firsthand. I worked to get members of my community access to the vaccine, advising them how to answer invasive, stigmatizing questions due to vaccine rationing. I supported men who acquired mpox dealing with debilitating physical symptoms causing unimaginable mental health and financial impacts.” said Malcolm Reid, longtime advocate and Founder of the Unity Arc Advocacy Group, about why he signed on to the letter. “Disparities in access to mpox-related resources such in prevention and care persist, disproportionately affecting marginalized communities. The Biden administration must prioritize equity by ensuring that everyone, regardless of their ethnicity, gender identity, or location, can access lifesaving interventions. This includes targeted outreach, culturally competent care, and removing barriers to testing and treatment.”
Founded in March 2018, PrEP4All is an organization of community members, healthcare professionals, lawyers, and academics all dedicated to increasing access to lifesaving HIV medication.
STICKITIN is a nonprofit coalition of community-based organizations and healthcare agencies serving diverse LGBTQ+ people and dedicated to mpox education and prevention.