For health advocates in Georgia, the monkeypox outbreak has reignited discussion on racial inequity. Whereas Black people make up nearly 80% of cases in the state, they represent less than half of the vaccine doses.
The state has distributed more than 17,000 vaccine doses, which have gone to people who are sexually active and have close, intimate, or sexual contact with men who have sex with men. Of those, 44.3% have gone to Black people, according to the Georgia Department of Public Health.
“Unfortunately, it’s not surprising because this is the landscape that has existed for hundreds of years,” said Larry Walker, the executive director of Thrive Support Services, which aims to increase health equity for Black gay men living with HIV. “Black people live in a hostile system that doesn’t value their lives, and this is what happens.”
Despite that disparity, some local experts see hope in the numbers as DPH partners with Black-led groups that have been assisting with getting vaccines and testing to community groups most affected by monkeypox.
A question of vaccine accessibility
DPH has its own centralized online portal where people can make vaccine appointments and get updates on the latest developments. Website visitors can book appointments based on where they live. Vaccine eligibility is limited to men who have sex with men, people who have close, intimate, or sexual contact with men who have sex with men, or have had close contact with someone who has monkeypox.
Dr. Cecil Bennett, a primary care physician in Newnan who has worked with COVID-19 patients, wonders if vaccine hesitancy could play a part in the inequity seen in Georgia.
Bennett says that county health departments should work harder to make it clear they are providing resources such as vaccines and testing. He feels like the majority of residents don’t realize that they have health departments within their counties that they can go to for information.
Other experts have criticized the fact that when the outbreak started, one of the few ways metro Atlanta county and state health departments made residents aware of vaccine appointment availability was through updates via their respective social media accounts.
“That information flows through those specific social networks, and the other thing is that because you have to sit at your computer and refresh to try to look for an appointment, it privileges people who have the time and ability to do that,” said Justin Smith, the director of the Campaign to End AIDS at Positive Impact Health Centers. “[That’s] going to be folks that are working at home and not working in service industries and places where we know Black folks are more likely to be employed.”
Working with community partners
An early mistake that Walker believes led to an inequitable vaccine rollout in Georgia was a lack of targeted messaging from health departments to affected communities.
“Not partnering with Black, queer led orgs like Thrive SS earlier, that was a misstep,” he said. “The framing of it as this ‘gay man’s disease’ that only promiscuous gay men got. I don’t think there was even a concerted effort to really get [helpful] information into our communities.”
Walker and Smith say partnering with organizations like Atlanta Black Pride are ways to boost public health responses. A spokesperson for DPH said the department has been doing concerted work to partner with Atlanta Black Pride organizers. The event, which takes place in Atlanta every Labor Day weekend, draws thousands of people to the heart of the city. DPH plans to have vaccines available at various Black Pride events.
Georgia isn’t alone in its vaccine rollout being inequitable. In New York City, Black residents make up 31% of the at-risk population, but make up just 12% of those who have had the vaccine. In North Carolina, 24% of vaccines have gone to Black people while they make up 70% of cases.
Smith is encouraged by the fact the state’s overall vaccination percentage for Black patients is higher than other places nationwide.
“[Georgia] looks better than the data I’m seeing coming out of New York and some other jurisdictions, where the percentage of Black folks that are vaccinated is far, far lower,” Smith said. “What that shows us is that some of the equity interventions that were put on really early in Georgia, which includes working directly with organizations that are embedded within Black communities, that kind of outreach is working.”
Walker says that despite health departments not partnering with LGBTQ+ groups sooner, he is encouraged by his and other organizations’ recent outreach efforts. He says DPH partnering with Atlanta Black Pride and local club promoters is a step in the right direction. The Thrive SS team has been out connecting with people in LGBTQ+ communities around the metro area to share information about monkeypox and vaccine eligibility.
“Over the last month, we’ve come in contact with over 1,000 gay men locally, which is good,” Walker said. “But I will be super happy when we can check off monkeypox and eventually HIV off the list of things that we have to push back against.”