With a name change, a drastic decline in cases nationally, and even less media coverage, the virus formerly known as monkeypox—now renamed mpox by The World Health Organization earlier this month—has nearly disappeared from the national conversation. But with Black gay and bisexual men disproportionately impacted and vaccinated less for mpox than their white and Latino counterparts, the health threat has not ended for this demographic, despite the recent announcement by the U.S. Department of Health and Human Services of the expiration of the mpox public health declaration.

“Facts and Vax” is a new GLAAD social media campaign encouraging Black gay and bisexual men to get educated and vaccinated for mpox. In partnership with GLAAD, eight social media influencers have published fact-based and original mpox videos on their Instagram platforms to a combined audience of over a million followers.

DaShawn Usher, Director of Communities of Color at GLAAD, says he hopes the campaign will drive local conversation, curiosity, and action.

“It’s important to still educate communities of color about prevention, vaccines, and treatment for mpox,” Usher says. “We selected eight social media influencers and community leaders that live or have influence in the areas with the highest rates of mpox: California, New York, Florida, Texas, and Georgia. Additionally, we included Washington, D.C.

Usher says of the social media influencers chosen for the campaign, “Maria, Dustin, Obio, Forever Mistah, Kvng David, Kenni, Henry, and Reggie were the perfect people to spread the message and increase awareness,” he adds.

On December 7, GLAAD hosted “Addressing Mpox in Communities of Color,” a webinar moderated by Courtney Johnson (Media Consultant), with Jennifer Barnes-Balenciaga (Director, Crystal LaBeija Organizing Fellowship) and Justin Smith (Director, Campaign To End Aids at Positive Impact) as panelists. The webinar followed news of the Biden Administration’s decision not to renew the public health emergency declaration for mpox issued in August.

“Given the low number of cases today, HHS does not expect that it needs to renew the emergency declaration when it ends on January 31, 2023,” said U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra in a statement released on December 2.

“But we won’t take our foot off the gas – we will continue to monitor the case trends closely and encourage all at-risk individuals to get a free vaccine,” he added.

Smith expressed concern for LGBTQ communities of color and the possibility of those at risk for mpox acquisition becoming less vigilant in safeguarding their health if the declaration expires.

“One of the challenges, when you lift an emergency declaration, is that it runs the potential of sending a message to the community to say, ‘Oh, this is over. You don’t have to worry about this anymore. It’s done.’ And while we are certainly not in the place with mpox that we were over the summer, we still have work to do,” Smith says.

Barnes-Balenciaga, a Black transgender woman, amplified the erasure of transgender people in mpox vaccine outreach.

“Trans people have saved gay and queer lives forever. It seems more important for people to see the 85% of transgender people and gender non-conforming individuals being killed by violence. The fact that we’re not including the [medical] measures that are inclusive of people who have romantic and happenstance relationships with trans bodies—it’s another commodity for people.”

Barnes-Balenciaga also utilized the webinar to elevate sex workers at risk for mpox acquisition. “Sex work should not be a hindrance or an acceptance to getting a vaccination. Sex work is not something that should be looked at as a liability,” Barnes-Balenciaga said.

Completing the vaccine series

In recent months, as the vaccine has become more widely available, public health officials have struggled to get Black gay and bisexual men vaccinated in large numbers, particularly in the South. And more recently, to return for their second dose of the JYNNEOS vaccine.

Dr. Melanie Thompson, an Atlanta-based HIV physician and researcher, explains why the surge of individuals receiving a mpox vaccination in early summer has dwindled.

“Initially, mpox was new and scary and painful, and everybody really wanted to get vaccinated,” Thompson says. “We are having more trouble getting people in for the second dose.”

Thompson tells GLAAD that individuals relying on the first dose of the vaccine for protection against mpox only receive half of the vaccine’s benefit.

“The second dose of that booster is really important,” she says. “It does a disproportionate job of elevating the antibodies and increasing protection. One dose is not half as good.”

Dr. Quintin Robinson, another Atlanta-based infectious disease physician, agrees.

“You really don’t have enough of those antibodies to neutralize an infection after that first dose. You really do need that boost that you get with the second dose 28 days later,” Robinson says.

“Breakthrough cases of mpox have occurred between the vaccine series if there was an early exposure or even a new exposure between completing your vaccine series. So it’s definitely important to make sure you get that second shot.”

With the latest national average of daily mpox cases at six as of December 6, it’s easy to assume the worst of the outbreak is over. However, Robinson says systemic hurdles must be overcome before any outbreak or epidemic involving Black people can be declared over, noting the decades-long medical mistrust in communities of color.

“Most Black men and Black gay men have probably not had the most pleasant experience in the healthcare setting,” he says. “Secondly, I think people in general, Black gay men included, are in vaccine overload.”

“[Mpox], I think, hits people in a very sensitive area because they don’t want to give up their sexual activity, yet they could very well get mpox. They don’t want to have that kind of disfigurement,” Thompson says. “So, I think there’s a different incentive for people to get the mpox vaccine.”

But Thompson acknowledges the physical scarring experienced by many men after receiving the vaccine is a concern of the vaccinated and unvaccinated.

“Having a mark on your body from anything is stigmatizing, and people feel the need to explain, Oh yeah, that’s a mpox vaccine [site],” Thompson says. “The whole thing becomes stigmatizing, and stigma is one of our worst enemies in terms of fighting mpox, but also HIV,” she says.

But unlike earlier this summer, Robinson says his mpox caseload has decreased significantly.

“Personally, in our practice, we’ve not had a positive case in the last four weeks in the office,” he said, signaling a move in the right direction towards hopefully one-day eradicating mpox in the U.S.

“I’m still considering it in the patients I see,” he says. “If there’s a new rash, if there’s a phone call with a complaint of a new rash in a sexually active adult outside of syphilis, mpox is on my list as well.”

Moving forward, Smith hopes access to the mpox vaccine is as easy as any other vaccine.

“What would it mean if the mpox vaccination could be accessed at CVS in the way that you get your COVID or your flu shot? I hope we can put those things in place as we move into a different phase,” he says before adding: “But the message has to continue to be to our people that this is not over.”