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D.C. reports monkeypox cases among homeless, expands vaccine program

D.C. Mayor Muriel E. Bowser, at lectern, talks about monkeypox during a July 18 news conference. (Bonnie Jo Mount/The Washington Post)
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Monkeypox has spread to D.C.’s homeless population, with two confirmed cases, as the city launches weekly walk-up vaccination clinics in an attempt to slow the spread of the virus.

D.C., which has more cases per capita than any state, as of Thursday reported 269 positive cases, according to city officials. The Centers for Disease Control and Prevention has recorded more than 6,600 infections nationwide since the first U.S. case was identified in May.

Public health workers have struggled to distribute limited supplies of monkeypox vaccine to at-risk populations. In the District, more than 16,500 eligible residents had registered for shots as of Tuesday, but public health officials estimate that anywhere from 50,000 to 100,000 residents could be eligible.

Federal officials on Thursday declared monkeypox a public health emergency and put in motion plans to expedite vaccination. The United States has only enough doses on hand to fully vaccinate about one-third of those at highest risk, federal officials said.

The virus, which spreads through close personal contact, has overwhelmingly infected men who have sex with men, but public health officials emphasize that monkeypox can infect anyone.

In D.C., the two homeless people who tested positive for monkeypox are among 25 clients isolating in hotel rooms through a program established in response to the coronavirus, city officials said. The cases were first reported by NBC4.

Patrick Ashley, senior deputy director at the D.C. Department of Health, said clinicians will hold vaccination events for homeless people at shelters — including the district’s first shelter for LGBTQ+ adults, which opened last month in Ward 7.

Homeless people often struggle to manage health issues while moving from place to place or living on the street or in shelters, said Carolyn Summer, a nurse practitioner at Unity Health Care.

“They are the same health challenges faced by everyone else, but they are amplified,” she said.

When coronavirus vaccines became available, the city helped organize town halls at shelters with trusted staff or social workers — a model that Summer noted could work with monkeypox.

D.C. shifts monkeypox vaccine policy to focus on first dose

Monkeypox spreads through personal, often skin-to-skin contact, including contact with a rash, scabs or bodily fluids from a person with monkeypox and touching clothing, bedding or towels used by someone with monkeypox, the CDC says. A pregnant person can spread the virus to their fetus through the placenta.

For weeks, D.C. officials have encouraged residents at risk for monkeypox to register in advance for vaccine appointments at preventmonkeypox.dc.gov, but access and privacy concerns have been an issue.

The new walk-up vaccination clinics are intended to serve D.C. residents who may not have the ability or the technology to register in advance online, and those who may not feel comfortable sharing personal details. City officials said personal information, including eligibility criteria, is kept confidential. As of Tuesday, the health department had administered more than 10,500 doses, and 1,300 additional appointments were scheduled.

Every Friday, while supplies last, D.C. Health will make some monkeypox vaccinations available on a first-come, first-served basis. Vaccination will be offered on Fridays from noon to 8 p.m., pending availability, and each city clinic will have 300 doses.

The walk-up clinics will be held Friday at three locations: 3640 Martin Luther King Jr. Ave. SE in Ward 8; 7530 Georgia Ave. NW in Ward 4; and 1900 I St NW in Ward 2.

The vaccine is available for District residents who are 18 or older and are men who have sex with men and have had multiple or anonymous sexual partners in the past 14 days; transgender women or nonbinary people assigned male at birth who have sex with men; sex workers, or staff at bathhouses, saunas and sex clubs.

Proof of residency is required and can include an identification card with a D.C. address; a utility bill or other mail showing the vaccine seeker’s name and D.C. address; or a current D.C. lease or mortgage that includes the person’s name.

There are no plans to expand beyond the three clinics, which Ashley said the city initially leased to respond to the coronavirus.

“A lot of people are really anxious about getting vaccinated, asking, ‘When is my demographic going to be eligible?’ ” Ashley said. “The whole reason we are spending so much time and effort focusing on at-risk populations is so we don’t have to expand eligibility.”

D.C. Health has asked community-based organizations Us Helping Us, HIPS and Whitman Walker, which work with at-risk people, to offer clients pop-up clinic slots.

The model was developed under covid, but with monkeypox, a discreet email or conversation with a trusted health-care provider is key, Ashley said.

DeAysia Johnson, a registered nurse with the outreach team at Pathways to Housing DC, sees about 75 unhoused people a week and tells her clients that monkeypox can infect anyone. Many have compromised immune systems because of HIV, heart failure, diabetes or kidney disease, “so a disease like monkeypox or coronavirus could put them at higher risk for worse health outcomes,” she said.

Johnson encouraged her clients to go to a walk-in vaccine clinic, and said she would join them for help and to navigate the proof-of-residency requirement.

Public health officials throughout the region are closely monitoring monkeypox cases.

Among the 122 cases reported by the Virginia Department of Health as of Thursday, 88 were from Northern Virginia. Most cases occurred in men who are in their 20s and 30s; about a third occurred in White men and a third in Black men, according to state data updated daily.

The CDC is reporting 157 cases in Maryland. Montgomery County public health officials on Thursday opened an online preregistration survey for monkeypox vaccination appointments to prioritize limited supplies as they become available.

James Bridgers, the acting county health officer, said in a statement: “As with the early days of the COVID-19 vaccination campaign, there is more demand for vaccination than there is supply.”

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