Black Texans are disproportionately affected by monkeypox. Do they have access to the vaccine?

The monkeypox outbreak in Texas has so far disproportionately affected Black Texans, who make up almost 30% of the state’s cases but only 12% of the state’s population, according to state data.

But understanding whether Black Texans have increased access to the Jyennos vaccine, which can prevent smallpox and monkeypox disease, is difficult to know. Texas law has an unusual provision that requires adults who receive a vaccine to consent to share their demographic information with the state. Essentially, the state’s public health department has demographic data only for some vaccine recipients, making it difficult to know whether Black Texans have equitable access, or whether this disease and vaccine rollout are a continuation of existing health disparities.

The data the state has “only includes those who have consented to having it recorded” in the state’s immunization registry, said Lara Anton, a spokesperson for the Department of State Health Services. “We don’t have a way to know how many people received the vaccine but did not consent to having it entered into” the registry.

Demographic data about the COVID-19 vaccine has been more widely available to local health departments, doctors, and communities because the virus was declared a statewide disaster, allowing for information about vaccine distribution to be shared more easily. But for most vaccines, communities are in the dark when it comes to knowing exactly how many people and which types of people have access to the vaccine, whether it’s the seasonal flu shot or the shingles vaccine.

“COVID has sort of been the first test to get that sort of population level data,” said Dr. Philip Huang, the director of the Dallas County Health Department.

Monkeypox has not been declared a statewide disaster, meaning that each person who gets the vaccine has to give consent to share their information with the state. Local health departments have asked the state if there is a way they can find out more about the monkeypox vaccine distribution efforts. Right now, local public health departments have limited information on who has gotten access to the vaccine.

Imelda Garcia, a top official with the state health department, said during a public meeting Wednesday that the department was “having multiple conversations with legal” to see if there was a way the state could share more information with local departments.

Tarrant County Public Health has also requested information from the state about the demographic data of the estimated 2,000 county residents who have received the vaccine, said Edrea Au, a spokesperson for TCPH .

Without knowing who has access to the vaccine in Texas, it’s hard to know if the vaccine rollout is reaching the people most at risk. In the first months of the COVID-19 pandemic, there was limited on data on what racial and socioeconomic groups were experiencing the highest rate of infection and death, said Nancy Krieger, a professor social epidemiology at the Harvard T.H. Chan School of Public Health.

“COVID did further demonstrate the utter importance of having data correctly identify who is at greatest risk of experiencing harm,” Krieger said. “And if the data can’t do that, you end up with a situation that is effectively ‘no data, no problem.’’’

It’s unclear whether the virus has disproportionately affected Black Tarrant County residents. Tarrant County Public Health does collect demographic data for positive cases, and the department “will be able to provide this information early next week,” said spokesperson Edrea Au in an email to the Star-Telegram.

Tarrant County Public Health only posts the total number of monkeypox cases on its online data dashboard. As of Thursday, there were 121 cases of the virus confirmed in Tarrant County residents.

“Not having those data is problematic for understanding who’s at risk,” Krieger said.

MPV, as monkeypox is sometimes known, and the virus that causes COVID-19 transmit very differently. The SARS-CoV-2 virus is much more contagious. So far in the outrbeak, monkeypox has spready primarily through skin-to-skin contact during sex, and men who have sex with men have made up about 94% of all cases.

Although monkeypox does not spread as easily as COVID-19, its emergence has illustrated that some of the most pressing challenges in public health remain, even as the nation nears three full years of a pandemic. State and local health departments have been underfunded for decades, Krieger said, but now are also grappling with personnel shortages and burnout after facing harassment and abuse throughout the pandemic.

“What defines an inequity is that you have social group or societal group differences that are, in principle, preventable, that are unfair, and that are avoidable,” Krieger said. “The only way you can know that is by making comparisons of the people that are more protected and more privileged.”