vaccine inequity

Black men are getting 70% of monkeypox cases in North Carolina—and only 24% of the vaccines

Demographic data shows the new public health emergency in North Carolina is exacerbating old inequities
Black men are getting 70% of monkeypox cases in North Carolina—and only 24% of the vaccines
Photo: Joe Raedle (Getty Images)
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Another epidemic, another spotlight on inequality. We’re less than two months into the monkeypox vaccination campaign—and only about three months since cases started appearing in the US—and the the landscape of infection and vaccination mirrors the structural inequities of healthcare at large.

A quintessential case study is offered by data released by North Carolina’s health department, which provides demographic insight into monkeypox testing, infection, and vaccination. According to the findings, the vast majority of cases of monkeypox are recorded among Black men who have sex with men, despite the fact that white men tend to test more, suggesting an even higher percentage of cases could be identified in Black patients. But when it comes to vaccines, the tables turn, and it’s white men who are receiving the most doses.

The most cases, the fewest vaccines

The data set is relatively small, but telling. So far, North Carolina has analyzed information for 111 cases of monkeypox, about 3,000 vaccines, and 162 tests.

Out of the cases, 71 (or about 70%) were among Black men, and 21 (19%) among white men. But white patients also received more tests, and many more vaccines: out of 3,048 administered in the state, 2,039 went to white men.

Image for article titled Black men are getting 70% of monkeypox cases in North Carolina—and only 24% of the vaccines
Graphic: Annalisa Merelli

Georgia has shared even more striking data: Out of the 466 cases for which the state had racial data, 382 (or 82%) were among Black patients.

Although this data is only reflective of two states, less detailed information collected by the US Centers for Disease Control and Prevention (CDC) point to a similar discrepancy. Analysis of about 1,000 cases for which race was available showed only 41% of cases occurred among the white population (though it represents 62% of the population), while Black and Latinx patients, who are about a third of the population, made up more than half the cases. The CDC hasn’t provided a racial breakdown of vaccinations, but has noted that the number of infections occurring among Black men is rising.

This pattern is similar to other outbreaks, notably covid. Although 23% of the deaths for covid, and 20% of the cases, occurred among Black Americans (who are only 13% of the population), they remained the group with the lowest vaccination levels, at 59%.

This is also in line with the racist distribution of monkeypox vaccines globally.
African countries, which have recorded the most monkeypox cases and deaths, and until about a week ago were alone in reporting any fatalities from the virus, have yet to receive any doses of vaccine.