PHILADELPHIA — As a thumping bass beat shook the floor, Gregory Pierce praised the good people and good vibes at Level Up, a Center City club.
The past two months, though, there's been another attraction. On a recent visit, the DJ interrupted a set for a public service announcement: In a lounge, upstairs from the bar where beams of primary colored light swept over people drinking and dancing, health workers were delivering vaccines for mpox, as the Centers for Disease Control and Prevention has recently renamed the virus long called monkeypox in an effort to reduce stigma associated with the name.
"I had been wanting to get it," said Pierce, 58, of Norristown.
He recently received his second shot at the pop-up clinic, a novel tactic from the Philadelphia Department of Public Health to promote vaccination to the population most at risk in a viral outbreak that has spread primarily among men who have sex with men. Transmission has largely been associated with sexual contact, though it can spread through various kinds of extended touch. The virus is rarely fatal, but causes painful lesions that can last weeks.
At Level Up, vaccination came with a voucher for a free drink or food order (alas, though, no shots for shots). The health department initiative relies on business owners and event promoters' credibility within the LGBTQ community.
Only 18 got vaccinated at Level Up on a recent Friday, an indication that the immunization initiative is only chipping away at the number of unvaccinated. But health workers knew that even a few vaccines could make a difference in an especially vulnerable community.
When it comes to pitching vaccines, health officials are seeing, a popular DJ is just as valuable as a robust supply of shots.
"It's right here at the club y'all go to," said Kevin Jones, who performs at Level Up as DJ Kid Roc, "so take advantage of it."
Throughout the mpox outbreak this year, Black Philadelphians have been the most at risk and least vaccinated. They account for 60% of all reported cases of the virus in the city, but have received just 26% of vaccine doses, according to city data. Hispanic Philadelphians' case rates are slightly higher than their vaccination rate.
A lack of vaccine providers in some neighborhoods and limited flexibility in people's work schedules contribute to those disparities. The mpox vaccine outreach represents an example of the health department's strategic push to make public health delivery more convenient for the public.
"We have vaccinations in schools, but not actually going out to the people where they live," said Frank Franklin, Philadelphia's deputy health commissioner. "I think it's something we're trying to move forward and strengthen."
In recent months, the mpox outbreak has abated. After a summer of spiraling case counts, two new cases were reported in Philadelphia the week of Nov. 13, the most recent data available. Many credit the vaccines, which became easier to get.
Federal health officials said last week they were ending the mpox health emergency declaration. Even in the LGBTQ community, customers said, anxiety about mpox has faded.
"It's possible to prevent it from becoming endemic," Franklin said. "We just don't want to take our foot off the pedal too quickly."
The virus is not yet under control. An estimated 12,000 Philadelphians are at high risk of catching mpox, largely gay, bisexual, and trans men who have sex with other men, according to the CDC.
Only about 7,000 people have received first doses of vaccine, city data showed. Fewer than half as many have gotten a second dose, despite recommendations that two shots are needed to provide robust protection. Earlier in the vaccination effort, city health officials had offered people only receive one dose to compensate for limited supplies.
A CDC study released Thursday reported that among 18-to 49-year-olds, cases among unvaccinated people were 7.4 times more common than among those who had received a single vaccine dose, and 9.6 times more common than in those with two doses.
With shots for mpox, flu, and COVID all vying for people's attention in recent months, Franklin said, vaccine fatigue may be setting in. He also thought early restrictions, driven by vaccine scarcity, that required people to share their sexual habits to qualify for vaccination probably hurt the effort.
"It was a missed opportunity," he said.
Now, anyone who wants a mpox shot can get one. Health officials hope that offering doses at clubs and events makes getting the shots easy, and allows people who might not be able to break away from work to get vaccinated.
David Brizan, a University of Pennsylvania worker, got his first shot in August, but delayed getting a second.
"With my work schedule, I probably missed three times having to get it," the 28-year-old said after getting his second dose at Level Up.
Level Up is Center City's only Black-owned gay club, according to Ken Lowe Jr., who opened it near 13th and Walnut Streets in 2019. He is one of five owners, organizers, or event promoters participating in the health department initiative.
"If we can make it easier to get vaccinated, why not go ahead and do it?" Lowe said.
Friday nights feature dancers, and Kris Ikomi, 37, of New York, who said, "this is my party," as he prepared to go on stage, checked in with familiar faces in the upstairs lounge, asking if they were getting vaccinated.
The outreach initiative mirrors efforts in New York City, Norfolk, Va., and elsewhere in the country, and the city will conduct vaccinations at events through February.
Events typically end with 25 to 30 shots administered. Nadirah Muhammad, clinical support services manager with the Mazzoni Center, a LGBTQ-focused health center that administered shots at the club in coordination with Bebashi, a provider that caters to patients with HIV, said even a few additional vaccinated people makes a difference.
"Even if we only do like five or three people that's still five or three more people that have that protection," she said.
