To obtain a monkeypox vaccine in the city of Richmond or Henrico County, residents are asked to fill out an interest form that asks several personal questions: Do you visit sex clubs? How many sexual partners have you had in the past 3 months? Have you engaged in anonymous sex?
Richmond resident Demas Boudreaux wanted a vaccine, but he felt uncomfortable answering the questions and sending his personal information into the World Wide Web, where it could be subject to hacking.
Boudreaux
Instead, he sought the vaccine in Roanoke, where the application process involved no personal questions. He called and got his shot a week later.
Roanokes process was infinitely more user-friendly and non-invasive, said Boudreaux, a member of the states LGBTQ advisory board. But he understands why the Richmond and Henrico Health Districts have to ask those questions to sort out who is most in need of the under-allocated shot.
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Im not trying to throw the health department under the bus, he said. I do trust the health department, but it feels a little icky.
Gay men in the Richmond area are unhappy with the limited number of monkeypox vaccine doses available, the personal information the health district is asking them to divulge, and the way some have stigmatized the virus as a gay disease.
I think theres obvious frustration about the number of vaccines that are available and how theyre being rolled out, said Narissa Rahaman, executive director of Equality Virginia, an organization that works on behalf of LGBTQ residents.
There have been nearly 14,000 cases of monkeypox in the U.S., but only 248 in Virginia and 21 in the states central region.
All but two have occurred in men, and most are in gay and bisexual men, health officials have said. Symptoms include lesions, fever and body pains. There have been no deaths in the U.S.
The U.S. recently made available an additional 1.8 million doses of the Jynneos vaccine, which was licensed in 2019 to prevent monkeypox and smallpox.
Vials of single doses of the Jynneos vaccine for monkeypox were seen in the vaccine hub at Zuckerberg San Francisco General Hospital and Trauma Center on July 29.
The Richmond and Henrico Health Districts have received 937 doses and distributed more than half. But thats not nearly enough to cover the roughly 4,000 people who have submitted an interest form.
The Biden administration recently recommended state health departments inject the shot intradermally, or between the layers of the skin, rather than subcutaneously, or under the skin. Injecting it intradermally allows for five doses per vial as opposed to the one dose per vial currently available.
The Richmond and Henrico Health Districts are training their staff to apply the shot intradermally but have not begun doing so, said Dr. Elaine Perry, the districts director.
Localities not putting it out there
When Boudreaux contacted a health district near Roanoke, the district asked him why he wanted a monkeypox shot. Boudreaux responded that hes gay, and that was enough to satisfy the health district.
About a week later, he drove to the Roanoke area. The timing worked out, as he had a work commitment nearby. After four weeks, hell return for a second shot.
I was able to make it work, Boudreaux said.
Phil Kazmierczak, a Virginia Beach resident who is also a member of the LGBTQ advisory board, was asked just one question when he sought the vaccine near his home.
Kazmierczak
The health officials wanted to know if he was eligible for the vaccine according to the state health departments standards. Residents are eligible if they are gay or bisexual men, transgender women who have sex with men, sex workers, people who work at establishments where sexual activity occurs or people who attend sex-on-premises venues.
Kazmierczak replied that yes, he is eligible. The next day, he received the shot.
He said local officials could do a better job notifying communities how to get it.
Our local governments are not putting it out there, he told the advisory council. Theyre just not.
Asking personal questions helps the Richmond and Henrico Health Districts determine who is at the highest risk, said Dr. Melissa Viray, a deputy director for the departments. With demand outpacing supply, the districts will prioritize the residents with the highest risk.
The local districts considered using a less invasive questionnaire, but decided to keep them while demand is high, Viray said.
To protect personal data from intrusion, the district uses Research Electronic Data Capture, or REDCap, a secure web application developed by Vanderbilt University, to house the information. REDCap is compliant with HIPAA, the federal standard for patient privacy, Viray said. Data is stored on a server internally managed by the health districts.
Staff also limits which employees can access patient records.
Its nobodys business except for those who absolutely have to have it, Viray said.
Theres no such thing as a gay disease
A lack of information and misinformation are still an issue with monkeypox, so Equality Virginia is doing its best to make sure people are educated, Rahaman said.
The organization is relaying information about the disease from the health department so people can understand the symptoms, how one becomes exposed and demand for the vaccine. That will help people make better decisions.
Equality Virginia is also encouraging people to get tested if they develop symptoms so officials can have a more accurate number of cases in the state.
Its also doing its best to fight misinformation.
Its not a gay disease because theres no such thing as a gay disease, Rahaman said.
Last week, Kazmierczak posted to his Facebook that a monkeypox vaccination event would be held at a Norfolk club. He was met with a lack of understanding and a lack of empathy.
Tell me this is a joke, commented one person.
Safe sex is always a better option than experimental vaccines provided by your tyrannical government, said another. The last one they forced on the American people should be a glaring example of their complete ineptitude.
(Jynneos was approved in 2019, but the virus material in the shot is similar to the first smallpox vaccine developed in 1796.)
Another said 90% of monkeypox infections are in men who have sex with men. Change the culture and keep men safe and healthy. Its safer than vaccines.
Health experts recommend people interested in the vaccine receive it if eligible.
According to health experts, monkeypox can be spread in ways other than sexual contact. It can be spread by sharing clothing or sheets that havent been washed or other skin-to-skin contact. Public health officials have warned college students that campuses could become incubators for the virus.
Should it spread to the community at large, Boudreaux worries the gay community will be blamed, similar to how Asian Americans were targeted for the spread of the coronavirus. Spread of the virus could be curtailed if there were more vaccines, Boudreaux said.
Theres just not enough vaccine, he added.
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Twitter: @EricKolenich
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