Ritu Jha-
With the number of people infected with monkeypox rising and vaccine supplies dwindling, the community is concerned, according to Sapna Pandya, former president of KhushDC, a non-profit that serves the South Asian LGBTQ community in the Washington DC Metropolitan Area.
Monkeypox was first identified in 1958 and primarily found in Central and West African countries, but there has been a recent uptick in reported cases outside those areas, such as Europe, Canada, and the United States, including California. The World Health Organization has declared the disease, recent cases of which particularly targeted the LGBTQ+ communities, as a global emergency.
“I heard anecdotally about South Asian gay men who are concerned about the delay and low supply of vaccines and who are signed up on a waiting list in the meantime. But they are definitely scared,” Pandya told indica.
As of July 22, there have been 434 cases of monkeypox confirmed in California, a large chunk of the 2,000 cases seen in the U.S. Two children have been diagnosed with monkeypox in the U.S., including one in California, according to the U.S. Centers for Disease Control.
An email from CDC to indica quoted Mark Ghaly, California Health and Human Services Secretary California estimates it needs at least 600,000 to 800,000 additional JYNNEOS vaccine doses, a cure to prevent Monkeypox.
Pandya said, “I also feel like it is important to say that the stigma that is being caused by the media saying this is a disease affecting LGBTQ communities primarily is very upsetting and problematic – it feels like the maligning public health messaging of the 1980s all over again.”
She said, “As an epidemiologist by training, I know that this is a disease of close physical contact, not a sexually transmitted disease, and certainly not a sexually transmitted disease only of gay men. So I too am concerned how this stigma can create even further homophobia amongst conservative communities, such as our own South Asian communities.”
Dr. William Schaffner, professor of preventive medicine at the Department of Health Policy at Vanderbilt University, told indica, “I am concerned that monkeypox is now so widespread that it may be with us for the foreseeable future… until we can get a [more specific] vaccine.”
Schaffner was not sure it would spread so fast.
“Monkeypox virus does not spread as readily as does the COVID virus,” he said. The “COVID virus is very contagious but the monkeypox virus requires very close skin contact to be transmitted from one person to another. Although there are cases, it is not going to cause an epidemic. “
He added that while more than 100 new cases are being reported daily, the cases found are a result of more testing being done, not necessarily because there are more cases.
Sharing his thoughts on the drug Tecovirimat given to those with monkeypox, Schaffner said that while it is used for the more severe cases, it is not originally intended for use monkeypox.
“We are gathering experience in exactly how good it is and trying to measure how good it is,” he said.
“This was used to treat smallpox, but this [monkeypox] is a different virus, though from the same family. I assume it has some beneficial effect but don’t know how much,” Schaffner said.
He said that while more than 90 percent of the recent cases reported involve gay and bisexual people, there have been some cases, more so in Europe, involving household transmission, even occasionally in children.
“How frequently the transmission in the home occurs, and what short contact does this require to transmit in a domestic environment, we don’t know,” he said. “These are things we have just started to look at.”
Schaffner said the vaccine being discussed was intended only for smallpox but had some effect on preventing monkeypox.
“The difficulty with this vaccine is that we have a limited quantity and there is only one manufacturer in the world – based in Denmark,” he said, adding that the vaccine also has many side effects.
The current cases of monkeypox appear to spread near the genitals and rectum, thus behaving differently in Europe than it did in West Africa.
“Seems like the virus did not read the textbook and has surprised everyone. It used to [affect the] hands, palms and legs…” he said with a laugh.
Asked if the government delayed action, Schaffner said, “I don’t think so, I think the virus behaved differently and surprised us all. It took us a while to learn that. And we did not have enough testing capacity. You need to be able to test people at the slightest suspicion.” This is now changing with large commercial laboratories offering testing.
“But I would say they [members of the LGBTQ+ community] have to be very conscious,” he said, before comparing it to HIV: “The difference is, HIV killed people, but not monkeypox. But it is [still] painful and annoying.”
Meanwhile, in a letter sent to CDC Director Rochelle Walensky, the California Department of Public Health stated that the virus is impacting the LGBTQ+ community specifically, with a disproportionate impact on men who have sex with men as well as transgender and nonbinary individuals.
It says the state of California needs at least 600,000-800,000 additional doses of the JYNNEOS vaccine to expand eligibility to people with confirmed and probable exposures, and those at high risk of the virus as a protective measure.
“We estimate that there are 250,000 to 300,000 individuals in California who we consider high-risk as they have two or more sexual partners,” it said. “When we look at the population who might be bisexual as well as those who are men who have sex with men, we estimate roughly 350,000 individuals who are high-risk. It is also important to ensure adequate vaccines for occupational exposures and prepare for the likelihood of wider spread. Based on these data, our estimate is conservative given the JYNNEOS vaccine requires two doses.”
