‘Everyone is struggling:’ LGBTQ Atlantans scramble for monkeypox vaccine

Federal data suggests Georgia’s vaccination rollout has been more sluggish than other states’

Monkeypox vaccine , to be released from national stockpile, for high-risk’ people, CDC says.On May 23, the CDC reported that there has been one confirmed and four suspected cases of monkeypox in the United States.As a result, a vaccine will be released from the nation's stockpile for high-risk individuals.I can report that there has been a request for release of the Jynneos vaccine from the National Stockpile for some of the high-risk contacts of some of the early patients, so that is actively happening right now, Dr. Jennifer McQuiston, deputy director of the Division of High Consequence Pathogens and Pathology within the CDC's National Center for Emerging and Zoonotic Infectious Diseases, via CNN.The U.S. reportedly has a "good stock" of the vaccine.Right now, we have over 1,000 doses of that available, and we expect that level to ramp up very quickly in the coming weeks as the company provides more doses to us, Dr. Jennifer McQuiston, deputy director of the Division of High Consequence Pathogens and Pathology within the CDC's National Center for Emerging and Zoonotic Infectious Diseases, via CNN.McQuiston said there's another smallpox vaccine, ACAM2000, that could provide protection against monkeypox.The U.S. has more than 100 million doses of that vaccine.ACAM2000 is an older-generation smallpox vaccine that has some potential significant side effects with it. So a decision to use that widely would have to have some serious discussion behind it, Dr. Jennifer McQuiston, deputy director of the Division of High Consequence Pathogens and Pathology within the CDC's National Center for Emerging and Zoonotic Infectious Diseases, via CNN.We are hoping to maximize vaccine distribution to those that we know would benefit from it. Those are people who've had contact with a known monkeypox patients, health care workers, very close personal contact, and those in particular who might be at high risk for severe disease, Dr. Jennifer McQuiston, deputy director of the Division of High Consequence Pathogens and Pathology within the CDC's National Center for Emerging and Zoonotic Infectious Diseases, via CNN

Nearly two months after monkeypox started appearing in Georgia, the state has cemented its place as one of the country’s biggest infection hotspots.

But the local population most affected in the current outbreak – men who have sex with men – say they’ve been unable to find the Jynneos vaccine, which protects against smallpox and monkeypox and can also help alleviate symptoms after exposure.

They raised questions of Georgia not being allocated enough vaccine by the federal government in the first place, and asked why the state did not immediately take all the vaccine it was allocated recently.

Among those calling into question the efficacy of Georgia’s vaccination rollout is John, an East Atlanta resident. John, who asked that his last name be withheld due to the stigma attached to monkeypox, said difficulty locating the vaccine has been frustrating.

On Wednesday morning, John was on the DeKalb County Board of Health website to sign up for a vaccination clinic through a link that was supposed to go live at 9 a.m. Instead, the website crashed. Phone calls to their office went unanswered. Now functioning again, the website says all appointments have been filled.

“I throw up my hands because it doesn’t seem, I don’t think, people are acting on this with the appropriate urgency. ... It seems like this is something that there’s actually a vaccine for and at least its spread right now is in a limited community that is more than willing to jump in and say, ‘Yeah, let’s nip this in the bud.’ And yet, you know, it’s being allowed to continue.”

On social media, other Atlanta residents have called the vaccine rollout “ridiculous,” a “lottery,” and reminiscent of “the Hunger Games.”

Todd Shoemaker of Buckhead said he has spent over 10 days trying to find information about how to get vaccinated, putting in calls to the Fulton County Board of Health and filling out a Fulton “vaccination eligibility survey” online – to no avail. He and his partner check the Fulton’s website daily for announcements of new vaccination clinics.

“It feels like our public health officials are failing us,” he said.

Shoemaker said an additional source of frustration is federal data indicating Georgia has been less proactive than other states when it comes to stockpiling vaccine doses.

According to a dashboard updated weekly on Wednesdays by the U.S. Department of Health and Human Services’ (HHS) Administration for Strategic Preparedness and Response (ASPR), Georgia had as of July 20 requested only about 40% of its total vaccine allocation – 5,985 doses out of an available total of 13,876 doses. Most other states had requested all or a larger portion of their vaccines by that date.

According to the Centers for Disease Control and Prevention, Georgia’s 312 confirmed cases account for the the fifth highest number of monkeypox infections in the country. Yet HHS data shows Georgia had as of July 20 requested fewer vaccines than jurisdictions with significantly fewer cases, including Washington D.C. (nearly 14,000 doses requested as of July 20), Texas (21,000 doses) or Massachusetts (9,400 doses) – all of which asked for their maximum allotment or more.

Georgia Department of Public Health spokeswoman Nancy Nydam said since July 20, all of Georgia’s allotted vaccines have been requested. She said the state didn’t order them all at once because they planned to stagger the shipments and needed time to prepare to administer the vaccines, including working with local health clinics to administer shots. Nydam also cited concerns about proper storage for the vaccine as another reason for not ordering the entire allotment at once.

Nydam said the department plans to officially request the remainder of its allotted vaccine doses over the coming days, and expects more will be coming. U.S. health regulators said Wednesday nearly 800,000 doses of vaccine will soon be available for distribution.

Delays in administering a vaccine during a rapidly spreading virus could hinder the state’s ability to contain the outbreak.

When reviewing the federal data on monkeypox vaccine distribution, “Georgia was a state that really stood out to me,” said Lindsey Dawson, associate director of HIV policy and director of LGBTQ health policy at the Kaiser Family Foundation.

The size of Georgia’s vaccine request didn’t match the state’s large population of individuals at risk for monkeypox – part of the reason why Georgia was allocated so many vaccine doses in the first place, Dawson said. “When we think about high risk, one of the metrics used is people living with HIV ... and Georgia is right up top in the country, suggesting that there could be a high benefit to receiving the vaccine in Georgia.”

Shoemaker says friends of his are planning on flying to places like New York or Florida because they believe doing so will boost their chances of finding vaccine. “A lot of people are trying to figure out how they can go get it somewhere else in the country.”

Dr. Jesse Couk, an infectious disease physician at Piedmont Atlanta Hospital and with the Atlanta ID Group, said the national and state response to monkeypox has been disappointing.

Throughout the monkeypox outbreak, Couk has seen several patients with monkeypox symptoms ranging from lesions on their hands to inflammation of the rectum and severe pain that lasted over a week. Two of his patients tested positive for monkeypox.

“The reality is that the supply is very low and the opportunity for vaccination is abysmally low for these patients. It’s particularly low in Georgia for reasons that I don’t understand,” Couk said.

“It’s frustrating because every person that reached out that wanted to be vaccinated and then ends up with monkeypox – it’s a total failure,” Couk noted. “What I’m seeing is that we have more supply than we’re actually using, and that’s very frustrating.”

Parker Ambler considers himself “incredibly lucky.” The Gwinnett resident received his first dose of the monkeypox vaccine at a clinic held at the Positive Impact Health Centers – an Atlanta-area HIV services organization – on July 13, after “randomly” coming across a sign-up link on social media.

He says his vaccination status makes him an outlier in his friend group.

“Everyone I know is struggling to get it, to find a vaccine. ... Everyone is on social media asking, ‘Does anybody have a link [to sign up to a vaccination event]? And then when people do provide a link, within minutes, every spot is full,” he said. Just one of his friends in Atlanta has been able to get a shot, and he says he traveled to Charlotte, North Carolina, to get it.

For Dawson at Kaiser Family Foundation, stories like those reflect how “privilege” and access to resources has resulted in an unequitable vaccine rollout nationwide.

“So examples would be when vaccination opportunities are advertised in the middle of the day on social media, and those vaccination spots are snapped up within a few minutes. ... You have to be somebody who’s in front of a computer in the middle of the day who can make that appointment and know that they can get out of their job ... in order to go get that vaccination.”

Given the seeming mismatch between vaccine supply and demand, Ambler says he is “concerned” his August appointment for his second dose will be canceled. The urgency he feels to become immunized is rooted in his identity as a gay man.

“If I were straight, I don’t know that I would get it. I was hanging out with some colleagues who are all heterosexual, and I mentioned that I got really lucky to get this monkeypox vaccine and they just said, ‘Well, we don’t really see a reason to get it.’ And that’s understandable at this point. But being queer, I absolutely felt that it was something you can do for your community.

Staff writers Helena Oliviero and Donovan Thomas contributed to this article.


Facts about Monkeypox

— Monkeypox is transmitted through close contact with an infected person or animal with the virus.

— The disease can be passed through lesions, body fluids, respiratory secretions during extended face-to-face or intimate physical contact, such as kissing, cuddling or sex and touching contaminated items such as towels and bedding.

— Symptoms of monkeypox include fever, muscle aches, chills, swollen lymph nodes, exhaustion, headaches and a rash that looks like pimples or blisters that appears on multiple parts of the body, such as the face, hands, feet, chest, anus, genitals and inside the mouth.

— Monkeypox is contagious from the first sign of symptoms until the rash has healed and a new layer of skin has formed. The illness can last two to four weeks.

Source: The Centers for Disease Control and Prevention


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