The Out Physician Fighting Monkeypox – outsmartmagazine.com

Recent national trends show a deceleration in new monkeypox cases as behavioral changes and vaccinations have proven to be effective. But there are still significant concerns related to equitable access to the vaccines. Black and Latino men who have sex with men represent both the largest in- crease in infections and the lowest rates of vaccination, while white LGBTQ men have had the greatest access to the vaccines.

Daskalakis is working to close this access gap. “We are really intentionally trying to do equity work, and we’ve launched a couple of equity interventions. There are large ones—the best example being Black Pride in Atlanta, where 4,000 vaccines were distributed and 70 percent of the recipients were people of color. We have also done smaller interventions as well, which are just as important—for example, going to medium-sized events or even a bar to do vaccines.”

Because the White House has initiated this vaccine program, Daskalakis, along with the program’s director, Bob Fenton Jr., have the ability to look out over all of the agencies that work on this response. One of their strategies involves “flex funding” to redirect existing grants from programs like the Ryan White Foundation to fight monkeypox.

Then there is the practical side of public health that Daskalakis can relate to as a queer man. In Houston, some of the early barriers to vaccines were related to stigma. You could only receive a vaccination if you were either on PrEP, had experienced an STI in recent months, or had been in close contact with an infected person. These requirements were put in place due to the initial vaccine shortages, but it contributed to a harmful narrative that was all too familiar in the queer community. Daskalakis has helped to address this through his work.

“We’ve heard so much from people who are concerned about getting the vaccine on the forearm, because it leaves a very identifiable mark. People are concerned this could reveal their gender identity or sexual orientation. We heard this [concern and are now] working with the CDC and FDA to change where the vac- cination can be administered. Now people can receive the shot on the upper part of their back or shoulder, in a place that is more discreet,” Daskalakis explains.

Most recently, the national monkeypox vaccine strategy shifted to a pre-exposure prophylaxis model, thereby removing a stigma by increasing the number of people eligible for vaccines. This addressed the problem that closeted men had with standing in a vaccine line that could reveal to others that they were eligible for the vaccine because they reported having sex with other men.

There is still much to do, but things are moving in the right direction. And as we have learned from COVID, things don’t always go as fast as we might want them to. Daskalakis says the same applies with monkeypox. “This is a long game, not a short game.”