Monkeypox outbreak requires swift public action

There have been 2,323 confirmed cases of monkeypox in the United States as of July 20. That number is only going to grow, especially as testing becomes more accessible.

While anyone can contract monkeypox, right now most cases in the United States are confined to bisexual and gay men and other men who have sex with men.

Monkeypox is not a sexually transmitted infection. The virus can spread through the air, and by skin-to-skin contact, and by sharing clothing and bedding. And yet, the current outbreak is spreading through the sexual networks of men who have sex with men.

If we lived in a perfect world, we would have the resources to get everyone vaccinated against monkeypox right now. We do not. And despite having two vaccines that have been around for years, the number of doses available is far below the number needed.

We must prioritize the people most at risk, and, for the time being, that’s men who have sex with men. That could change at any time.

That leaves public health officials straddling two important messages:

  • The virus is currently traveling through networks of men who have sex with men.
  • Anyone can contract the virus.

This is the exact same line the HIV movement has been walking for decades. For too long, HIV was dismissed as a “gay disease.” Indeed, there are already echoes of the early days of HIV, with homophobic members of Congress dismissing monkeypox as something you can only get “through gay sex.”

That’s wrong about HIV, and it’s wrong about monkeypox.

Vaccine availability, access, uptake

There are currently two vaccines available, ACAM2000 and JYNNEOS. These vaccines prevent and lessen the severity of monkeypox.

The Food and Drug Administration approved ACAM2000 in 2007 and JYNNEOS in 2019. At the beginning of the outbreak, there were millions of doses of ACAM2000 available, but only about 2,000 of the JYNNEOS.

The JYNNEOS has fewer side effects. It’s also the only vaccine those of us living with HIV should get, regardless of viral load. So, there has naturally been a much stronger demand for the JYNNEOS vaccine.

That demand has far outpaced production.

The federal government has made steps to increase manufacturing, including expediting the approval of a factory in Denmark. It must do more, swiftly, to get additional doses.

We have also seen that the vaccine uptake has been inequitable, where those who have access to care and information are more likely to get the vaccine. As more doses become available, we need to reach those who are less likely to access care or receive public health news.

The HIV and COVID-19 epidemics have taught us that we must quickly deploy prevention and treatment care. Not doing so undermines our progress to address public health threats.

We have the tools

Monkeypox is just the latest outbreak to highlight the necessity of a quick response.

Years of clinical research grant us the ability to end this outbreak with effective vaccines. However, we must pair this research with swift government action to mobilize.

AIDS United will host a listening session for community-based organizations Tuesday, Aug. 2, at 3 p.m. EDT. We will be joined by Dr. Demetre Daskalakis, the director of the Division of HIV/AIDS Prevention at the Centers for Disease Control and Prevention. We will discuss what role HIV organizations can play around monkeypox vaccinations, testing and messaging. Registration for the event will open in the coming days.

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