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Monkeypox vaccine: At-risk gay and bi men being overlooked by rollout

Some of the people most vulnerable to monkeypox may be getting overlooked for vaccines because of existing inequalities, LGBTQ+ communities have warned, while gay and bi men are having to rely on word-of-mouth to find out about walk-in clinics and appointment booking tools.

Londoners are queueing for hours for jabs based on clinic details shared on social media. The city is the epicentre of the disease outbreak, with 1,906 of the 2,759 confirmed UK cases – just under 70%. More than 99% of the confirmed cases have been in men, with those who have sex with men overwhelmingly the most affected.

But there are fears that people with disabilities and men who are not out as gay or bi could be left behind as they are not known to sexual health services, unable to queue for long periods, or afraid of being outed. Some who spoke to openDemocracy said the lottery of provision meant they had so far been unable to get the jab despite fitting the risk profile.

Sexual health and LGBTQ+ rights groups published an open letter today calling on health secretary Steven Barclay to step up efforts to control the outbreak, including better communication and coordination with gay and bisexual men and men who have sex with men.

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Dan, who asked us not to publish his surname, told openDemocracy: “I’m currently on crutches after a leg injury so I can’t queue for three hours at Guy’s Hospital like my peers have been doing for the past two weeks.”

The only other option is to book an appointment, but this is far from straightforward. “I’ve tried to book on the website but it’s been unsuccessful so far,” he added. “I’ve been refreshing the page every two hours since last Friday. [There are] no open spots for now.”

The UK government announced this week that it had acquired more than 100,000 doses of the smallpox vaccine, which is being used to inoculate against monkeypox. It comes as the WHO declared monkeypox a “global emergency”. 

Vaccines minister Maggie Throup has urged people to wait to be invited to receive their jabs. 

“Some sexual health services will contact men who are likely to be at higher risk – for example, those who have had a recent sexually transmitted infection – to come in first. Other services will offer vaccines alongside other appointments, such as HIV PrEP [pre-exposure prophylaxis, which protects against contracting HIV],” Throup said. There are 18 clinics offering these vaccinations.

But Dan pointed out: “The official NHS website just states that the people who need it will be contacted. As if all gays have a file in a sexual health clinic. We don’t. Not everyone is on PrEP, and not everyone gets tested.”

Without Twitter, he said, it wouldn’t have been clear to him and his peers where to go or who to call.

He also believes a group of men have been forgotten about – which he believes could be damaging to public health: “The whole narrative of monkeypox impacting only gay men is wrong because many straight men have sex with other men. We meet them online, in sex clubs, in gay cruising spots, and there are a lot of them.”

Dan added: ”The problem is many won’t enter a sexual health clinic out of fear of being recognised or outed. They are not signed up for PrEP anywhere so they won’t get any kind of calls to get vaccinated.

“Meanwhile, we the gays and bis are being stigmatised as if it’s all our fault.” 

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