Why Monkeypox vaccine tourism is a good thing
When Jackson Hern asked his primary care physician about getting a monkeypox shot in Seattle last week, he was surprised at the lack of information she had to offer.
Concerns about a growing number cases of monkeypox among gay men in Seattle were featured on all of Hern’s social media accounts.
But Hern, 29, found he wouldn’t be eligible for a vaccine against the virus in Seattle until the fall.
That is, until a friend told him he had been able to get one in Vancouver and sent Hern the link to make an appointment.
“He said they welcomed Americans with open arms and encouraged them to tell our friends in Seattle,” Hern recalled.
So on Wednesday, he and four friends drove across the border and received their first doses of the monkeypox vaccine, known as Imvamune in Canada, at a Fraser Health clinic in Burnaby.
“I knew that being in Seattle, with a very active and tight-knit gay community, it was inevitable that we would have an outbreak here…and I wasn’t willing to wait until the fall,” Hern said in an interview with The Tyee.
Dozens of Washingtonians are come to British Columbia getting vaccinated as monkeypox spreads across the border and around the world, especially among men who have sex with men.
It’s a reverse version of the steady stream of Canadians who have been heading south for the third and fourth doses of the COVID-19 vaccine over the past few months.
Although there is no official count, Hern and two others told The Tyee they know of more than 100 people who have traveled from Seattle to the Lower Mainland for the monkeypox vaccine in recent years. weeks while access to the vaccine remains limited in Washington State.
And while BC health officials say they are not encouraging people in the US to come to Canada for their vaccines, Hern and others say they have been welcomed with ‘open arms’ at Lower Mainland vaccination clinics.
“It’s very unfortunate that we don’t have the infrastructure or support that we need today in King County,” Hern said, referring to the Seattle area.
About 6,000 doses of the vaccine have been administered in British Columbia, according to a statement from the BC Center for Disease Control.
A “small number” of them are from outside the province, but it’s unclear how many of those people came from the United States, a spokesperson said.
By contrast, King County currently has about 1,420 doses to immunize 710 people with the two-dose vaccine. The state Department of Health attributed this to the diversion of supplies to states with higher case numbers, the Seattle Times reported.
Monkeypox disease is caused by the monkeypox virus.
It is not a sexually transmitted infection. But it spreads through close physical contact with someone with sores and lesions and through items like bedding, towels, and utensils. Transmission also occurs through respiratory droplets during prolonged direct contact with an infected person, including during sexual intercourse.
The virus can infect anyone, regardless of sexual orientation or sexual habits, as is the case in central African countries where it is more common.
Symptoms include fever, rash, swollen lymph nodes, open lesions on the genitals and hands, and headache. Symptoms can develop five to 21 days after infection, and sores can spread all over the body.
Canada has reported 745 confirmed cases so far, including 58 in British Columbia.
In Washington state, at least 100 people have tested positive, including 90 of the confirmed cases in King County, which includes Seattle.
The World Health Organization has declared the current outbreak to be a “public health emergency of global concern” Last week.
Monkeypox currently primarily affects men who have sex with men, as an initial super-spreading event took place in that community, Vancouver Coastal Health chief medical officer Dr. Mark Lysyshyn told The Tyee in June. .
But the vaccine is much harder to access south of the border in Washington, where only people with confirmed direct exposure are eligible at this time.
Antonio Leon, 29, considered driving to Vancouver when he realized he couldn’t get a shot in Seattle. Luckily, a friend referred him to a small clinic that had a handful of doses to administer before he arranged his trip.
“It feels like public health has dropped the ball,” said Leon, who knows up to 20 other people who have traveled to Vancouver to get vaccinated.
Meanwhile, British Columbia health authorities recently expanded eligibility. Anyone 18 or older who is “transgender or self-identified”[ies] as belonging to the gay, bisexual or other men who have sex with men community” and has had or plans to have more than one sexual partner is eligible.
But Hern and another person who traveled here said no questions were asked about their lifestyle. “It seems as long as you consider yourself at increased risk, they didn’t ask for anything else.”
No ID number or MSP number is required to book or receive an injection at one of the province’s 11 vaccination clinics.
Matt, 37, started looking for a vaccine last week when someone he knew in Seattle was infected. “It went from just numbers on the map to someone around me,” he said in an interview. (The Tyee does not use Matt’s last name to protect his privacy).
Facing the same obstacles as Hern and Leon, he eagerly agreed when three friends invited him to join their carpool in Vancouver. Dozens of his other friends had already been turned away from vaccinations in Seattle, and he wanted to be protected.
All four got their shots “quick and easy” at a clinic in Vancouver’s West End and enjoyed brunch before heading home. He says he knows about 100 people who have done the same in recent weeks.
He is grateful that he was able to get protection, but frustrated he had to cross the border to get it.
“I think it sounds a bit like Reagan,” Matt said, referring to the US president who ignored and then dismissed concerns in the early years of the HIV/AIDS crisis.
“It’s a disease that mostly affects LGBTQ+ people right now, but it’s not treated as an emergency until it breaks that. [general population] wall.”
It’s no surprise that Americans are flocking to British Columbia for vaccines, say two experts, and it’s encouraging to see health officials welcoming them.
“It makes perfect sense given what we know about the slower rollout in the United States,” said Michael Kwag, director of knowledge exchange and policy development at the Community Research Center in Vancouver.
“When the communities most affected by infectious diseases do not receive the care they need, we are ready to put action in our hands,” he added. “It reflects the resilience of the community.”
This knowledge, Kwag, Matt and Leon said, is rooted in lessons learned from the devastation of the HIV/AIDS epidemic among gay men.
“This isn’t the first time my demographic has been left alone,” Leon said. “And so the previous generations who saw their friends die know what to do.”
But not everyone at risk in Washington state has the money, vehicle, job flexibility or passport privileges to make a day trip or longer for a vaccine, Kwag added.
Kwag wants to see a comprehensive, global vaccine rollout accessible to everyone, regardless of citizenship, income, race or ability.
The Community Research Center has also been outspoken in advocating for increased government support for those infected and forced to self-isolate, including housing, income support and wound care materials.
“Prevention is very important, but we’ve really neglected care and support for this issue,” Kwag said.
Health Initiative for Men executive director Aaron Purdie said it makes sense for B.C. to vaccinate anyone at increased risk right now, regardless of citizenship or place of residence. The initiative aims to strengthen health and well-being in communities of self-identified GBQ men and people of diverse gender identities in British Columbia.
“Epidemiologically, there is a huge amount of transmission between Seattle and Vancouver, two major urban centers, so health care providers are logical and know that people would cross the border and have access to the vaccine,” Purdie said. .
Purdie says that despite initial supply concerns, the vaccine rollout in British Columbia has so far been successful. The initiative has partnered with health authorities to coordinate clinics and spread the word about how to prevent monkeypox at community venues and events.
And it will continue to welcome Washingtonians until it becomes available south of the border.
“Queer men are connected in ways that cross borders,” Purdie said. “Disease prevention would be much easier if there were fewer restrictions and more of a global plan.”