Southern states’ lackluster monkeypox attempts to leave LGBTQ+ groups alone

Dan DeChales began looking for a monkeypox vaccine around the Fourth of July but was unable to find a place that offered one in Orlando, Florida, where he lives.

After searching online for about a week, he and three friends met the car in Wilton Manors, a town about 3½ hours south. DeChales, who is gay, said he didn’t understand why the vaccine wasn’t available closer to home or why it was so difficult to get answers from his local health department about whether he was eligible.

“My biggest takeaway from our experience has just been the county-to-county variation in the state of Florida,” said DeChelles, 30, a supply chain manager who worked part-time while traveling to receive her first vaccine dose. lost.

The perception that the South’s response to the monkey virus has lacked coordination has reignited familiar concerns about recent state policies that marginalize and discriminate against members of the region’s LGBTQ+ communities. has to More immediately, it raises the question of whether state and local health departments are doing enough to protect the people most likely to be infected with the virus: men who have sex with men.

States such as New York and California have followed recommendations from the Centers for Disease Control and Prevention to prioritize gay and bisexual men in harboring treatment, vaccinations and treatments. Such states have declared public health emergencies and launched aggressive, targeted vaccination campaigns. While New York and California are the states with the highest number of cases, Florida, Georgia and Texas are home to strong gay communities and together account for more than a quarter of the nation’s confirmed cases of monkeypox.

But in Florida and elsewhere in the South, gay men fear the monkeypox response is not being consistently prioritized because the virus affects the health of gay men, especially those who are black or Hispanic. And they worry that local governments are not responding quickly enough to diseases that primarily affect marginalized communities.

“They’re not going to go out of their way to help us,” said Hank Rosenthal, 74, a gay man and retired emergency medicine physician who lives in Fort Lauderdale, Florida.

Florida Department of Health spokesman Jeremy Redfern, speaking on behalf of local health departments, said the agency is “fully coordinated” to meet the public health needs of the state’s 67 counties. “We have no jurisdiction in Florida to access,” he said. “There is no politics with a monkey.”

But recent laws like Florida’s that ban instruction about gender identity and sexual orientation in some elementary school grades — dubbed “don’t say gay” bills by opponents — and transgender people on Medicaid. The state’s restriction on maintenance has created LGBTQ+ advocacy groups say a highly politicized environment surrounds issues related to sexual orientation and gender identity. And it has some groups feeling the need to take matters into their own hands, particularly in states that have slowed the spread of the Covid-19 pandemic and mandated face masks and vaccines to limit the spread of the virus. banned.

“We mobilize, and we try to make things happen because our job is to take care of our community,” said Ricardo Martinez, CEO of Equality Texas, an advocacy group for LGBTQ+ rights. “We can’t depend on the state to provide the support and security we need, so we have to organize ourselves.”

The first suspected case of monkeypox in Florida was reported in Broward County in late May. Since then, the health department has reported that more than 2,200 of the state’s cases — about 2 in 3 — have occurred in South Florida’s Miami-Dade and Broward counties, where DeChales and his friends went to get the monkeypox vaccine. What was the trip for?

The vaccine, called Genius, is shipped directly from the strategic national stockpile to five county health departments. From there, the state sends vaccines to doctors, hospitals and other county health departments “as needed,” Redfern said.

The national stockpile ships the vaccine to five locations per state and at first uses a distribution system that was unfamiliar to state officials. This requires them to manually track food and place orders via email rather than an automated system, which creates disruption. On September 6, the US Department of Health and Human Services announced that it had awarded a $20 million contract to a private wholesale company to “significantly” expand vaccine distribution to more sites in the coming weeks.

As the government’s response improves, LGBTQ+ advocates and people trying to get vaccinated in Florida say vaccine access and information were inconsistent during the first months of the virus outbreak. Local health departments used different eligibility criteria, appointment schedules, and public access, he said.

Brandon Lopez of Orlando said that when he first tried to get vaccinated through his local health department in June, he was told that only health care workers and blood collectors in laboratories were eligible. Lopez, 30, said he considered going to Miami after hearing that friends there had been shot but was told the meetings were only for local residents.

Some counties announced online scheduling for appointments in mid-July, but many who tried to sign up said no slots were available or received an error message asking them to sign up for a new appointment. You are prompted to create an email account.

“I see my friends who live in Chicago, who live in San Francisco, who live in Washington, D.C., and they’re only able to walk to one place,” said Josh Roth, 33, of Orlando. Waited almost three weeks to get my first dose of vaccine. “They may have a few hours to wait, but they are able to get the shots.”

Advocates are also concerned that people with more education, money and time may have better access to the shots.

According to the CDC, preliminary data show that black and Hispanic men are disproportionately affected by monkeypox cases, yet non-Hispanic white patients receive the first doses of the vaccine more than any other group. are, according to the CDC.

More appointments began rolling out in Florida in mid-August after the FDA adopted a new method of administering the vaccine that required training and specialized equipment but stretched the nation’s limited supply.

DeChellis didn’t have to drive to Wilton Manors for her second shot on Aug. 23, and Roth got her second dose on schedule. After weeks of trying to get an appointment online, Lopez was vaccinated in early August at the Orange County Health Department in Orlando.

But the experience made him feel as though monkeypox was not an urgent matter for local health officials. “My expectation is that if it doesn’t affect a large group of people, it’s not going to be a priority,” Lopez said.

After the monkeypox epidemic began, some health departments in the South began partnering with so-called Trusted Messengers in the LGBTQ+ community to raise awareness and host vaccine clinics.

In South Florida, for example, Broward County’s health department reached out to help vaccinate people from high-risk groups in the community, said Robert Boe, CEO of the Pride Center Equality Park, an LGBTQ+ organization. Provides health and social services. People and he hosted a vaccine drive. In Texas, Equality Texas held a webinar with doctors and other experts who answered questions from the public.

But in other areas, gay and bisexual men said they couldn’t get an answer, not even from their local health department.

Florida, Georgia and Texas together account for 26 percent of the nearly 22,000 confirmed cases reported as of Sept. 9, but their response has been in contrast to California and New York, where governors’ emergency declarations have forced more health care workers. Vaccination is allowed. and local health departments to get more money from the state for vaccinations, education, and outreach.

“An emergency declaration does nothing for the response,” said Redfern, a spokeswoman for the Florida Department of Health, which is responding to an outbreak of meningococcal disease that primarily affects gay and bisexual men.

Andrew Eisenhower, a spokesman for Republican Gov. Brian Kemp, said the state of emergency for Georgians is nothing new that is not already in place. He also said that the Georgia Department of Public Health is raising awareness about monkeypox and recently launched a statewide portal for vaccination schedules.

Authorities in Texas, Austin and Dallas declared local states of emergency in early August. The Texas Department of State Health Services declined to comment on whether the statewide announcement has been confirmed.

Some providers, such as Dr. Ivan Melendez of the Hidalgo County Health Authority in South Texas, agree that because monkeypox is primarily spread among men who have sex with men, a statewide announcement is needed. do not have. Lab testing, vaccines, and guidance are available for both clinicians and the public.

But others say an emergency declaration would signal that a threat exists, free up funding, require additional reporting, and cut bureaucratic red tape.

“It gives us a solid answer,” said Jill Roberts, an epidemiologist and associate professor at the University of South Florida. “It allows for more information: Where are the vaccines going? Where are the cases happening? Where are the hot spots that we can hit?”

Dr. Melanie Thompson, an Atlanta physician who cares for people living with HIV, said she wants the state and governor to take a stronger role in coordinating a uniform response across Georgia’s 159 counties. Not all local health departments are adequately staffed or funded, Thompson said.

“They’re all out there doing their own thing,” she said. “Some counties do a great job with it. Other counties don’t.”

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