In nearly every area where the vaccine has been made available, recipients are required to attest that they are a gay or bisexual man who has sex with other men or a transgender person.
In some areas, like Washington, DC and San Francisco, sex workers of any gender or sexual orientation can get the vaccine, but that is not the case in other places like New York City, which has borne the brunt of criticism online.
To receive the vaccine in New York City, patients must be 18 or older, be “gay, bisexual, or other man who has sex with men, and/or transgender, gender non-conforming, or gender non-binary,” and have had sex with multiple or anonymous partners in the last 14 days.
While it is true that the vast majority of monkeypox cases have occurred in gay men, the disease does not require sexual contact to spread; it can be spread through simple skin-to-skin contact. Earlier this week, the CDC confirmed two cases of monkeypox in young children, thought to have been spread through household contact. The two children were unrelated but both had close contact with men who have sex with men.
Critics say that requiring vaccine recipients to be part of the men who have sex with men community gives the general public a false sense of security and creates the perception that monkeypox is exclusive to the gay community.
In 1984, after more than 4,200 people had died of AIDS, Reagan Whitehouse spokesman Larry Speakers took a nonchalant attitude towards the growing epidemic, refusing to provide answers about Reagan’s thoughts on the growing epidemic and repeatedly taunting the reporter who asked questions about the disease, Lester Kinsolving.
Many at the time believed that HIV/AIDS was exclusive to the gay community. While it is more commonly spread through homosexual sex, it can also be spread through heterosexual sex, sharing needles, and breastfeeding.
But it is also the reaction to the vaccine requirements that bring up memories of the early stages of the AIDS epidemic. While early education attempts concerning AIDS were focused on higher-risk communities, like gay men, and encouraged safe sex measures at a time when that was a foreign concept for most Americans, that ended in the later stages of the Reagan administration.
Republicans and Reagan took issue with the PSAs that promoted safe sex and banned any ads that could be perceived as promoting homosexual activities. PSAs about HIV/AIDS then moved toward scare-mongering tactics and shaming sexual activities. Many now believe those decisions hurt the fight against HIV/AIDS because they removed the focus, and funding, from those at the highest risk.
Some commentators have pointed out that heterosexuals at low risk of the virus getting the vaccine will prevent those most at risk, namely the gay community and sex workers, from getting the vaccine. If officials tried to prevent the false perception that monkeypox is sexually transmitted and exclusive to men having sex with men by opening up the vaccine to everyone, it could hurt the very community such actions would be meant to protect.
Ultimately, the solution is for more monkeypox vaccines to become available, so that anyone at risk of getting the disease, homosexual, transexual, or otherwise, can get it. When monkeypox was first detected in the United States, President Joe Biden assured the American people that the country has enough smallpox vaccines, which are also effective against monkeypox, in reserve to fight the virus.
However, Time reported that most of the vaccines in reserve are the older ACAM2000 vaccine, which has serious side effects and must be administered carefully. ACAM2000 uses a weaker version of smallpox to provide immunity, which means recipients who come into close contact with non-vaccinated individuals may spread the virus. Additionally, around 1 in 175 recipients of ACAM2000 develop myocarditis, and people with compromised immune systems cannot take it.
Instead, the United States and most other countries have been attempting to contain the virus using a newer vaccine known as Jynneos. But when monkeypox first appeared in the United States, it held a little more than 2,000 doses of the newer vaccine. Jynneos is made by Bavarian Nordic, a small biopharmaceutical company in Denmark, and it has had trouble keeping up with the global demand for its vaccine.
While the US has ordered nearly 7 million doses of the vaccine, it has only received 372,000 of them as of last week. Earlier this month, it was reported that the FDA hopes to approve 786,000 doses by the end of July.
Until that happens, it is unlikely that the US will be able to contain the virus in any significant way. “Without the widespread availability of vaccine, it can't be contained," Michael Osterholm, director of the University of Minnesota's Center for Infectious Disease Research and Policy said in a recent editorial.