Wednesday, May 22, 2024

Opinion: The university’s monkeypox vaccine criteria: Clear as mud

OpinionOp-EdOpinion: The university's monkeypox vaccine criteria: Clear as mud

BY SHAYNA DEMICK
Opinion Columnist




On Sept. 6, the university announced via email that the monkeypox vaccine will now be available to its “high-risk” populations. On Sept. 8, the university held its first monkeypox vaccine clinic. To obtain a vaccine from this clinic, a student must meet a very narrow set of criteria that qualifies them as having a high risk of contracting monkeypox.

It is worth noting that these criteria were identical to those published by the Delaware Department of Public Health. While the university did not create the criteria, it neglected to modify issues in the criteria or add clarifying information about monkeypox and its spread. 

The vaccine clinic criteria are as follows: 

Must be age 18+

Must be an individual who meets one of the following criteria:

  • Suspected or confirmed monkeypox exposure within the past 14 days
  • HIV+
  • Receiving PrEP to prevent HIV
  • Men who have sex with men and have had more than one partner and/or any anonymous sexual partners
  • Transgender women or non-binary people assigned male at birth who have sex with men
  • Sex workers (any gender or sexual orientation)
  • Employed (any gender or sexual orientation) at any business where sexual activity occurs, for example, bathhouses, sex clubs or saunas

These vaccine criteria were presumably created to prioritize men in queer relationships receiving the vaccine as that population happened to contract monkeypox early on.  While the criteria identify queer men as the high-risk group, they do so in a way that may imply that the monkeypox virus is a disease exclusive to the LGBTQ+ community. 

Image source: CDC

Looking only at monkeypox case demographics, it may appear that the virus is connected to the LGBTQ+ community. However, there is no scientific connection – the case demographics are an accident of fate. Without making this fact clear to its student body, the university has potentially reinforced homophobic prejudices on campus. 

The university missed the opportunity to clarify that the current disease demographic is purely circumstantial and not genetically explained. It should have stated alongside its vaccination criteria that monkeypox is a close-contact disease and clusters within communities of close contact. These communities happened to consist primarily of queer men. While this is where the disease is primarily spreading, anyone can contract the disease. 

Another problematic criterion that implies an LGBTQ+ monkeypox connection is the identification of transgender and nonbinary individuals as a high-risk group for monkeypox. 

“Transgender women or non-binary people assigned male at birth who have sex with men”, states the criterion. 

But according to the disease case data thus far, these individuals do not have a higher risk than cisgender and/or heterosexual individuals. The university explicitly states that only individuals assigned male at birth who have sex with men are considered high-risk for the disease. However, one’s assigned identity would only be useful if the disease was linked to male genetics, which is not the case. 

Groups like the Center For Disease Control and the World Health Organization have stated that homosexual men are the most at-risk group. With that said, a man who is engaging in sexual activity or in a relationship with a non-binary person or transgender woman is not inherently queer. 

Grouping non-binary people and transgender women with the male demographic is not only ineffective in focusing vaccine distribution on groups engaging in male-loving-male relationships, but it is invaliding to these individuals and their identities. 

It is interesting to note that the university has a website consisting of valuable and credible information about monkeypox risk and how the disease spreads. Why did it fail to mention this site on its vaccination page? Doing so would ensure that its students do not assume that they are free of risk if they do not meet the vaccination criteria.

Why did the university not follow its own rationale for an individual’s risk of monkeypox when producing its criteria for the clinic?

In its earlier posted monkeypox information, the university states: 

  • It is important to note that anyone can get monkeypox if they have very close contact with someone who is infected. 
  • Monkeypox spreads in close-knit social groups. A person’s individual risk is dependent on the amount of interactions with at-risk social circles and spaces.
  • Your level of risk increases if you have multiple sexual partners or are engaging in social activities where there is skin-to-skin contact. 
  • Currently, cases are predominantly among men who have sex with men. This may include men who identify as Gay, Bisexual, Heterosexual, or any man who engages in sexual activity with other men.

On this site, the university does a good job of clearly explaining who is currently contracting monkeypox without harmful language or implications while also communicating the general population’s risk of contracting the disease. 

Unlike the troubling language used in the vaccine clinic criteria, this language suggests that the groups experiencing the most spread get vaccinated first and promotes a general caution regarding the disease. For some reason, the university decided that copying the state’s language was a better idea. It was not.

The university’s monkeypox vaccine clinic page is problematic in the language that it uses, the message that it conveys and the stigmas it reinforces. As a large institution with great social and educational influence, the university should be more thoughtful with the information it dispenses to the public. 

For more information on monkeypox, visit: 

https://www.nejm.org/doi/full/10.1056/NEJMoa2207323

https://health.hawaii.gov/docd/files/2022/06/monkeypox-and-gay-and-bisexual-men-fact-sheet-06-02-2022.pdf

https://www.npr.org/2022/08/05/1116036167/talking-about-monkeypox-effectively-without-stigmatizing-men-who-have-sex-with-m

https://www.gavi.org/vaccineswork/monkeypox-isnt-hiv-gay-and-bisexual-men-are-risk-unfair-stigma?gclid=Cj0KCQjwjvaYBhDlARIsAO8PkE2fMal3zbKozMUtI2bYspot4VUnl8ZIoC5awpTMugAKQUiHNsieh7kaAjxhEALw_wcB

Shayna is an opinion columnist at The Review. Her opinions are her own and do not represent the majority opinion of The Review staff. She may be reached at sddemick@udel.edu

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