The shortage of vaccines, the fear combined with ignorance and the revival of the stigmatization of the group of homosexual and bisexual men is the trail that also leaves behind, at least in Spain, the epidemic of monkeypox detected in more than 70 country. Experts and patients agree that the most important thing to stop the spread of this virus is for more vaccines to arrive. Right now in our country two people died from the infection.
Infectious diseases reappear silently, but continuously
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Spain received a total of 5,300 vaccines to combat monkeypox, which have already started to be injected at different rates depending on the community. For example, Madrid put 790 vials, while in Aragon none were administered. At the moment, Spain is waiting for more doses, more precisely 7,200, which will arrive in a few days, as confirmed to this newspaper by the Ministry of Health. But while they arrive, infections continue to occur, while spreading stigma reminiscent of the shadows that brought with them the worst times of the HIV epidemic four decades ago.
Daniel, a 34-year-old architect who lives in Madrid, says there is a lot of misinformation about monkeypox and that’s what has increased stigma and fears. “Since there is no direct channel of information, from people who knowingly alert, we seek information on our own. Depending on where you read, it seems to be one thing or another,” he said.
Like many other people, Daniel still wonders whether or not he should get vaccinated. “I took it for granted that it was impossible to get infected by taking off your shirt at a party, but my partner is more worried. We don’t have sex with other people, but we like to do the Party.” “We know there is a danger, but we don’t know how to minimize it,” he admits.
The idea that it is a disease that only affects men who have sex with men is wrong. Monkeypox is not a sexually transmitted disease, it is transmitted through close skin to skin or mucosa to mucosa contact. Is it possible to be infected in the metro? How about a music festival? Experts insist that nothing is impossible and this is one of the many lessons learned from the coronavirus pandemic. “The contact must be intimate and prolonged. What can happen at a concert? It can happen. But it is more difficult”, recognizes epidemiologist Mario Fontán.
The focus was not as it would have been had it affected the whole world, as with COVID-19
Fontán, like all the experts consulted, believes that the key to stopping the spread of the epidemic lies in vaccines. “It seems that at the moment it’s something that affects men who have sex with men, which is a bit of a limited term for other realities, the emphasis has not been put as it is. would have been if it affected the entire population of the world, as with COVID-19, “he criticizes. “Now that the WHO has declared it an international health emergency, it seems that a greater effort will have to be done. If this is not done, the risk of more people being affected will increase and it will affect other people and even vulnerable people. It is now up to governments to put in place measures that prevent contagion. For its part, the WHO has launched a series of recommendations dividing it into four groups of countries.
Difficulties accessing the vaccine
Getting vaccinated is not an easy task. This is how Javi, a 30-year-old boy who now works in a city for the homeless, tells it. According to his account, he tried several times to get an appointment to get vaccinated, but he reports that the appointments end very quickly. “I learned from a friend that they already give appointments on the Community of Madrid website, but the appointments sell out in seconds or minutes,” he explains.
“Once or twice they told me there were appointments at that time and I left half an hour later and there were none left,” he protests. . “Accessibility is very low or non-existent.” Until this Tuesday, the Community of Madrid has confirmed a total of 1,925 cases and administered 790 doses of the 1,835 received. As was the case with COVID-19, self-nomination is the system chosen by the community for people to request the injection.
In Catalonia, for example, it is the health centers that come into contact with people who have “a high risk of contracting the disease”, according to the Ministry of Health. The Catalan administration contacts people who “maintain high-risk sexual practices included in PrEP programs for HIV or who are infected with HIV”.
Close contacts of confirmed cases who, in the event of contracting the disease, could present complications will also be vaccinated: girls and boys, pregnant and immunocompromised people. Catalonia began vaccination against monkeypox on July 21, with 1,643 vaccines available, and as of the 29th of last month, 655 had been administered.
In Aragon, however, none of the 52 doses available have yet been administered, and in Castilla-La Mancha, SESCAM sources say they have already started injecting some of the 59 doses available. The Canary Islands are still awaiting the arrival of their first 200 doses and “vaccination points are already ready to start inoculating”, according to its health ministry. In Galicia, four doses of the 138 available for the Servizo Galego de Saúde were administered.
Alberto, a 31-year-old interior designer, spent most of July cooped up at home recovering from the infection. “It lasts more than a day without bread,” he said on the other end of the line. “I would send a message to institutions and that is to vaccinate as soon as possible, and also to people, to register and get vaccinated,” he encourages. Regarding the stigma generated, he finds it normal that it appeared because of the way “the media expressed it”. “But a little consistency. You have to learn about the disease, know that it has nothing to do with sexual tastes.
“It was eradicated in the 1950s. We have a lot of technology to eradicate it”
The FELGTBI+ federation calls for more vaccines and measures to stop infections, but also stigma. “After the declaration of the WHO [que recomendaba a los hombres que tienen sexo con hombres reducir el número de parejas sexuales], a gigantic stigma has been generated, as we had already anticipated, on the population of gay and bisexual men. A debate has opened on the legitimacy of the WHO to speak about the personal and sexual relations of the population, and we consider that it is unfortunate and inappropriate”, denounces Nahum Cabrera, HIV coordinator within the federation.
“You have to keep in mind that monkeypox is a disease that is transmitted by contact, like measles or rubella”, compares Cabrera, who asks that work continue on “vaccination lines”. “It’s a very old disease, we don’t have to explain to virologists how to do it. It was eradicated in the 1950s and we have a lot of technology to eradicate it,” he concludes.
Another consequence that the stigmatization of a single group could have, as has been the case, is the creation of a false sense of security for others.
Pablo, a 34-year-old molecular biologist, recently recovered from the infection. In his view, monkeypox “is only the tip of the iceberg of a deep problem”. “As long as society continues to deny that people have a sexuality, it will continue to happen, it will continue to stigmatize more,” he says.
“What I believe after having smallpox is that socially, you are not only rejected because you are homosexual, but also because you are “vicious”. I think this is an opportunity to open the debate on sexual freedom today”, he adds, and understands that there are people who do not want to talk about it. “In fact, I had problems coming to work after finishing quarantine. There are friends who don’t want to stay with you. It’s very dramatic, but I don’t care. I think what needs to be done is precisely the opposite, to normalize it,” he defends himself.