ACT UP Dublin talk Ireland's Monkeypox Response and Vaccine Supply

Campaigners continue to call for a fast vaccine rollout for those most at risk of contracting the monkeypox virus, which are currently gbMSM communities (gay, bisexual and men who have sex with men).

The HSE have stated that since the multi-country monkeypox outbreak began, the service has received limited supplies of smallpox vaccine and has been using this to respond to cases of monkeypox.

An incident management team has been meeting since the first cases were identified in May. In line with the National Immunisation Advisory Council's advice, people who are close contacts of cases of monkeypox are being offered vaccination.

The vaccine is being offered to close contacts after a risk assessment and also to some healthcare workers who may be at risk of exposure through their work.

Multiple states in North America (including California) declared the monkeypox outbreak a public health emergency this week, a move expected to free up additional funding and resources to fight the disease.

The World Health Organization has also declared monkeypox a "public health emergency of international concern," its highest alert level.

Information at the beginning was worryingly scarce, but HIV Ireland's MPOWER programme and ACT UP Dublin have both worked hard to gain knowledge of the virus and to call for a faster response in Ireland.

ACT UP Dublin is a diverse, non-partisan group of individuals united in anger and committed to direct action to end the HIV crisis.

"I went to a meeting with Stephen Donnelly last Friday with HSE Ireland, so we're in direct contact with the Department of Health," Noel Donnellon from ACT UP Dublin told Hot Press. "I sit on a gbMSM sexual health committee so we're getting information through contacts there, and through our members, healthcare professionals and those who actually have the monkeypox virus. In terms of the gbMSM community, the knowledge is there. People know what to look out for and also are very good as a cohort for getting checked. People are certainly asking us more and more about vaccine availability."

"We would have first heard, like everybody else, about monkeypox when the first cases started happening in the United Kingdom. In terms of action, communications have been very bad, which was acknowledged by the Minister for Health in the meeting in terms of vaccinations," Donnellon continued.

"We understand that vaccines are difficult to get and Ireland has a small allotment right now, but it might be possible to purchase more from other countries who don't need as many. Everything has to be very targeted and rationed, in a way, which is hard. The problem is that a lot of countries got rid of their smallpox vaccine stockpiles because they didn't need them anymore. There's only a tiny amount of pharma companies making them now, if not just one. The FDA have only approved one, and there's two that may get approval. But so far there's only one, and it's two doses given 28 days apart."

The latest information we have on access to #monkeypox vaccine.

💉Ireland has a supply but it’s ‘low and limited’
👉🏻 Gay and bi men identified as most in need of access
📆HSE is creating a vaccine plan but no date yet

We’ll continue to share info here: https://t.co/w4exWvblHR pic.twitter.com/pejHeXgZeC

— Adam Shanley (@Adlers1) August 5, 2022

As Adam Shanley of HIV Ireland confirmed, there is no date yet for vaccines and the supply remains low and limited. Noel stresses the need for people to be able to self-declare their risk status.

"The main thing is the Department of Health getting vaccines out. From our point of view, we'd love for people to self-declare if they're at risk, so they can go and get it. Public health would prefer to make assessments on other people's needs with vaccines, whereas we would suggest that some people should be able to self-declare if they're at high risk of monkeypox."

"At the moment, stigma seems to be quite low in Ireland, and hopefully it stays like that," he adds, when queried on the rising fears of repercussions for the LGBTQ+ community. "That's something we raised with the Department of Health and they agreed. Communication with the media and Department is really important. Ireland has been quite good actually. Even though it's been mainly gbMSM people getting it, monkeypox is an everybody issue - anyone can get it. The virus doesn't care who you are.

"We'll see as things go on, but a vaccine would really help in terms of stigma. A number of individuals have gone public with their recovery in order to try negate shame. That's important, personal stories."

There has been disinformation circulating around social media, predominantly around whether the virus is airborne (not confirmed) and who can get it (anyone). Ireland appears to be keeping that under control, for the time being.

"The main thing is that people realise it's close contacts that are most at risk. There are high, medium and low risks to monkeypox, and getting that information out is really important. A lot of that will come from the HSE, and their messaging to date has been good. The most important thing is that people with monkeypox know to isolate, and have people they can reach out to as well - especially after the two years we've had. It's seen as a mild disease for most people, so that's some comfort as well."

Sexual health services in Ireland overall sadly took a dive during the Covid-19 lockdowns, despite the SH:24 programme by the HSE being introduced. Clinics were closed for months at a time.

"I brought that up to Stephen Donnelly, and John Gilmore, and everybody reiterated that sexual health services really do need proper funding. Through Covid, all of those clinics closed and the workers were taken into the Covid programme. The Minister for Health said he's very aware of that and is looking at providing more money for sexual health services in general. It's definitely now on his radar."

"We'd love to see HIV rates going down. They've been going up, unfortunately. I'd also like to see an expansion of the PrEP programme. A lot of people would like to be on the medication but can't get it at the moment because sexual health services have seen budget cuts."

For more information, visit actupdublin.ie and the HSE website page on monkeypox.