There was a time when John Fahey, a hair stylist in Springfield, wasn’t particularly concerned with the spread of monkeypox.
“Originally, when we started to see the news stories come out about monkeypox, it seemed far away and not something that was going to come here," he said. "But now when we watch the news, we notice not only what communities it’s growing in and spreading in faster—but also [that] it is growing faster.”
The CDC says transmission can occur through close, skin-to-skin contact, through respiratory secretions, or by touching objects that have been used by someone with monkeypox.
Monkeypox can spread to anyone, but this outbreak has rapidly spread among sexually active gay and bisexual men.
Typically, Fahey enjoys traveling and socializing with others in the LGBTQ community. But now the increasing number of monkeypox cases has him worried —especially because he tends to travel to larger metropolitan areas where the outbreak is more pronounced.
Most concerning, he said, is how difficult it’s been for him to get a vaccine.
One man’s efforts to get a vaccine in Missouri
As of Tuesday, Missouri had 17 confirmed cases, with neighboring Illinois reporting 701 cases and New York documenting a surging tally of 2,104. Health and advocacy groups in more metropolitan areas have criticized the federal government’s vaccination efforts as being woefully behind the outbreak—with much of the problem tied to a vaccine shortage.
In Springfield, Fahey said he first reached out to AIDS Project of the Ozarks to find out how he could get a vaccine. When he didn’t find answers there, he contacted the Springfield-Greene County Health Department. Finally, he said he was referred to the Missouri Department of Health and Senior Services with his vaccine inquiry.
He was asked to tell about his sexual history over the last six months—something he felt he shouldn’t have to disclose.
“I think as an adult we are all capable of reading what the risk factors are and assessing our own risk and then also making the decision to treat ourselves if we choose to,” he said.
In the end, the state health department told him he wasn’t eligible to receive a monkeypox vaccine.
What are Missouri’s criteria for getting a monkeypox vaccine?
Nathan Koffarnus, bureau chief for the Missouri Department of Health and Senior Services, said the state is strictly following criteriaset by the Centers for Disease Control and Prevention regarding who can get a monkeypox vaccine.
Koffarnus said there are two categories of eligibility right now: People who have been exposed to a confirmed case, and people who are at “high risk,” which includes individuals with multiple sexual partners or other close contacts in areas with ongoing transmission.
“Unfortunately, what we can’t give out right now are the ‘pre-exposure.,'" he said. "So, we would love to be able to vaccinate people before they go and potentially get exposed, but right now the supply’s just so limited that that hasn’t been approved by CDC.”
According to Koffarnus, monkeypox vaccines have been distributed to five regional sites in Missouri: Springfield, St. Louis County, Columbia, Kansas City and Butler County.
The state is rolling out the vaccine in phases: so far, it’s received 2,413 doses, or enough to vaccinate 1,206 individuals statewide, since the vaccine requires two doses.
How severe is the shortage in Greene County?
As of Monday, the Springfield-Greene County Health Department had vaccinated only five individuals against monkeypox. Aaron Schekorra, a spokesman for the department, said all five of those people live in Greene County and had been exposed to the virus elsewhere. Only one case of monkeypox has been confirmed in Greene County so far, he said.
Chief medical officer for the Springfield-Greene County Health Department Dr. Nancy Yoon said the local health department been allotted 140 doses of the JYNNEOS vaccine—which is enough to vaccinate 70 individuals.
“They have not told us definitively when we might be getting more. There is a shortage nationwide, and the doses are being prioritized for states that have the highest number of cases, and right now Missouri is not, and so we’re just waiting hopefully in the coming weeks to months that we’ll be getting more," she said.
Yoon said officials are communicating with AIDS Project of the Ozarks—since they may share some of the same patients—to provide information and facts about monkeypox.
She urges those who are concerned about contracting the illness to know the signs and symptoms. If a person suspects they may have monkeypox, they should contact a healthcare provider and isolate as much as possible while waiting for test results.
Shortage of vaccine leads to anxiety
In late July, the director-general of the World Health Organization, Dr. Tedros Adhanom Ghebreyesus, said for now, gay men should take steps to avoid exposure to monkeypox.
"That means making safe choices for yourself and others," he said. "For men who have sex with men this includes, for the moment, reducing your number of sexual partners, reconsidering sex with new partners and exchanging contact details with any new partners to enable follow up if needed."
Meanwhile, back in Springfield, John Fahey is thinking about canceling upcoming trips to larger cities to avoid the illness. The illness generally lasts two to four weeks, and he’s concerned about the impact on his income if he contracts the virus.
“Looking forward and trying to be preventative, I don’t want to miss 30 days of work,” he said.
He has friends in Springfield’s LGBTQ community, he said, who are thinking about traveling to larger cities where the monkeypox vaccine is more readily available.
President Joe Biden recently declared the monkeypox outbreak a public health emergency, opening up access to federal resources and triggering grant funding, according to NPR.
But Nathan Koffarnus with Missouri’s health department said the Show-Me State won’t feel much impact from that in the short term. He said the U.S. is expected to get an additional 150,000 doses for the entire country in December, which won’t go far.
NPR reported Wednesday that the Biden Administration has approved changing the way the monkeypox vaccine is administered in order to further stretch the supply.
