NC health experts discuss stigma and access to monkeypox vaccination at town hall

Health experts from the North Carolina Department of Health and Human Services and other organizations discussed monkeypox testing, prevention and vaccines at the town hall on August 30.

Speakers at the event included NCDHHS Medical Consultant Dr. Victoria Mobley, NCDHHS Deputy Secretary of Health Mark Benton, and NC Sexual Health Conference founder Tanya Bass.

The event was moderated by Reby Kern, Director of Education Policy for Equality NC.

According to Mobley, there were 48,844 cases of monkeypox worldwide and 18,101 cases nationally on August 29 and 312 cases in North Carolina on August 30.

As of Sept. 1, North Carolina had a total of 322 cases of monkeypox with a total of 11,420 vaccines, according to the NCDHHS.

Men make up 99 percent of North Carolina’s current cases. Black patients made up 68 percent of cases, and Hispanic patients made up 9 percent. Mobley also said North Carolina sees a high proportion of cases among people living with HIV.

An Aug. 10 equity report from the NCDHHS found that although about 70 percent of monkeypox cases are diagnosed in black men, black North Carolinians receive less than a quarter of the vaccinations.

He said this report is a call to action and that vaccination clinics are being held by both Pride events and the Triangle Empowerment Center to better reach the most affected populations.

Mobley said global levels of monkeypox are starting to decline, and that trend could be seen in North Carolina as well.

“This is an acknowledgment that we are catching up with the spread of monkeypox in our population,” she said. “So with testing, with vaccines, we’re actually able to contain the outbreak at this point.”

Monkeypox is spread through close personal contact or skin-to-skin contact with someone who has a monkeypox rash. Mobley advised people not to look for typical symptoms, but to talk to their doctor about anything unusual, including rashes, painful swallowing or bowel movements.

Bass said people should be careful about close contact with others, especially at gatherings, clubs and in the heat — when skin is more likely to be exposed.

Mobley noted other methods of transmission, including respiratory droplets, an infected person’s sheets or bedding, and sexual activity.

“There are many ways in which it can be transmitted, but we absolutely know that right now it is transmitted through activities that occur during sex,” she said.

Mobley said the debate about whether monkeypox is a sexually transmitted infection is still ongoing. She said the virus has been isolated in multiple bodily fluids, including those typically associated with sexual transmission, but it is unclear whether that material is infectious.

“We don’t want people to be in a state of panic, but we want people to be concerned about their health and the health of others in general, while being able to pay special attention to the communities that are most affected,” Bass said.

She said she and her colleagues are working to reduce the stigma surrounding monkeypox because of its association with sex.

Benton said there is widespread access to testing for monkeypox, which can be done with primary care doctors, community clinics or county health departments. He said access to vaccines is not that great, but supplies are increasing.

“In the last few days alone, we’ve received just over 18,000 new doses of the monkeypox vaccine,” Benton said.

Mobley said the Centers for Disease Control and Prevention and the US Food and Drug Administration have provided guidance on how to make the vaccine supply last longer.

Initially, North Carolina used one vial of the vaccine per patient and was delivered subcutaneously. Now one-fifth of the vial can be used per person if the vaccine is delivered intradermally.

She said this method will leave a small blister under the skin and may be associated with more redness or swelling of the arm.

Patients aren’t fully immunized until two weeks after their second dose, according to Mobley.

Monkeypox testing is available at Campus Health, according to an emailed statement from Ken Pittman, executive director of Campus Health at UNC. The need for testing is determined based on symptoms and potential exposure. Results are available in two to three business days.

Vaccines are also available at Campus Health for people with known or suspected exposure to monkeypox — as well as men who have sex with men or transgender people who report having multiple or anonymous sex partners, diagnosed with a sexually transmitted infection, or getting HIV pre-exposure prophylaxis (PrEP).

Doses are subject to weekly allocations from the Orange County Department of Health and NCDHHS.


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