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As monkeypox spreads, some Louisianans struggle to get care, vaccine

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Men who have had sex with more than one man over the past 14 days are eligible for the monkeypox vaccine in Louisiana. (Canva image)

This story was originally published by the Louisiana Illuminator.

It took New Orleans resident Jared Zeringue three days of incessant calling to find a dose of the monkeypox vaccine in Louisiana.

First, he contacted New Orleans health care offices listed on the Louisiana Department of Health’s website as vaccine providers but couldn’t find anyone willing to give it to him.

Then he called the public health unit in St. John the Baptist Parish, where he owns a business. The state website said there were vaccine doses at that location, too, but its staff told Zeringue he needed to contact a regional state public health office first for approval.

The regional public health office couldn’t help Zeringue and bounced him back to St. John, where staff then told him it didn’t have any vaccines doses on hand but would try to locate one.

Eventually, the public health unit called Zeringue back and said it had found him a shot, though Zeringue would have to drive to Thibodaux, 40 miles away in Lafourche Parish, to receive it.

Cautiously optimistic, he is taking off work Friday to make the trip for the first of two doses he needs to be fully vaccinated.

Zeringue doesn’t believe he has been “directly exposed” to monkeypox yet. But as a gay man, he considers himself to be higher risk for the virus.

“I keep hearing about people that are closer and closer to me that are positive or that have been fighting it for weeks and are going through hell,” he said.

‘Supply will increase, just not fast enough’

Public health officials across the country have complained they don’t have nearly enough monkeypox vaccine to meet demand for a growing outbreak. As of Friday, Louisiana has been allocated a little over 9,200 of the over 1 million shots the U.S. Government is distributing, though it won’t receive all of those doses at once.

Most of the vaccine will come in three separate allotments over the next four to six weeks, according to the health department. In total, it will only be enough to fully vaccinate about 4,600 people, since each person requires two shots taken 28 days apart.

Officials and health experts have said this sum will not meet the state’s overwhelming needs.

As of Thursday, there were 31 monkeypox cases in Louisiana out of approximately 4,900 across the country. While that’s a relatively small amount of infection, the number is also five times higher than it was just two weeks ago, when Louisiana had only six cases. So the virus is spreading rapidly, primarily in the Southeastern region of the state around New Orleans.

The lack of vaccine has sounded alarms among Louisiana’s gay and bisexual men. Almost all American monkeypox infections have been found in men who have sex with men, though health experts stress that anyone, regardless of their sexual history, can contract the virus.

“We get dozens of calls per day from people who want the vaccine,” said Joe Hui, spokesperson for CrescentCare health clinic, which caters to the LGBTQ+ community in New Orleans.

Given its small supply, the state has limited monkeypox vaccine access to people who have been directly exposed to the virus and men who have had sex with more than one man or an anonymous male partner in the last 14 days. Sex workers, their clients and men who have had sex with men in a social setting also qualify.

State health officials said the general public shouldn’t become complacent about monkeypox though. The current strain of the virus is thought to be spread through skin-to-skin contact, which isn’t always sexual. It could include nonsexual cuddling or dancing closely, for example. Monkeypox should not be thought of as a “gay disease,” they said.

“[Gay and bisexual men] is where it started in terms of the demographic that’s involved, but there’s nothing innate within that demographic that would necessarily make them more or less susceptible than the general population,” said Chad Roy, a professor of microbiology and immunology at Tulane University who spent years studying monkeypox for the U.S. government.

Monkeypox is rarely fatal, but the so-called “pox” that develops can cause scarring.

“There is a threat of disfigurement, even if it has a very, very low mortality rate,” Roy said.

The illness can also be agonizing.

‘I have never felt pain like that in my entire life’

Ronnie Dufrene was one of the first people in Louisiana to test positive for monkeypox earlier this month. He started developing symptoms on Friday, July 15, when an intense itching began in his lower back.

By Saturday, Dufrene had a high fever of over 103 degrees. He woke up on Sunday morning in sheets and bedding soaked through with sweat. A subtle rash of small bumps – that he initially had a hard time seeing – developed on his lower back.

Dufrene’s doctor tested him for monkeypox the following Monday. It took four more days for those test results to come back for Dufrene to learn that he was positive. By that time, he had become far more ill. He had trouble going to the bathroom, his lymph nodes swelled and his muscles ached. The pain was debilitating.

“I have never felt plain like that in my entire life. I couldn’t lay down. I couldn’t sit. I couldn’t get comfortable,” Dufrene said. “I was sleeping every one or two hours and then I would wake up from the pain.”

The bumps on his back had also gone from being tiny to mosquito-bite size and rising up in a white ring. They also started to multiply.

“I’m a 37-year-old man, and I cried to my mother on the phone about the pain,” he said.

A few days into his illness, Dufrene saw an article online from Columbia University in New York about Tpoxx, the antiviral drug that can be taken to lessen symptoms of monkeypox. He asked his doctor if he could obtain the drug, and she managed to get it from the state.

Dufrene said within two days of taking Tpoxx, his symptoms started to wane. The lesions on his body flattened and his pain started to retreat. A week later, he was still in isolation but had started to feel normal again.

He believes a sexual partner from earlier in July gave him monkeypox, though that person told Dufrene that he never developed a rash or any other symptoms. The two people Dufrene had close contact with after he was infected were also able to get vaccinated quickly, and he doesn’t think exposed anyone else to the illness, he said.

Dufrene worries, though, about people who may not be as fortunate as him. He had to take several days off work to recover from the illness and isolate, and not everyone has that flexibility. People infected with monkeypox can be sick and contagious for as long as four weeks.

“If I had been in the service industry and a waiter, or something like that, what would I have done? What if I couldn’t work for four weeks?” he said.

The rash Dufrene experienced is typical what infected people are seeing in Louisiana. Many people assume – because of images that pop up during Google searches of monkeypox – that the virus’ lesions are large and difficult to miss, said Hui with CrescentCare. Instead, the health clinic is seeing a monkeypox rash that consists of very small bumps that can be easily overlooked. People need to be mindful that they may not be able to spot the rash easily on themselves or a sexual partner, he said.

“[The rash] looks like a lot of other things. If you are in a dark area where those things aren’t visible, you might not be able to see it,” he said.

‘We’ve been through this already’

In interviews, gay men said they have decided to limit their sexual and social contact until they can get access to the vaccine. Brad, a resident of Algiers who declined to use his last name, said he’s only attended one small gathering at a friend’s house since the monkeypox outbreak escalated earlier this month.

Brad has called CrescentCare several times for a vaccine appointment, but the clinic ran out of shots on Tuesday and wasn’t sure when they might be getting more doses. His primary care physician’s office also told him it doesn’t have access to the medication.

Last week, when he called a number on the state’s health department website for information about where to get the vaccine, he was directed to a state office that runs a nutrition program for breastfeeding and postpartum mothers.

For both Brad and Zeringue, lack of access to the monkeypox vaccine reminds them of the early years of the AIDS crisis, when government officials did little to stop the spread of that deadly disease in the gay and bisexual community.

“We’ve been through this already,” Zeringue said. “This rollout is something that reminds us all of the deaf ears in the ‘80s.”

When they can’t find access to the vaccine in Louisiana, gay and bisexual men of means are traveling out of state to get the shot, several people interviewed for this article said. Some have driven to Houston or made vaccine appointments while traveling to New York. Zeringue said one of his friends flew to Montreal to be vaccinated.

“Right now, people are doing whatever they have to do,” he said.