Stigma and racism contribute to low monkeypox vaccination rates for black Houstonians

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Kimberly Thomas had to lie to get the monkeypox vaccine – and she’s not the only one.

When a meager supply of doses became available at the Houston Health Department in July, the narrow eligibility criteria targeted men who have sex with men (MSM), especially those with confirmed exposure or multiple partners. anonymous sex. When Thomas called to make an appointment, she was turned away.

Then his friends told him how to answer the screening questions.

“I had to tell them I was a sex worker,” she said. “I had to tell them that I had just slept with someone who is an MSM. I’m a lesbian woman and I had to tell them I was bisexual.

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Experts say the barriers Thomas has faced have a disproportionate effect on black people like her, compounding systemic inequalities that already prevent people of color from seeking health care.

The problem is particularly apparent with monkeypox, the latest virus to inflict an unequal toll on racial minorities and illustrate the ongoing struggle to protect them. Similar to national trends, non-Hispanic black people in Houston account for 33% of all monkeypox cases — most of any racial group — and just 15% of vaccinations, according to the Houston Health Department. The reverse is true for whites, who account for 17% of cases but 29% of vaccinations.

People can register for an appointment for the monkeypox vaccine by calling the Houston Health Department hotline at 832-393-4220 or the Harris County Public Health hotline at 832- 927-0707. Normal Anomaly also helps with vaccine registration at 832-853-7709.

AIDS Foundation Houston is partnering with the Houston Department of Health for two vaccine events, October 1 and 29, at 6260 Westpark, Suite 100. To register in advance, call 832-234-7737.


Early access issues, along with persistent stigma and misinformation, all play a role in this disparity, experts say.

“There’s still a lack of trust in the medical community, and there’s still a fear of being identified as gay or bisexual — and how that knowledge will be perceived even by people we don’t know,” Jeffrey said. Campbell, Director of Health. at the AIDS Foundation of Houston. “They’re going to assume I’m gay…because I’m trying to get vaccinated.”

Although most cases of monkeypox have been reported in men who have sex with men, anyone can become infected through close contact, such as hugging, kissing, and touching fabrics used by someone with the virus. A Los Angeles County resident is the only person confirmed to have died from monkeypox in the United States so far. The cause of death is still pending for a Harris County resident who died three weeks ago from several serious illnesses, including the virus.

More commonly, the infections cause fever, headache, and painful rashes that look like pimples or blisters. As of Thursday, there had been 794 total cases in Houston and Harris County.

The rate of new cases is slowing, with a similar drop in vaccination coverage. In early August, more than 150 people a day received their first dose through Harris County Public Health. That number hasn’t topped 50 since Sept. 6, with the vast majority of vaccinations now among people receiving a second dose, according to data from the Harris County Public Health website.

Now, with an ample supply of vaccines and broader eligibility, health activists like Thomas are heading to Houston’s predominantly black, low-income neighborhoods to break the reluctance. Thomas is a research coordinator with the Normal Anomaly Initiative, a Houston nonprofit that tackles inequality in the black LGBTQ community. She distributes educational flyers in areas like Third Ward and Southwest Houston and addresses common misconceptions about monkeypox.

Thomas spoke to women who believe the virus only infects black gay men. Some people think it only threatens people who have “massive amounts of sex,” she said. Others believe the vaccine causes monkeypox, even though it contains a weakened version of the virus that does not lead to infection.

At first, the specific and sometimes demeaning questions during the registration process fueled a false narrative of this “ideal client” that may have discouraged vaccinations in the black community, said Ian Haddock, executive director of Normal Anomaly.

Those factors complicated efforts to recruit people for a pop-up vaccination event Thursday at the group’s headquarters in southwest Houston, Haddock said.

“We knew it would be hard to recruit people…but it was absolutely harder than we thought,” he said.

Studies show that young gay black men are particularly vulnerable to stigma, in part because of gendered social norms and historical exclusion from the white gay community.

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Houston and Harris County Health Departments have attempted to address this issue by expanding vaccine eligibility criteria to include “all persons, of any sexual orientation or gender, who have recently had multiple sexual partners.” . Anyone living with HIV and those taking PrEP are also eligible.

Dr. Ericka Brown, the Harris County deputy local health authority, said the challenge initially was to stretch the limited supply of vaccines to immediately protect the most vulnerable. She acknowledged that other vulnerable populations “probably should have” received the vaccine during the rollout, but the health department simply didn’t have enough to meet the demand. She hopes more inclusive criteria will eliminate the stigma.

Outreach efforts have improved in recent weeks. Harris County is sending a mobile vaccination clinic to Cypress Station, which has the highest rate of new HIV diagnoses in the county, Brown said. City health workers also stayed up until the wee hours of a recent Sunday morning in Montrose, offering vaccines at two pop-up sites where bars and clubs held a “hip-hop party”. More than 100 people, mostly people of color, have been vaccinated, said Kaylan Henderson, who helps manage community outreach for the health department.

The city’s health department also partnered with Normal Anomaly for Thursday’s vaccine event in southwest Houston. About 67 people had received a dose by mid-afternoon, including Houston resident Jamaal Clue.

Clue received his first dose in Dallas last month, after being denied in Houston. He was ready to return to Dallas for the second dose until he saw the Normal Anomaly event.

As someone raised in a family that emphasized the importance of preventative health care, Clue feels like an exception in the black community. Most young black people don’t learn to ask for help “until the house burns down,” he said. On top of that, the monkeypox vaccine is considered a sort of “scarlett letter,” he said.

“It’s an uphill battle,” he said. “But I think partnerships with organizations like (Normal Anomaly) are key.”

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