Alberta gay men heading out of province to get monkeypox vaccine

Gay and bisexual men and their advocates say they’re frustrated by having to travel to other provinces to get vaccinated against monkeypox.

While British Columbia, Ontario and Quebec run preventative vaccination campaigns targeted at those considered at high risk of being exposed to the virus, Alberta only gives the shot to people who have actually been exposed.

Edmonton resident Kory deGroot is planning to head to Montreal next week with his partner. They are going to try to get vaccinated there because the vaccine wasn’t available to them in Alberta, despite being at higher risk of contracting the virus and fitting the vaccination criteria in other provinces.

The majority of new monkeypox cases in Canada and Europe have occurred in men who have sex with men (MSM) and deGroot, a gay man, says he’s frustrated by what he sees as Alberta’s slow reaction to an unfolding public health emergency.

“I don’t want to get [the virus] and you know, I just want to decrease risk,” he said. “I feel like what we’ve learned through the pandemic is just, prevention is key.”

DeGroot searched Alberta Health and AHS websites for ways he might be able to get a monkeypox vaccine but couldn’t find any indication he is eligible. Then he spoke with friends and found out it was being offered in Montreal.

“So we do plan on getting it while we’re there because tourists can get the monkeypox vaccine,” he said.

Two provinces, two different policies

Many places in Canada are approaching vaccination based on self-identified behaviours, vaccinating trans people, gay, bi and other groups of men who have sex with men who are having non-monogamous sex.

An Alberta Health policy dated June 7 says the monkeypox vaccine is only available to those who have been exposed to the virus, but a spokesperson for the ministry said they are “expecting to provide an update in the near future.”

As of Wednesday, Alberta has given out 36 doses of Imvamune, the vaccine used to prevent and treat monkeypox and smallpox. The province currently has 1,200 doses from the federal government and is working with the feds to acquire more, according to an Alberta Health spokesperson.

As of July 26, there have been 13 confirmed case of monkeypox in Alberta.

Alberta Health would consider changing to a more preventative approach if there was an increase in cases where there was no known exposure or transmission in specific settings, according to the spokesperson.

By comparison, there have been 58 monkeypox cases in B.C., as of July 26.

Vancouver Coastal Health (VCH), the B.C. health authority stretching from Richmond to the Sunshine Coast and part of the Central Coast, started a pre-exposure vaccination campaign on July 1. It targets transgender people, gay, bisexual and other men who have sex with men who meet additional high-risk criteria and are 18 years old and over, a spokesperson said in an email.

As of July 26, VCH had vaccinated more than 6,000 people — some of whom reside outside of B.C. — at booked clinic appointments and at pop-up outreach clinics at events and businesses in Vancouver’s queer community.

“We are not actively encouraging people from outside of B.C. to seek vaccination at our clinics,” wrote VCH public affairs specialist Jeremy Deutsch, “but if they are in the VCH region and meet the eligibility criteria, they can be vaccinated.”

Deutsch added they did not know how many or what percentage of patients had come from out of province.

Possible updated policy coming

In what appears to have been a technical mix-up, an updated policy dated July 27 may have been posted on the Alberta government data portal.

The updated indications were: Pre-exposure use in outbreaks and the following individuals eligible for pre-exposure Imvamune:

• Trans-, cis-gender or two-spirit individuals 18 years of age or older who self-identify as belonging to the gay, bisexual and other men who have sex with men (gbMSM) community and who meet at least one of the following criteria:   
     
  • Have received a recent (e.g. in the last 6 months) diagnosis of STI.

     

  • Are planning to have, or in the past 90 days had, sex outside of a mutually monogamous relationship.

     

  • Have attended venues for sexual contact within the past 90 days (i.e., bathhouses, sex clubs) or may be planning to, or who work/volunteer in these settings.

     

• Any sexual contacts of the individuals described above.
• Staff and volunteers in a social setting or venue or event where sexual activities between men (individuals described above) may take place.

The document containing the information appeared for at least a brief period online on the evening of July 26 but was replaced with the previous June 7 policy by Wednesday.

CBC News brought this to the attention of Alberta Health but did not receive a response to that question.

While the previous policy is still in place, many who work in gay men’s health see it only as a matter of time before case numbers start to grow.

“Even though our case numbers are still relatively low in comparison to places like Ontario, Quebec and in British Columbia, it’s hard not to see us as behind the eight ball,” said Nolan Hill, a gay men’s heath specialist at the Centre for Sexuality in Calgary. 

He said there is a lack of information from the provincial government for patients who are increasingly asking about testing and vaccinations for monkeypox when coming in for STI testing.

Instead it’s falling on the community who are often left in the dark, which he said leads to increased stigma and worries of monkeypox being seen as a gay disease.

“That lack of information just I think breeds a sense of mistrust and a sense of feeling left behind by the health system,” he said.

“We’ve seen that there is historical mistrust of the community, in our health systems, starting all the way back in with the AIDS epidemic.”

DeGroot is hopeful the lack of pre-exposure vaccination isn’t because of discrimination but still worries it could be.

“It would be interesting to see the response if it was impacting a different demographic, for sure,” he said.

DeGroot still plans to get his vaccine when he heads to Montreal next week but he worries about the equity issues for those who aren’t planning vacations or just can’t afford the plane ticket.

“If it continues to be like the only way that Albertans can get a vaccine is by travelling out of province,” he says, “that is a huge concern.”