The Alberta government announced Thursday it will begin offering a monkeypox vaccine to people who self-identify as meeting eligibility criteria for targeted pre-exposure prophylaxis — bringing the province’s policy in line with British Columbia, Ontario and Quebec, where some gay and bisexual men from Alberta have traveled to get photos.
Gay and bisexual men and their advocates told CBC News they were frustrated by having to travel to other provinces to get vaccinated against monkeypox.
While British Columbia, Ontario and Quebec offer preventive vaccination campaigns targeting those believed to be at high risk of exposure to the virus, until Thursday’s policy change, Alberta only gave the shot to people who had actually been exposed to the virus.
But starting July 29, Albertans 18 and older who self-identify as meeting the criteria for targeted pre-exposure prophylaxis can get the monkeypox vaccine, Alberta Health said in a Thursday news release.
Eligible will include:
- A transgender, cisgender, or two-spirit person who self-identifies as belonging to the gay, bisexual, and other men who have sex with men (gbMSM) community and who meets at least one of the following criteria:
- You have received a recent (within the last six months) diagnosis of a sexually transmitted infection.
- You are planning to have or in the past 90 days have had sex outside of a mutually monogamous relationship.
- You have visited places of sexual contact in the past 90 days (eg bathrooms, sex clubs) or may plan to or work/volunteer in these settings.
- All sexual contacts of the persons described above.
- Staff and volunteers in a social setting or place or event where sexual acts between men (persons described above) may occur.
Some Albertans were looking for shots outside the province
Edmonton resident Corey de Groot plans to go to Montreal next week with his partner on vacation. While there, the two would try to get vaccinated because the vaccine was not available to them in Alberta, even though they were at higher risk of contracting the virus and met the criteria for vaccination in other provinces.
The majority of new cases of monkeypox in Canada and Europe have occurred in men who have sex with men (MSM), and de Groot, a gay man, said before the change that he was frustrated by what he saw as a slow response to Alberta on an unfolding public health emergency.
“I don’t want to receive [the virus] and you know, I just want to reduce the risk,” he said. “I feel like what we’ve learned through the pandemic is just that prevention is key.”
DeGroot searched the Alberta Health and AHS websites for ways he could get a monkeypox vaccine, but could find no indication he was eligible. Then he talked to friends and found out he was being offered in Montreal.
“So we plan to get it while we’re there because tourists can get the monkeypox vaccine,” he said.
Many places in Canada are already approaching vaccination based on self-defined behaviour, vaccinating trans people, gay, bisexual and other groups of men who have sex with men who have non-monogamous sex.
An Alberta health policy dated June 7 states that the monkeypox vaccine is only available to those who have been exposed to the virus.
As of Wednesday, Alberta had distributed 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 are 13 confirmed cases of monkeypox in Alberta.
By comparison, there were 58 cases of monkeypox in British Columbia as of July 26.
Vancouver Coastal Health (VCH), British Columbia’s health authority that stretches from Richmond to the Sunshine Coast and part of the Central Coast, launched a pre-exposure vaccination campaign on July 1. It targets transgender, gay, bisexual and other men who have sex with men who meet additional high-risk criteria and are 18 and older, a spokesperson said in an email.
A health worker prepares a monkeypox vaccine in Montreal on July 23, 2022. Tourists are among those lining up to receive monkeypox vaccines in Montreal as the World Health Organization declares the virus a global medical emergency. (Graham Hughes/The Canadian Press)
As of July 26, VCH has vaccinated more than 6,000 people – some of whom live outside British Columbia – at scheduled clinic hours and at pop-up clinics at events and businesses in Vancouver’s queer community.
“We do not actively encourage people outside of British Columbia 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 that they do not know how many or what percentage of the patients came from outside the province.
A stained transmission electron micrograph of monkeypox particles (blue-green) found in an infected cell (brown) is shown in a handout photo taken at the NIAID Integrated Research Facility (IRF) in Fort Detrick, Maryland. (HO-National Institute of Allergy and Infectious Diseases/The Canadian Press)
Many who work in gay men’s health care see it as only a matter of time before the number of cases starts to grow in Alberta.
“Even though our case numbers are still relatively low compared to places like Ontario, Quebec and British Columbia, it’s hard not to see us as behind the eight,” said Nolan Hill, a gay men’s health specialist at the Center for Sexuality in Calgary.
He said there is a lack of information from the provincial government about patients who are increasingly asking about monkeypox tests and vaccinations when they come in for STI testing.
Instead, it falls on the community, which is often left in the dark, which he says leads to increased stigma and concerns about monkeypox being seen as a gay disease.
“I think this lack of information breeds a sense of mistrust and a sense of abandonment by the health care system,” he said.
“We’ve seen that there is a historic distrust of community in our health care systems, going all the way back to the AIDS epidemic.”
DeGroot hopes the lack of pre-exposure vaccination isn’t due to discrimination, but worries it might be.
“It would be interesting to see the reaction if it certainly resonates with a different demographic,” he said.
DeGroot still plans to get his shot when he leaves for Montreal next week, but worries about equity issues for those who don’t plan vacations or simply can’t afford the plane ticket.
“If it continues to be like the only way Albertans can get a vaccine is to travel out of the province,” he says, “that’s a huge concern.”
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