Ontario’s top doctor says the province’s current monkeypox vaccination strategy is working and cases of the virus appear to be leveling off, but some who work with people in shelters say the immunization program should be expanded to serve better for those communities.
Medical Director of Health Dr. Kieran Moore said the province has vaccinated more than 20,000 people against monkeypox so far, with the priority group being gay, bisexual and other men who have sex with men who they meet certain criteria.
“We’ve been able to get the vaccines we need from our federal partners, we’ve been able to staff our immunization clinics to meet the needs of our population, we have the necessary funding and partnerships to ensure our health care system protects those at risk.” by this virus,” Moore said in a recent interview.
“Our response in Ontario has been pretty strong. We still have a long way to go, but it looks like our total number of (monkeypox) cases is plateauing.”
But for some, the province’s vaccination strategy doesn’t do enough to protect those living in high-risk settings like homeless shelters, highlighting a recent confirmed case of monkeypox in a person who attended a Toronto shelter.
Diana Chan McNally, a community worker at a Toronto center for people in need, said she believes monkeypox vaccines should be widely available to those living in shelters given the congregate nature of the settings and the fact that those living there they can share their belongings.
“This kind of laissez-faire attitude toward the vaccine is integral to the fact that we don’t seem to prioritize creating special protocols or really taking into account the unique conditions that can lead to monkeypox infection in the shelter system.” “, said. Chan McNally.
He also said the current monkeypox vaccine strategy does not take into account intersections between people living in shelters and those who might be eligible for the vaccine, such as sex workers and LGBTQ homeless people. they may not have access to the city. -Direct immunization clinics.
“I don’t know why we can’t get, even in small quantities, dedicated amounts of the vaccine to priority groups within the shelter system,” he said. “I think that’s something that could potentially help mitigate any chance of spread.”
Chan McNally also said he wants to see the opportunity offered to shelter workers. “If we protect your health, we can protect other people in the shelter system,” he said.
Toronto Public Health held pop-up monkeypox vaccination clinics at the shelter where a case was recently reported, which Moore says is part of Ontario’s “ring immunization” strategy targeting those who may have been exposed to a known case.
Patricia Mueller, executive director of Homes First, the company that oversees the shelter where the case was confirmed, said there have been no other monkeypox cases linked to it. She said her staff, the city and the Toronto Department of Public Health acted quickly to move the infected person to an isolation and recovery site and set up a vaccination clinic.
Mueller added that shelter workers are considered low risk for monkeypox.
Rita Shahin, associate medical officer of health at Toronto Public Health, said the city is not currently planning a broader program of monkeypox vaccinations for all shelter residents, although those who meet the criteria are eligible for vaccination. vaccine.
“We need to look at where the disease is, who is most at risk, and if we see additional cases or spread in the shelter system, that’s certainly something we would look at,” Shahin said.
Shahin also said the city’s supply of monkeypox vaccines is “pretty limited,” though Moore said the province has a “significant stockpile” of doses ready for emergency situations.
Thomas Tenkate, a professor at the Metropolitan University of Toronto’s School of Public and Occupational Health, said he agrees that men who have sex with men should remain the primary group to be vaccinated against monkeypox. based on transmission trends, but added that pop-up clinics in shelters could be a way to proactively slow the spread of the virus.
“If you’re going to vaccinate people who are in shelters, the strategies need to be different than the general community,” Tenkate said. “People who use shelters or are homeless, you really have to go to them.”
He said another challenge in vaccinating people in shelter settings is understanding their health history to point out any potential complications from receiving the vaccine. “That could also be a limiting factor to implement it,” she said.
Public Health Ontario reported a total of 449 confirmed cases of monkeypox in the province as of Thursday, up from 423 on Tuesday. The agency’s latest report said the majority of cases, more than 77 percent, were reported in Toronto.
It also said that almost all infected people are men, with only two reported in female patients. The virus generally does not spread easily and is transmitted through prolonged close contact via respiratory droplets, direct contact with broken skin or body fluids, or through contaminated clothing or bedding.
— With files from Allison Jones.
This report from The Canadian Press was first published on August 8, 2022.