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New vaccine guidance drops references to sexual orientation and gender after officials identified it as a barrier.

COURTESY PHOTO: KOIN 6 NEWS - A man receives a dose of the monkeypox vaccine at the Edison municipal vaccination centre in Paris on July 27, 2022.State health officials have expanded the eligibility criteria for monkeypox vaccinations as their response to the outbreak of the virus enters a new phase.

Anyone who knows someone who has had monkeypox and anticipates having or has had recent skin-to-skin contact with at least one other person can now receive a vaccine, the Oregon Health Authority announced in a statement Thursday, Sept. 15.

Additionally, the OHA will no longer refer to sexual orientation or gender identity in its vaccination eligibility guidance, officials said.

Since the onset of the outbreak earlier this year, most cases of monkeypox globally and in Oregon, but not all, have been among men who have sex with men. Amid a national shortage of vaccines, public health agencies around the country used sexual orientation and gender identity in their vaccine guidance to prioritize doses for people most at risk.

That approach may have been a barrier to people seeking vaccinations, said Tim Menza, senior health advisor for the OHA's monkeypox response.

The new guidance was developed with input from community partners, local public health authorities, health care providers and tribal health organizations, Menza said.

"We heard loud and clear that if we wanted to get people in the door to get vaccinated against monkeypox, we needed to rethink how we talked about who is at greatest risk of infection," he said. "In doing so, we hope to reduce the stigma associated with eligibility for monkeypox vaccination."

Rather than calling out specific populations, the new guidance calls out the virus' most common route of transmission: skin-to-skin contact.

Menza said he believes the state's response to the monkeypox outbreak has entered a new phase, after seeing the demand for the vaccine, JYNNEOS, drop in recent weeks.

"Initially, folks were stepping forward, and we had a lot of demand for the vaccine up front," Menza said. "In the last four weeks, since mid-August, we've seen a steep drop-off in demand. Wait lists have dropped to zero, and available slots are not being filled. We need to reinvigorate our vaccination campaign and find new ways to get the vaccine to people who most need it."

As of Wednesday, Sept. 14, there were 189 cases of monkeypox, also known as hMPXV, in Oregon. Most of those cases — 129 — have been in Multnomah County.

The new OHA guidance encourages vaccine providers to "think creatively" about planning vaccine events in partnership with community-based organizations or local businesses to offer "venue-based vaccine events" that prioritize communities most affected by monkeypox.

Multnomah County has been coordinating its vaccination strategy and messaging about the virus with community organizations that work with people of color and members of the LGBTQ community. For example, county health officials have partnered with LGBTQ bars to distribute information about monkeypox, conduct testing and more. The work is similar to that of the early days of the AIDS crisis.

For more information about monkeypox and how to protect against it, visit the county's website.

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