PUBLIC HEALTH - It is early August 2022 and I am in San Francisco for a few days.
In urban areas with large gay populations such as Los Angeles, where I’m from, and here, monkeypox is on the mind of all my gay friends, and a topic of great interest among my straight ones. As with the first days of COVID-19, this consciousness seems to have come out of nowhere. Only weeks ago monkeypox seemed like a minor issue. Now there are more and more stories of friends of friends who have contracted it—experiences of the worst pain ever, like broken glass scraping on skin, and of the horror when the lesions travel to the genitals and anal canal, where the pain is constant and agonizing.
For those of us who are sexually active gay men, the timing seems particularly cruel. It was only recently that the shadow of COVID lifted a bit, giving something of a return to normalcy in regards to sexual practices. Monkeypox spreads through close contact, particularly sexual contact, and many gay men have contracted it. Sex and physical intimacy are dangerous again. It’s time to once again limit sexual contact—to heave another sigh, accept the new reality, and try and find a way to get the vaccine.
It isn’t easy. I had registered for the vaccine in Los Angeles and in nearby Long Beach, but had been unable to obtain it. Now, in San Francisco, at a little after 8 in the morning on a Tuesday, a friend texts me that he’d gotten out of bed at 4:30 a.m. to get in line at Zuckerberg San Francisco General Hospital. Rumor was, they had a batch of monkeypox vaccine—maybe 600 doses, no one knows for sure—which they were going to start giving out at 8 a.m.
When my friend arrived at 5:30 a.m. there was already a two-block line, and he was lucky number 125—assured he would get the vaccine that day. His text urges me to get down to SF General ASAP. I pull on some clothes, call a Lyft, and rush out the door. I haven’t had my coffee yet, and I have a work Zoom scheduled later, but this may be my only chance.
When I get there, the line is down to one block long, and there is a moment of joy and relief when a smiling health outreach worker hands me a paper slip: number 531. I will get my first monkeypox vaccine dose that day! She also gives me a questionnaire to fill out and a small, bright yellow pencil, as if I were about to commence a round of miniature golf. I try to remember the last time I have used or even held a pencil. Filling out the form in faint graphite feels somehow inadequate to the importance of the moment.
The vaccine line snakes along slowly but constantly. It is a warm day in the city, and it’s nice to be in the sun. I look around at my companions in line. We are all of us gay men, most alone, some in pairs. I have flashbacks to the early days of the AIDS crisis. The desperate waiting for initial treatments, taking an early HIV test and waiting an unnerving two weeks for the result, struggling to get the first doses of combination therapies. We were stigmatized in those early days, and we fear we could be stigmatized anew.
And of course there are more recent flashbacks, to COVID-19—the confusion and anxiety for everyone seeking to get vaccinated and the glorious memory of getting that first dose, and the sense of liberation and newfound safety that came with it.
About halfway through the line, an earnest young activist hands each of us a card urging us to sign a petition demanding the government take more urgent steps to fight monkeypox, including making more vaccine doses available immediately. Later, near the vaccine site entrance, I come across a huge pile of petition cards discarded on a bench. Political apathy will always exist to some degree, but I wonder how much this castoff mound may also speak to the number of gay men who feel exhausted and overwhelmed in the face of a seemingly endless barrage of political and health threats.
Getting the vaccine goes amazingly smoothly. I walk to a numbered table where an intern in scrubs greets me warmly and transcribes the information on my penciled questionnaire into a database. I go upstairs to receive my vaccine. An older, jovial male nurse smiles broadly at me, offers me a seat, and asks: Which arm? The injection is painless, and I do not at first realize it is over. I see the nurse toss my used syringe into a gigantic red sharps box, on top of hundreds of other spent doses. There we are, thrown together, as we were in line.
I think of all the death and suffering among gay men that the organized, friendly health professionals at San Francisco General Hospital must have seen since the first days of the AIDS epidemic. In some ways this is just another response to a health crisis, offered generously and efficiently, without judgment, and mustering the greatest resources they are capable of providing.
I walk out of the vaccine facility with a lightness in my step, knowing that I am one of the lucky ones. There are still vaccines available today, just as there had been when my friend texted me a few hours earlier. I text other friends to tell them to come down here, and see other men doing the same. We are in this together—men who are still in many ways outsiders to mainstream American sexual culture, who have achieved a certain level of liberation in our celebration of the joy and intimacy of sex, and who, if we are lucky, have good friends who reach out in a time of crisis and tell us to get our ass down here right away.
(Robert Whirry is a freelance grant proposal and report writer who has worked in HIV and public health since 1985. This article was featured in Zocalopublicsquare.org.)