Inside Sheffield's monkeypox vaccine rollout

Good afternoon members — and welcome to Thursday’s Tribune.

It’s been three weeks since the World Health Organization declared monkeypox — a rare disease caused by close contact — a global health emergency. The UK Health Security Agency has assigned the greatest number of vaccines to London — something that makes sense, given the capital has the highest number of cases. But what about those in Sheffield who are trying to access the vaccine?

Over the last week, Dani Cole has been speaking to some of the Sheffielders who are trying to access a monkeypox vaccine, as well as public health professionals in the city, to try to find out what is going on. We think this is a really crucial story, which is why we’re running this as our un-paywalled piece for the week. However, the research our work requires doesn’t come for free — if you feel moved to support us with a monthly subscription, we’d be very grateful.

Mini-briefing

🏬 The former John Lewis building on Barker’s Pool is now a listed building. Historic England says the listing has been made because of the building’s “national significance” and “special architectural and historic interest”. Yesterday, The Star reported that 15 “exciting and credible” bids for the building had been made. Councillor Mazher Iqbal said he favoured retaining at least part of the building so Sheffield could “deliver on its net-zero ambitions”.

🎭 The Crucible’s Studio Theatre has been renamed in honour of the woman who designed it. As part of the beloved theatre’s 50th birthday celebrations, the Crucible’s small and intimate in-the-round second stage will be renamed the Tanya Moiseiwitsch Playhouse in honour of the hugely influential theatre designer who had a key role in the creation of the complex. To read more about Tanya Moiseiwitsch see our piece about The Crucible here.

📻 Sheffielder reports the sad news that the first voice heard on Radio Hallam when it started in 1974 Johnny Moran has died. Moran, who was also one of the original Radio 1 DJs, was Australian by birth but came “home” to Sheffield (where his mother was from) to set up the new radio station after a chance meeting with programme director Keith Skues at a party given for singer Barry White! Moran presented Hallam’s breakfast show until the late 1980s.

Things to do

🦕 Sheffield’s newest museum opens this weekend in the slightly unlikely location of Hillsborough. The Yorkshire Natural History Museum on Holme Lane is the brainchild of 23-year-old palaeontology expert James Hogg and will be filled with a treasure trove of fossils from his private collection including the head of an ichthyosaur thought to be 175 million years old. A nice piece on the museum can be found in the Yorkshire Post here.

🍻 The latest Quayside Market returns to Victoria Quays on Saturday, bringing street food and drink, music and entertainment to the beautiful canalside location between 12noon and 9pm. This month traders include hot dog stall Get Wurst and Middle Eastern kebabs and mezze from Leeds-based Mor Mor. Permanent Victoria Quays attractions Dorothy Pax and True Loves will also be open and there will be music from Cirque Du Funk, Wow and Flutter.

🖼️ If over the next few days you want (or need) a break from the sun and to imagine cool water and breezy coastlines, the Fronteer Gallery’s latest exhibition could be just the ticket. The show features the work of 50 artists all based on the theme of “The Sea”. Also on in the (cool) basement gallery is “The Specimen Cabinet”, an exhibition featuring the work of 30 artists which all focus on natural curiosities. Fronteer opens 10am-3pm Wednesday-Saturday.

Despite living in Sheffield, Jamie Dunk made the decision to travel down to London to get the monkeypox vaccination.

It wasn’t one the 39-year-old took lightly. The cost of travel — a day return to London from Sheffield costs around £50 — was one consideration. Another factor was that there were higher rates of the virus in the capital: 75% of confirmed cases in the UK are currently in London.

He had seen posts on social media about the vaccine rollout in the capital, but when it came to what Sheffield was doing, he found the information confusing.

“I rang the sexual health clinic in Sheffield, just to get an understanding of what they were doing,” he tells The Tribune. He was told that the clinic had requested the vaccines, but beyond that, they weren’t able to share much else.

It’s almost three weeks since the World Health Organization delivered a media briefing in which they called monkeypox a “public health emergency of international concern”. While monkeypox is not a sexually transmitted disease, it is spread through tiny droplets and close contact with others.

According to World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus, it is currently concentrated “among men who have sex with men.” Given the limited amount of vaccines available, the UK Health and Security Agency is focusing the rollout on men who have sex with men (MSM) who are at the highest risk of exposure. 

Jamie is in the at-risk group, not only because he is taking PrEP (pre-exposure prophylaxis, a combination of drugs that reduces the risk of getting HIV), but because he also has a rare condition called sarcoidosis which causes inflammation in parts of his body and means he is immuno-suppressed. During the coronavirus pandemic, he shielded for nine months. 

He booked an appointment at Guy’s Hospital, London as he didn’t want to feel uncertain about being able to get the vaccine in Sheffield. His previous experience with Sheffield Sexual Health services is positive. “Normally the planning is really good,” he says. “I just think it's the distribution of the vaccine more than anything.”

He was vaccinated on Sunday 7 August. Due to a shortage of the vaccine, Guy’s Hospital had to cancel walk-ins, but Jamie was one of the few who were able to go ahead with their pre-booked appointments. He was told by a nurse that they were “running out of vaccines.” He is feeling “absolutely fine” after getting his jab.  

Jamie’s experience wasn’t an anomaly. Nick, 45, a resident of Broomhill, reports similar difficulty in finding reliable and clear information about the vaccine in Sheffield. He was offered the monkeypox vaccine in mid-July after being called about a PrEP check-up. Initially he was pleased because he had heard the vaccination was hard to get. “They called me proactively, which was great,” he says.

But when he turned up for his PrEP checkup at Sheffield Sexual Health clinic, he was told they had received 20 doses, and that they had all gone. “I was really frustrated, but it felt like they were doing their best,” Nick remembers. “Sexual health clinics are being told to deal with this vaccine, when they are already stretched for resources.”

He was told to keep ringing the clinic and was eventually booked in for an appointment for 9am Monday 8 August. “It all went very smoothly,” he said, and the process took about 10 minutes. “I am thrilled.”  Like Jamie, Nick says he used social media to keep up to date with information about the vaccine, predominantly using Twitter. 

He is frustrated about the misconception that monkeypox is a sexually transmitted infection and that it is spread by promiscuous behaviour. Currently, it is most prevalent among MSM but it can affect anyone. “I’ve been told to ‘keep it in my pants’ for a few weeks by someone on Twitter,” he says. “There’s an air of judgement, stigma and shame out there.” 

‘We are working extremely hard’

In the UK, as of 8 August, the number of confirmed monkeypox cases was 2,914, up from 2,768 on 5 August. More than 100,000 doses of Imvanex, a smallpox vaccine, were procured which according to the vaccines minister Maggie Throup is the “most of any EU country”. The monkeypox virus is similar to the one that causes smallpox, and a modified smallpox vaccine is being used to innoculate people. Currently, one dose of the vaccine is being offered to people who are eligible. 

Speaking to The Tribune, Dr Claire Dewsnap, the president of the British Association for Sexual Health and HIV (BASHH) and a genitourinary consultant at Sheffield Teaching Hospitals said that health professionals were working around the clock to ensure people could get a vaccine, but that there was a very limited supply. 

Sheffield Teaching Hospitals — which runs Northern General Hospital, the Royal Hallamshire Hospital, the Jessop Wing and Weston Park Hospital — was contacted in early July by NHS England, and vaccines were given to people who were eligible on 25th July. Sheffield Sexual Health clinic is run in Royal Hallamshire Hospital and is the main sexual health clinic in the city. 

Dewsnap told The Tribune that Sheffield Teaching Hospitals had only been allotted 20 doses initially. “We knew those 20 doses were going to go very quickly and they did — they went in two days.” She stresses the importance of understanding the context: millions of pounds have been cut from the public health budget over the last decade.

Since 2014, £200m has been cut from sexual health services, according to a BASHH report submitted to the government last year. Obviously, some of this has come out of Sheffield Sexual Health’s budget, too.

“In terms of Sheffield, we are working extremely hard. Staff are working over their hours for free.” She continued: “I have other consultant colleagues who are working on their annual leave, they're working on the weekend, they're not getting paid for that.”

From Monday 8 August, vaccinations were made available from Sexual Health Sheffield for people who are eligible. Dewsnap said that Sheffield had been given another 60 doses, which she anticipates will “not go very far”. She says the government’s original plan was to vaccinate approximately “35,000 to perhaps 50,000 men who meet the eligibility criteria”. BASHH estimates that 250,000 doses need to be procured to vaccinate 125,000 people nationally. “It won’t be a surprise to anybody [working] in the national bodies that they [the government] haven’t procured enough doses of the vaccine.” 

‘There will always be a lag time’

For some Sheffield men, getting the vaccine has been difficult and they are still waiting. Frazer Scott, 30, who helps run a social media account for Sheffield-based LGBTQ+ collective Working Thems Club told the Tribune he had been booked in for an appointment for 13 September and had been ringing Sheffield Sexual Health clinic about his vaccine. “I thought it [the information] was quite vague,” he said. “Personally I am quite concerned, but I would say that it doesn't seem to be spreading here like it is in London. I do want to get my vaccine as soon as possible.” 

Ed Simpson, 23, first heard that Sheffield was offering monkeypox vaccines after reading a PinkNews article, in which Dewsnap explained that it was being offered in Sheffield’s PrEP clinics. “I had to go through Twitter and Google to find this article,” Ed said. After ringing Sheffield Sexual Health, he was given a date of 18 August.

“I've not seen it advertised anywhere,” he said. “I’m not very optimistic if I am honest. I was hoping with a bit of time after the initial rush they would have enough supplies. We just did one of the best vaccination efforts [Coronavirus] Europe has ever seen — surely we can do better than this.” 

Dr Andrew Lee, Professor of Public Health at the University of Sheffield said it was important to bear in mind that in Yorkshire and Humber, there were 59 cases of the virus, compared to over 2,000 in London. “We want to target it where the risk is greatest, and at this point in time, the risk is greatest in London,” he said. 

With the increased demand for the monkeypox vaccine globally, “there will always be a lag time, and especially when there’s such high demand.” On fears that the UK would run out of vaccines, he offered some balance. The next delivery of doses is due to arrive in September, which “is only a few weeks away,” he said. 

“For the average person on the street who has no contact with somebody with monkeypox, the risk is fairly low,” he said as contracting monkeypox required close contact with others. For gay, bisexual and men who have sex with men (GBMSM), Lee advised exercising more caution but stressed:

“We must be careful that we don't stigmatise anyone. I want to reiterate that we want people of whatever persuasion to feel like they are able to come forward and seek treatment, get tested and see vaccines.”  

For people frustrated or worried about accessing the vaccine, Dewsnap said: “If people using our services feel that they can't get what they need, they should be raising this with their MP. Because the only way we are going to get a change in direction is from political decision making.”