Pivoting COVID-19 Resources for an Equitable Mpox Vaccine Response in Louisiana

Abstract

Introduction: The first case of mpox in Louisiana was identified 2 months ahead of Southern Decadence Festival in New Orleans, the largest LGBTQ+ Pride festival in the South. With mpox case numbers reflecting racial disparities, the objective was to mount an equitable vaccination response.

Methods: The Louisiana Department of Health rapidly pivoted its COVID-19 resources and strategies-specifically, using vaccine strike teams and mobile events, in-state vaccine redistribution through centralized warehousing and shipping support, and community partnerships-to now control mpox transmission. Here, the authors have evaluated state-based Immunization Information System data to examine whether the vaccination response was geographically and racially equitable. Geographic equity was measured by taking into account vaccine availability as well as uptake in areas with high Social Vulnerability Index.

Results: A total of 113 providers were enrolled in the vaccination program, and 96 mobile vaccination events were held in locations frequented by at-risk populations. Racial disparities among vaccine recipients decreased over time, and vaccine availability and uptake were equitable in areas with high Social Vulnerability Indices. However, Black, female, and Hispanic/Latinx patients had significantly higher risk of not completing the 2-dose series than their counterparts.

Conclusions: The mpox vaccination response in Louisiana was geographically equitable, though some demographic disparities remained.

Figure 1

Racial equity among JYNNEOS recipients. Note: Racial disparity among first-dose recipients reduced steadily over time among Louisiana residents. A) By October 31, 2022, Black and White patients both received 40-45% of the vaccines administered each day. Trend lines for % recipients by race only shown July 22, 2022 onwards; data were unstable prior to that due to low daily vaccination counts. B) The following provider types had the largest contribution towards eliminating the Black/White disparity over time with regards to vaccines: University/Medical Schools, FQHC/Rural Health Centers, and public health facilities. Over a quarter of the patients they vaccinated (26-31%) identified as Black. Addl Grp includes all people who did not identify their race as Black or White. This included people whose self-reported race was American Indian/Alaskan Native, Native Hawaiian/Pacific Islander, Asian, and other. FQHC, Federally Qualified Health Centers; Addl Grp, Additional Groups; STD, Sexually Transmitted Diseases.