Stories from the Mpox Response

Hawaii Pride

Photo of Pride festival 2019 in Honolulu

In October 2022, Honolulu celebrated its first in-person Pride festival since 2019 due to COVID-19 precautions. The event presented an ideal opportunity for mpox vaccination efforts, given that gay, bisexual, and other men who have sex with men accounted for the majority of mpox cases on Oahu.

As part of the CDC’s Mpox Vaccine Equity Pilot Program , the Hawaii Department of Health (DOH) mobilized community partners and medical professionals to provide vaccination during Honolulu Pride. In a short period of time, the Hawaii DOH was able to stand up a vaccination clinic and offer vaccination at the largest annual LGBTQ+ event in Hawaii. Along with the mpox vaccine, the Hawaii DOH and community partners offered a variety of preventive health screenings, education, and other vaccines on site.

By participating in Honolulu Pride and partnering with the community, the Hawaii DOH was able to reach people who may otherwise have not received the vaccine. Ultimately, the Hawaii DOH administered 82 mpox vaccinations at the event. Of the vaccines administered, 74% were first doses, and 87% were given to Hawaii residents. Many of the people vaccinated felt it was easy to get the vaccine at an event they were already planning on attending. Throughout the event, attendees expressed gratitude that Hawaii DOH was there and providing vaccination.

National Conference Provides Opportunity for Mpox Vaccination in Puerto Rico

In October 2022, Puerto Rico welcomed people from all over the world to the United States Conference for HIV/AIDS (USCHA). Organized by NMAC, USCHA is the largest HIV-related gathering in the United States, bringing together thousands of participants from all segments of the HIV prevention community. The Puerto Rico Department of Health (DOH) saw this as a great opportunity to collaborate with conference organizers to offer mpox vaccination on site during the conference. The organizers promoted the vaccination event in English and Spanish leading up to the event in the conference program, during registration, and throughout the conference.

Through this collaboration, the Puerto Rico DOH administered 63 mpox vaccinations. Of the vaccines administered, 62% were first doses and 60% were for Puerto Rico residents. The event helped break down accessibility barriers for Puerto Rican residents and conference attendees who perhaps could not access vaccines or felt stigmatized in their home jurisdictions.

Mobile Mpox Vaccination Efforts in Washington State

Care a Van

Since the start of mpox response in Washington, health equity has been the center of discussion for the state. The Washington State Department of Health (WADH) and local community-based organizations met early in the response to strategize how they would address the needs of people directly affected by mpox. The meeting led to the development of a partner toolkit for mpox designed to provide education and address issues such as stigma. The WADH mpox partner toolkit includes general information in 13 languages along with items for organizations that serve the LGBTQ+ community and for service and health care providers. The kit also includes important information and vaccine resources to help facilitate outreach activities with a focus on equity in the communities they serve.

As part of the resources available in Washington, the WADH has a “Care-A-Van”, a mobile service that provides vaccine administration at community-based organizations and events. Through this service, 276 mpox vaccine doses were administered directly in the community. This service helps break down barriers like limited vaccine access and stigmatization to mpox vaccination throughout the state. Services like these also help WADH sustain strong connections throughout the state.

Vaccine Equity at Southern Decadence

A Southern Decadence Health Hub sign advertising vaccination for monkeypox and COVID-19.

CDC responded to a request from the Louisiana Department of Health (LDH) and New Orleans Health Department to support a series of vaccine distribution events before and during the Southern Decadence festival as mpox cases were on the rise in the U.S. in June and July 2022. Organizers sought to reach communities hardest hit by mpox, including gay, bisexual, and other men who have sex with men.

Southern Decadence, described as “Gay Mardi Gras,” attracts more than 250,000 visitors to New Orleans, making it one of the largest annual festivals in the city. In response to the LDH and New Orleans Health Department request, CDC worked across the agency—and with state, private, and community partners—to support the diverse needs of the community and festival planners. In total, 14 CDC staff deployed to assist, with expertise ranging from epidemiology and vaccines to communication and behavioral science. CDC helped LDH and community partners set up the Southern Decadence Health Hub in Armstrong Park. Armstrong Park, one of the oldest historic Black neighborhoods in the United States, remains a vibrant center of Black activity in New Orleans today. The Southern Decadence Health Hub offered mpox vaccines, clinical consultations, testing, and health education, along with COVID-19 bivalent vaccines and COVID-19 home test kits.

LDH and partners also hosted 13 vaccine events in New Orleans in the weeks leading up to the festival. Many of these pre-Decadence events were held at venues frequented by Black men who have sex with men. This helped ensure equitable access to services for local Black residents who may not attend Southern Decadence. Given that Black Louisianans make up 60% of mpox cases identified in the state, it was critical to bring resources directly to the people who need them. By participating in CDC’s Mpox Vaccine Equity Pilot Program, LDH was able to obtain additional JYNNEOS vaccine doses beyond what was already allocated to them to ensure adequate mpox vaccine was available. In total, more than 3,000 doses of mpox vaccine were administered before and during the Southern Decadence festival.

Grassroots Connections are Key to Mpox Vaccination Efforts in Georgia

A mobile health unit utilized for a monkeypox vaccination clinic.

In Georgia, Black men who have sex with men made up 78 percent of mpox cases this summer. As Atlanta Black Gay Pride (ABGP) weekend celebrates diversity and the impact of distinctly Black gay and queer culture on the community, it presented an ideal opportunity to put health equity in action.

In total, more than 4,200 doses of the JYNNEOS vaccine were administered at events leading up to and during ABGP. Nearly half of vaccine recipients were Black, and eight percent were Hispanic/Latino. GA DPH’s collaboration with ABGP organizers, local health departments, and community-based organizations was critical to the success of this event, as they directly engaged and encouraged attendees to get vaccinated. CDC and the GA DPH have plans for additional vaccine events so that people who were vaccinated for mpox before and during ABGP will be able to receive their second doses.

Vaccine Equity Efforts at Charlotte Pride

Charlotte Pride Parade participants ride past a sign offering monkeypox vaccine to event attendees.

Charlotte Pride is the city’s largest street festival and parade, attracting more than 200,000 people. The events presented the perfect backdrop for an mpox vaccine effort, given that gay, bisexual, and other men who have sex with men accounted for nearly all the mpox cases this summer. Near the end of summer 2022, almost all of North Carolina’s mpox cases were found in men who have sex with men, and 70% of cases were in Black men.

The North Carolina Department of Health and Human Services partnered with community-based organizations, key influencers on social media, respected members of the clergy, and diverse night club promoters to connect with diverse populations. The Mecklenburg County Health Department, which serves Charlotte, vaccinated 540 people at a series of festival events, clinics, and non-traditional settings. These non-traditional settings—including private parties, bars, and clubs—were most successful in reaching Black men.