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在国家应急响应期间减少疫苗接种差距:美国猴痘疫苗公平试点计划。

Reducing Vaccination Disparities During a National Emergency Response: The US Mpox Vaccine Equity Pilot Program.

机构信息

CDC Mpox Emergency Response Team (Mr Bautista, Drs Madera-Garcia, Carter, Schwitters, Carnes, and Prejean, and Ms Byrkit), National Center for HIV, Viral Hepatitis, STD, and TB Prevention (Mr Bautista and Drs Madera-Garcia, Carnes, and Prejean), Epidemic Intelligence Service (Dr Madera-Garcia), National Center for Immunization and Respiratory Diseases (Dr Carter), National Institute for Occupational Safety and Health (Dr Schwitters), and Office of Readiness and Response (Ms Byrkit), Centers for Disease Control and Prevention, Atlanta, Georgia.

出版信息

J Public Health Manag Pract. 2024;30(1):122-129. doi: 10.1097/PHH.0000000000001818. Epub 2023 Aug 21.

Abstract

CONTEXT

In response to the first reported mpox cases in May 2022, the US government implemented plans to bring testing, treatment, and vaccines to communities disproportionately affected by mpox-including the population of men who have sex with men (MSM) and Black/African American and Hispanic/Latino men, 2 subpopulations experiencing vaccination disparities. We describe the development and implementation of the US Mpox Vaccine Equity Pilot Program (MVEPP), characteristics of completed vaccination projects, and challenges that occurred. We also discuss opportunities for reducing vaccination disparities in future outbreaks.

PROGRAM

To address reported vaccination disparities, the US government launched MVEPP in 2 phases. Phase 1 centered around public events attended by large numbers of gay, bisexual, and other MSM, such as Pride festivals. Phase 2 asked health departments to propose mpox vaccination projects specifically aimed at reducing or eliminating racial/ethnic and other demographic disparities in mpox vaccination.

IMPLEMENTATION

MVEPP received 35 vaccination project proposals. We analyzed data from 22 completed projects that resulted in 25 675 doses of JYNNEOS administered. We note 3 innovative strategies that were implemented in several projects: direct collaboration with organizations providing services to MSM and transgender women; implementation of MVEPP projects in unique nonclinical community settings and at venues frequented by MSM and transgender women; and offering an array of services as part of mpox vaccination projects, rather than offering only mpox vaccination.

EVALUATION

MVEPP highlighted the importance of recognizing and working to eliminate racial/ethnic and other disparities in access to medical countermeasures during a public health emergency. Jurisdictions developed and implemented innovative strategies to bring mpox vaccination and related services to communities disproportionately affected by mpox-including MSM and the subpopulations of Black/African American and Hispanic/Latino MSM. Lessons learned from MVEPP may inform efforts to reduce disparities during future public health responses.

摘要

背景

在 2022 年 5 月首次报告猴痘病例后,美国政府实施了计划,为受猴痘影响不成比例的社区提供检测、治疗和疫苗,包括男男性行为者(MSM)和黑人和非裔美国人和西班牙裔或拉丁裔男性,这两个亚人群存在疫苗接种差距。我们描述了美国猴痘疫苗公平试点计划(MVEPP)的制定和实施、已完成的疫苗接种项目的特点以及出现的挑战。我们还讨论了在未来疫情爆发中减少疫苗接种差距的机会。

计划

为了解决报告的疫苗接种差距问题,美国政府分两个阶段启动了 MVEPP。第一阶段围绕着吸引大量男同性恋、双性恋和其他男男性行为者参加的公共活动,如骄傲节展开。第二阶段要求卫生部门提出专门旨在减少或消除在猴痘疫苗接种方面的种族/族裔和其他人口统计差异的猴痘疫苗接种项目。

实施

MVEPP 收到了 35 个疫苗接种项目提案。我们分析了 22 个已完成项目的数据,这些项目共接种了 25675 剂 JYNNEOS。我们注意到在几个项目中实施的 3 项创新策略:与为男男性行为者和跨性别女性提供服务的组织直接合作;在独特的非临床社区环境中和男男性行为者和跨性别女性经常光顾的场所实施 MVEPP 项目;以及作为猴痘疫苗接种项目的一部分提供一系列服务,而不仅仅是提供猴痘疫苗接种。

评估

MVEPP 强调了在公共卫生紧急情况下,认识到并努力消除获得医疗对策方面的种族/族裔和其他差异的重要性。各司法管辖区制定并实施了创新策略,为受猴痘不成比例影响的社区提供猴痘疫苗接种和相关服务,包括 MSM 以及黑人和非裔美国人和西班牙裔或拉丁裔 MSM 亚人群。从 MVEPP 中吸取的经验教训可能为减少未来公共卫生应对中的差距提供信息。

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