Division of Communicable Disease Control and Prevention, Alameda County Public Health Department, San Leandro, California (Drs Ouyang, Trivedi, Yette, Dunne, and Chitnis, Mss Marusinec, Peña, Shemsu, and Sheppard, and Messrs Johnson, Menker, and Moore); Alameda County Health Care Services Agency, San Leandro, California (Dr Moss); Office of Public Health Director, Alameda County Public Health Department, San Leandro, California (Dr Ayala); La Clínica de La Raza, Oakland, California (Dr Bayard); LifeLong Medical Care, Oakland, California (Dr Edmunds); Alameda Health System, Oakland, California (Dr Lai); Asian Health Services, Oakland, California (Dr Nguyen); Kaiser Permanente Medical Center, Oakland, California (Dr Rajagopal); Bay Area Community Health, Fremont, California (Dr Slome); and East Bay Advanced Care, Alta Bates Summit Medical Center, Sutter Health, Oakland, California (Dr Tang).George Ayala and Amit Chitnis are senior co-authors.Current affiliation of Dr Megan Ouyang is County of Santa Clara Public Health Department, San Jose, California.Current affiliation of Ms April Peña is San Francisco Department of Public Health, San Francisco, California.
J Public Health Manag Pract. 2024;30(5):744-752. doi: 10.1097/PHH.0000000000002010. Epub 2024 Jul 22.
The 2022 United States mpox outbreak disproportionately affected racial and ethnic minority gay, bisexual, and other men who have sex with men.
We utilized surveillance data and vaccination registries to determine whether populations most impacted by mpox in Alameda County received JYNNEOS vaccines and tecovirimat (TPOXX) during June 1-October 31, 2022.
Alameda County Public Health Department responded to the mpox epidemic through partnerships with local health care providers who serve communities disproportionately affected by mpox.
During June 1-October 31, 2022, a total of 242 mpox cases were identified in Alameda County. Mpox incidence rates per 100 000 were highest among Black/African American (35.7; 95% confidence interval [CI], 26.8-46.5) and Hispanic/Latinx (25.1; CI, 20.1-30.9) residents, compared to Asian (3.8; CI, 2.3-5.9) and White (10.5; CI, 7.7-13.9) residents. Most confirmed cases were identified as gay, lesbian, or same-gender-loving (134, 67.3%) and bisexual (31, 15.6%); 226 (93.8%) cases were male. Sixty-nine (28.5%) mpox patients received TPOXX. There were no statistically significant differences in demographic and clinical characteristics of mpox cases when compared by TPOXX receipt status. JYNNEOS vaccine was received by 8277 Alameda County residents. The largest proportion of vaccinees were White residents (40.2%). Administration rates per 100 000 men who have sex with men were lowest among Asian and Hispanic/Latinx individuals, at 8779 (CI, 8283-9296) and 14 953 (CI, 14 156-15 784), respectively. Black/African American and Hispanic/Latinx males had the lowest vaccination-to-case ratios at 16.7 and 14.8, respectively.
Mpox disproportionately affected Black/African American and Hispanic/Latinx men who have sex with men in Alameda County. Strong partnerships with local health care providers ensured that persons with mpox received TPOXX treatment when indicated. However, higher JYNNEOS vaccine uptake in Black and Latinx communities needs improvement through ongoing and meaningful engagement with Black/African American and Hispanic/Latinx gay, bisexual, and transgender communities.
2022 年美国猴痘疫情主要影响种族和族裔少数群体中的男同性恋者、双性恋者和其他与男性发生性关系的男性。
我们利用监测数据和疫苗接种登记处，确定在 2022 年 6 月 1 日至 10 月 31 日期间，阿拉米达县受猴痘影响最严重的人群是否接种了 JYNNEOS 疫苗和特考韦瑞（TPOXX）。
阿拉米达县公共卫生部通过与当地医疗保健提供者合作，对猴痘疫情做出了回应，这些医疗保健提供者服务于受猴痘影响最严重的社区。
在 2022 年 6 月 1 日至 10 月 31 日期间，阿拉米达县共发现 242 例猴痘病例。与亚洲人（3.8；置信区间 [CI]，2.3-5.9）和白人（10.5；CI，7.7-13.9）居民相比，黑人和非洲裔美国人（35.7；CI，26.8-46.5）和西班牙裔/拉丁裔（25.1；CI，20.1-30.9）居民的猴痘发病率最高。大多数确诊病例被确定为男同性恋者、女同性恋者或同性爱人（134 例，67.3%）和双性恋者（31 例，15.6%）；226 例（93.8%）为男性。69 例（28.5%）猴痘患者接受了 TPOXX 治疗。在按 TPOXX 接受情况进行比较时，猴痘病例的人口统计学和临床特征没有统计学上的显著差异。阿拉米达县有 8277 名居民接种了 JYNNEOS 疫苗。最大比例的疫苗接种者是白人居民（40.2%）。与亚洲人和西班牙裔/拉丁裔个人相比，男男性行为者的疫苗接种率最低，分别为 8779（CI，8283-9296）和 14953（CI，14156-15784）。黑人和非洲裔美国男性和西班牙裔/拉丁裔男性的疫苗接种与病例比例最低，分别为 16.7 和 14.8。
猴痘在阿拉米达县主要影响黑人和非洲裔美国男性和男男性行为者。与当地医疗保健提供者建立强有力的伙伴关系，确保出现猴痘症状的患者在需要时接受 TPOXX 治疗。然而，需要通过与黑人和拉丁裔同性恋、双性恋和跨性别社区进行持续和有意义的接触，提高黑人和拉丁裔社区对 JYNNEOS 疫苗的更高接受度。
