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Epidemiology of Mpox Cases, and Tecovirimat and JYNNEOS Utilization, Alameda County, California, June-October 2022
Megan L Ouyang1, Rachel Marusinec, Paul J Bayard
1Division 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.
Context:
The 2022 United States mpox outbreak disproportionately affected racial and ethnic minority gay, bisexual, and other men who have sex with men.
Program:
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.
Implementation:
Alameda County Public Health Department responded to the mpox epidemic through partnerships with local health care providers who serve communities disproportionately affected by mpox.
Evaluation:
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.
Discussion:
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.
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