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U.S. states with stronger LGBTQ+ equality laws saw significantly higher mpox vaccination rates during the 2022–2023 epidemic compared to states with weaker protections, according to a study by CUNY SPH researchers.
For the study, doctoral student Claudia Jimenez Castro and Associate Professor and Interim Associate Dean Elizabeth Kelvin analyzed monthly vaccination data and found that states with high LGBTQ+ equality had, on average, four times the vaccination rate of those with low equality.
The association between state LGBTQ+ equality and vaccination uptake was most pronounced in the early months of the outbreak when vaccine access was limited but persisted throughout the outbreak.
“Our findings suggest that during health crises, in addition to offering free care, policies that promote equity may play a role in improving healthcare uptake”, says Claudia.
The study, which accounted for over 1.2 million mpox vaccine doses administered across all 50 states and Washington, D.C., highlighted that financial barriers were not a major factor since the vaccine was offered for free nationwide. Instead, mistrust of healthcare systems and societal stigma in less inclusive states may have contributed to lower vaccination rates
Dr. Kelvin says the findings stress the importance of policy environments in responding effectively to epidemics, particularly for at-risk communities.
“Improving legal protections for LGBTQ+ groups could be vital in future public health responses,” she says.
