With limited monkeypox vaccine, Southern Decadence is a concern for Louisiana

Louisiana is headed into one of the largest gatherings of gay and bisexual men in the country next month without nearly enough monkeypox vaccine to meet the demand – and with a shortage of vaccine nationwide during a growing outbreak of the virus. 

Any person, regardless of gender or sexual history, can contract monkeypox, health officials have emphasized, but an overwhelming number of the cases in the United States and Eurpoe so far have been among men who have sex with men. If the outbreak in the LGBTQ+  is not controlled, health experts expect that the virus will spread farther into the general population.

Yet so far, the federal government has resisted calls from Louisiana health officials to provide the state with more vaccine ahead of one of the major events on the national gay social calendar. 

Southern Decadence, advertised as the largest LGBTQ+ festival held annually in the Deep South, is scheduled for Labor Day weekend (Sept. 1-5) in New Orleans. It typically attracts 100,000 to 300,000 participants and is a major economic boon to the city in a season when tourism is otherwise sluggish.

People come from all over the country and world to attend, and anticipation is particularly high this year, since the festival was canceled in 2020 and 2021 over COVID-19 concerns.

Yet health officials at the state and local level say Louisiana’s meager vaccine supply will leave the state vulnerable to a large monkeypox outbreak following such a massive event. Southern Decadence could also further the virus spread in other parts of the country if visitors become infected while in New Orleans and carry monkeypox back to their hometowns, they said. 

“This will be a superspreader event without additional vaccine doses ahead of time to get as many people as possible [vaccinated],” said Jennifer Avegno, New Orleans health director and an emergency room physician, in an interview this week.

Ideally, Louisiana and New Orleans would launch a widespread vaccine drive to inoculate as many people – particularly gay and bisexual men – before Southern Decadence.

But the federal government has only agreed to give the state 9,200 doses of the monkeypox vaccine in total.  Some of those doses might not arrive until the middle of September, after Southern Decadence has already taken place, state officials said last week. 

The Louisiana Department of Health pleaded with the federal government to give the state an additional 15,000 doses “outside of the state’s normal allocation” ahead of Southern Decadence to help prepare for the event, but the request has not been granted so far. U.S. Centers for Disease Control officials are more likely to provide technical assistance – expertise in communication, education, epidemiology and behavioral science – ahead of the event. 

“We have been advocating for weeks and weeks at the highest level of the federal government to put this on their radar – because it was not on their radar,” Avegno said of Southern Decadence. “We need to vaccinate an awful lot of people and we need supply.”

Absent more vaccine doses, Avegno said public health officials are working with Southern Decadence organizers and bars that cater to the LGBTQ+ community to educate them on how the virus spreads. Louisiana and New Orleans are totally dependent on the federal government to provide the drug.

Monkeypox is thought to be easily transmitted through prolonged skin-to-skin contact, though it could also spread through sharing personal items like towels and bedsheets. The virus can produce flu-like symptoms and a painful rash, which is subtle at first but then turns into oozing scabs. A person who has monkeypox can be contagious and sick for as long as a month. 

The disease is only rarely fatal, but may leave scarring. People who get monkeypox have a difficult time going to the bathroom and describe it as one of the most uncomfortable experiences of their lives. They can have trouble sleeping because the pain is so severe.

Yet the monkeypox vaccine has been very hard to come by in Louisiana, even for people who have spent days trying to find it. The state’s largest healthcare provider that caters to the LGBTQ+ community, CrescentCare in New Orleans, ran out of doses for several days last week. 

“Southern Decadence is alarming – to put it lightly,” said Joe Hui, spokesperson for the clinic.

Louisiana may have an uphill battle when it comes to advocating for more vaccine doses. It has a lower infection rate – about 1 in about 80,400 residents has monkeypox – than the country as whole, where 1 in every 49,800 residents has tested positive. The state is also competing with places like California and New York, that are experiencing larger monkeypox outbreaks and have larger populations of gay and bisexual men.

Louisiana only has 58 confirmed cases of monkeypox, 42 of which are in New Orleans or its surrounding parishes, as of Wednesday evening. By comparison, New York had 1,666 and California had 826. In the South, Texas and Florida both had over 500 cases. 

But organizers of Southern Decadence events said they felt other communities who host major events for gay and bisexual men were given more resources than New Orleans ahead of time.

Mark Louque, who splits his time between New Orleans and Provincetown, Mass., said Provincetown residents had far more access to vaccine ahead of Bear Week, another population festival for gay men, in early July. 

“All of those people were able to get vaccinated two weeks prior to Bear Week,” he said.

Louque hosts a dance party at the Ace Hotel during Southern Decadence which typically attracts 1,200 to 1,500 people. 

In light of monkeypox, he’s lowered the capacity by 100 people for the event, so dancers can spread out more and don’t have to touch each other if they don’t want to do so. He’s also offered refunds to any guest who has already bought a ticket if they don’t feel safe attending. Louque also plans to send emails to people who have signed up for the party, educating them on the risk associated with monkeypox.

““Keeping these nightlife spaces safe for people is part of my work,” he said. “And maybe we have to dance with our shirts on this year? I don’t know.”

Ross Ransom, who is throwing two parties during Southern Decadence, said it is difficult to know what to expect. His events could attract a few hundred people, but the monkeypox outbreak may also cut down on attendance. Ransom is trying to share resources about where to get the vaccine in Louisiana and how to identify monkeypox through  social media accounts. 

Ransom, who owns a house in New Orleans but lives part time in California, said he has already been vaccinated. He wishes there could be a vaccine site in the French Quarter during Southern Decadence to reach more people. 

“The vaccine appears to be disproportionately unavailable in the South,” he said. 

A large outbreak of monkeypox could have a potentially devastating impact on Louisiana, which is significantly dependent on tourism and headed into football season, when tens of thousands of people squeeze into LSU’s Tiger Stadium and the Superdome in New Orleans for games.

New Orleans at-large City Council Member J.P. Morrell said he hopes to see a more robust education campaign on monkeypox from Mayor LaToya Cantrell’s administration headed into Southern Decadence. 

“[The city] hasn’t taken it as seriously as COVID because the incidents of death aren’t as high as COVID,” Morrell said. “But you don’t want collapsing school attendance and a collapsing economy because people are home for a month bedridden with sores.”