•The first mpox case in Louisiana was 2 months before a large LGBTQ+ Pride festival.•COVID-19 resources were rapidly adapted to also serve the mpox vaccine response.•The strategy was highly successful in mounting an equitable response based on Social Vulnerability Index.•Some disparities remained, however, in those who completed the 2-dose JYNNEOS series.•Further outreach is needed to encourage at-risk populations to be fully protected. The first case of mpox in Louisiana was identified 2 months ahead of Southern Decadence Festival in New Orleans, the largest LGBTQ+ Pride festival in the South. With mpox case numbers reflecting racial disparities, the objective was to mount an equitable vaccination response. The Louisiana Department of Health rapidly pivoted its COVID-19 resources and strategies—specifically, using vaccine strike teams and mobile events, in-state vaccine redistribution through centralized warehousing and shipping support, and community partnerships—to now control mpox transmission. Here, the authors have evaluated state-based Immunization Information System data to examine whether the vaccination response was geographically and racially equitable. Geographic equity was measured by taking into account vaccine availability as well as uptake in areas with high Social Vulnerability Index. A total of 113 providers were enrolled in the vaccination program, and 96 mobile vaccination events were held in locations frequented by at-risk populations. Racial disparities among vaccine recipients decreased over time, and vaccine availability and uptake were equitable in areas with high Social Vulnerability Indices. However, Black, female, and Hispanic/Latinx patients had significantly higher risk of not completing the 2-dose series than their counterparts. The mpox vaccination response in Louisiana was geographically equitable, though some demographic disparities remained.