www.cdc.gov/mpox

Information on Mpox vaccine acceptability and uptake sectional surveys

Kevin P. Delaney, PhD, MPHCommunity Engagement and Vaccine Policy and Implementation Task Force2022 Multinational Mpox ResponseCenters for Disease Control and PreventionAdvisory Committee on Immunization PracticesFebruary 22, 2023
Information from US-based Clinicians

 Sermo – online community of >1.3 million clinicians Conducted a worldwide survey of physicians

July 31-August 1st; results reported 8/8/2022

• At that point (N=415 US-based clinicians)

• 69% said that the US did not have enough 

mpox vaccine to handle the outbreak

 Brief updated survey (N=62) on 9/12/2022

• 66% had treated at least one patient with monkeypox• 76% knew where to send patients for JYNNEOS vaccination• 86% wanted to be able to offer vaccine in their practice

More at https://app.sermo.com/barometer/unitedstates
Information from affected populations
Studies included

Study Timeframe Population MethodsPorter Novelli August –

December 16 

N= up to 371 LGBTQ+Data weighted to match census population

Four KAP surveys in the including LGBTQ+

AMETHST: American Transformative HIV Study

Aug 9th – November 15th N=8,551 50% Black and Latinx 

GBMSM

Monthly cross-sectionanew cohorts of personQuestions related to m

AMIS: American 

Men’s Internet Survey

August 5 –August 15

N = 824 GBMSM Emory conducted a on

2021 AMIS population. Survey available here

October 6 –December 31

N=3041 GBMSM Ongoing recruitment o

survey summarized thr

San Francisco study among persons experiencing homelessness (PEH)

Oct 23rd – November 5th N= 273 57 with higher risk sexual 

activity35 GBMSM

Cross-sectional survey understand vaccine acccoverage
Studies included

Study Timeframe Population MethodsPorter Novelli August –

December 16 

N= up to 371 LGBTQ+Data weighted to match census population

Four KAP surveys in the including LGBTQ+

AMETHST: American Transformative HIV Study

Aug 9th – November 15th N=8,551 50% Black and Latinx 

GBMSM

Monthly cross-sectionanew cohorts of personQuestions related to m

AMIS: American 

Men’s Internet Survey

August 5 –August 15

N = 824 GBMSM Emory conducted a on

2021 AMIS population. Survey available here

October 6 –December 31

N=3041 GBMSM Ongoing recruitment o

survey summarized thr

San Francisco study among persons experiencing homelessness (PEH)

Oct 23rd – November 5th N= 273 57 with higher risk sexual 

activity35 GBMSM

Cross-sectional survey understand vaccine acccoverage
Methods

 Porter Novelli conducted 4 online general population surveys 

2022 on knowledge, attitudes, and beliefs of mpox-related to

 Data are weighted to match U.S. Census proportions Survey includes a question about whether the individual “ide

member of the LGBTQ+ community”

 Most responses remained stable across the 4 months In the December Survey we asked specific questions designed 

directly measure mpox vaccine acceptability and value

 All results here are stratified by LGBTQ+ status 
The population thinks that the vaccine is safe 

important

LGBTQ+ Status

Variable Overall, N = 1,323

1

Part of LGBTQ+ 

Community, N 

= 147

1

Not part of 

LGBTQ+ 

community, N 

= 1,176

1

The monkeypox vaccine is safe

Agree 36% (475) 51% (76) 34% (399)

Disagree 9.7% (128) 11% (16) 9.5% (112)Don't Know 54% (721) 38% (56) 57% (665)

It is important for me to get the monkeypox vaccine to protect myself against monkeypox

Agree 33% (440) 50% (74) 31% (366)

Disagree 30% (400) 18% (27) 32% (373)Don't Know 37% (484) 32% (46) 37% (437)

1% (n)

2Bolded numbers are significant p < .05, chi-squared test with Rao & Scott's second-order correction
Studies included

Study Timeframe Population MethodsPorter Novelli August –

December 16 

N= up to 371 LGBTQ+Data weighted to match census population

Four KAP surveys in the including LGBTQ+

AMETHST: American Transformative HIV Study

Aug 9th – November 15th N=8,551 50% Black and Latinx 

GBMSM

Monthly cross-sectionanew cohorts of personQuestions related to m

AMIS: American 

Men’s Internet Survey

August 5 –August 15

N = 824 GBMSM Emory conducted a on

2021 AMIS population. Survey available here

October 6 –December 31

N=3041 GBMSM Ongoing recruitment o

survey summarized thr

San Francisco study among persons experiencing homelessness (PEH)

Oct 23rd – November 5th N= 273 57 with higher risk sexual 

activity35 GBMSM

Cross-sectional survey understand vaccine acccoverage
AMETHST: American Transformative HIV Stud

 NIH funded study to build new cohorts of individuals at 

risk for HIV

 FY1-FY2 (2022-2024): Build cohort, enrolling at least 

5000 people at increased risk for HIV infection; at least 50% people of color• AMETHST cohort will focus on the mechanisms 

through which meth use increases bio-behavioral vulnerability to HIV. 

• Added questions re: Mpox knowledge, vaccine 

uptake and behavior change to their screening questionnaires 

• 8551 participants surveyed through 11/15/2022

https://grants.nih.gov/grants/guide/rfa-files/RFA-AI-21-018.html
While Mpox 

concern has decreased over time, some concern remains

66%

59%

42%

34.0%

40.6%

58.0%

Aug Sept Oct 

WORRY ABOUT MPOX OVER THE LAST 

Some or more than half of the days 
>85% of respondents remain interested in vacc

 Vaccine coverage nearly 

doubled between August and September 

 As of November, 30.5% 

received at least one dose• ~90% overall and 88% of 

the sample from November either have been vaccinated or would like to be vaccinated

0% 20% 40% 6

August

September

October

November

VaccinatedExtremely likely to get vLikely to get vaccinated Unlikely to get vaccinate
Vaccine uptake by Month and Race/Ethnicity

AMETHST recruitment survey August-Novem In August, Black 

participants had higher vaccine coverage than participants from other racial and ethnic groups

0 10 20 30 40 50 60 

August

September

October

November

Proportion that received at least one dose of 

Other Latinx Black White
Vaccine uptake by Month and Race/Ethnicity

AMETHST recruitment survey August-Novem In August, Black 

participants had higher vaccine coverage than participants from other racial and ethnic groups

0 10 20 30 40 50 60 

August

September

October

November

Proportion that received at least one dose of 

Other Latinx Black White
Vaccine uptake by Month and Race/Ethnicity

AMETHST recruitment survey August-Novem In August, Black 

participants had higher vaccine coverage than participants from other racial and ethnic groups

 But black men did not 

see the “doubling” in vaccine coverage that we reported overall

0 10 20 30 40 50 60 7

August

September

October

November

Proportion that received at least one dose of v

Other Latinx Black White
Vaccine uptake by race, gender identity and 

sexual orientation, August- sexual orientation, August-November 2022 November 2022

Had at least one dose of the MPV vaccine

No=5943 Yes=2608 Chi-s

n n Row %

Race or ethnicity 11.80

White 2907 1323 31.28%Black 895 329 26.88%Latinx 1419 625 30.58%Other 659 331 33.43%

Age (M, SD) 35.65, 10.44 37.12, 10.74 35.09Sex Identity 23.67

Cisgender male 5204 2364 31.24%Transgender male 12 1 7.69%Transgender female 138 30 17.86%Non-binary, Other 589 213 26.56%

Sexual orientation 161.15

Gay, Queer 4378 2245 33.90%Bisexual 1093 241 18.07%Something else 472 122 20.54%
Studies included

Study Timeframe Population MethodsPorter Novelli August –

December 16 

N= up to 371 LGBTQ+Data weighted to match census population

Four KAP surveys in the including LGBTQ+

AMETHST: American Transformative HIV Study

Aug 9th – November 15th N=8,551 50% Black and Latinx 

GBMSM

Monthly cross-sectionanew cohorts of personQuestions related to m

AMIS: American 

Men’s Internet Survey

August 5 –August 15

N = 824 GBMSM Emory conducted a on

2021 AMIS population. Survey available here

October 6 –December 31

N=3041 GBMSM Ongoing recruitment o

survey summarized thr

San Francisco study among persons experiencing homelessness (PEH)

Oct 23rd – November 5th N= 273 57 with higher risk sexual 

activity35 GBMSM

Cross-sectional survey understand vaccine acccoverage
American Men’s Internet Survey (AMIS)

 In August 2022, Emory University conducted a special one-tim

2021 AMIS participants to explore knowledge, attitudes and related to the US monkeypox outbreak.• Also asked about behavior change and vaccination• Survey conducted August 5-15, during the peak of the curre

 Survey is available here. Questions ask about vaccine knowledge, access or availabilit

sources of advice

 824 men completed all questionnaire sections

• Overall, 53.1% reported concern about getting mpox• 18.6% of the sample had received at least one dose of mp

https://www.cdc.gov/mmwr/volumes/71/wr/mm7135e1.htm
AMIS survey results 

 Conducted August 5-15th 2022

• 18.2% of the sample had 

received at least one dose of MPOX vaccine

https://www.cdc.gov/mmwr/volumes/71/wr/mm7135e1.htm

“Equitable vaccine program implementation involve...diverse partners already working with special populdelivering vaccines through mobile outreach and poand diversifying times and locations for vaccine adm“Expanding vaccine availability geographically, includdiversifying vaccination locations to include nonurbahelp ensure that those who need vaccination have a
https://www.whitehouse.gov/briefing-room/statements-releases/2022/08/30/fact-sheet-white-house-monkeypox-response-team-announces-new-plans-to-support-large-lgbtqi-events-andequity-interventions-to-reach-communities-at-highest-risk-of-contracting-the-virus/
Vaccine Equity Pilot Program

Created to:

• Support innovative ways to 

address vaccination disparities

• Encourage vaccination 

coordination between health departments and communitybased organizations

• Promote innovation to 

strengthen existing vaccination infrastructure

Ju

28 

Programs

~2
Studies included

Study Timeframe Population MethodsPorter Novelli August –

December 16 

N= up to 371 LGBTQ+Data weighted to match census population

Four KAP surveys in the including LGBTQ+

AMETHST: American Transformative HIV Study

Aug 9th – November 15th N=8,551 50% Black and Latinx 

GBMSM

Monthly cross-sectionanew cohorts of personQuestions related to m

AMIS: American 

Men’s Internet Survey

August 5 –August 15

N = 824 GBMSM Emory conducted a on

2021 AMIS population. Survey available here

October 6 –December 31

N=3041 GBMSM Ongoing recruitment o

survey summarized thr

San Francisco study among persons experiencing homelessness (PEH)

Oct 23rd – November 5th N= 273 57 with higher risk sexual 

activity35 GBMSM

Cross-sectional survey understand vaccine acccoverage
Concern for mpox disease

AMIS 2022 This survey has been recruiting since 

October 6th 2022

 As of December 31, 2022

• 3041 cis-gender MSM have been enrolled• 33.3% (n=1006) had received at least one 

dose of mpox vaccine

 Mpox vaccination associated with

• Mpox awareness, • Mpox concern, • STI risk,• and engagement in sexual health and 

prevention services

Variable AdjAny mpox vaccination 

HIV+ High Mpox awareness 

 High Mpox concern 

STI testing Recent CAS PrEP use (ever)** PrEP use (past year)** 

* Adjusted models included age g45-59, 60+) and race/ethnicity (HiHispanic Black, Other) ** PrEP models considered for pe(HIV-negative)
Studies included

Study Timeframe Population MethodsPorter Novelli August –

December 16 

N= up to 371 LGBTQ+Data weighted to match census population

Four KAP surveys in the including LGBTQ+

AMETHST: American Transformative HIV Study

Aug 9th – November 15th N=8,551 50% Black and Latinx 

GBMSM

Monthly cross-sectionanew cohorts of personQuestions related to m

AMIS: American 

Men’s Internet Survey

August 5 –August 15

N = 824 GBMSM Emory conducted a on

2021 AMIS population. Survey available here

October 6 –December 31

N=3041 GBMSM Ongoing recruitment o

survey summarized thr

San Francisco study among persons experiencing homelessness (PEH)

Oct 23rd – November 5th N= 273 57 with higher risk sexual 

activity35 GBMSM

Cross-sectional survey understand vaccine acccoverage
Overview of San Francisco Mpox Study

 Dates: October 23 – November 5, 2022 Project Goals:

1. Understand mpox vaccine 

acceptability and coverage among people experiencing homelessness

2. Characterize orthopoxvirus

seroprevalence among people experiencing homelessness
Vaccine acceptance by subgroups at higher ri

Any higher risk 

sexual activity (n=57), 56%

GBMSM (n=35), 74%

0% 10% 20% 30% 40% 50% 60% 70% 8

Any higher risk

sexual activity (n=57)

GBMSM (n=35)

Would accept or had accepted vaccine Unsure Would decline or had declined vac
Acknowledgements

 SERMO

• Joanna Molke (SERMO)• Mansi Das (CDC)

 Porter Novelli

• Fred Fridinger • Christine Prue• Guila Earle-Richardson• Christine Agnew-Brune• Saskia Vos• Ciara Nestor• Gordon Mansergh• Deborah Gelaude

 AMIS (Emory University)

• Travis Sanchez• Patrick Sullivan• Marissa Hannah• O. Winslow Edwards

 A

• C• A• D• D• V• T• Je• D• K• M• M• A• C• M• S• A• L• Y

 AMIS (Johns Hopkins University)

• Stefan Baral• Tom Carpino• Kaitlyn Atkins• Evan Eschliman• Amrita Rao• Sarah Murray

 AMIS (CDC)

• Alexandra Oster• Christine Agnew-Brune• Winston Abara• Neal Carnes• Rachel Kachur• Kaytlin Renfro• Elizabeth DiNenno• Amy Lansky• Kathleen Ethier

 CDC 2022 Mult

Outbreak RespEngagement Ta