CS000000-A | 6/23/23

Centers for Disease Control & Prevention, 

COVID-19 Response, Vaccine Task Force

Vaccine Confidence & Demand Team, Insights Unit

The findings and conclusions in this report are those 

of the author(s) and do not necessarily represent 

the official position of the Centers for Disease 

Control and Prevention (CDC).

CDC’s State of 

Vaccine Confidence 

Insights Report 

Mpox in Chicago Special Report 

June 23, 2023

May 5, 2023 – May 19, 2023
Page: 2

State of Vaccine Confidence Insights Report | June 23, 2023

Report Summary 

Themes with the potential to impact vaccine confidence and 

demand:

 Theme 1: Consumers continue to have questions about the 

availability and need for mpox vaccination, including booster 

doses. 

 Theme 2: Many social media users and consumers believe the 

JYNNEOS mpox vaccine is not effective. 

 Theme 3: Many social media users believe the mpox outbreak in 

Chicago is not concerning due to the low number of cases, the 

ability of the disease to only affect the LGBTQ+ population, and the 

belief that governmental agencies exaggerate community risks. 

Ways public health and partners can take action to improve vaccine 

confidence:

 Create, promote, and share messages that promote stories from 

community members about positive vaccine experiences, vaccine 

safety and rarity of adverse events from the mpox vaccines.

 Work with community-based organizations, members of the 

LGBTQ+ community, and trusted messengers to rapidly identify and 

counteract the circulation of inaccurate mpox health information. 

Disseminate factual information through trusted channels used by 

members of the community. 

 Continue to work with community members and trusted 

messengers to communicate any new changes in guidance, spread, 

and vaccine uptake about the mpox outbreak in Chicago as soon as 

possible.

 Continue to increase accessibility to vaccines where people go for 

sexual health care, HIV care, pre-exposure prophylaxis (PrEP) or 

condoms and other public health and primary care settings. Meet 

people where they are. Work with your local health department to 

support a pop-up vaccination site in your community. 

 Continue messaging the need for full vaccination (2 doses) through 

partnering with local trusted messengers through dissemination 

channels used by the priority audiences such as social media, 

online and offline influencers, community events, medical providers 

including organizations that serve members of the LGBTQ+ 

community.

 Create and disseminate messages with LGBTQ-serving 

organizations and community members to highlight the work done 

by these groups in preventing the spread of mpox and reducing 

stigma towards the LGBTQ+ community. 

Contents

3

Aims and Methods

4

Theme 1: Consumers continue 

to have questions about the 

availability and need for mpox 

vaccination, including booster 

doses.

4

Theme 2: Many social media 

users and consumers believe 

the JYNNEOS mpox vaccine is 

not effective.

5

Theme 3: Many social media 

users believe the mpox 

outbreak in Chicago is not 

concerning.

6

Commonly Asked Questions 

and Queries from the Public

7

Inaccurate Themes That May 

Affect Vaccine Confidence

7

Ways Public Health and Partners 

Can Take Action to Improve 

Vaccine Confidence

9

References

11

Appendix: Inputs and Sources
Page: 3

State of Vaccine Confidence Insights Report | June 23, 2023

Aims and Methods

By rapidly reviewing and analyzing numerous Illinois-specific data sources and inputs, this State of 

Vaccine Confidence Insights Report emphasizes major themes influencing the concerns and uptake 

of the recommended mpox vaccine, JYNNEOS. In addition, by examining how consumers think and 

feel, social processes, and the practical issues around vaccination, the Insights Report seeks to identify 

emerging issues of inaccurate health beliefs to help identify where intervention efforts can improve 

vaccine confidence. Social media posts and news stories for this report were specifically gathered from 

Illinois to help analyze themes across the state during the mpox outbreak in the Chicago area reported 

by the CDC Health Alert Network on May 15, 2023.

The information in this report is only a snapshot, and certain populations may be underrepresented. 

Images and quotes are illustrative examples and are not meant to comprehensively cover all content 

related to the highlighted themes. Social media posts referenced throughout this report can be 

viewed in this linked document.

How do you classify this theme/information? 

High risk Moderate risk Low risk Positive sentiment

 May lead to 

vaccine refusals 

and decreased 

uptake 

 Wide reach, 

pervasive  

 Potential to 

trigger hesitancy 

to vaccination

 Moderate 

reach, modest 

dissemination 

 Concerning, but 

low risk to vaccine 

confidence 

 Limited 

reach, limited 

dissemination 

 Could increase 

vaccine 

confidence, intent, 

or motivation

 Variable reach and 

dissemination

How has this theme/idea changed over time (since last report or over the course of 

multiple reports)? 

Increasing

Information spreading 

rapidly 

Stable

Information remaining 

constant at prior level 

Decreasing

Information is not gaining further traction and 

there has been no indication of additional activity 
Page: 4

State of Vaccine Confidence Insights Report | June 23, 2023

Theme 1: Consumers continue to have questions about 

the availability and need for mpox vaccination, including 

booster doses. 

As a new outbreak of mpox emerges in the Chicago area, local public health authorities are encouraging 

all individuals at risk for mpox who are not currently vaccinated to get vaccinated against mpox.1,2 A 

potential reemergence of mpox this summer has many public health officials, advocacy organizations 

and online influencers concerned and speaking out to encourage vaccine uptake.3,4,5

Theme 1: Perceptions, Concerns, and Threats to Vaccine Confidence 

 Some social media users continue to express confusion and concern about eligibility requirements 

for the mpox vaccine.6

 Some consumers,8 including those that have previously received the mpox vaccine, have questions 

and concerns about vaccine effectiveness and whether booster doses will be offered.9

 Cases of mpox among those who have been previously vaccinated have caused some to question 

the effectiveness of mpox vaccines.10

Theme 2: Many social media users and consumers believe 

the JYNNEOS mpox vaccine is not effective.   

The promotion and distribution of the 2-dose JYNNEOS vaccine to populations most at risk is the 

cornerstone of the U.S. national mpox vaccination strategy developed to counteract the mpox outbreak 

of 2022.11 Three recently published studies12,13,14 of mpox vaccine effectiveness demonstrated that two 

doses of the JYNNEOS vaccine are between 66% and 89% effective at preventing symptomatic disease.

Additionally, a recent MMWR on the safety of the JYNNEOS vaccine found that “JYNNEOS post-licensure 

and post-authorization vaccine safety surveillance findings to date are consistent with those observed 

in the clinical trials, and support JYNNEOS vaccine safety with no new or unexpected safety concerns 

identified.”15

Theme 2: Perceptions, Concerns, and 

Threats to Vaccine Confidence

 Consumers express concern that new mpox 

infections among vaccinated persons means 

vaccine-derived protection wanes over 

time.16,17 Consumers are also responding to 

updates from public health authorities18,19,20 

on the recent mpox cluster with requests for 

more details on their vaccination and health 

status. 

 Consumers want more information about 

vaccinated cases, including number of doses, whether doses were administered intradermally, and 

underlying illnesses, to understand their personal risk.21,22,23
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State of Vaccine Confidence Insights Report | June 23, 2023

 Some consumers have questions and 

concerns about the effectiveness of the 

JYNNEOS vaccine when administered 

subcutaneously.24,25

 Some social media users spread their belief 

that the mpox vaccine is more experimental 

than COVID-19 vaccines.26

 Some social media users share inaccurate 

information about vaccines on local health 

department and other organizations’ social 

media posts about mpox vaccination. These themes and citations can be found in the section 

below: Inaccurate Themes That May Impact Vaccine Confidence.

Theme 3: Many social media users believe the mpox 

outbreak in Chicago is not concerning due to the low 

number of cases, the ability of the disease to only affect the 

LGBTQ+ population, and the belief that governmental 

agencies exaggerate community risks.  

The end of the mpox public health emergency may have influenced people’s perceptions about the 

need for vaccination. The Department of Health and Human Services did not renew the mpox public 

health emergency after it was set to end on January 31, 2023.27 Since the end of the mpox public 

health emergency, CDC continues to publish studies about mpox prevention and treatment which, 

for some, feeds into the COVID-19 pandemic narrative that public health emergencies have been 

exaggerated.28,29 Additionally, news media continues to highlight the successful efforts of the LGBTQ+ 

community to protect themselves against mpox during periods of low community transmission.30,31

Public health professionals are once again warning members of the LGBTQ+ community about the 

importance of vaccination as potentially rising cases in Chicago are cause for concern.32,33

Theme 3: Perceptions, Concerns, and Threats to Vaccine Confidence 

 Some social media users do not trust the government to accurately communicate the risks of 

mpox.34,35,36

 Some social media users believe the 

outbreak in Chicago is not cause for 

concern, and many consumers are 

overreacting.37,38,39

 The World Health Organization recently 

announced that mpox, while still a 

public health challenge, no longer represents an international public health concern40which 

might decrease perceived risk of infection and negatively impact vaccination efforts.

 Many social media users blame the LGBTQ+ community for the rise in mpox cases.41,42,43
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State of Vaccine Confidence Insights Report | June 23, 2023

Commonly Asked Questions and Queries from the Public

 Who is eligible for mpox vaccination?

 For which populations is the mpox vaccine recommended?

 CDC recommends vaccination against mpox if:

 You had known or suspected exposure to someone with mpox

 You had a sex partner in the past 2 weeks who was diagnosed with mpox

 You are a gay, bisexual, or other man who has sex with men or a transgender, nonbinary, or 

gender-diverse person who in the past 6 months has had any of the following:

» A new diagnosis of one or more sexually transmitted diseases (e.g., chlamydia, 

gonorrhea, or syphilis)

» More than one sex partner

 You have had any of the following in the past 6 months:

» Sex at a commercial sex venue (like a sex club or bathhouse)

» Sex related to a large commercial event or in a geographic area (city or county for 

example) where transmission of the virus that causes mpox is occurring

» Sex in exchange for money or other items

 You have a sex partner with any of the above risks 

» You anticipate experiencing any of the above scenarios

» You have HIV or other causes of immune suppression and have had recent or anticipate 

future risk of mpox exposure from any of the above scenarios

 Is mpox vaccination necessary?

 Yes. It is important to take both doses of the 2 dose JYNNEOS vaccine. Vaccination makes 

getting and spreading mpox less likely. Vaccine may also protect you against severe infection, 

hospitalization, and death. No vaccine is 100% effective, so vaccination should be combined 

with other prevention measures such as avoiding skin to skin contact with someone who has 

mpox and reducing the number of sexual partners.44

 Should people wait to get vaccinated until a new updated mpox vaccine becomes available?45

 No, eligible people should get vaccinated with two doses of the current vaccine, JYNNEOS, as 

soon as possible. There is no information about a new or updated mpox vaccine.

 Is vaccination available to immunocompromised people?

 Yes, JYNNEOS vaccine is recommended for persons with HIV or other causes of immune 

suppression who anticipate exposure to mpox since they may be at increased risk of severe 

prolonged mpox and protracted infectiousness. Limited data suggest that people with HIV, 

particularly people with low CD4 counts (<350 cells/ml) or who are not virally suppressed, are 

more likely to be hospitalized and possibly die if they get mpox than people without HIV.46
Page: 7

State of Vaccine Confidence Insights Report | June 23, 2023

Inaccurate Health Information Themes that May Affect 

Vaccine Confidence

 One vocal vaccine opponent claims the JYNNEOS vaccine causes myocarditis, that people are at 

a greater health risk from receiving the vaccine than getting mpox, that COVID-19 vaccination is 

causing a decrease in immune response making mpox acquisition more likely and more severe, 

and that mpox might have been intentionally released.47,48

 When some organizations share social media posts about mpox, some social media users reply 

with links to videos that claim vaccines cause sudden death.49

 Some social media users believe the Chicago mpox outbreak is resistant to vaccines.50

 Some social media users believe the mpox vaccine does not work because some cases were in 

vaccinated individuals.51,52,53

 An interviewer claimed working near monkeys puts people at an increased risk for mpox.54

 Some social media users feel government is using the rise of mpox cases as a way to spread 

unwarranted fear and to spend more money on vaccines.55,56,57

 Some social media users cite open 

borders and immigrants as the cause 

of rising mpox cases.58,59,60

 Some social media users believe mpox 

only affects members of the LGBTQ+ 

community.61,62,63

Ways Public Health and 

Partners Can Take Action to Improve Vaccine Confidence 

 Distribute easy-to-understand 

information through a variety of 

mediums, including handouts and 

social media posts, with facts about 

mpox and locations that offer the 

vaccine. 

 Clinical partners might consider 

getting technical assistance from the 

CDC-funded National Network of STD 

Clinical Prevention Training Centers 

(NNPTC) to create a more inclusive clinical environment. 

 The NNPTC also offers regular clinical update webinars on mpox and has a free clinical 

consultation line to answer clinicians’ questions about mpox and STIs. 

 Create, promote, and share messages that promote stories from community members about 

positive vaccine experiences, vaccine safety and rarity of adverse events from the mpox vaccines.

 Work with community-based organizations, members of the LGBTQ+ community, and trusted 

messengers to rapidly identify and counteract the circulation of inaccurate mpox health 

information. Disseminate factual information through trusted channels used by members of the 

community. 
Page: 8

State of Vaccine Confidence Insights Report | June 23, 2023

 Work with a range of community partners to increase vaccine equity. 

 Continue to work with community members and trusted messengers to communicate any new 

changes in guidance, spread, and vaccine uptake about the mpox outbreak in Chicago as soon 

as possible.

 Continue to increase accessibility to vaccines where people go for sexual health care, HIV care, 

pre-exposure prophylaxis (PrEP) or condoms and other public health and primary care settings. 

Meet people where they are. Work with your local health department to support a pop-up 

vaccination site in your community. 

 Continue messaging the need for full vaccination (2 doses) through partnering with local 

trusted messengers through dissemination channels used by the priority audiences such as 

social media, online and offline influencers, community events, medical providers including 

organizations that serve members of the LGBTQ+ community.

 Create and disseminate messages with LGBTQ-serving organizations and community members 

to highlight the work done by these groups in preventing the spread of mpox and reducing 

stigma towards the LGBTQ+ community. 
Page: 9

State of Vaccine Confidence Insights Report | June 23, 2023

References

Dalton, A. F., Diallo, A. O., Chard, A. N., Moulia, D. L., Fothergill, A., Deputy, N. P., . . . Wegner, C. W. (2023, 

May 19). Estimated Effectiveness of JYNNEOS Vaccine in Preventing Mpox: A Multijurisdictional 

Case-Control Study — United States, August 19, 2022–March 31, 2023. Retrieved from Centers 

for Disease Control and Prevention:https://www.cdc.gov/mmwr/volumes/72/wr/mm7220a3.htm

Deputy, N. P., Deckert, J., Chard, A. N., Sandberg, N., Moulia, D. L., Barkley, E., . . . Sandmann, D. (2023, 

May 18). Vaccine Effectiveness of JYNNEOS against Mpox Disease in the United States. The New 

England Journal of Medicine. doi:10.1056/NEJMoa2215201

Duffy, K. (2023, May 8). Mpox resurgence: What you should know. Retrieved from LGBT News Now: 

https://lgbtnewsnow.org/mpox-resurgence-what-you-should-know/

Fact sheet: Biden-Harris administration’s monkeypox outbreak response. (2022, June 28). 

Retrieved from The White House: https://www.whitehouse.gov/briefing-room/statementsreleases/2022/06/28/fact-sheet-biden-harris-administrations-monkeypox-outbreak-response/

Interim clinical considerations for use of JYNNEOS and acam2000 vaccines during the 2022 U.S. mpox 

outbreak. (2023, March 22). Retrieved from Centers for Disease Control and Prevention: 

https://www.cdc.gov/poxvirus/mpox/clinicians/vaccines/vaccine-considerations.html

Mpox and HIV. (2023, May 22). Retrieved from Centers for Disease Control and Prevention: 

https://www.cdc.gov/poxvirus/mpox/prevention/hiv.html

Mpox (monkeypox) home. (2023, May 19). Retrieved from Chicago.gov: https://www.chicago.gov/city/

en/sites/monkeypox/home.html

Mpox cases on the rise in Chicago and Cook County, health officials say. (2023, May 18). Retrieved from 

NBC Chicago: https://www.nbcchicago.com/news/local/mpox-cases-on-the-rise-in-chicagoand-cook-county-health-officials-say/3144580/

Mpox outbreak. (2023, May 19). Retrieved from Cook County Public Health: https://

cookcountypublichealth.org/communicable-diseases/monkeypox/

Mpox vaccination basics. (2023, May 5). Retrieved from Centers for Disease Control and Prevention: 

https://www.cdc.gov/poxvirus/mpox/vaccines/index.html

Nirappil, F. (2023, May 19). The Washington Post. Retrieved from Mpox shows a risk of summer return: 

https://www.washingtonpost.com/health/2023/05/12/mpox-monkeypox-gay-bisexual-men/

Orthopoxviruses (smallpox and monkeypox) acip vaccine recommendations. (2022, June 3). Retrieved 

from Centers for Disease Control and Prevention: https://www.cdc.gov/vaccines/hcp/aciprecs/vacc-specific/smallpox.html

Park, I., & Savage, D. (2023, April 16). New York Times. Retrieved from how gay men saved us from 

mpox: https://www.nytimes.com/2023/04/16/opinion/gay-men-mpox.html

Potential risk for new mpox cases. (2023, May 15). Retrieved from Centers for Disease Control and 

Prevention: https://emergency.cdc.gov/han/2023/han00490.asp
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State of Vaccine Confidence Insights Report | June 23, 2023

Rao, A. K., Schrodt, C. A., Minhaj, F. S., Waltenburg, M. A., Cash-Goldwasser, S., Yu, Y., . . . Damon, I. K. 

(2023). Interim clinical treatment considerations for severe manifestations of mpox — United 

States, February 2023. Morbidity and Mortality Weekly Report, 232-243.

Riser, A. P., Hanley, A., Cima, M., Lewis, L., Saadeh, K., Alacron, J., . . . Pavlick, J. (2023). Epidemiologic and 

clinical features of mpox-associated deaths — United States, May 10, 2022–March 7, 2023. 

Morbidity and Mortality Weekly Report, 404-410.

Rosenberg, E. S., Dorabawila, V., Hart-Malloy, R., Anderson, B. J., Miranda, W., O’Donnell, T., . . . Abrego, 

M. (2023, May 19). Effectiveness of JYNNEOS Vaccine Against Diagnosed Mpox Infection — 

New York, 2022. Retrieved from Centers for Disease Control and Prevention: https://www.cdc.

gov/mmwr/volumes/72/wr/mm7220a4.htm?s_cid=mm7220a4_w&utm_campaign=morning_

rounds&utm_medium=email&_hsmi=258955744&_hsenc=p2ANqtz-8VmlHf5JjiycOZY8AGo0B

oGHPIZJPj4q62vcZuNLjjq_MUXjMm42g4-rulnDRJDT4-rgNtxQEdAAvZaYPaz24F7lO2pA&utm_

content=25895

Ryan, B. (2023, May 8). CDC alerts doctors about mpox outbreak in Chicago and possible summer 

rise in cases. Retrieved from NBC News: https://www.nbcnews.com/health/mens-health/risempox-cases-chicago-raises-concern-possible-summer-spread-rcna83315

Saric, I. (2023, May 11). Mpox no longer a global health emergency, WHO says. Retrieved from Axios: 

https://www.axios.com/2023/05/11/mpox-global-health-emergency-who

Salzman, S. (2023, February 2). A public health success story: How the mpox crisis was controlled 

within 6 months. Retrieved from abc News: https://abcnews.go.com/Health/public-healthsuccess-story-mpox-crisis-controlled-6/story?id=96848750

State & territorial health department websites. (2023, January 23). Retrieved from Centers for Disease 

Control and Prevention: https://www.cdc.gov/publichealthgateway/healthdirectories/

healthdepartments.html

Statement from HHS secretary Becerra on mpox. (2022, December 2). Retrieved from U.S. Department 

of Health and Human Services: https://www.hhs.gov/about/news/2022/12/02/statementfrom-hhs-secretary-becerra-on-mpox.html

Vaccination. (2023, February 6). Retrieved from Centers for Disease Control and Prevention: 

https://www.cdc.gov/poxvirus/mpox/interim-considerations/overview.html#vaccines
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State of Vaccine Confidence Insights Report | June 23, 2023

Appendix: Inputs and Sources

Social Media Listening & Media Monitoring Data Sources

Input Cadence Sources Tactics for Utilization

Communication 

Surveillance Report

Daily on 

weekdays

Google news

Meltwater

CrowdTangle

Native platform 

searches

Share of voice topic analysis to 

identify themes

Emerging topics 

Meltwater Daily Facebook, Twitter, 

Instagram

Blogs

News media

Online forums

Share of voice topic analysis

Emerging theme topics

Identify high reach/velocity topics

OADC (Office of the 

Associate Director 

of Communication) 

Channel COVID-19 

Post metrics

Weekly Sprout Social

Native OADC (Office of 

the Associate Director 

of Communication) 

account analytics

Analyze # of posts, topics 

Success of messages, # of 

impressions, reach, # engagements

OADC Channel 

Comment Analysis

Daily on 

weekdays

Native platform 

searches

Sentiment analysis

Identify message gaps/voids

Direct Report Data Sources

Input Cadence Sources Tactics for Utilization

CDC-INFO Metrics Weekly CDC-INFO inquiry line 

list

Prepared response 

(PR) usage report

Cross-compare PR usage with 

inquiry theme analysis

Sentiment analysis

Identify information gaps/voids

VTF Media 

Requests

Weekly Media request line list Leading indicator for news 

coverage

Identify information gaps/voids

Web Metrics Weekly Top pages

Google search queries

Top FAQs

Referring domains

Identify information gaps/voids,

Identify keywords/search terms, 

changes in web traffic
Page: 12

State of Vaccine Confidence Insights Report | June 23, 2023

Research and Literature Data Sources

Input Cadence Sources Tactics for Utilization

Poll Review Weekly Harris Poll, PEW 

research, Gallup Poll, 

KFF, Annenberg Public 

Policy Center 

New data related to 

vaccine hesitancy

Identify socio-behavior indicators 

related to motivation and intention 

to vaccinate 

Literature Review Weekly PubMed, LitCovid, 

ProQuest Central, 

Altmetric 

New data related to 

vaccine hesitancy

Identify current vaccination 

intention

Identify barriers to vaccination

Third Party Report Data Sources

Input Cadence Sources Tactics for Utilization

Tanaq Social 

Listening +Media 

Monitoring Report

Weekly Meltwater

Sprout Social

First Draft

Native platform 

searches

Trending topics

Demographic and geographic 

conversation monitoring

Washington St. 

Louis iHeard

Weekly Proprietary methods Survey results

Emerging threats and data deficits

Vaccine narratives

Project VCTR Weekly Proprietary methods National and regional trends 

in negative attitudes toward 

vaccination

Conversations around Legislation