CS000000-A | 5/18/23

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 Outbreak 

Special Report 

May 18, 2023

Date Range: November 15, 2022 - February 25, 2023
Page: 2

State of Vaccine Confidence Insights Report | May 18, 2023

Summary

Major themes identified from social media, news, and other sources 

that may impact vaccine confidence:

 Consumers and social media users in the LGBTQ+ community are taking 

proper precautions to prevent mpox (formerly known as monkeypox), 

including getting vaccinated with JYNNEOS vaccine. While the 

ACAM2000 vaccine has rarely, if ever, been used in the current mpox 

outbreak, some are concerned about its side effects.

 Consumers and social media users are concerned about poor access to 

vaccines in Black and Hispanic/Latino communities.

 Some social media users are confused about the name change from 

monkeypox to mpox and believe it is part of an agenda to push more 

vaccines.

 Activism and engagement from the LGBTQ+ community has 

contributed to an increase in mpox vaccine confidence and uptake. 

Ways public health and partners can take action to improve vaccine 

confidence:

 It is critical that public health supports men who have sex with men, 

transgender and gender-diverse persons, and others at increased 

risk of infection in getting mpox vaccination; increase community 

engagement and outreach efforts to improve prevention messages; 

and ensure equitable approaches to mpox testing, treatment, and 

prevention strategies.

 Work with community organizations and advocacy groups that focus 

on sexual health, HIV, and sexually transmitted infections (STIs), in 

addition to members of the LGBTQ+ community, to increase vaccine 

uptake and identify ways to reduce LGBTQ+ stigmatization related to 

mpox.

 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.

 Speak with leaders in the LGBTQ+ community to learn more about 

how they were able to garner activism and engagement from the 

community.

 Work with local LGBTQ+ pride event organizers to include messaging 

about the importance of receiving two doses of mpox vaccines as 

soon as possible and prior to participating in LGBTQ+ pride events, 

as appropriate. Partners can also coordinate with event organizers to 

provide mpox vaccines on-site, where possible.

 Use a health equity lens when framing information about health 

disparities.

 Consider key principles of health communication, such as using personfirst language, avoiding unintentional blaming, and using preferred 

terms for select population groups while recognizing that there isn’t 

always agreement on these terms.

 Consider how communications are developed and look for ways to 

develop more inclusive health communications products.

Contents

4

Introduction and Background

4

Theme 1: Consumers and social 

media users of the LGBTQ+ 

community are taking proper 

precautions to prevent mpox, 

including getting vaccinated 

with JYNNEOS vaccine; some are 

concerned about side effects from 

ACAM2000

8

Theme 2: Some social media users 

are confused about the name 

change from monkeypox to mpox 

and believe it is part of an agenda 

to push more vaccines

9

Theme 3: Consumers and social 

media users are concerned about 

the lack of vaccine access in Black 

and Hispanic/Latino communities

12

Theme 4: Activism and engagement 

from the LGBTQ+ community has 

contributed to an increase in mpox 

vaccine confidence and uptake

14

References

17

Appendix: Inputs and Sources
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State of Vaccine Confidence Insights Report | May 18, 2023

Aims and Methods 

By rapidly reviewing and analyzing numerous sources and inputs (see Appendix), the Mpox State of 

Vaccine Confidence Insights Report emphasizes major themes influencing mpox vaccine hesitancy 

and uptake. These are characterized by the level and type of threat to vaccine confidence, degree of 

spread, and directionality. 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 

misinformation, disinformation, and places where intervention efforts can improve vaccine confidence 

across the United States. 

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.  

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 
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State of Vaccine Confidence Insights Report | May 18, 2023

Introduction and Backgrounda

a

 Social media posts referenced throughout this report can be found in this online document.

The first case of mpox (formerly known as monkeypox) of the current outbreak in the United States 

was identified on May 18, 2022.1 As of March 7, 2023, there have been 30,225 cases of mpox and 

38 deaths in the U.S.2Overall, the number of new mpox cases in the U.S. has been declining since a 

peak in August 2022. There were 846 new cases during the November 15, 2022–February 25, 2023 

reporting period, which represent less than 3% of all total cases since the outbreak began.3

This report is an update to CDC’s Mpox State of Vaccine Confidence Insights Report, which covers 

the reporting period of May 21–September 20, 2022. Data for this report was specifically gathered to 

help analyze themes across the U.S. during the mpox outbreak, which has disproportionally affected 

the LGBTQ+ community. Information about mpox vaccine eligibility, priority populations, and interim 

clinical guidance can be accessed here. 

Major Themesa

Theme 1: Consumers and social media users of the LGBTQ+ 

community are taking proper precautions to prevent mpox, 

including getting vaccinated with JYNNEOS vaccine; some are 

concerned about side effects from ACAM2000

Mpox is a rare disease caused by infection with the mpox virus. Mpox virus is part of the same family of 

viruses as variola virus, the virus that causes smallpox. Two vaccines, ACAM2000 and JYNNEOS, may be 

used to prevent mpox disease. JYNNEOS is a 2-dose vaccine that protects against mpox and smallpox. 

People need to get both doses of the vaccine for the best protection against mpox. The second 

dose should be given 4 weeks after the first dose. People are considered fully vaccinated 14 days 

after receiving the second dose.4 During the current outbreak, JYNNEOS is the main vaccine being 

administered in the United States.

ACAM2000 is a vaccine approved for immunization against smallpox prior to the development of the 

JYNNEOS vaccine. The vaccine is made from a virus called vaccinia, which is a “pox”-type virus related 

to smallpox but causes milder disease. ACAM2000 cannot cause smallpox; it does not contain the 

smallpox virus, but rather the “live” vaccinia virus. ACAM2000 can be used to prevent mpox under an 

Expanded Access Investigational New Drug (EA-IND) protocol; it has rarely, if ever, been used during 

the current outbreak. Because this vaccine is a live, replicating virus vaccine, it should not be used 

for persons who are immunocompromised (including those with HIV infection), pregnant, under 12 

months old, or who have a history of eczema, cardiac risk factors, eye disease treated with topical 

steroids, or severe allergic reaction following a previous ACAM2000 dose.5 For more information, refer 

to FDA’s ACAM2000 Q&A and CDC’s ACAM2000 interim guidance.

Individuals can help protect themselves against mpox by avoiding close, skin-to-skin contact with 

people who have a rash that looks like mpox, avoiding contact with objects and materials that a 

person with mpox has used, and washing hands often.6
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State of Vaccine Confidence Insights Report | May 18, 2023

Perceptions, Concerns, and Threats to Vaccine Confidence

 Google searches and Meltwater mentions for terms “monkeypox,” “mpox,” “jynneos,” and “ACAM2000” 

decreased significantly to near-zero searches during the reporting period.b,c

 During the reporting period (November 15, 2022–February 25, 2023), an average of 2,444 first 

doses of JYNNEOS and 3,313 second doses were 

administered weekly in the U.S.7

 As of February 28, 2023, 1,198,336 total JYNNEOS 

vaccine doses were administered in the 57 U.S. 

jurisdictions reporting data.7

 According to an MMWR report published 

in December 2022, 466 cases of mpox were 

reported among transgender and gender-diverse 

adults between May 17 and November 4, 2022, 

accounting for 1.7% of reported cases among 

adults. Most of these cases were among transgender women (43.1%) or gender-diverse persons 

(42.1%), while 14.8% were among transgender men.8

 An MMWR published in December 2022 analyzing mpox virus infections found that compared to 

unvaccinated individuals, individuals who received one JYNNEOS vaccine dose at least 14 days 

before illness onset had significantly lower odds of hospitalization, fever, headache, malaise, myalgia, 

and chills.8

 Among men aged 18-49 years who are eligible 

for the JYNNEOS vaccine, the incidence 

of mpox was considerably higher among 

unvaccinated persons compared to those who 

received one or two vaccine doses. Specifically, 

the incidence among unvaccinated persons 

was 9.6 times higher than the incidence 

among persons who had received two vaccine 

doses, and 7.4 times higher than the incidence 

among persons who had received only the first dose.9

 In comparison to gay, bisexual, and other men who have sex with men (MSM) living in urban areas, 

MSM living in rural areas were less likely to report modifying their behaviors to decrease mpox 

exposure, reported lower perceived susceptibility to and severity of mpox, and reported lower 

intention to get vaccinated for mpox.10

 Forty-six percent of U.S. adults intended to get an mpox vaccine if it were recommended to them.11

 Sixty-five percent of U.S. adults think it would be extremely/very bad to have mpox.12

 Seventy-six percent of U.S. adults say that, if exposed to mpox, they would be likely to take the mpox 

vaccine, which can be given after exposure.12

 Some social media users stated increasing access to the mpox vaccine would decrease cases 

and deaths.13

b

Google trends.

c

Meltwater.
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State of Vaccine Confidence Insights Report | May 18, 2023

 Individuals in the LGBTQ+ community are using social media to share that they have received the 

mpox vaccine and have fought against anti-vaccine rhetoric.14,15,16

 Members of the LGBTQ+ community are encouraging others to practice safe sex and receive the 

mpox vaccine to mitigate risk of mpox.17,18

 Misinformation and exaggerated claims about mpox on social media may have contributed to 

inaccurate perceptions about the risks and transmissibility of mpox.19

 Some social media users are concerned about the side effects from the ACAM2000 vaccine.20,21,22

Commonly Asked Questions and Queries from the Publicd

 Can the mpox vaccine be co-administered with other vaccines?e

 Currently, there are no data on administering JYNNEOS vaccine at the same time as other vaccines. 

Because JYNNEOS is based on a live, attenuated non-replicating orthopoxvirus, JYNNEOS typically 

may be administered without regard to timing of most other vaccines. This includes simultaneous 

administration of JYNNEOS and other vaccines, including influenza vaccine, on the same day, but at 

different anatomic sites if possible.23

 People who previously received COVID-19 vaccination (i.e., Moderna, Novavax, or Pfizer-BioNTech) 

may be given JYNNEOS vaccine without a minimum interval between vaccinations.23

 Those who previously received orthopoxvirus vaccination (either JYNNEOS or ACAM2000), 

particularly adolescent or young adult males, might consider waiting 4 weeks before receiving 

a COVID-19 vaccine (i.e. Moderna, Novavax, or Pfizer-BioNTech) because of the observed risk for 

myocarditis and pericarditis after receipt of ACAM2000 orthopoxvirus vaccine and COVID-19 

vaccines (i.e. Moderna, Novavax, or Pfizer-BioNTech) and the unknown risk for myocarditis and 

pericarditis after JYNNEOS administration.23

 Is mpox a sexually transmitted infection?e

 In the current mpox outbreak, the virus is spreading primarily through sexual contact; however, 

infections have occurred through other exposures, including non-sexual contact with infectious 

lesions and from contaminated instruments in clinical settings.24

 Are there any possible side effects associated with the use of ACAM2000?e

 Yes, health complications can occur after receiving the vaccine, and the risk of experiencing 

serious side effects must be weighed against the risk of experiencing a potentially fatal smallpox 

infection. The vaccine may cause serious side effects including myocarditis and pericarditis, which 

are inflammation and swelling of the heart and surrounding tissues. Based on clinical studies, 

myocarditis and/or pericarditis occur in 1 in 175 adults who get the vaccine for the first time. Serious 

health problems can occur in individuals who are immunocompromised, pregnant, or who have 

cardiac risk factors or skin conditions such as eczema, dermatitis, or psoriasis. More commonly 

observed side effects include: itching, sore arm, fever, headache, body ache, mild rash and fatigue.25

For more information, refer to FDA’s ACAM2000 Q&A and CDC’s ACAM2000 interim guidance.

d

 These questions come from online data sources such as social media, news stories, Google trends, and CDC-INFO.

e

 CDC-INFO.
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State of Vaccine Confidence Insights Report | May 18, 2023

Identified misinformation themes that may impact vaccine confidence

 Some social media users believe mpox can only spread 

through sexual contact.26

 Some social media users believe vaccination is not the 

best way to prevent mpox.27

 Some social media users believe the ACAM2000 

vaccine will cause a smallpox pandemic.21

 Some social media users believe that the ACAM2000 

vaccine sheds smallpox.28,f

 Some organizations are fighting against the 

misconception that mpox is a “gay” disease.29

Ways public health and partners can take action to 

improve vaccine confidence 

 It is critical that public health supports men who have sex with men, transgender and genderdiverse persons, and others at increased risk of mpox in getting mpox vaccination; increase 

community engagement and outreach efforts to improve prevention messages; and ensure 

equitable approaches to mpox testing, treatment, and prevention strategies.8

 Work with community partners and advocacy groups that focus on sexual health, HIV, and STI care 

and prevention, in addition to members of the LGBTQ+ community, to increase vaccine uptake and 

identify ways to reduce LGBTQ+ stigmatization due to mpox virus infection.

 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 the mpox virus and has a free clinical 

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

f Note that ACAM2000 is made from a virus called vaccinia, which is a “pox”-type virus related to smallpox but 

causes milder disease. ACAM2000 cannot cause smallpox; it does not contain the smallpox virus, but rather the 

“live” vaccinia virus. For this reason, attentively caring for the vaccination site is important to prevent the virus 

from spreading from the vaccination site to other parts of the body, or to other people.25
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State of Vaccine Confidence Insights Report | May 18, 2023

Theme 2: Some social media users are confused about 

the name change from monkeypox to mpox and 

believe it is part of an agenda to push more vaccines 

In August, a group of global experts convened by the World 

Health Organization (WHO) agreed on new names for monkeypox 

virus variants, as part of ongoing efforts to align the names of the 

monkeypox disease, virus, and variants with current best practices. 

Following a series of consultations with global experts, in November 

2022, WHO began using a new preferred term “mpox” as a synonym for 

monkeypox. Both names will be used simultaneously for one year while 

“monkeypox” is phased out.30

In support of the November 28, 2022 recommendation by WHO30

and the U.S. Department of Health and Human Services (HHS), CDC 

adopted “mpox” as the term used to refer to monkeypox disease.31

According to the WHO’s best practices, changes to disease names 

should be made with the aim to minimize unnecessary negative 

impact of names on trade, travel, tourism, or animal welfare, and avoid 

causing offense to any cultural, social, national, regional, professional, 

or ethnic groups.

Moving forward, U.S. federal public health agencies, including CDC, will adopt the “mpox” name in 

correspondence with the medical community and the public. This change from the WHO will enhance 

the U.S. response to mpox by using a less stigmatizing term.31

Perceptions, Concerns, and Threats to Vaccine Confidence

 When the outbreak of mpox expanded in 2022, racist and stigmatizing language online, in other 

settings, and in some communities was observed and reported to WHO. In several meetings, public 

and private, a number of individuals and countries raised concerns and asked WHO to propose a way 

to change the name moving forward.30

 Some social media users believe that the name change was unnecessary.32,33

 Some social media users do not understand how the term “monkeypox” was offensive.34,35,36

 Some social media users are sarcastically suggesting names other than mpox that are offensive.37,38,39

 Some social media users are supportive of the name change and believe it was long overdue.40,41

 Some social media users believe vaccine supply is a more pressing issue that should have been 

addressed before the mpox name change.42,43

Commonly Asked Questions and Queries from the Public 

 Why did WHO decide to change the name from monkeypox to mpox?e

 When the outbreak of mpox expanded earlier this year, racist and stigmatizing language online, in 

other settings, and in some communities was observed and reported to WHO. In several meetings, 

public and private, a number of individuals and countries raised concerns and asked WHO to 

propose a way to change the name moving forward.30
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State of Vaccine Confidence Insights Report | May 18, 2023

 When did the name change to “mpox” become effective?e

 Following a series of consultations with global experts, 

WHO began using a new preferred term “mpox” as a 

synonym for monkeypox beginning November 28, 

2022. Both names will be used simultaneously for one 

year while “monkeypox” is phased out.

 Will there be a new vaccine developed for mpox?e

 While mpox is the term that will now be used to refer 

to monkeypox disease,31 scientists will continue to 

conduct research on new vaccines irrespective of the 

name change to mpox.

Identified misinformation themes that may impact 

vaccine confidence

 Some social media users believe the name change was 

solely for marketing purposes and to push a political 

agenda.44,45

 Some social media users believe the disease is still called 

“monkeypox” and refuse to use the term “mpox.”46,47

 Some social media users believe the new name is an excuse to create and sell more vaccines.48,49

 Some social media users believe the new name reflects a government agenda to push toxic 

vaccines.50,51

Ways public health and partners can take action to improve vaccine confidence 

 Partners may use the term “mpox” in all web content, guidance, and communications materials.

 Partners may create informational materials explaining the rationale behind the name change and 

why it was necessary.

 Partners may provide healthcare workers and community leaders with communication materials to 

ensure consumers know “mpox” is the new name for “monkeypox,” and not a new disease. 

Theme 3: Consumers and social media users are 

concerned about poor access to vaccines in Black and 

Hispanic/Latino communities

Mpox cases are disproportionately higher among Black and Hispanic/Latino MSM and, in smaller 

numbers, Black and Hispanic/Latina women.52 As of March 1, 2023, 33.1% of mpox cases have occurred 

among Black individuals, and 31.2% have occurred among Hispanic/Latino individuals. Many social, 

geographic, political, economic, and environmental factors create challenges to health equity and 

vaccine access. Some of these factors include racism, gaps in healthcare access, lack of trust because of 

past medical racism and experimentation, and stigma when accessing medical care.53
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State of Vaccine Confidence Insights Report | May 18, 2023

Perceptions, Concerns, and Threats to Vaccine Confidence

 An MMWR published in December 2022 showed that during 

May 22, 2022–September 3, 2022, 68.2% of vaccinated mpox 

patients and 49.9% of unvaccinated mpox patients were White, 

whereas Black individuals comprised 12.4% and 30.9% of 

vaccinated and unvaccinated mpox patients, respectively.54

 The authors note that “the predominance of White 

persons among vaccinated mpox patients compared with 

unvaccinated patients reflects the ongoing racial and ethnic 

disparities in receipt of the JYNNEOS vaccine nationwide 

and could indicate differential access to or acceptance of the 

vaccine,” also adding that “disparities in access to health care 

and additional treatment options could also have played a 

role in decreasing the severity of illness in vaccinated 

White persons.”54

 An MMWR published in January 2023 found that between May 

11 and November 7, 2022 a total of 769 mpox cases were identified in cisgender women aged 15 

years or older, accounting for 2.7% of all reported mpox cases. Of these cases with available data, 

44% were in non-Hispanic Black women, 25% in non-Hispanic White women, and 23% in Hispanic/

Latina women.55

 The ongoing mpox epidemic has disproportionately affected Black and Hispanic/Latina women, 

who make up a higher percentage of mpox cases than their share of the U.S. population. This 

disparity is consistent with overall mpox cases in the U.S. and emphasizes the importance of 

continued public health efforts to provide education on mpox prevention and ensure equitable 

access to mpox vaccines, testing, and treatment.55

 Some social media users are frustrated that some individuals outside of racial/ethnic minority 

communities, due to stigma in their own communities, are depleting the mpox vaccine supply in 

under-resourced communities.

56

 Nonprofit organizations dedicated to LGBTQ+ acceptance, such as Gay & Lesbian Alliance Against 

Defamation (GLAAD) and Human Rights Campaign, have used social media to highlight disparities in 

vaccine distribution and access, especially those faced by Black communities and other racial/ethnic 

minority groups.57,58

 However, it is worth noting that community engagement and total interactions on these posts 

are low.

 Some individuals in the LGBTQ+ community 

believe the Biden administration is doing 

whatever is in their power to help address 

mpox infection rates in disproportionately 

affected groups,59 while others are more 

reluctant to applaud the U.S. government 

for their efforts.60

 Some social media users believe stigma 

around sexual health and healthcare 

inequities contribute to low vaccination 

rates in Black and Hispanic/Latino 

communities.

61,62
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State of Vaccine Confidence Insights Report | May 18, 2023

 Black or African American people represented one-third of all new mpox cases from May 2022 (when 

the first cases of the outbreak were found) until the end of January 2023 (when the public health 

emergency ended), but only represented one-tenth of all vaccine recipients for the virus during that 

time.63 Data from a recent Morbidity and Mortality Weekly Report indicate that 33 (87%) of the 38 

mpox-associated deaths in the U.S. between May 10, 2022 and March 7, 2023 occurred in Black or 

African American persons. 

 Hispanic and Latino people made up 20% of those who received at least one dose of the JYNNEOS 

vaccine, but accounted for 31.2% of all mpox cases.53

Commonly Asked Questions and Queries from the Public 

 Why were Black and Hispanic/Latino communities disproportionately affected by the mpox 

outbreak?e

 Many social, geographic, political, economic, and environmental factors create challenges to 

health equity and vaccination access. Some of these factors include:52

 Literacy, education, income, and wealth gaps

 Job access and working conditions

 Racism and discrimination

 Misinformation

 Gaps in healthcare access

 Transportation and neighborhood conditions

 Lack of trust because of past medical racism and experimentation

 Perceived or actual stigma when accessing medical care

Ways public health and partners can take action

CDC’s Health Equity Guiding Principles for Inclusive Communication emphasizes the importance of 

addressing all people inclusively and respectfully. These principles are intended to help public health 

professionals ensure their communication products and strategies adapt to the specific cultural, 

linguistic, environmental, and historical situation of each population or audience of focus. CDC 

encourages all public health professionals and partners at the federal, state, and local levels to apply 

these principles across their public health communication work. This means:

 Using a health equity lens when framing information about health disparities.

 Considering the key principles of health communication, such as using person-first language and 

avoiding unintentional blaming.

 Using preferred terms for select population groups while recognizing that there isn’t always 

agreement on these terms.

 Considering how communications are developed and look for ways to develop more inclusive 

health communications products.

 Exploring other resources and references related to health equity communications.64

In addition, CDC’s Mpox Equity and Anti-Stigma Toolkit provides background, strategies, actions, and 

resources to increase the number and effectiveness of prevention strategies that advance health 

equity among populations most affected by mpox, including vaccination efforts.
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State of Vaccine Confidence Insights Report | May 18, 2023

Theme 4: Activism and engagement from the LGBTQ+ 

community has contributed to an increase in mpox 

vaccine confidence and uptake

The mpox virus has disproportionally affected the LGBTQ+ community in the current outbreak, with 

the highest incidence rates being among Black and Hispanic/Latino MSM.52 Public health efforts 

are focused on increasing awareness of mpox 

among the LGBTQ+ community with the goal of 

reducing transmission through behavioral change 

and increasing vaccine uptake, confidence, and 

knowledge of the mpox vaccines.65,66,67 The LGBTQ+ 

community has played an active role in bringing 

awareness to others within the community and striving to increase vaccine confidence and access to 

those who are most at risk for the disease. 68,69 Influencers and social media played an important role in 

reaching those who were most at risk in the LGBTQ+ community, while also showing support for the 

mpox vaccines.70,66

Perceptions, Concerns, and Threats to Vaccine Confidence

 Public health experts and LGBTQ+ community members 

have suggested that the most significant contributor to 

successful mpox vaccination uptake was the activism and 

engagement from the community itself in promoting the 

efficacy, safety, and availability of the vaccine.68,71,72

 Community members felt that they were more prepared 

than others due to their past experiences with the HIV/AIDS 

crisis.73,74,70

 Other co-morbidities, such as HIV infection, increased the risk of mortality among LGBTQ+ 

members.75 Public health experts believe that the desire among community members to protect 

each other has encouraged vaccination among vaccine hesitant individuals.66,68

 The LGBTQ+ community led effective equity outreach programs ensuring that as many members as 

possible in the community had access to the mpox vaccines.72

 Campaigns such as GLAAD’s “Facts and Vax” initiative have been used in providing accurate and 

important information about the mpox vaccines to LGBTQ+ people from racial and ethnic minority 

groups.66

 Some news outlets and experts believe that the rapid deployment of vaccines to communities 

facing higher risk of mpox exposure, in tandem with an aggressive public awareness campaign, were 

highly successful in curtailing mpox and leading to a high uptake of the mpox vaccines among the 

LGBTQ+ community.69,70,74
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State of Vaccine Confidence Insights Report | May 18, 2023

Ways public health and partners can take action 

 Partners may speak with leaders in the LGBTQ+ community to learn more about how they were able 

to garner activism and engagement from the community.

 Partners may ensure the LGBTQ+ community is well-prepared for any potential future rise in cases 

and continue to encourage vaccination. 

 Partners may educate the public by highlighting the work being done by LGBTQ+ serving 

organizations and communities on a regular basis.

 Partners may work with local LGBTQ+ pride event organizers to include messaging about the 

importance of receiving two doses of mpox vaccines as soon as possible and prior to participating in 

LGBTQ+ pride events, as appropriate. Partners can also coordinate with event organizers to provide 

mpox vaccines on-site, where possible.

 Public health partners may continue to support and utilize effective mpox vaccination campaigns. 
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State of Vaccine Confidence Insights Report | May 18, 2023

References

Note: omitted numbers are social media citations, which can be accessed here.

1. Dawson, L., Moss, K., Michaud, J., & Kates, J. (2022, July 27). Key questions about the current U.S. 

monkeypox outbreak. KFF. https://www.kff.org/other/issue-brief/key-questions-about-thecurrent-u-s-monkeypox-outbreak/

2. Centers for Disease Control and Prevention. (2023, April 26). 2022 Outbreak Cases and Data. 

U.S. Department of Health and Human Services. https://www.cdc.gov/poxvirus/mpox/response/2022/index.html

3. Centers for Disease Control and Prevention. (2023, April 26). U.S. Mpox Case Trends Reported to 

CDC. U.S. Department of Health and Human Services. https://www.cdc.gov/poxvirus/mpox/

response/2022/mpx-trends.html

4. Centers for Disease Control and Prevention. (2023, April 25). Mpox Vaccination Basics. U.S. Department of Health and Human Services. https://www.cdc.gov/poxvirus/mpox/vaccines/

index.html

5. Centers for Disease Control and Prevention. (2022, October 21). ACAM2000 Vaccine. U.S. Department of Health and Human Services. https://www.cdc.gov/poxvirus/mpox/interim-considerations/acam2000-vaccine.html

6. Centers for Disease Control and Prevention. (2022, October 31). How to Protect Yourself. U.S. Department of Health and Human Services. https://www.cdc.gov/poxvirus/mpox/prevention/

protect-yourself.html

7. Centers for Disease Control and Prevention. (2023, April 25). Mpox Vaccine Administration in the 

U.S. U.S. Department of Health and Human Services. https://www.cdc.gov/poxvirus/mpox/

response/2022/vaccines_data.html

8. Blackburn, D., Roth, N. M., Gold, J. A. W., Pao, L. Z., Olansky, E., Torrone, E. A., McClung, R. P., 

Ellington, S. R., Delaney, K. P., Carnes, N., & Dawson, P. (2022). Epidemiologic and clinical 

features of mpox in transgender and gender-diverse adults - United States, May-November 2022. MMWR. Morbidity and Mortality Weekly Report, 71(5152), 1605–1609. https://doi.

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9. Payne, A. B., Ray, L. C., Cole, M. M., Canning, M., Houck, K., Shah, H. J., Farrar, J. L., Lewis, N. M., 

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and Answers. U.S. Department of Health and Human Services. https://www.fda.gov/vaccines-blood-biologics/vaccines/acam2000-smallpox-vaccine-questions-and-answers

30. World Health Organization. (2022, November 28). WHO recommends new name for monkeypox 

disease [News release]. https://www.who.int/news/item/28-11-2022-who-recommends-newname-for-monkeypox-disease

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J., Brassil, B., Youngkin, E., Glenn, B., Mangla, A., Kupferman, N., Saunders, K., Meza, C., Nims, 

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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
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State of Vaccine Confidence Insights Report | May 18, 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