2026/05/01 by Annabeth Simpson, James MacGibbon, Joanne Jackson +6 · 1 voice
Immunology and Microbiology · Medicine · Social Sciences · #Poxvirus research and outbreaks #Vaccine Coverage and Hesitancy #Virology and Viral Diseases
paper · doi:10.1016/j.eclinm.2026.103903
openalex publication_date 2026/05/01 · openalex created_date 2026/05/05 · openalex updated_date 2026/07/23
Background: Australia implemented publicly-funded mpox vaccination in August 2022, targeting at-risk groups including gay, bisexual and other men who have sex with men (GBMSM). Data on mpox disease epidemiology, vaccine uptake and coverage are limited. Methods: From 2022 to 2024, mpox epidemiology was described using National Notifiable Diseases Surveillance System data and mpox vaccine uptake (number of doses) using Australian Immunisation Register (AIR) data, for the total population. Vaccination coverage was estimated among GBMSM using AIR data and denominators from the third Australian Study of Health and Relationships (ASHR3; MSM aged 16-69 years, reporting sex with men in past year) and Australian Bureau of Statistics LGBTI+ estimates (gay, bisexual, queer+ [GBQ+]-identifying men aged ≥16 years). Findings: From May 2022 to December 2024, 1579 mpox cases were reported, with small (2022) and large (2024) outbreaks. Most cases were male (99.2%), aged 20-49 years (85.6%); 7.4% were hospitalised and 45.2% unvaccinated. From January 2022 to December 2024, 114,966 vaccine doses were administered to 66,982 people, mostly male (94.2%) and aged 20-49 years (75.6%). Estimated two-dose coverage was 9.6% (8.4%-11.2%) among MSM and 15.0% (13.7%-16.6%) among GBQ+-identifying men. Interpretation: Australia's epidemiological pattern (small 2022 and large 2024 outbreak) appears unique among high-income countries, which may reflect effective initial containment via vaccination and contact tracing in dense sexual networks of GBMSM with strong GBQ+ community connections, resulting in low levels of both disease and vaccine-induced immunity in the broader MSM population. Coverage estimates were lower than self-reported Australian surveys, which are likely not representative of the overall MSM population. Funding: Australian Government Department of Health, Disability and Ageing.