Richterman Aaron, O'brien Caroline, Ghadimi Fatemeh, Sumners Elijah, Ford Andre, Houston Nafisah, Tate Sebrina, Aitcheson Nancy, Nkwihoreze Hervette, Jemmott John B, Momplaisir Florence
Division of Infectious Diseases, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Penn Leonard Davis Institute of Health Economics, Philadelphia, Pennsylvania, USA.
Open Forum Infect Dis. 2025 Jul 16;12(8):ofaf417. doi: 10.1093/ofid/ofaf417. eCollection 2025 Aug.
The 2022 mpox outbreak serves as an important example of a rapidly emerging epidemic that disproportionately affected marginalized populations. Despite the availability of a preventive vaccine, its deployment ultimately fell short of reaching the populations at greatest risk. Therefore, we sought to evaluate the vaccination campaign from the perspectives of key stakeholders.
We conducted semistructured interviews to assess knowledge and perceptions of mpox, as well as barriers and facilitators to vaccine uptake in Philadelphia. We recruited health care clients and community members who were eligible for mpox vaccination and health care workers and community-based organization staff involved in vaccination efforts. We used purposeful selection to ensure inclusion of people with HIV. We used an integrated analysis approach that combined modified grounded theory and implementation science constructs.
We interviewed 21 health care clients, 9 community members, 10 health care workers, and 3 community-based organization staff after the primary mpox response in 2022 between February 2023 and October 2024. Participants varied in their knowledge and perceptions of mpox risk, primarily varying based on the perceived importance of sexual identity vs sexual behaviors. They generally believed that at-risk individuals should be vaccinated. Participants reported trusting mpox information from sources they trusted for other health information, such as health departments or knowledgeable members of social networks. Most participants expressed concern about inequitable distribution of the vaccine. Commonly reported facilitators to vaccination included one's own risk perception, technological literacy, co-locating vaccinations with existing clinical and social spaces, and outreach through trusted health-, community-, and social network-based resources. Knowledge, administrative (eg, difficulty signing up), and logistical (eg, limited clinic hours) barriers to vaccine access were thought to exacerbate inequities.
While an effective mpox vaccine was a key asset in the response, barriers related to availability, accessibility, awareness, and logistical constraints limited its reach to those at highest risk.
2022年猴痘疫情是迅速出现的流行病的一个重要例子，该流行病对边缘化人群的影响尤为严重。尽管有预防性疫苗，但疫苗的推广最终未能覆盖到风险最高的人群。因此，我们试图从关键利益相关者的角度评估疫苗接种运动。
我们进行了半结构化访谈，以评估对猴痘的了解和认知，以及费城疫苗接种的障碍和促进因素。我们招募了有资格接种猴痘疫苗的医疗保健客户和社区成员，以及参与疫苗接种工作的医护人员和社区组织工作人员。我们采用有目的的选择方法，以确保纳入艾滋病毒感染者。我们使用了一种综合分析方法，将改良的扎根理论和实施科学结构相结合。
在2023年2月至2024年10月期间的2022年主要猴痘应对措施之后，我们采访了21名医疗保健客户、9名社区成员、10名医护人员和3名社区组织工作人员。参与者对猴痘风险的了解和认知各不相同，主要根据对性身份与性行为的感知重要性而有所不同。他们普遍认为，高危人群应该接种疫苗。参与者报告说，他们信任来自他们信任的其他健康信息来源的猴痘信息，如卫生部门或社交网络中有见识的成员。大多数参与者对疫苗的不公平分配表示担忧。普遍报告的疫苗接种促进因素包括个人的风险认知、技术素养、将疫苗接种与现有的临床和社会场所设置在一起，以及通过基于健康、社区和社交网络的可信赖资源进行外展。疫苗获取的知识、行政（如注册困难）和后勤（如诊所营业时间有限）障碍被认为加剧了不平等。
虽然有效的猴痘疫苗是应对措施中的一项关键资产，但与可及性、可获得性、认知度和后勤限制相关的障碍限制了其对最高风险人群的覆盖范围。
