Drivers, barriers, and implications of mpox vaccine uptake in Australia among gay, bisexual, and other men who have sex with men: results from a prospective observational mixed-methods study (2022–2024)

This study found high uptake of the first mpox vaccine dose and a high rate of second dose completion. Most participants made decisions aligned with public health guidance, though some underestimated their risk. With low vaccine coverage and natural immunity, Australia's 2024 mpox outbreak likely reflected insufficient population-level protection. Australia likely entered 2024 with little infection induced immunity because few cases had occurred in 2022-2023, and with incomplete vaccine coverage among people at ongoing risk. Our findings point to practical steps to prevent future outbreaks by increasing vaccination rates, including addressing side-effect concerns, streamlining vaccination, and improving awareness of personal risk factors.