Mpox vaccine eligibility, uptake and coverage among gay, bisexual and other men who have sex with men in Aotearoa New Zealand.

The 2022 multi-country mpox outbreak predominantly affected gay, bisexual, and other men who have sex with men (GBM). As a small country distant from transmission hotspots but vulnerable to imported cases, New Zealand's (NZ) response involved numerous challenges, including low vaccine supplies and lack of regulatory approval, prohibiting vaccine promotion and inhibiting vaccine delivery. We triangulated data sources to estimate mpox vaccine eligibility among GBM. National Immunisation Register data was used to estimate mpox vaccine coverage. Finally, we estimated the probability of a resurgent NZ epidemic using modelling by the US CDC. By April 2024, 3050 individuals had received one mpox vaccine dose and 1065 two doses. National first and second dose coverage among GBM in April 2024 was 12.6 % (range 9.1 %-16.7 %) and 4.4 % (range 2.9 %-5.8 %) respectively. Modelling predicted a > 50 % chance of a future outbreak. With ongoing mpox transmission globally, vaccine coverage among GBM in NZ must urgently increase.