In May 2022, an outbreak of mpox emerged in Canada. In June 2022, the province of Ontario began offering first doses of a 2-dose regimen of Modified Vaccinia Ankara\u2013Bavaria Nordic (MVA-BN) to those at high risk of exposure. Second doses became available in September 2022. To help increase dose 2 access and uptake, we sought to understand how individuals who received 2 doses differed from those who received only 1 dose. We conducted a cross-sectional study using population-level data among individuals who received \u22651 dose of MVA-BN between June 6, 2022 and October 31, 2023 in Ontario. We used age-adjusted Poisson regression to examine the association between demographic, social, and economic characteristics; co-morbidities; and proxies for sexual exposure (e.g., bacterial sexually transmitted infection [STI] diagnoses) and proxies for healthcare engagement (e.g., syphilis testing, past receipt of other vaccines) with MVA-BN dose 2 receipt. Among 33,012 individuals with \u22651 MVA-BN dose, 38.2% (12,620) received 2 doses. Receipt of dose 2 versus only dose 1 was associated with region (e.g., higher in Ottawa compared with Toronto [prevalence ratio, PR\u2009=\u20091.08, 95% confidence interval, CI 1.06-1.09]); syphilis testing (\u22654 tests PR\u2009=\u20091.12, 95%CI 1.11-1.14) or receiving a COVID-19, influenza, or other vaccine (PR\u2009=\u20091.12, 95%CI 1.11-1.14) in the year before dose 1; and syphilis testing (\u22654 tests PR\u2009=\u20091.19, 95%CI 1.18-1.20) or bacterial STI diagnoses >3 months after dose 1 (\u22654 diagnoses PR\u2009=\u20091.07, 95% CI 1.05-1.08). Refugees were less likely to get dose 2 versus Canadian-born individuals or long-term immigrants (PR\u2009=\u20090.93, 95%CI 0.91-0.95).Our findings suggest lower healthcare access and\/or engagement may play a role in limiting dose 2 receipt in Ontario. Public messaging around availability and eligibility of second doses, tailored strategies for eligible refugees, increased access outside healthcare venues, and adopting promotion strategies from regions with high uptake, may help increase dose 2 coverage.<\/p>\n","protected":false},"excerpt":{"rendered":"
In May 2022, an outbreak of mpox emerged in Canada. In June 2022, the province of Ontario began offering first doses of a 2-dose regimen of Modified Vaccinia Ankara\u2013Bavaria Nordic (MVA-BN) to those at high risk of exposure. Second doses became available in September 2022. To help increase dose 2 access and uptake, we sought […]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[39,35],"migration-helper-qa-sample-set":[],"class_list":["post-22922","journal_article","type-journal_article","status-publish","hentry","topic-infectious-diseases","topic-public-health"],"acf":{"citation":"Grewal R, Lau C, Kwong JC, Burchell AN, Friedman L, Navarro C, Okpokoro E, Tan DHS, Zygmunt A, Bai L, Mishra S, Buchan SA; Canadian Immunization Research Network (CIRN) Investigators. PLOS Glob Public Health<\/em>. 2025; 5(11):e0005452.","source_url":"https:\/\/doi.org\/10.1371\/journal.pgph.0005452","ices_scientist":[16240,1149,1171,1320,1161],"site":[6733],"research_program":[6745],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"\n