Mpox immunization coverage survey: Understanding the data

This tab has information on the importance of mpox vaccination among key, at-risk Canadian populations. It includes details about the data source and considerations.

On this page

• About mpox immunization in 2SLGBTQI+/MSM individuals
• Summary of survey characteristics
• Data considerations
• Definitions and acronyms
• Acknowledgements
• Suggested citation
• More information

About mpox immunization in 2SLGBTQI+/MSM individuals

There is limited national data on mpox vaccination coverage among at-risk populations. This type of surveillance information helps monitor the mpox situation in Canada. It also informs public health vaccination programs and prevention strategies.

This dashboard uses data from the Mpox Immunization Coverage among 2SLGBTQI+ and Men who have Sex with Men (MSM) Survey. The survey was designed to address missing or inadequate surveillance data and evidence. This survey also applies a sex and gender-based analysis plus (SGBA+) lens. It considers the multiple identities and contextual factors of 2SLGBTQI+ people or those who are MSM in Canada.

Summary of survey characteristics

Summaries of populations and methods for each survey cycle.

Cycle 1 in 2023

Cisgender men who are not heterosexual were compared with cisgender, heterosexual men.

Table 1: Cycle 1 sample size by population group

Population groups (2023)	Sample size (n)
Cisgender men (gay)	321
Cisgender men (bisexual, asexual, pansexual, or other sexual orientation)	232
Cisgender men (heterosexual)	4,534
Total *	5,519

Table 1: Notes

• *: One category is not shown. This category includes 72 transgender men and 50% of non-binary, Two-Spirit, bi-spirit persons, and persons of other genders surveyed. The data for this category does not conform to reporting guidelines.

Cycle 2 in 2024

2SLGBTQI+ community members were compared with those not part of the 2SLGBTQI+ community.

Table 2: Cycle 2 sample size by population group

Population groups (2024)	Sample size (n)
2SLGBTQI+ and not heterosexual	803
2SLGBTQI+ and heterosexual	49
Heterosexual cisgender men	2,322
Heterosexual cisgender women	2,495
Total *	5,885

Table 2: Notes

• *: One category is not shown. The category includes 216 individuals with no available information.

Survey methods

The detailed data tables and methodological report from Cycles 1 and 2 can be found on Library and Archives Canada:

• Cycle 1 methodological report and tables
• Cycle 2 methodological report and tables

Table 3: Summary and comparison of survey methods

Survey characteristics	Cycle 1	Cycle 2
Period of data collection	March 10 to April 9, 2023	December 7, 2023 to January 29, 2024
Full analytical sample size (n)	5,159*	5,885^
Population groups used for weighting	4 (Table 1)	2 (Table 2)
Sampling approach	Probability-based survey of respondents from the general population
Data collection tool	Electronic questionnaire+

Table 3: Notes

• *: Women+ (n=275) were included in the Cycle 1 sample but not analyzed due to the small sample size.
• ^: Women+ (n=3,023) were included in the Cycle 2 sample and analysis.
• +: A baseline questionnaire developed in Cycle 1 was enhanced in Cycle 2.

Data considerations

Limitations and notes related to the data in this publication.

Limitations

There is limited population data in Canada for MSM. As such, it is impossible to design population weights and properly weight the data for this group. Because of this constraint, weighted estimates for the MSM group are not shown for either cycle.

For Cycle 1, analysing the data by being "part of 2SLGBTQI +" compared to "not part of 2SLGBTQI+" was not conducted to align with the weighting scheme used. Therefore, direct comparisons between cycles are limited.

Reporting guidelines

Any results with an unweighted base size (denominator) of less than 30 should be interpreted with caution.

For confidentiality, any results in this report with an unweighted base (denominator) of less than 10 are suppressed.

Weighted estimates

The estimates (percentages) derived from the survey data and shown from the key at-risk populations considered in this dashboard are all weighted estimates. This means estimates were adjusted to more closely reflect population groups in Canada. Factors used to adjust the sample were age group, gender, and sexual orientation.

Confidence intervals (CIs)

The small black bars visible on some of the charts represent the confidence intervals around the estimates. Confidence intervals are one way to relay information about how "good" or "true" an estimate is. The wider the confidence interval for an estimate, the more caution is required when using the estimate.

Definitions and acronyms

Vaccination (or immunization) coverage

The percentage of a population that is immunized against a vaccine-preventable disease.

Vaccine hesitancy

The World Health Organization (WHO) defined vaccine hesitancy as refusing or a delay in accepting available vaccines. Vaccine hesitancy is influenced by many factors. Hesitancy also plays a role in understanding vaccine uptake (the number of people vaccinated with a certain dose of the vaccine in a certain time period).

2SLGBTQI+

The acronym used to refer to sexually and gender diverse people in Canada’s 2SLGBTQI+ Federal Action Plan.
2S recognizes Two-Spirit people as the first 2SLGBTQI+ communities. The acronym also represents lesbian, gay, bisexual, transgender, queer, intersex, and additional people who identify as part of sexual and gender diverse communities.
The “I” for intersex considers sex characteristics beyond sexual orientation, gender identity and gender expression.
The “+” is inclusive of people who identify as part of sexual and gender diverse communities, who use additional terminologies.

SGBA+

Sex and gender-based analysis plus

MSM

Men who have sex with men

Women+

The Women+ category includes:

• cisgender women
• transgender women
• 50 % of non-binary persons, Two-Spirit persons, bi-spirit persons, and persons of other genders

Acknowledgements

This report would not have been possible without the respondents. They generously dedicated their time and energy to answer numerous survey questions. We would like to thank everyone who participated in the 2023 and 2023/2024 Mpox Immunization Coverage Surveys. Your contribution potentially benefits many others.

Suggested citation

Public Health Agency of Canada. Mpox immunization coverage survey. Ottawa: Public Health Agency of Canada; .... https://health-infobase.canada.ca/mpox/immunization-coverage/

More information

Inquiries about this publication can be directed to:

vacc.cover.effect.surveil-surveil.couvert.efficacite.vacc@phac-aspc.gc.ca