Mpox immunization coverage survey: Understanding the data

Data on mpox (formerly monkeypox) immunization coverage. The data covers Two-Spirit, lesbian, gay, bisexual, transgender, queer, and other individuals who are part of sexual and gender diverse communities (2SLGBTQ+) and men who have sex with men (MSM).

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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.

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About mpox immunization in 2SLGBTQ+ and MSM people

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 2SLGBTQ+ and Men who have Sex with Men (MSM) Survey. The previous survey's interactive report has been archived. 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 2SLGBTQ+ people or those who are MSM in Canada.

Summary of survey characteristics

Summaries of populations and methods for each survey cycle.

2023 (cycle 1) survey

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

Table 1: 2023 (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.

2024 (cycle 2) and 2025 (cycle 3) survey

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

Table 2: 2024 (cycle 2) and 2025 (cycle 3) sample size by population group

Survey year Population groups Sample size (n)
2024 2SLGBTQ+ and not heterosexual 803
2024 2SLGBTQ+ and heterosexual 49
2024 Heterosexual cisgender men 2,322
2024 Heterosexual cisgender women 2,495
2024 Total 5,885
2025 2SLGBTQ+* 1,111
2025 Heterosexual cisgender men 2,147
2025 Heterosexual cisgender women 2,331
2025 Total 5,823
Table 2: Notes
  • In 2024 and 2025, one category is not shown in the total. The category includes 216 (2024) and 234 (2025) individuals with no available information
  • *: Includes people who are heterosexual but are considered 2SLGBTQ+ because of their gender (e.g., a transgender, heterosexual person).

Survey methods

The detailed data tables and methodological report from 2023, 2024 and 2025 can be found on Library and Archives Canada:

Table 3: Summary and comparison of survey methods

Survey characteristics 2023 (cycle 1) 2024 (cycle 2) 2025 (cycle 3)
Period of data collection March 10 to April 9, 2023 December 7, 2023 to January 29, 2024 December 17, 2024 to January 31, 2025
Full analytical sample size (n) 5,159 5,885 5,823
Population groups used for weighting 4 (Table 1) 2 (Table 2) 2 (Table 2)
Sampling approach Probability-based survey of respondents from the general population
Data collection tool Electronic questionnaire
Table 3: Notes
  • 275 women+ were included in the 2023 sample but not analyzed due to the small sample size.
  • 3,023 women+ were included in the 2024 sample and analysis.
  • 2,987 women+ were included in the 2025 sample and analysis.
  • The electronic questionnaire is a baseline questionnaire developed in 2023, which was enhanced in 2024 and 2025.

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 all cycles.

For 2023, analysing the data by being "part of 2SLGBTQ+" compared to "not part of 2SLGBTQ+" was not conducted to align with the weighting scheme used. Therefore, direct comparisons between 2023, 2024 and 2025 are limited. Comparisons are possible between 2024 and 2025.

Reporting guidelines

Interpret any results with an unweighted base size (denominator) of less than 30 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. 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.

Non-response adjustments were not possible since the non-respondent’s information is unknown. Data were unavailable to do such a correction, though there were no extreme weights caused by small sample size.

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

Mpox
Mpox (formerly referred to as “monkeypox”), is a disease caused by a virus that can cause a rash or sores on the body that typically lasts 2 to 4 weeks. It is accompanied by a fever, headache, muscle aches, swollen lymph nodes and exhaustion.
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).
2SLGBTQ+
The acronym used to refer to sexually and gender diverse people in Canada’s 2SLGBTQ+ Federal Action Plan.
2S recognizes Two-Spirit people as the first 2SLGBTQ+ communities. The acronym also represents lesbian, gay, bisexual, transgender, queer, and additional people who identify as part of sexual and gender diverse communities.
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, 2024, and 2025 Mpox Immunization Coverage Surveys. Your contribution 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

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