MPOX 2024:
what we know so far
As the world – and our queer communities – come to grips with yet *another* outbreak, we’ve created this resources page with the latest information. We are still learning more about MPOX (formerly known as monkeypox), how it is transmitted, and how it is affecting us; so keep an eye out on this page while we update it, and you, regularly.
Headlines - updated 29th November 2024
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Only five cases of the new MPOX variant have been discovered in the UK
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The overall risk level in the UK remains low
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If you haven’t had your first or second vaccine yet, you can get them at your next regular checkup at a sexual health clinic (provided it’s based in London, Brighton or Greater Manchester) or you can find one from here
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Third doses (booster shots) are currently not recommended
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This is a developing situation, so the advice below may change as and when new information arises
All about MPOX.
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What is MPOX?
MPOX (formerly known as monkeypox) is an infectious disease that, until 2022, was mostly seen in parts of West and Central Africa. It spreads through skin to skin contact, often as part of sex, and can cause fevers, headaches, nausea, and distinctive lesions that can lead to scarring.
A major outbreak of MPOX occurred in the summer of 2022, when the variation known as Clade II spread across the globe, mostly in sexual networks of gay, bi, and men who have sex with men (GBMSM), including in the UK. Since then, thanks to a massive effort from the community and a targeted vaccination programme, we’ve managed to lower the rate of transmission of MPOX in the UK, so very few people are discovered to have the infection.
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Why is MPOX back in the news?
Inequalities between richer nations and the Global South means that access to vaccines has not been universal, and there is considerable demand but a lack of supply in the countries where MPOX remains common. Between 2023 and 2024, there was a 160% rise in the number of cases discovered in Africa.
Some of these nations, such as the Democratic Republic of the Congo, have suffered severe disruption in healthcare networks due to war and exploitation, making MPOX testing, treatment, and vaccination programmes much more challenging to implement.
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What is the new variant Clade 1b?
On 14th August 2024, the World Health Organisation declared a Public Health Emergency of International Concern (PHEIC) in relation to a rise in cases of a new variant of MPOX in the Democratic Republic of the Congo, with further cases discovered in several surrounding nations - including Burundi, Kenya, Rwanda, and Uganda.
This newer variant is known as Clade 1b, and as with Clade II, also appears to be transmitted through close contact, including during sex. However, the available evidence suggests that not only can it be transmitted more easily, but can make people sicker, compared to Clade II infections.
At the time of writing, only a few cases of Clade 1b have been discovered outside of Central Africa, with one each in Sweden, Germany, Thailand, the US, and India, and five in the UK. Most of these cases are related to people who had recently travelled to Central Africa, or are household contacts of people who had done so.
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Am I at risk from the new variant?
Clade II - the dominant variant transmitted in 2022 - mostly affected gay and bi men, and other men who had sex with other men (GBMSM). Research suggests that additionally sex workers and children are being significantly affected by the Clade 1b outbreak in the DRC.
Because Clade Ib and Clade II are genetically similar, it is thought that the MPOX vaccine will provide a high degree of protection from getting severely ill or hospitalised if you’re exposed to the virus, regardless of which variant it is. This means if you received one or two doses at some point since the summer of 2022, you are likely to be effectively protected against Clade Ib.
The targeted vaccination programme in the UK means that many people who would be at risk of MPOX infection are very well protected against illness, and hospitalisation. For this reason, at the time of writing, if you’re a GBMSM in the UK, and you’ve received two doses of the MPOX vaccine, your likelihood of being impacted by Clade 1b MPOX is low.
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Who in the UK is at risk?
If you have recently travelled from the DRC or neighbouring countries AND you’ve had sex there or think you may have come into close contact with someone with MPOX symptoms - this includes being in the same household - you may be at a higher risk of having been exposed to Clade 1b MPOX. This is also true if you’re a close contact of someone who fits the above description.
If this is the case, you should look out for symptoms of MPOX (a skin rash or pus-filled lesions, fever, headaches, muscle aches, back pain, low energy and swollen lymph nodes) and contact NHS 111 for further advice. In doing so, you should make sure to share with the person on the phone your recent travel history, as well as if you’re immunocompromised, and whether you’ve had zero, one, or two doses of the MPOX vaccine. You should also make sure to self-isolate as much as possible, and to not share towels, bedding, and clothing with others in your household.
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What if I haven’t had my first or second vaccine?
Research has shown that vaccinated individuals experienced far less severe symptoms of MPOX if they were exposed to MPOX and transmission occurred.
This means - if you’re eligible - it’s still a great idea to go and get your first or second shot if you haven’t yet done so, and the best way to do this is enquire at your next routine sexual health clinic appointment. There’s still a good supply of vaccines available in the UK with more along the way.
All about the vaccine.
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Am I eligible for a vaccine?
You are entitled to a course of MPOX vaccination if you are part of any of the following communities:
● Gay/bi/queer men who are having sex● Trans men, trans women, and non-binary people assigned male at birth (AMAB) who are having sex with men
● Men who have sex with other men who don’t identify as gay, bi, or queer, such as DL men.
Vaccination is especially encouraged if you visit sex on premises venues such as saunas or backrooms, or engage in group sex or sex parties.
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Where are vaccines available?
At the moment, vaccines are available only in Greater Manchester, Brighton and London-based sexual health clinics. However, if you are eligible (see previous), clinics will allow you to receive your shots if you travel into either city. Use this search function to find places offering the vaccine.
There are currently recommendations for a national routine MPOX vaccination programme to be introduced, meaning vaccination will be available again beyond London, Brighton and Manchester.
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What does the vaccine course look like?
If you are eligible, you will be offered two shots of the MPOX vaccine, the second of which you can receive at any time at least 28 days after the first shot.
It’s important to know that the MPOX vaccine doesn’t offer immediate protection – after the first shot, you’ll be at your most protected after around four weeks. After your second shot, you’ll be most protected after two weeks.
While the vaccine is highly effective at preventing serious illness and hospitalisation, it is important to remember that no vaccine is 100% effective with everyone. Be aware of the symptoms of MPOX and get tested for other STIs regularly.
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Do I need a third shot?
Going by current advice, you do not need a third shot (unless someone is immunocompromised, in which case a third vaccine might be recommended). There is some evidence to suggest immunity levels could be boosted by a third dose of the MPOX vaccine two years after the first two doses of vaccine. However, third doses are not currently widely offered.
With the vaccine supplies currently available, it is important to also consider there are people who are eligible for the vaccine, and who may not have had their second or even first shot.
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What are the side effects?
The most common side effects of the vaccine are itching and pain at the injection site, with some muscle ache or tiredness. This is perfectly normal and will usually go away after a few days. 1 in 10 people may experience chills and fever, but as with the more common effects, this will subside after a few days.
Some people may experience very rare side effects, like difficulty breathing or a swollen tongue, immediately after the vaccine is given to them. For this reason, you might be asked to wait for 15 minutes in a waiting room after the vaccine is given.
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How will the vaccine be given?
You can either receive the vaccine intradermally or subcutaneously.
An intradermal vaccine is where the vaccine is injected between the top layers of the skin, usually on the forearm. This usually requires a smaller dose per shot than an injection delivered subcutaneously, making this the most likely way you’ll receive the MPOX vaccination.
In a subcutaneous injection, the vaccine is injected into the fat layer underneath the skin on the back of your upper arm, where the tricep is. This is how most other vaccinations are delivered.
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Is one kind of vaccine better than the other?
No matter the administration, the vaccine works. But you may wish to receive the injection subcutaneously if you are under 18, have ever had keloid scars, or if you have a weakened immune system (a CD4 count below 200).
Most people living with HIV, and with an undetectable viral load, are able to take the vaccine intradermally.
What happens next?
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Staying Aware
As the situation evolves, we need to stay aware of what MPOX symptoms look like, and check back on trusted sources in case the advice for how we should respond as individuals and communities changes.
So far, the five cases of Clade 1b discovered in the UK consist of two people who had recently travelled to areas in Central Africa where community transmission is occurring, and three of their immediate household contacts. There is no record of any further community transmission of Clade 1b occurring in the UK. This means that if you get MPOX in the UK, it’s much more likely to be the Clade II variant.
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Looking out for symptoms
We can look out for the symptoms of MPOX on our own body and take a break from sex until we’ve had it checked out by a medical professional.
We can look out for the symptoms of MPOX on other people’s bodies, and respectfully and gently ask them if the symptoms are new, or if they’ve noticed them before. We can do this kindly: many of us have pre-existing skin conditions, birthmarks, or spots, and we’re already self-conscious about them.
Remember that the symptoms of Clade Ib and Clade II MPOX are very similar, and without a specific test from medical professionals, you will not know which variant you may have been exposed to.
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Beyond our own context
Our response to the public health emergency issued by the WHO will determine how Clade 1b spreads globally, and the degree to which it will impact us. This means that healthcare systems in the UK and Europe are staying alert to the possibility of “import cases”, where people travelling from affected regions may not realise they have been exposed to MPOX, and may then expose others.
Moreover, the focus is, and ought to be, on the affected regions in Central Africa. We’ve already mentioned that many of the nations where MPOX is endemic have suffered under enormous healthcare inequalities, including a chronic undersupply of vaccines - including the MPOX vaccine. A comprehensive response to the threat of Clade 1b must begin with an attempt to eliminate endemic MPOX from the region, which will involve an upscaling in testing, treatment, and vaccine outreach efforts, as well as addressing the roots of broader healthcare inequalities.
View our assets.
A4 poster
Info-wrap
Mobiliser t-shirts
Helpful guides.
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The MPOX Gay Guide: tips & tricks by and for our queer communities
Bite-sized helpful ways to work together to educate, activate and organise! Produced together with MPact.
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MPOX – information for festivals, Pride events, and large gatherings
We've produced guidance for festivals, Pride events and other large gatherings with the European Pride Organisers Association.
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Navigating MPOX – considerations for gay and bisexual men
We've worked together with the European Centre for Disease Control and MPact to provide this new briefing.
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Important information for London gay venues, promoters, and sex on premises venues.
We’ve worked with UKHSA and local authority public health teams on this guidance for sex on premises venues.
Watch the livestreams.
Want to know what's happening with MPOX?
Join us, with colleagues from the UK Health Security Agency (UKHSA), for these livestream community panel.
Podcasts.
What The Pox? | MPOX stories and resources by QueerAF.
In this podcast, Martin Joseph speaks to experts, people who've had the virus and those who see this outbreak as part of a bigger picture.
Resources.
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General information.
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General guidance from the UKHSA.
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MPOX: Q&A factsheet
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Frequently Asked Questions.
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Ireland & MPOX.
Under-the-radar (UTR) case studies
In summer 2022 The Love Tank started to work with clinical partners to provide MPOX vaccine in community settings. We called these under-the-radar or UTR events – as many were not advertised in advance, or widely. We present case studies and key-learning from each of these events.
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Date & Time:
Saturday 6th August 2022, Afternoon SessionVenue:
Glass House, Bethnal Green, London E2 9QBNHS Trust:
Barts Health (Ambrose King Sexual Health Centre)Rationale
Existing event taking place at Glass House, dominantly attended by GBMSM from South Asian communities.
Event Notes
Strong initial showing, and throughout the day as fewer participants at the event took up vaccination, individuals within the venue were asked to contact nearby peers to encourage vaccination. Venue staff also invited if they were eligible, as well as outreach staff from nearby sexual health organisation.
Almost all those who received vaccination reported problems with being able to access the vaccine through clinics. Some individuals felt unable to access vaccines owing to not being “out”, while others who were trans or non-binary felt like they would be “judged” at vaccination events.
Widespread appreciation that vaccination was being made available in a community setting, that was discreet, easy to use, friendly, and accessible.
Numbers
40 shots administered
More than half of those vaccinated were from a racialised minority. Significant minority identified as trans or non-binary, and/or involved in sex work.
Key Learnings
Small pop-ups overall vaccinate fewer people, but this pilot demonstrated the ability to provide vaccines to eligible people are not easily accessing them in other settings.
Identifiable NHS staff meant recipients were confident in the quality of the service.
Relative discretion of service was a plus, as well as use of community space and how outreach was done by community peers.
May have needed more than one vaccinator to speed up process.
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Date & Time:
Sunday 14th August 2022, Afternoon Session, 4.5 hoursVenue:
Queer Elizabeth Olympic Park, London, E20NHS Trust:
Barts Health/ HomertonRationale
Piloting medium scale vaccination event, as part of UK Black Pride (UKBP).
UKBP attracts up to 25,000 people, majority racialised minorities.
Very enthusiastic response from UKBP organisers.
Event Notes
No socials put out prior to event, given relatively limited supply of vaccines and likelihood of high uptake.
Long queue to receive shots developed within one hour of the vaccine service commencing.
Almost all receiving vaccination reported difficulty in accessing shots via clinics, some saying they had given up trying. Significant minority not linked to any health services, including number of recently arrive queer migrants. Appropriate referrals were able to be made.
After 200 shots, outreach staff informed people in queue they may not receive vaccination, small number opted to be added to waitlist, QR code with information about receiving shots from Mortimer Market Centre handed out to others.
Numbers
260 shots administered
Majority of those vaccinated were from a racialised minority. Significant minority identified as trans or non-binary, and/or involved in sex work.
Fewer than ten decided not to proceed with vaccination after filling out their registration for and/or discussions with doctor/vaccinator.
Key Learnings
Ineligible people who were refused vaccine had heard “anyone get get mpox”
Pacing of event made it harder to offer bespoke support to each recipient, but having community peer outreach staff on hand was an advantage.
Having capacity to offer referrals for other health services was essential, including for PrEP, HIV testing, and contraception.
A number of people were persuaded to take the shot after conversations with friends. Some stated public visibility of getting shots was making a positive statement.
Vaccine supply finished within 4 hours. It would have been possible to offer at least double the amount, had more vaccine been available.
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Date & Time:
Wednesday 25th January 2023, 4pm-7pmVenue:
The Outside Project, Unit 1, 52 Lant St, London SE1 1RBNHS Trust:
Guys & St Thomas’ NHS Foundation TrustRationale
The Outside Project works with queer people experiencing homelessness, and run monthly socials inviting service users and friends.
Event Notes
Strong initial showing at a very busy event, coinciding with social. Lots of interest and plentiful conversation with attendees.
Some vaccine skepticism, one person mentioned wanting only “natural things” in their body and that they’d had a covid shot by obligation. Wanted only “natural antibodies” and felt like their “system” was already optimal.
Another person had had very few vaccines at all, and when offered flu and COVID alongside Mpox, was happy to take these as well.
One person had to be turned away on the basis of pre-existing respiratory condition, and were already under heavy treatment, so suggested they come back to get the shot in about 3-4 weeks’ time.
Numbers
15 shots administered, of which 9 were first doses, and 6 were second doses.
1 person opted for a flu vaccine in addition to an mpox shot, and 4 people opted for both covid and mpox vaccines.
1 person had a covid shot alone, and 1 person had a flu shot alone.
Relatively few people from racialised minorities, but considerable minority were trans and non-binary.
Key Learnings
Providing other vaccines on the spot alongside Mpox increased enthusiasm and uptake of this other shots. It might be worth considering if this could be extended to Hep A/B and HPV vaccines.
The process of filling out the patient forms slowed things down a little, to the extent that at one point four people were all waiting at once for their turn to be vaccinated. May further be due to there needing to be a separate vaccinator for Mpox shots vs. the other shots.
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Date & Time:
Saturday 18th February 2023, 12pm-3pmVenue:
London LGBTQ+ Community Centre, 60-62 Hopton St, London SE1 9JHNHS Trust:
Guys & St Thomas' NHS Foundation TrustRationale
Community centre that runs regular events for queer people, often attracting target demographics for Under The Radar scheme.
Tarot Group and Book Club events were happening concurrently, meaning plenty of people would already be present.
Event Notes
CC staff had posted about the event on their Eventbrite and social media pages.
Clinical team arrived 45 minutes earlier than scheduled, during closed yoga class, and had to be asked to wait until it was finished before setting up.
Centre became progressively busier within first hour as people arrived to join their groups, during which the outreach worker spoke to groups and individuals and encouraged them to take up the vaccine.
Some people arrived exclusively to take up the vaccine, having seen the event advertised on social media, and left straight after receiving the shot.
A few vaccine skeptics on site, and some did not want the shot at all, citing a lack of interest in getting an injection.
Productive conversations with other users or services, directing them to the Queer Health website, which they found especially useful and a helpful resource.
After the first hour, once the groups had started in earnest, if became difficult to pull people away. This was especially true of the book group, which was a no-breaks discussion group.
Numbers
12 shots administered, of which 5 were first doses, and 7 were second doses.
Majority of those vaccinated were from a racialised minority, and most were cis gay men, with a small minority being non-binary people.
Key Learnings
Even from the same NHS trust, different vaccination teams may require different lead times to prepare everything before starting administration, would be important to confirm this beforehand.
It might be better to run the pop-up clinics alongside events more open in their nature, or at the confluence of several events at once i.e. as some events stop and others begin, to avoid having considerably less uptake in second half of vaccination window.
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Date & Time:
Wednesday 22nd February 2023, 4pm-7pmVenue:
The Outside Project, Unit 1, 52 Lant St, London SE1 1RBNHS Trust:
Guys & St Thomas’ NHS Foundation TrustRationale
The Outside Project works with queer people experiencing homelessness, and run monthly socials inviting service users and friends.
Some of the people who’d attended the previous pop-up clinic at The Outside Project had just received their first shots, and would by this time be due for a second.
Event Notes
Very little footfall overall - although the space was open, the attendees were mostly a single group of regular service users who had all been offered the shot in the previous session, and had already accepted, declined or were ineligible.
All of the people who did receive a vaccine came to The Outside Project exclusively to receive the shot, before leaving straight afterwards. Of these, most were within the first hour, with one in the final 20 minutes.
Numbers
5 Mpox shots administered, of which 2 were second doses.
Of these, 2 people also accepted a COVID vaccine.
1 other person took a flu vaccine.
1 person took a COVID vaccine only.
Key Learnings
Considerably more promotion would need to be done for the event in the lead up.
A more popular event to arrange the clinic around would be better, but as would making use of the internal staff to gauge the amount of interest from users of the service.
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Date & Time:
Sunday 26th February 2023, 1pm-7pmVenue:
London LGBTQ+ Community Centre, 60-62 Hopton St, London SE1 9JHNHS Trust:
Guys & St Thomas’ NHS Foundation TrustRationale
Community centre that runs regular events for queer people, often attracting target demographics for Under The Radar scheme.
Board Games group happening concurrently, which was due to attract 50-60 people, and less formalised than previous event meaning easier outreach attempts.
Event Notes
CC staff had posted about the event on their eventbrite and social media pages.
When clinical team arrived, already two people were waiting to receive their Mpox vaccine.
Very strong initial showing as people arrived for the board games event, with many open to receiving the vaccine and filling out a registration form immediately, with others asking if they could think about it or get theirs later.
As with previous event, some people arrived exclusively to receive a vaccine, and then left without joining the event.
Several people mentioned that they didn’t realise second doses of the Mpox vaccine were even being widely offered.
Quieter turnout from 3.30pm, as most people wanting to come to the event were already there.
Numbers
12 shots administered, of which 4 were first doses, and 8 were second doses.
1 person accepted a flu shot, 1 person received a COVID vaccine.
Significant minority of those vaccinated were from a racialised minority, and most were cis gay men, with a small minority being non-binary people.
Key Learnings
With the strong initial showing, it was very easy to walk up to people’s games, join in, be more involved and talk about sexual health and the vaccines available.
However, with the peak of the attendance happening more than 3 hours before the clinicians were due to stop, they may not have needed to be on site as long, since no other events were due to happen on that day that would have feasibly attracted more people.
More signage would have been helpful, so that people could recognise both the outreach worker, and the fact that vaccines were available and that they could walk-in.
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Date & Time:
Friday 3rd March 2023, 6pm-9pmVenue:
Dalston Superstore, 117 Kingsland High St, London E8 2PBNHS Trust:
Homerton NHS TrustRationale
DSS is a very popular bar and nighttime venue for queer people based in East London. Many of their nights are community specific.
3/3/23 was a QTIPOC themed night called “Where Are You From”, expecting many people from target demographic to show.
Event Notes
DSS staff had posted about the event on their social media page, and displayed a poster on premises advertising the vaccine pop-up.
On the day itself, regular outreach worker was ill, covered by colleague.
Very strong initial showing as people were showing up for the main night, and the added incentives of having sexual health testing available as well.
Twinirix and Gardasil were also on offer.
Lots of enthusiasm and discussions with outreach workers, although most of the work was effectively done by 8.30 as the main event started.
One person who wanted a vaccine left as they needed to leave, but was given a QR code to find out where to get their vaccine from.
One person misunderstood and thought the vaccines available were for meningitis.
Numbers
16 shots administered, of which 12 were first doses, and 4 were second doses.
Of these, 7 also accepted a Twinirix and/or a Gardasil shot.
6 STI screenings were also conducted.
Majority of those vaccinated were from a racialised minority, and a considerable number were trans and non-binary.
Key Learnings
Very easy to speak to community peers in a social nighttime setting, despite the relatively crowded and loud nature.
An extra person to help on vaccines on site would have smoothed and speeded up the process.
Further sexual health testing, and the offer of HPV and Hep A/B vaccines is a clear incentive.
Low light in the venue also a challenge so that the tiny needle would be correctly oriented and in the right place.
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Date & Time:
Tuesday 7th March 2023, 6pm-8pmVenue:
Naz Project, 30 Blacks Road, Hammersmith W6 9DTNHS Trust:
Chelsea & Westminster NHS Trust (10 Hammersmith Broadway)Rationale
Naz Project run an onsite monthly evening gathering of South Asian GBMSM called “Dost” to discuss sex and relationships.
Several clients had already expressed interest in receiving the Mpox vaccine prior to confirming the date with the clinicians.
Event Notes
Nature of event was informal gathering in kitchen and common room areas for first 30 minutes, until the formal discussion circle began, which would have a 10 minute break at 7.30pm.
Considerable enthusiasm on site for receiving the vaccination, most people had either had the Mpox shots already or wanted to receive one, very little pushback or skepticism.
People mentioned they had struggled to get appointments for both vaccines and wider sexual health, including STI checkups and PrEP appointments.
Most of those who wanted to receive their vaccination did so before the discussion circle started, and at times a small queue developed and people had to wait a little.
The outreach worker also gave a small speech, with support from the group leader, letting people who’d arrived just in time for the formal discussion that vaccination was available.
The rest of those who agreed to take up the vaccine did so during the discussion circle break.
Numbers
11 shots administered, of which 5 were first doses, and 6 were second doses.
All of those who were vaccinated were cis men of South Asian descent.
Key Learnings
Clients recognised outreach worker was from the same background as them which facilitated easygoing and amicable conversations, and established trust in the vaccination process.
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Date & Time:
Thursday 16th March 2023, 6pm-9pmVenue:
Metro New Cross, The Mulberry Centre, 15 Amersham Vale, London, SE14 6LENHS Trust:
Lewisham & Greenwich NHS TrustRationale
Closing event for the Speaking Positive project, which focused on internalised HIV stigma affecting London’s Latinx community.
The event would attract around 30 people, mostly of Latin American descent, and a number of whom were not English speakers.
Event Notes
During informal social time before the event started, many people came forward to sign up for their shot, and a queue system was put in place where each person was called up based on when they handed in their vaccine form.
As the event and presentation started, the outreach worker quietly guided people into and out of the vaccination area as and when it was their turn.
The registration form was somewhat different from those employed by other NHS trusts, which covered aspects that some people found a little confusing but not to the extent of refusing vaccination.
Several event attendees were happy to step in as interpreters and assisted non-English speakers with filling out the registration form, and accompanied them in the vaccination space to discuss further questions with the clinical team.
Effectively done within the first 90 minutes, as most of those who wanted to come to the event were already there.
Numbers
7 shots administered, of which 6 were first doses, and 1 was a second dose.
All of those who were vaccinated were of Latin American descent, with a considerable number being trans or non-binary.
Key Learnings
It may have been helpful to bring along vaccination forms in other languages, if possible, especially since almost everyone who visited would speak either Spanish or Portuguese.
As with previous UTR events, given relatively formal structure of event, and that most people who would want to arrive would do so within the first 30-45 minutes, it may have been better to finish earlier.
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Date & Time:
Friday 14th April 2023, 6pm-9pmVenue:
Dalston Superstore, 117 Kingsland High St, London E8 2PBNHS Trust:
Homerton NHS TrustRationale
DSS is a very popular bar and nighttime venue for queer people based in East London. Many of their nights are community specific.
14/4/23 was a queer event called “Fussy”, designed for queer communities and allies.
Event Notes
DSS staff had posted about the event on their social media page, and displayed a poster on premises advertising the vaccine pop-up.
Event started with one person already waiting for a shot, but very quiet for following hour as focus was on serving food rather than more casual socialising.
Clientele on this particular evening consisted of more cis straight men and cis women than target demographic.
Homerton team were also offering full sexual health screenings, several of the people who accepted a dose of the Mpox vaccine also accepted screening.
At its busiest, three people were waiting for a shot, but broadly found it more difficult than previous DSS event to gather interest in receiving the vaccine.
Numbers
6 shots administered, of which 2 were first doses, and 4 were a second doses.
No other shots were administered (Twinirix and/or Gardasil)
Most of these were cis gay men, small minority being trans or non-binary, all were non-PoC.
Key Learnings
The client base for this particular evening did not largely consist of the demographics we’re hoping to reach through the UTR scheme, so may need to ensure the next event is far more directly focused on GBMSM, PoC and trans people.
The screening service is again, a clear incentive.
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Date & Time
Saturday 13th May 2023, 2pm-5pmVenue
The Eagle London, 349 Kennington Lane, London SE11 5QYNHS Trust
Guys & St Thomas’ NHS Foundation TrustRationale
Eagle is a very popular bar and nighttime venue for LGBTQ people based in Vauxhall. Many of their nights are community specific, but they also run daytime events.
13/5/23 was a collaborative event between Duckie and Club Kali, the latter of which is a South Asian-run organisation that holds club nights and daytime gatherings for the South Asian LGBTQ+ people. HIV testing was also made available on site.
Event Notes
Event space was spread across the interior of the club and a beer garden. The testing and vaccination teams set up in the latter.
Relatively slow start for first half of the allotted time, as people filtered in, although it became clear that majority of people showing up were not of the target demographic for vaccination that the UTR project was aiming for.
However, interest in the vaccination and testing picked up as the venue got busier, and a small queue eventually formed.
Some of the men were bi, two of whom initially hesitated to accept the vaccination, one was overhead saying he wasn’t gay and wouldn’t need a shot, despite also saying he was having sex with men.
Some vocal antivax sentiment present - did not engage further.
Numbers
16 shots administered, of which 13 were first doses, and 3 were a second doses.
Around 2/3 of these were cis white MSM, while the rest were to Queer Asians.
Of those receiving their first dose, one was a South Asian man living with HIV, two were of East Asian descent, and most were over the age of 40.
Key Learnings
That 13 of the 16 shots were first shots, to older individuals, suggests many people are still unaware of vaccine availability or eligibility, even with the prospect of the vaccine programme ending in Jun/Jul 2023.
The outreach team wearing T-shirts saying “Ask me about the monkeypox vaccine” compensated for the relatively loud interior, leading to conversations and referrals to the waiting clinicians in the beer garden.
Still some degree of stigma to be tackled both in terms of who is eligible for the vaccine, i.e. “I’m not gay”, and in reference to anti-vax sentiment.
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Date & Time:
Wednesday 31st May 2023, 3pm-6pmVenue:
The Green House - Ethical Property, 244-254 Cambridge Heath Rd, Cambridge Heath, London E2 9DA.NHS Trust:
Homerton Hospital NHS TrustRationale
Initially conceived as a collaborative event between The Love Tank and Micro Rainbow, to provide vaccines to their client base.
Further opened out to others on an appointment basis, with the event promoted through club night mailing lists and Love Tank socials.
Event held on office premises, for ease of access to Micro Rainbow services for attendees.
Event Notes
Triage set up for attendees to be able to enter the building, check their name off the attendee list, and go upstairs to office space where shots were administered.
Many mentioned how they had heard of the event through the club mailing list, other mentioned finding out through social media.
One person thought they needed a third shot, so left without receiving a vaccine.
Of the 30 people who signed up, 7 were unable to or did not attend.
Numbers
22 shots administered, of which 10 were first doses, and 12 were a second doses.
Of those who received an Mpox vaccine, 3 also accepted a Hep A/B vaccine, and 2 also accepted a HPV vaccine.
Around half of those receiving their dose were from a PoC background.
Key Learnings
Running an event on our own terms is a different model to previous UTR initiatives, where the team would work with a previously scheduled event. The turnout suggests this is as effective, if not more, as a strategy.
Making use of club mailing lists is a highly effective way of getting the word out, and galvanising interest in getting shots.
Using a booking platform like Outsavvy helped to regulate the flow of people arriving, rather than forcing people to wait for a long time.
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Date & Time:
Saturday 24th June 2023, 10am-12pmVenue:
St. Margaret’s House, 21 Old Ford Rd., London E2 9PL.NHS Trust:
Homerton Hospital NHS TrustRationale
Large event that would be attended by key demographic the UTR project is aiming to serve (queer migrants).
Community-focused event with stalls on sexual health and legal advice, as well as workshops on dance, yoga, and talks. Non-alcohol focused setting ideal for delivering vaccines.
Event Notes
Vaccines administered in room separate from main event area, requiring short (2 minute) walk to separate building.
Outreach team focused on spending time in main space, speaking to attendees about vaccines and HIV testing.
Most of those accepting the vaccine arrived in the second hour of provision.
Several attendees were cis and straight men, who initially accepted the offer of the vaccine, before realising they were ineligible.
Considerable vaccine skepticism elsewhere, some attendees saying they didn’t want any vaccines at all.
One attendee mentioned they had been trying to access a vaccine for months, and that their local service in Manchester was only available to contact once a week for a few hours. They were able to get their first shot from this event.
Numbers
7 shots administered, of which 5 were first doses, and 2 were second doses.
At least 2 shots were delivered to PoC, and one delivered to a trans masc person.
Key Learnings
There is still considerable demand for first shots.
Eligible people from outside of London who are looking for first or second shots are finding it very difficult to secure vaccine appointments. We should be taking advantage of summertime events as people from outside the city visit London, and provide shots where we can.
Vaccine skepticism is still an issue, focus on providing peer support where possible to encourage uptake.
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Date & Time:
Saturday 1st July, 3pm-6pmVenue:
Colour Factory, 8 Queen's Yard, London, E9 5EN.NHS Trust:
Homerton Hospital NHS TrustRationale
Same weekend as Pride in London, Colour Factory running an alternative Pride event alongside Howl.
Approx. 600 people estimated to attend over the two days, including considerable number of people from target demos (trans folk, sex workers, PoC, migrants).
Aiming for 3-6pm would allow for considerable reach as crowds entered the space, but not too late where gaining informed consent would become more challenging.
Event Notes
Set up on corner outside toilets and by the garden entrance. By 3.45pm this was a main thoroughfare with lots of people constantly passing through, queueing to use the toilets, and seeing others getting vaccinated. Led to many people enquiring, discussing sexual health and vaccines, and some signing up to receive a shot.
Several of those who accepted vaccines mentioned difficulties in accessing SH services, including vaccines. Two said they couldn’t access walk-in services, one of whom had a positive diagnosis for an STI and took two months to receive treatment.
Other people mentioned that they hadn’t thought about getting their second shot owing to not seeing Mpox in the news as much, and further some found the booking systems at some clinics difficult to navigate.
Visibility of vaccine administration also helped pique curiosity and provoke questions, and seeing peers accept the shot encouraged others to do the same.
Some vaccine hesitation, at least one person said they hadn’t taken any vaccines at all.
Many people, including those who did not take accept a vaccine, said they were happy that we were there, that being present at events was a great initiative, and one said that we were doing “God’s Work”.
Numbers
25 shots administered, of which 15 were first doses, and 10 were a second doses.
Considerable diversity in uptake, including PoC, trans folks, and some cis women.
Key Learnings
Running vaccine pop-ups at crowded events, and deliberately being visible in main thoroughfares rather than in closed off areas, provokes conversation, interest, and vaccine uptake.
Peer groups encouraging each other to take the shot is still a highly effective mechanism for uptake.
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Date & Time:
Monday 10th July 2023, 4pm-7pmVenue:
Regulation Store, 13a Bateman Street, Soho, London, W1D 3AFNHS Trust:
Chelsea & Westminster Hospital NHS Trust (Dean Street)Rationale
Regulation is a Soho-based retailer of BDSM and fetish gear, and is extremely well-known in the kink community.
9-16 July was Fetish Week London, a major kink and BDSM festival attracting visitors from across the UK and Europe for a series of events, workshops, and club nights.
Event Notes
Booking system set up and promoted throughout fetish networks in the preceding two weeks, with 25 people signing up in the run-up to FWL.
Triage set up with people waiting in the shop area, and receiving the vaccine from space within the changing room.
Some people who received their first shot at the event had not signed up, and just happened to be in the shop at the time.
Some apprehension over side effects - for one person, the first shot had been quite intense. On speaking to the clinicians on site, the person felt confident enough to accept their second shot.
Numbers
22 shots administered, of which 14 were first doses, and 8 were a second doses.
Of those who received an Mpox vaccine, 4 also accepted a Hep A/B vaccine, and 4 also accepted a HPV vaccine.
Most of those receiving the vaccine were white cis men, with several being of migrant experience. At lease one person was trans, and some were of SE Asian heritage. Mostly over-30s.
Key Learnings
Retail locations are a viable option to explore for future vaccination outreach, given popularity and footfall of certain shops.
Targeting the UTR around specific calendar events - in this case, FWL - ensured outreach to audiences we’d normally not reach, some of whom may not be from London.
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Date & Time:
Wednesday 19th July 2023, 4pm-7pmVenue:
The Outside Project, Unit 1, 52 Lant St, London SE1 1RBNHS Trust:
Guys & St Thomas’ NHS Foundation TrustRationale
The Outside Project works with LGBTQ+ people experiencing homelessness, and run monthly socials inviting service users and friends.
Previous UTR held on premises was more nearly five months prior, suggesting scope for second shot administration.
Event Notes
Very little footfall. Small group of regular service users in attendance were either not interested in receiving a shot, ineligible or had already received both.
Outreach worker on site reached out to wider audience using Grindr, messaging up to 200 people to garner interest in receiving a shot.
Numbers
No shots administered.
Key Learnings
It is very likely that with the OP’s service user base, we have reached saturation with vaccine administration, following two other events earlier in the year.
Opening the event out further, with more promotion, may have increased attendance, as well as the use of a booking platform as has been done on other UTR events.
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Date & Time:
Saturday 19th August 2023, 12pm-4.30pmVenue:
Queen Elizabeth Olympic Park, London, E20NHS Trust:
Barts NHS Trust/ Homerton Hospital NHS TrustRationale
Up to 25,000 people attend UK Black Pride, majority of attendees are from racialised minority backgrounds.
Enthusiastic uptake in the previous year suggests high demand for the 2023 festival.
Event Notes
Marquee set up in area near community performance tent, and toilets.
Unlike previous year, vaccination team worked with cool bags instead of a fridge contained within a mobile vaccine unit.
Triage set up with pharmacist, vaccinators, and outreach team working in tandem to keep up the pace and vaccinate as many people as possible.
Friends and colleagues at UKBP were also asked to direct people to the vaccination marquee.
Subcutaneous administration was used for most shots, until demand started outpacing supply at around 3.30pm. For the last hour, intradermal administration was used.
Specific forms for ID administration were used, but not enough were available, team improvised with forms at hand, and spare paper.
Within last hour, demand peaked, and queue was closed as supplies of vaccine ran out. People were signposted to where they could get their Mpox shot from.
Numbers
76 shots administered, of which 49 were first doses, and 27 were a second doses.
Vast majority of those receiving shots were of a racialised minority background, considerable number were also migrants, and a small number were trans or non-binary.
Key Learnings
Many people, particularly from racialised or migrant backgrounds, have not had their first Mpox vaccine. There is still considerable demand for first shots.
On the day, it may have been more prudent to start with intradermal administration to conserve vaccine supplies and vaccinate more attendees.
Into the afternoon, the overall attendance of UKBP increased and likely peaked in the early evening after supplies of the vaccine had run out. A later start, alongside more supplies, and a focus on ID administration, may have allowed more people to receive their shot.
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Date & Time:
Wednesday 23rd August 2023, 5pm-8.30pmVenue:
Vault 139, Whitfield Street, London W1T 5EWNHS Trust:
Central & North West London NHS TrustRationale
Popular sex-on-premises venue, generally attracts a post-work crowd that makes it quite busy on weekday evenings.
Target demographics in attendance would include people of colour, young people, adults over 55, and closeted MSM or those who otherwise identify as straight.
Event Notes
Triage set up in semi-private space near bar area. Vaccination team worked with smaller fridge unit, small queue had already developed by 5pm.
Curiosity drove initial engagement and uptake, following hours involved outreach worker speaking directly with venue attendees in bar and lounge areas.
Many of those accepting vaccines were over 50, and had either not received a first shot, or were unfamiliar with the availability of a second shot.
Some attendees had questions about wider sexual health, and utilised the opportunity to discuss these matters further with the vaccine administrators on site.
One person was worried about the resultant bump from vaccine administration, mentioning their spouse at home may notice, and subsequently refused vaccination.
Numbers
20 shots administered, of which 10 were first doses, and 10 were second doses.
Vast majority of those receiving shots were over 55, considerable racial and ethnic diversity in uptake pool.
Key Learnings
Two of the demographics attending the venue - gay men aged 55+, and MSM identifying as straight - are some of the least likely people to access mainstream sexual health services. The UTR pop-up model is especially useful in reaching out to these key groups.
Messaging around monkeypox - and SH in general - for MSM doesn’t always reach these groups, meaning some people were not even aware of what Mpox was, let alone that they were at risk.
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Date & Time:
Monday 4th September 2023, 4pm-7pmVenue:
Regulation Store, 13a Bateman Street, Soho, London, W1D 3AFNHS Trust:
Chelsea & Westminster Hospital NHS Trust (Dean Street)Rationale
Regulation is a Soho-based retailer of BDSM and fetish gear, and is extremely well-known in the kink community.
Folsom Berlin, Europe’s largest kink and BDSM festival, ran over 6-10 September, with attendees from London likely to fly out early in the week, and visit Regulation for last-minute purchases.
Event Notes
Booking system set up and promoted throughout fetish networks in the preceding two weeks, with 10 people signing up in the run-up to Folsom.
Triage set up with people waiting in the shop area, and receiving the vaccine from space behind a privacy curtain near the till.
Some of the people who had signed up to the vaccine via outsavvy did not show up to receive it on the day.
One person was unsure about their eligibility for the vaccine, but after speaking to the doctors, was happy to accept one.
Three people who accepted a vaccine did so after being spoken to by the outreach team during or after their shopping experience.
Numbers
8 shots administered, of which 4 were first doses, and 4 were a second doses.
Most of those receiving the vaccine were white cis men, with several having a migrant background.
Key Learnings
Almost everyone who received a first shot were people who were not normally based in the UK, or were migrants. There is still considerable demand for first shots.
Targeting UTR events around wider festival periods is still a viable means of driving up engagement and vaccine uptake.
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Date & Time:
Monday 9th October 2023, 5pm-8pmVenue:
Vault 139, Whitfield Street, London W1T 5EWNHS Trust:
Central & North West London NHS TrustRationale
Popular sex-on-premises venue, generally attracts a post-work crowd that makes it quite busy on weekday evenings.
Monday evening would be especially busy, given the popularity of “Naked Night”.
Target demographics in attendance would include people of colour, young people, adults over 55, and closeted MSM or those who otherwise identify as straight.
Event Notes
Triage set up in semi-private space near bar area. Vaccination team worked with smaller fridge unit, small queue had already developed by 5.15pm.
Curiosity drove initial engagement and uptake, following hours involved outreach worker speaking directly with venue attendees in bar and lounge areas, engaging in one to one conversations and explaining Mpox and vaccination programme.
Most of the those receiving a vaccine were over 50, several were over 60, and were less familiar with the epidemic, or had thought it had “passed”.
Some attendees struggled with spoken English, but were able to understand and fill out the consent forms in English.
Numbers
18 shots administered, of which 11 were first doses, and 7 were second doses.
Vast majority of those receiving shots were over 55, considerable racial and ethnic diversity in uptake pool.
Key Learnings
Two of the demographics attending the venue - gay men aged 55+, and MSM identifying as straight - are some of the least likely people to access mainstream sexual health services. The UTR pop-up model is especially useful in reaching out to these key groups.
Messaging around monkeypox - and SH in general - for MSM doesn’t always reach these groups, meaning some people were not even aware of what Mpox was, let alone that they were at risk.
It may be a worth bringing along ESOL resources to SOP venues to serve non-English speaking or ESOL clients.
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Date & Time:
Wednesday 11th October 2023, 5pm-8pmVenue:
The Green House - Ethical Property, 244-254 Cambridge Heath Rd, Cambridge Heath, London E2 9DA.NHS Trust:
Homerton Hospital NHS TrustRationale
Third bookable vaccine event held on office premises, to serve GBMSM in local area, following two successful and well-attended events of the same nature.
Event Notes
Triage set up for attendees to be able to enter the building, check their name off the attendee list, and go upstairs to office space where shots were administered.
Many mentioned how they had heard of the event through the Instagram stories promoted by QTIPOC focused club nights, as well as a prominent Doctor/TV personality.
Of the 27 people who originally signed up, 15 attended, with a further three attending after finding out about the event on the day through staff messaging them on Grindr.
Numbers
18 shots administered, of which 8 were first doses, and 10 were second doses.
Of those who received an Mpox vaccine, at least one other person accepted a Twinirix vaccine.
Most of those receiving a vaccine were GBMSM, from white and Latino backgrounds, as well as some from Black and Asian backgrounds. Two of those accepting the vaccine were trans masc.
Key Learnings
In the week running up to the event, booking slots near the beginning and end of the pop-up filled quickly, yet several from these cohorts did not attend. These slots could have gone to others who could have only attended at these times, meaning a stronger word or incentive needs to be put out to emphasise commitment to attending.
The sharing of the booking link by a major QTIPOC-focused club night boosted signups, working closer with them for our next event could prove fruitful.
At least 4 other people reached out to via Grindr could make this pop-up, but have committed to coming along to the next one.
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Date & Time:
Tuesday 7th November 2023, 7pm-8.45pmVenue:
Naz Project, 30 Blacks Road, Hammersmith W6 9DTNHS Trust:
Chelsea & Westminster NHS Trust (10 Hammersmith Broadway)Rationale
Naz Project run an onsite monthly evening gathering of South Asian GBMSM called “Dost” to discuss sex and relationships.
7th November gathering was part of a series of brief presentations and talks delivered by C&W NHS Trust to discuss PrEP and wider sexual health issues.
Event Notes
In comparison to previous outreach attempt with DOST in March 2023, fewer people overall were in attendance for this month’s meeting, likely due to rain and cold.
Clinical partners presented information and material on PrEP and culturally sensitive sexual health.
Following our own presentation on vaccines for GBMSM, made space to answer questions, generating energetic discussion and questions. However, people in the room either already received the shots they needed, did not want to receive their own today, or wanted to take time to think about it and defer for later.
Numbers
No shots administered
Key Learnings
Clients recognised outreach worker was from the same background as them which facilitated easygoing and amicable conversations.
Lower attendance cannot be wholly predicted, but being present on site where people could ask questions and learn about sexual health was still valuable.
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Date & Time:
Wednesday 8th November 2023, 5pm-8pmVenue:
The Green House - Ethical Property, 244-254 Cambridge Heath Rd, Cambridge Heath, London E2 9DANHS Trust:
Homerton Hospital NHS TrustRationale
Fourth bookable vaccine event held on office premises, to serve GBMSM in local area, following three successful and well-attended events of the same nature.
Event Notes
Clinical team arrived late, leading to one person who had booked to receive a shot to leave.
Triage set up for attendees to be able to enter the building, check their name off the attendee list, and go upstairs to office space where shots were administered.
Most had mentioned seeing the event promoted through Twitter and Instagram stories, which had been shared by individuals rather than organisations.
Of the 13 people who originally signed up, 8 attended.
One other person attended after outreach via Grindr on the day, but could not receive a dose due to a lack of equipment to administer a dose through subcutaneous means.
Numbers
8 shots administered, of which 3 were first doses, and 5 were second doses.
Most of those receiving a vaccine were GBMSM, from white backgrounds.
Key Learnings
Once again, booking slots near the beginning and end of the pop-up filled quickly, yet several from these cohorts did not attend. Another means of maintaining commitment from attendees who sign up should be explored.
Timing and preparation is critical for clinical partners, in order to avoid losing out on being able to provide shots to people who have arrived on time, or who required subcutaneous administration.