Shoppers are turning to targeted health drives: Scotland’s focused mpox vaccine campaign aimed at gay, bisexual and other men who have sex with men (GBMSM) rolled out in June 2022, and new analysis shows who got two doses, who didn’t, and why it matters for prevention and equity.

Essential Takeaways

  • Coverage snapshot: Of 8,846 eligible GBMSM in Scotland, 4,000 received at least one mpox vaccine dose and 2,257 completed the recommended two doses, leaving 4,846 unvaccinated.
  • Younger men lagged: People aged 24 and under were far more likely to be unvaccinated than those 55 and over, with a more than threefold higher adjusted odds of not getting vaccinated.
  • Deprivation matters: Those living in the most deprived neighbourhoods were both more likely to be unvaccinated and less likely to complete two doses after starting the course.
  • Different risk routes, different take-up: Men eligible because of recent bacterial STI diagnoses were less likely to be vaccinated or to finish two doses than men on PrEP.
  • Diverse partnerships affected: GBMSM reporting partners of both men and women had lower uptake and completion versus those reporting men only, signalling gaps in outreach.

Who was vaccinated , and who wasn’t? A quick reality check

The data reveal a mixed picture: almost half of eligible GBMSM had not received any mpox vaccine, while just over a quarter completed two doses. That “sturdy feel” of protection from a full course is clearly uneven across groups. According to public health records, Scotland’s campaign focused on offering vaccine to those at highest risk, but uptake varied sharply by age, deprivation and route of eligibility. For readers, the headline is simple: eligibility doesn’t equal access or acceptance.

Age and engagement , why younger people fell behind

Young people under 25 showed markedly higher odds of remaining unvaccinated. That likely reflects a bundle of factors: lower perceived personal risk, more tenuous links to sexual health services, and practical barriers such as time or transport. This echoes global observations from WHO and other public health agencies that outreach needs to be youth-friendly. Practical tip: clinics and campaigns aiming at younger GBMSM should use social media, flexible hours and drop-in options to bridge that gap.

Socioeconomic divides: deprivation cuts two ways

Living in the most deprived quintile was linked to both being unvaccinated and failing to complete the two-dose schedule. Deprivation often brings logistical hurdles , less predictable work hours, childcare pressures, or difficulty reaching vaccine sites , and those barriers can derail a course that requires two visits. NHS Inform guidance highlights where and how to get vaccinated; making vaccines available in community settings, sexual health clinics and pop-ups in deprived areas would be one obvious fix.

Why route of eligibility matters , PrEP users versus STI diagnoses

Men who were eligible because they were on PrEP had higher vaccination and completion rates than men identified via recent bacterial STI. That suggests people already connected to ongoing sexual health care and regular follow-up are easier to reach. Clinics prescribing PrEP routinely remind patients about prevention, so integrating mpox vaccination into those touchpoints works. For others, especially those who might only see services episodically after an STI, a single appointment might not be enough , proactive follow-up and easy rebookings help.

Sexual behaviour patterns and outreach blind spots

The study found lower uptake among GBMSM reporting partners of both men and women compared with men-only partners. That’s important because outreach that assumes identities or sexual networks may miss people with bisexual partnerships, who might not frequent gay-focused services or community events. Messaging and channels should be broad and inclusive: sexual health clinics, general practice, and community organisations all have a role. A human note: many people who fall between community labels just want clear, private access to care.

What this means for public health and the next steps

Mpox spread internationally in 2022 and public-health agencies have tracked it closely; WHO and the CDC documented the outbreak and response worldwide. Scotland’s targeted programme shows the value of focusing on high-risk groups, but also exposes how social factors shape who actually gets protected. The practical takeaway is straightforward , make doses easy to get, keep follow-up light and empathetic, and tailor outreach to younger people, those in deprived areas, and people with diverse sexual partnerships.

It's a small change in delivery and messaging that can make every dose count.

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