Communications and text message reminders support mpox immunization uptake in Toronto, Canada

Background

In 2022, Toronto faced one of Canada’s largest mpox outbreaks, disproportionately affecting gay, bisexual & other men who have sex with men (GBMSM). Emerging shortly after COVID‑19, the outbreak required a rapid, trusted, and equity‑centred public health response to reduce transmission and support vaccine uptake amid evolving guidance, limited resources, and resumption of in-person pride celebrations.

Description of practice

Toronto Public Health (TPH) implemented a community‑informed outbreak communications and immunization strategy. It combined partnership‑based communication with targeted service delivery, developed collaboratively with community‑based organizations trusted by GBMSM communities. Highlights: • Co‑development of culturally relevant & stigma‑free messaging. • Placement of vaccination clinics in settings accessed by GBMSM communities. • Use of text message reminders to encourage completion of two‑dose vaccine series. • Alignment of strategic communications with real‑time epidemiological data & outbreak status. Text message reminders were introduced during periods of renewed transmission risk, particularly when second‑dose completion lagged.

Results

The communications campaign showed higher recall among GBMSM than the general population, confirming successful targeting. There were 290,051 visits to toronto.ca/mpox for info and vaccine appointment bookings during the campaign period. Of 17,811 text messages sent, there were 2,819 appointment clicks, 714 confirmed bookings, a substantial increase over previous weeks without text message reminders.

Lessons learned

Community trust and partnership were key. Text message reminders were a low‑cost, high‑impact tool, with the strongest engagement occurring within 24–48 hours of message delivery. This approach is transferable to other jurisdictions managing emerging infections, particularly where trust‑building and vaccine completion are critical to interrupting transmission.

Key messages

• Community engagement and partnership was essential to co-developing trusted communications for mpox vaccine.

• The use of text message reminders increased mpox vaccine uptake, particularly in the 24-48 hours after message.