(PL39) MPOX CLINICAL CARE EXPERIENCES AND VACCINE PERCEPTIONS AMONG PERSONS DIAGNOSED WITH MPOX DURING A CHICAGO MPOX OUTBREAK INVESTIGATION: MAY 16-JUNE 1, 2023

Background:
Between March 18 and June 27, 2023, forty-nine mpox cases were reported in Chicago among gay, bisexual, and other men who have sex with men, 57% of whom were fully vaccinated. Between May 16–June 1, 2023, CDC and the Chicago Department of Public Health (CDPH) conducted qualitative interviews with case-patients exploring patients’ mpox diagnosis experiences, vaccination status and vaccine perceptions.

Methods:
CDPH contacted thirty-three case-patients who were diagnosed with mpox between March 18–May 26, 2023. Nineteen agreed to an in-depth interview. Questions focused on case-patient experiences during the time-period of symptom onset and receipt of diagnosis. Interviews were transcribed, coded, and analyzed for key themes using the Framework Method.

Results:
Sixty-eight percent (13/19) reported mild or no symptoms, 85% (11/13) of whom were vaccinated. Seventy-nine percent (15/19) initially suspected other causes, like other sexually transmitted infections, hemorrhoids, or folliculitis. Case-patients did not think their initial presentation was consistent with symptoms of mpox. Regarding medical care, 37% (7/19) reported concerns over providers’ mpox knowledge, resulting in negative care experiences, testing delays and, in some cases, misdiagnosis. Twenty-one percent (4/19) mentioned their providers did not suspect mpox because they were vaccinated, or providers were unaware of the recent outbreak. Self-advocacy was a strong theme among case-patients after suspecting mpox either by insisting the provider test for mpox or by going to a different provider. All case-patients said they perceived the vaccine to be effective and would recommend it to others.

Conclusion:
Key themes highlight the importance of ensuring clinicians’ awareness of a mpox virus infection irrespective of vaccination status and the importance of maintaining mpox on the differential diagnosis for rashes among persons with potential exposures. Understanding perceptions about vaccination among providers and patients with mpox, as well as patient experiences with medical care is critically important to informing prevention and control efforts.