The Sexual Health Clinic Role in Vaccine and Treatment Access During the 2022 Mpox Outbreak in King County, Washington.

Background: Sexual health clinics (SHCs) were frontline providers in the 2022 US mpox public health response, although data on clinic-based mpox vaccine scale-up, diagnoses, and treatment are limited. We describe the role of a public health SHC in King County's mpox response between May 23, 2022, and October 31, 2022.
Methods: In July 2022, the SHC implemented a dedicated vaccine clinic and presumptive tecovirimat treatment (before laboratory confirmation) with on-site dispensation. We describe SHC's vaccine scale-up and contribution to clinical care by calculating the weekly number of vaccines administered by SHC and the total number of patients diagnosed and treated for mpox within SHC, and by comparing with countywide data. We calculated time from symptom onset to testing and time from testing to treatment, and assessed temporal changes in these metrics using linear regression.
Results: The SHC provided ≥1 vaccine doses to 7442 individuals (10,295 doses), administering 42% of the 24,409 vaccine doses provided countywide, with the greatest contribution in the first week of August (n = 1562, 58% of countywide vaccinations that week). Of 598 patients evaluated for mpox and tested, 178 (30%) tested positive (37% of countywide cases), and 152 (85% of SHC patients with mpox) received tecovirimat (46% of treatment countywide). Median time from symptom onset to testing decreased from 12 to 6 days ( P = 0.045); time from testing to treatment decreased from 4.5 to 0 days ( P < 0.001).
Conclusions: The SHC was central to mpox vaccination and treatment scale-up, particularly in the first months of the 2022 epidemic.
Competing Interests: Conflict of Interest and Sources of Funding: C.S.T., K.Z., S.O.H., N.O., and S.P. have no conflicts of interest to disclose. E.N.K. and E.J.C. have received Infectious Diseases Society of America travel grants to attend ID week. C.A.C. has received consultant fees from Roche Diagnostics. M.R.G. has received research support from Hologic and SpeeDx. M.S.R. received research funding from Nabriva unrelated to this work that has since ended. J.C.D. has conducted research with donated supplies from Hologic and Mayne Pharmaceuticals.
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