CDC’s Mpox Large Gatherings and Social Events Toolkit for Health Departments

Large gatherings and social events are great opportunities for people to connect and enjoy themselves. They are also places where attendees are crowded together, which can lead to close, prolonged, and frequent interactions between people. They may also be associated with behaviors, like meeting new sex partners, that can contribute to the spread of mpox. Large, social gatherings can also be an important opportunity to deliver and amplify public health messages and provide public health services.

This toolkit is designed to help organize events in a safe way and can be a starting point for conversations between local, tribal, state, and federal public health authorities, and event organizers and business owners. Your health department can play an important role in providing up-to-date information on mpox, offering resources and services including vaccination at local events, and acting as a hub to connect people and organizations.

Take Steps to Reduce the Spread of Mpox

Consider the following actions to reduce the spread of mpox in your area by joining forces with event organizers, local businesses, and other community organizations.

Disseminate Accurate Information

• Find up-to-date information on mpox at cdc.gov/mpox.
• Share mpox prevention messages with event organizers before, during, and after their Provide messages and content that are simple, available in the languages spoken in your community, and include visual content. The social media toolkit has sample posts about mpox testing, prevention, and treatment. Refer to CDC’s Safer Sex, Social Gatherings, and Mpox guidance.

Pre-event strategies and actions:

• Think about locations and venues where information can be shared, or services, such as mpox vaccination, offered. Is there one main event? Multiple events over many days? What side events may be taking place? What will attendees be doing when not at the event (e.g., shopping, dining, sightseeing, using public transportation)?
• Share information with these venues. Ask hotels to display information or include information in hotel rooms. Include information in registration packets, on registration websites or in email confirmations. Advertise on public transportation. Share information with local businesses.
• Design and print communication materials like flyers and palm cards in languages needed.
• Order materials and equipment needed to set up an information booth or vaccine tent at the event.
• Hold a town hall event with participating businesses to share the latest data on mpox and answer questions. Consider holding information sessions for different groups of businesses (e.g., hotels/housekeeping, bars/restaurants, commercial sex venues).
• Notify local healthcare providers about the event and provide a timeframe for when they may expect presentation of mpox symptoms in patients. Provide them with care and treatment guidance, vaccination information, and resources for laboratory testing.
• Share mpox information—including harm reduction messages—on health department websites and social media channels.
• Consider a health department booth/tent and consider choosing a location that allows for privacy and limiting stigma. You can set up signage to direct attendees to your booth/tent.
• At least 2–3 weeks before the event, work with the event organizers to promote the health department’s booth, tent, table, etc. at the event to encourage a good turnout. If you have a limited budget, consider social media, as well as flyers and posters, or local airtime on the radio. If you have a larger budget, consider paid ads on social media, Google, and radio or print ads in local newspapers or magazines.

During event:

• Staff an information booth at the event. Have experts on hand to answer questions. Make sure everyone working at your booth, tent, or table is prepared with talking points and messages. Also, make sure your team is prepared to answer questions about mpox vaccines, testing, prevention, treatment, and how to prevent stigma.

• Consider setting up a temporary mpox vaccination site at the event.
• Provide event-goers with materials like flyers and palm cards (in all languages you feel are needed), as well as condoms and hand sanitizer.
• Engage and involve event staff and volunteers. Make sure they know where you are located so they can easily direct event participants to you.
• Make your team comfortable. Consider bringing a speaker to play music and providing water, snacks, and chairs to make sure your team members and booth visitors enjoy the day.

Event Booth Logistics

• Arrive at the event site early to set up your booth. If people will be entering and moving around in your booth or tent, create an easy-to-navigate flow.
• Send messages to your volunteer staff to remind them of their shift, any location updates, and what they should bring.
• Have a staffing schedule that includes time slots, roles, and responsibilities.
• Display materials in a way that is organized and inviting.
• Note the starting totals of your inventory. At the end of the event, when you count how many are left, you’ll be able to report exactly how many you distributed.
• If possible, assign one person to orient volunteers as they arrive for their shifts. That person can remind the volunteers of their roles, talking points, and any other important information.
• If you are tracking the number of individuals you engage with at your booth, using clickers/counters can simplify this.

Engaging attendees

Here are some suggestions for making the most of your engagement.

• Introduce yourselves and describe your organization, share messages, and answer questions by providing mpox materials (such as palm cards) and information from your organization.
• Focus on making your interactions personal but also professional. Get to know people. Ask them questions. But remember to respect people’s personal space and privacy.
• Make your booth both fun and educational. Play music. Plan for educational games about mpox.

Post-event:

• After the event, provide event organizers with health information and guidance on how to recognize mpox symptoms and when to seek medical advice, and encourage them to share on their websites, social media accounts, and apps. Share the same information on health department websites and social media accounts.
• Remind healthcare providers about the event and to be alert to symptoms of mpox in their patients. Remind them of proper testing and treatment guidance. Provide a health department liaison to expedite testing and care for any suspected cases.
• Review what worked and what didn’t. Record lessons learned and recommendations for future events. See the Evaluate your Efforts section of this toolkit.
• Provide event organizers with information on how their guests can access health services in your area. Also, provide information on how event planners can connect out-of-town guests to health services in the areas where they live.
• If cases of mpox do arise, work with the event organizers and help them notify guests who may have been exposed. If attendees who have been diagnosed with mpox are not able to share contact information for their close contacts, advise them to notify their close contacts directly or ask a healthcare provider to do so anonymously.

Collaborate with other organizations

Pre-event:

• Engage with organizers of peripheral events, such as parties or club nights, and local businesses, such as hotels, bars, night clubs, saunas, and sex-on-premises venues. Encourage them to share and post mpox prevention messages.
• Where relevant, engage local community-based organizations to provide health information and guidance through their networks.
• Consider who will attend the event. Are they mostly local or do they come from across the country or around the world? If eventgoers are traveling from far away, collaborate with national organizations like the National Association of County and City Health Officials (NACCHO) and National Coalition of STD Directors (NCSD) to let other health departments from around the United States know about an upcoming event in your area. Health departments can then reach out to their local communities around education and vaccination promotion.

• Events are a good place to collect data from attendees about their knowledge and awareness of mpox and engagement in behaviors that increase risk for mpox, which can help inform future messages and prevention efforts.

• Consider reaching out to event organizers about hosting a vaccination site leading up to an event, at an event, or after an event. Share information on the locations of mpox vaccination sites in the state or local area.

During event:

• Share resources with organizers and partners on mpox testing, treatment, and vaccination.

Post-event:

• Remind healthcare providers to ask patients about attending the event and to be alert to symptoms of mpox in their patients. Remind them of proper testing and treatment guidance. Provide a health department liaison to expedite testing and care for any suspected cases.
• If cases of mpox that are associated with the event, work with the event organizers to notify participants about possible exposure. Provide information on where event attendees can go for testing and treatment.

Prevent and control mpox

Pre-event:

• Work with event organizers to encourage both doses of mpox vaccine at least 6 weeks before the event. Attendees should get the second dose 4 weeks after the first dose. It takes 2 weeks after the second dose to be the most protected.
• Ensure that event organizers provide sufficient hand-washing facilities and hand sanitizers.
• Ensure hand-washing facilities are available to participants, that they are located across the venue area, and that information is provided to alert attendees about where they can wash or sanitize their hands.
• Encourage alcohol-based hand sanitizer at multiple sites across the venue, particularly near toilets and in food courts, or near food trucks.
• Share cleaning and disinfecting procedures with event organizers and management staff at local hotels or lodging venues. Specific information is available in CDC’s Disinfecting Home and Other Non-Healthcare Settings guidance.

During event:

• Recommend event organizers provide a dedicated and private space at event venues for attendees, volunteers, and staff who may start to show symptoms while they are attending the event. Event organizers should ensure proper medical assistance is available to those who develop symptoms.

Post-event:

• Work with organizers on how to properly clean and disinfect the premises and shared items.

Evaluate your efforts

Consider how you can measure your success and have a plan for evaluation. Try to align your goal with things you can measure, such as the number of people referred to your event booth or to clinical services.

Social Behavioral Information

Collecting information about mpox knowledge, awareness, and behaviors can help inform future messages and prevention efforts. Below are some examples of domains for data collection.

• Demographics
• Awareness of mpox
• Knowledge about symptoms, testing, treatment, vaccines, etc.
• Behaviors including engagement in behaviors that increase and decrease risk

Reporting Metrics

Capturing and reporting on your activities can inform efforts. Below are some possible metrics you could report.

• Number of people engaged
• Number of materials distributed
• Number of staff/volunteers on the ground daily
• Number of tests administered
• Number of on-site vaccines administered
• Number of social media engagements
• Number of partner organizations who visited your booth
• Anecdotes from attendees

Appendix

Examples of Mpox Messages to Share

Key Messages—Pre-event:

• Mpox cases in the United States are down dramatically since the peak in the summer of 2022. This progress is due to the close collaboration between the LGBTQ+ community and public health organizations. Data show that gay, bisexual, and other men who have sex with men, as well as transgender and gender diverse people, changed behaviors to reduce the risk of getting mpox.
• Even though cases are down, the potential for mpox exposure and future outbreaks remain a concern. Let’s continue to protect our communities.
• You can protect yourself and other event goers by learning about and getting vaccinated for mpox before coming to [event name]. Go to [insert trusted source e.g., cdc.gov/mpox] to learn more.
• Mpox vaccines have also been effective in reducing the spread of mpox. Many people got the mpox vaccine, which is effective at reducing the risk of getting mpox.
  • A CDC study found that there were 10 times more mpox cases in unvaccinated people compared to fully vaccinated people.

• You can protect yourself and other event goers by learning about and getting vaccinated for mpox before coming to [event name]. Go to [insert trusted source,g., www.cdc.gov/mpox ] to learn more.
• Getting two doses of the mpox vaccine before you are exposed to mpox provides the best chance to prevent disease.
• Get your second dose. Even if you received your first mpox vaccine dose months ago, you can and should get your second dose now.
• More than 1 million mpox vaccine doses have been given in the United States with no new or unexpected safety concerns.
• You have a choice! You can choose if you want an intradermal or a subcutaneous shot.
• Mpox is often transmitted through close, sustained physical contact, almost exclusively through sexual contact in the current outbreak. Learn more about protecting yourself.
• Symptoms of mpox may include flu-like illness with fever, headache, muscle aches, exhaustion, and enlarged lymph nodes. A characteristic rash, which can appear like blisters or pimples, occurs a few days later. Some people get a rash first, followed by other symptoms. Others only experience a rash.
• If you have symptoms, do not travel until you confirm you do not have mpox.
• If you feel sick or have a new or unexplained rash, do not attend [event name], and see a healthcare provider.
• To help protect you and your community, follow the recommended prevention steps and get vaccinated if you were exposed to mpox or are at higher risk of being exposed to the virus.

Key Messages—During event:

• If you notice a new or unexplained rash or other mpox symptoms while at [event name], avoid close, skin-to-skin contact with other eventgoers and go directly to [designated private space at event venue where people can go if they start to show symptoms].
• We hope you are having a great time at [event name]. Remember, if you feel sick or have a new or unexplained rash, talk to a healthcare provider right away.
• Symptoms of mpox may include flu-like illness with fever, headache, muscle aches, exhaustion, and enlarged lymph nodes. A characteristic rash, which can appear like blisters or pimples, occurs a few days later. Some people get a rash first, followed by other symptoms. Others only experience a rash.
• Consider minimizing skin-to-skin contact (including kissing, hugging, cuddling, or having sex) with someone with mpox and avoid contact with any rash you see on others.
• Wash your hands often with soap and water or use an alcohol-based hand sanitizer, especially before eating or touching your face and after you use the bathroom.
• Even if you feel well, here are some ways to reduce your chances of being exposed to mpox if you are sexually active:
  • Take a temporary break from activities that increase exposure to mpox until two weeks after your second vaccine dose. This will greatly reduce your risk.
  • Limit your number of sex partners to reduce your likelihood of exposure.
  • Talk with your partner about any mpox symptoms and be aware of any new or unexplained rash or lesion on either of your bodies. If you or your partner has or recently had mpox symptoms or you have a new or unexplained rash anywhere on your body, do not have sex and see a healthcare provider. In some cases, symptoms may be mild, and some people may not even know they have mpox.
  • Be aware that mpox can also spread through respiratory secretions with close, face-to-face contact.
  • Remember to wash your hands, fetish gear, sex toys, and any fabrics (bedding, towels, clothes) after having sex. Learn more about infection control.

Remember to include information on how participants should access health services if they think they have mpox symptoms.

Key Messages—Post-event:

• We hope you had a great time at [event name]. Remember, if you feel sick or have a new or unexplained rash, talk to a healthcare provider right away.
• Symptoms of mpox may include flu-like illness with fever, headache, muscle aches, exhaustion, and enlarged lymph nodes. A characteristic rash, which can appear like blisters or pimples, occurs a few days later. Some people get a rash first, followed by other symptoms. Others only experience a rash.
• If you have been exposed to mpox but do not have symptoms, speak to your healthcare provider or health department about getting the vaccine.
• If you have symptoms of mpox, you should talk to your healthcare provider, even if you have been vaccinated.
• If you experience mpox symptoms, you should talk to your close contacts right away. Think about the people you have had close, skin-to-skin, or sexual contact with, including people you met through dating apps.
• If a partner contacts you and tells you that you may have been exposed to mpox, monitor your body for mpox symptoms and be aware of any new or unexplained rash or lesion on either of your bodies. If you have a new or unexplained rash anywhere on your body, do not have sex and see a healthcare provider.
• Discuss vaccination options with your healthcare provider after known or presumed exposure to someone with mpox [i.e., post-exposure prophylaxis (PEP)], ideally within 4 days.
• Antiviral drugs used to treat mpox, such as tecovirimat (TPOXX), may be recommended for people who are more likely to get severely ill, like patients with weakened immune systems.
• Do not travel if you have mpox. Isolate at home or in another location until your symptoms are gone and your rash has healed; this means all scabs have fallen off and a fresh layer of skin has formed.
• If you have mpox and must travel:
  • Make sure that you do not have fever or respiratory symptoms such as sore throat, nasal congestion, or cough.
  • Cover your rash and wear a well-fitting face mask.