Leading Where the Vaccine Had to Go: The Public Health Nurse's Role in a County's 2022 Mpox Vaccine Response
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Master of Science in Nursing Program, Aspen University
N680: Public Health Nursing
Instructor Name
Month Day, Year
Leading Where the Vaccine Had to Go: The Public Health Nurse's Role in a County's 2022 Mpox Vaccine Response
Public health nursing is often described in general terms: population focus, prevention, partnership. Those words become clearer when they are seen at work in a single event. In the summer of 2022, mpox spread rapidly in the United States, largely through close intimate contact among gay, bisexual and other men who have sex with men, and county health departments had to deliver a scarce two-dose vaccine to the people at highest risk in a matter of weeks. This paper uses that response, as it unfolded in a composite mid-sized county health department, to describe the public health nurse's role across the three core functions of public health and to show where nurses led rather than followed. It closes with what the response teaches about nursing leadership in population health.
The Core Functions as a Frame
The report that shaped modern public health practice in the United States described the mission of public health as making sure the conditions for good health exist, and gave government health agencies three core jobs: watching the community's health (assessment), turning evidence into plans and rules (policy development), and seeing that services are delivered (assurance) (Institute of Medicine, 1988). Residents ideally help shape the plans, and the services may come from the agency itself or from partners it funds or oversees. The ten essential public health services, whose 2020 revision placed equity as the organizing principle, break these jobs down further in more detail, and public health nurses work in every one of them (Centers for Disease Control and Prevention [CDC], 2025).
Assessment: Finding Who Was at Risk
When the first local cases were reported, the county's public health nurses carried out case interviews, identified close contacts and offered postexposure vaccination. Interviews were sensitive: they involved questions about sexual partners and venues, asked of men who had often experienced stigma in health care. Nurses trained in nonjudgmental interviewing obtained information that a form alone would not have yielded, and their notes showed that most cases were linked to a few social venues and to dating applications rather than to the general population.
National data soon confirmed a second pattern that the county's figures hinted at. By the end of 2022, nearly 30,000 cases had been reported in the United States, and at the peak in August the incidence among Black men was 6.9 times and among Hispanic men 4.1 times that among White men (Kota et al., 2023). The county's nurses compared local case counts with the demographic makeup of vaccine recipients each week and found the same gap: the men receiving vaccine were not the men getting sick. That comparison, a simple piece of population data work, became the basis for everything that followed.
Policy Development: Deciding Who Came First
Vaccine supply was limited, so the department had to decide who would be offered doses first. The initial approach, first come, first served through an online booking system, favored people with flexible jobs, reliable internet and prior contact with sexual health services. The nursing supervisor, drawing on the weekly comparison, proposed a change to the department's allocation policy: reserve a share of each week's doses for events organized with community partners serving Black and Hispanic men, and allow walk-up appointments without an online account. The proposal was brought to the health officer with data, not only with concern, and was adopted within a week.
When the federal government authorized intradermal administration of a smaller dose in August 2022, allowing up to five doses from a single vial, nurses also developed the local protocol, trained staff in the technique and wrote the script used to explain the change to people who had heard that the smaller dose was inferior. Policy in public health is often written by those closest to the work, and in this response it was written largely by nurses.
Assurance: Getting the Vaccine There
Assurance was the function in which nurses were most visible. The department's nurses staffed clinics at an LGBTQ community center, a Black Pride event, a Latino-serving clinic and two bars that agreed to host evening sessions. Each event was planned with a partner organization that recruited attendees, and bilingual nurses and peer volunteers answered questions about side effects, the second dose and privacy. Nurses followed up by text message to schedule second doses, since protection was substantially higher after two. In a national case-control study, adjusted effectiveness against medically attended mpox was 66.0% after two doses and 35.8% after one (Deputy et al., 2023).
The nurses also delivered prevention messages that avoided stigma. A national survey during the outbreak found that roughly half of men who have sex with men reported reducing numbers of partners, one-time encounters or use of dating applications because of mpox, and it recommended tailored, respectful harm reduction messages (Delaney et al., 2022). Nurses used that finding to frame education as supporting choices men were already making rather than as instructions.
Where Nurses Led
Three features of the response show public health nursing as leadership rather than task completion. First, nurses produced the evidence of inequity from routine data and brought it to decision makers. Second, they redesigned a policy, allocation, rather than only working harder within it. Third, they built relationships with community partners that outlasted the outbreak; the same partners later hosted HIV preexposure prophylaxis and sexually transmitted infection testing events. National figures illustrate why this leadership mattered. By the end of 2022, 43 White men had been vaccinated for every reported case among White men, compared with 17 Hispanic and 9 Black men for every case in their groups (Kota et al., 2023). Closing that gap depended on exactly the kind of targeted, partnership-based work the county's nurses had begun.
Lessons for Public Health Nursing Leadership
The response offers four lessons. Data become useful when a nurse turns them into a comparison that shows who is being missed. Equity requires changing systems, such as booking rules and clinic locations, not only adding outreach. Trust is built before an emergency, through relationships that nurses maintain in ordinary times. And nurses must be at the table where policy is made, since those who deliver services often see first where policy fails. These lessons apply equally to future responses, from new vaccines to heat emergencies.
Conclusion
The 2022 mpox vaccine response shows the public health nurse working across assessment, policy development and assurance: interviewing cases and reading population data, rewriting an allocation policy that favored the already advantaged, and carrying vaccine to the places where men at highest risk would accept it. The role is one of leadership grounded in data and relationships. For a nurse entering public health practice, the lesson is that the population focus is not a distance from individual patients but a way of seeing which patients the system is failing, and then changing the system.
References
Centers for Disease Control and Prevention. (2025). 10 essential public health services. https://www.cdc.gov/public-health-gateway/php/about/index.html
Delaney, K. P., Sanchez, T., Hannah, M., Edwards, O. W., Carpino, T., Agnew-Brune, C., Renfro, K., Kachur, R., Carnes, N., DiNenno, E. A., Lansky, A., Ethier, K., Sullivan, P., Baral, S., & Oster, A. M. (2022). Strategies adopted by gay, bisexual, and other men who have sex with men to prevent Monkeypox virus transmission: United States, August 2022. MMWR Morbidity and Mortality Weekly Report, 71(35), 1126-1130. https://doi.org/10.15585/mmwr.mm7135e1
Deputy, N. P., Deckert, J., Chard, A. N., Sandberg, N., Moulia, D. L., Barkley, E., Dalton, A. F., Sweet, C., Cohn, A. C., Little, D. R., Cohen, A. L., Sandmann, D., Payne, D. C., Gerhart, J. L., & Feldstein, L. R. (2023). Vaccine effectiveness of JYNNEOS against mpox disease in the United States. New England Journal of Medicine, 388(26), 2434-2443. https://doi.org/10.1056/NEJMoa2215201
Institute of Medicine. (1988). The future of public health. National Academies Press. https://doi.org/10.17226/1091
Kota, K. K., Hong, J., Zelaya, C., Riser, A. P., Rodriguez, A., Weller, D. L., Spicknall, I. H., Kriss, J. L., Lee, F., Boersma, P., Hurley, E., Hicks, P., Wilkins, C., Chesson, H., Concepción-Acevedo, J., Ellington, S., Belay, E., & Mermin, J. (2023). Racial and ethnic disparities in mpox cases and vaccination among adult males: United States, May-December 2022. MMWR Morbidity and Mortality Weekly Report, 72(15), 398-403. https://doi.org/10.15585/mmwr.mm7215a4
How this N 680 Module 1 example is structured
Aspen does not publish N680 module prompts, so check your classroom for the exact instructions. This example frames the role with the three core functions and the ten essential services, then follows one real outbreak through assessment, policy development and assurance, names where nurses led, and draws lessons for leadership.
N680 Module 1 questions, answered
What does N680 Module 1 usually ask for?
Aspen's description of N680 centers on the public health nurse's leadership role, so an opening paper on the role, the core functions and the essential services is a typical first assignment. Check your classroom for the prompt.
What are the three core functions of public health?
Assessment, policy development and assurance, defined in the Institute of Medicine's 1988 report The Future of Public Health and elaborated in the ten essential public health services.
Can I use one event to describe the public health nurse's role?
Yes, and it often makes a stronger paper. Tracing one response through the core functions shows specific nursing actions and decisions rather than a general list of duties.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Aspen University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.