Monkeypox awareness and low vaccination hesitancy among men who have sex with men in China

Abstract

Men who have sex with men (MSM) have been recommended for targeted monkeypox vaccination. We aimed to investigate monkeypox awareness and explore the correlates of monkeypox vaccination hesitancy among MSM in China. We conducted a cross‐sectional survey from August 10 to September 9, 2022. Awareness related to monkeypox and attitude toward monkeypox vaccination among MSM aged ≥18 years were collected. Multivariable logistic regression was applied to evaluate correlates of vaccination hesitancy. The discrepancy in awareness between subgroups regarding HIV status was assessed. A total of 1090 MSM were included (age: median 30 years, interquartile range [IQR], 25–35; HIV‐infected: 53.12%). Only 13.85% of respondents expressed high monkeypox vaccination hesitancy. Hesitancy was associated with no fixed income (adjuster odds ratio [aOR], 2.46, 95% confidence interval [CI], 1.48–4.11), infrequent information following (sometimes, 3.01, 1.55–5.83; seldom or never, 5.66, 2.58–12.45), and lack of worries about monkeypox endemic (1.78, 1.11–2.87). Participants who believed that HIV‐infected cases accounted for a smaller proportion (1.62, 1.01–2.60), disagreed that monkeypox virus could be detected in semen (2.21, 1.26–3.88), and considered either replication‐competent (1.84, 1.14–2.96) or replication‐deficient (4.80, 2.26–10.21) monkeypox vaccine unsuitable for HIV‐infected people were generally more hesitant. Compared with HIV‐uninfected MSM, HIV‐infected MSM supported more for vaccination promotion. MSM in China had low hesitancy toward monkeypox vaccination. Safety and affordability of vaccine and availability of information were essential aspects to reduce hesitancy. Education on vaccination benefits should be encouraged to promote future vaccination plans.

A Systematic Review on the Mental Health Status of Patients Infected With Monkeypox Virus

“…Li et al [ 25 ] emphasized the need for stringent measures, such as contact tracing and border control, to prevent epidemics. People in developing countries such as India and Bangladesh have also reported cases of MPX.…”

“…Chen et al [ 24 ] and Li et al [ 25 ] have reported poor knowledge of MPX disease in China and high acceptance of vaccination among male sex workers (MSW). The spread of the disease (55%) was reported in MSW, and the acceptability and availability of vaccinations contributed to reducing fear among them.…”

A cross-sectional investigation of factors influencing mpox vaccine hesitancy for students in Southwest China

“… 39 A recent study conducted in China specifically observed that MSM individuals infected with HIV displayed lower levels of vaccine hesitancy compared to their HIV-uninfected counterparts. 27 …”

“… 42–44 Furthermore, surveys which were conducted among MSM population and healthcare workers also demonstrated the lack of association between awareness of vaccine efficacy and mpox vaccine hesitancy. 27 , 37 It was believed that the outstanding performance in COVID-19 vaccine development increased the confidence in vaccines of the people, which further extended to mpox vaccination. 37 On the other hand, the low-level knowledge of mpox and low risk perception of mpox among the Chinese population may also weaken the relationship between awareness of vaccine efficacy and vaccine hesitancy.…”

“…The sample size was determined by referring to a previous cross-sectional study conducted in Chinese MSM population regarding mpox vaccine hesitancy. 27 The employed sample calculation formula was based on the equation n = Z 2 1−α/2 p (1 − p)/e 2 , where n represents the minimum required number of participants, p represents the vaccine hesitancy rate, and e represents the required accuracy. This study accounted for an estimated non-response rate of 10%.…”