Mpox Vaccination Hesitancy and Its Associated Factors among Men Who Have Sex with Men in China: A National Observational Study

Abstract

More than 400 confirmed mpox cases have been reported in China. The mpox vaccination is crucial to mitigate mpox transmission, especially for at-risk populations. This study aimed to determine mpox vaccination hesitancy and its associated factors in Chinese men who have sex with men (MSM). This nationwide cross-sectional study was conducted among 7538 Chinese MSM in 27 MSM social organizations from 21 provinces, municipalities, and autonomous regions of China from 31 July to 4 August 2023. Of them, the rate of mpox vaccination hesitancy was 5.59% (421/7538). The most common reason for mpox vaccination hesitation was concerns of safety and side effects (62.71%, 264/421), followed by concerns of privacy (38.24%, 161/421), thoughts of impossible infection (37.53%, 158/421), no effectiveness in preventing reinfection (30.88%, 130/421), and no worry about infection (12.35%, 52/421). Regarding the concerning characteristics of the vaccines, concerns of vaccine safety ranked first (71.74%, 5408/7538), followed by vaccine effectiveness (14.05%, 1059/7538), vaccine costs (7.35%, 554/7538), and the continuity of vaccine effectiveness (3.91%, 295/7538). The highest odds ratio of mpox vaccination hesitation was seen in MSM who were infected with mpox virus (aOR = 2.38; 95%CI = 1.08, 5.23), followed by those aged ≥60 years (aOR = 2.25; 95%CI = 1.31, 3.88), those who were unemployed (aOR = 1.66; 95%CI = 1.25, 2.19), and those who had an education level of postgraduate and above (aOR = 1.55; 95%CI = 1.01, 2.37). However, MSM who had a higher level of mpox-related knowledge (moderate: aOR = 0.53; 95%CI = 0.36, 0.77; high: aOR = 0.30; 95%CI = 0.23, 0.40) had a lower odds ratio of mpox vaccination hesitation. MSM in China had low hesitancy toward mpox vaccination. The safety and effectiveness of the vaccine and privacy were important aspects of hesitancy. Health education on mpox-related knowledge should be encouraged to promote future vaccination plans.

Mpox patients' experience from infection to treatment and implications for prevention and control: A multicenter qualitative study in China

“…In addition, vaccines remain essential in disease prevention and control as an effective means of protection. Similar to previous research on mpox vaccine among MSM,56 we found that patients also expressed a strong desire for vaccines. This underscores the urgency of accelerating the introduction and development of vaccines.Our study has several limitations.…”

The prevalence of mpox and its association with sexual behavior among Chinese men who have sex with men in early August 2023

“…All participants were recruited and guided by training health staffs to confirm the accurate selection of participants and the completion of the questionnaire. The distribution of MSM social organizations is seen in Table 22 . Briefly, after excluded female respondents, we recruited participants who provided informed consent, identified as gay or bisexual, aged ≥18 years old, self‐reported having sex with at least one man in the past 12 months (anal sex, oral sex, hand sex, hugging, touching, kissing, etc.)…”

“…The distribution of MSM social organizations is seen in Table S1. 22 Briefly, after excluded female respondents, we recruited participants who provided informed consent, identified as gay or bisexual, aged ≥18 years old, self-reported having sex with at least one man in the past 12 months (anal sex, oral sex, hand sex, hugging, touching, kissing, etc.) and lived in mainland, China.…”

Lower rate of mpox vaccination hesitancy and medical consultation among Chinese men who have sex with men living with HIV in comparison with those living without HIV: A national observational study

“…The details were described in our previous study. 20 We recruited MSM who were at least 18 years old and reported engaging in sexual activities with at least one man in the past 12 months (including anal sex, oral sex, hand sex, hugging, touching, kissing, etc.) in mainland China.…”

“…In our previous study, we analyzed the factors that influenced mpox vaccination in PLWH and PLWoH. 20 However, we did not analyze the association between HIV status and hesitation toward mpox vaccination. PLWH may face greater challenges in receiving the mpox vaccine due to concerns about the safety of the vaccine in immunocompromised populations.…”