Psychological Antecedents of Healthcare Workers towards Monkeypox Vaccination in Nigeria

Abstract

The ongoing monkeypox (MPX) outbreak has been declared a public health emergency of international concern. People in close contact with active MPX cases, including healthcare workers (HCWs), are at higher risk of virus acquisition since the MPX virus can be transmitted by skin contact or respiratory secretions. In this study, we aimed to assess the psychological antecedents of MPX vaccination among Nigerian HCWs using the 5C scale. We used an anonymous online cross-sectional survey to recruit potential participants using snowball sampling. The questionnaire aimed to assess the geo/socioeconomic features and the 5C psychological antecedents of vaccine acceptance (confidence, complacency, constraints, calculation, and collective responsibility). A total of 389 responses were included, with a median age of 37 years (IQR: 28–48), 55.5% males, and 60.7% married participants. Among the studied Nigerian HCWs, only 31.1% showed confidence in MPX vaccination, 58.4% expressed complacency towards vaccination, 63.8% perceived constraints towards MPX vaccination, 27.2% calculated the benefits and risks of vaccination, and 39.2% agreed to receive MPX vaccination to protect others. The determinants of MPX vaccine confidence were being single (OR = 5.07, 95% CI: 1.26–20.34, p = 0.022), a higher education level (with pre-college/high school as a reference, professional/technical: OR = 4.12, 95% CI: 1.57–10.73, p = 0.004, undergraduate: OR = 2.94, 95% CI: 1.32–6.55, p = 0.008, and postgraduate degree (OR = 3.48, 95% CI: 1.51–8.04, p = 0.003), and absence of chronic disease (OR = 2.57, 95% CI: 1.27–5.22, p = 0.009). The significant complacency predictors were having a middle-income (OR = 0.53, 95% CI: 0.33–0.89, p = 0.008), having a bachelor’s degree (OR = 2.37, 95% CI: 1.10–5.11, p = 0.027), and knowledge of someone who died due to MPX (OR = 0.20, 95% CI: 0.05–0.93, p = 0.040). Income was associated with perceived vaccination constraints (OR = 0.62, 95% CI: 0.39–0.99, p = 0.046). Participants aged 46–60 years had decreased odds in the calculation domain (OR = 0.52, 95% CI: 0.27–0.98, p = 0.044). Middle-income and bachelor degree/postgraduate education significantly influenced the collective responsibility domain (OR = 2.10, 95% CI: 1.19–3.69, p = 0.010; OR = 4.17, 95% CI: 1.85–9.38, p < 0.001; and OR = 3.45, 95% CI: 1.50–7.90, p = 0.003, respectively). An investigation of the 5C pattern-based psychological antecedents of MPX vaccination in a sample of Nigerian HCWs revealed low levels of vaccine confidence and collective responsibility with high levels of constraints and complacency. These psychological factors are recommended to be considered in any efforts aiming to promote MPX vaccination needed in a country where MPX is endemic.

Mpox in Nigeria: Perceptions and knowledge of the disease among critical stakeholders—Global public health consequences

“…The perception about mpox found in this study agrees with the report of Ghazy et al . [ 41 ] in which 58.4% of Nigerian health workers expressed complacency towards mpox vaccination. Although it is difficult to predict the exact reason for the mismatch between good knowledge and positive perception; it may not be unconnected with the facts that MPXV infection is a self-limiting disease and the West African clade largely responsible for the disease in Nigeria has a lower case fatality ratio [ 22 ].…”

Knowledge, Attitude and Conspiracy Beliefs of Healthcare Workers in Lebanon towards Monkeypox

“…Considering the survey timing (November–December 2022), this result shows that gaps in MPOX knowledge still exist despite the intensive awareness campaigns and the growing literature on MPOX prevention [ 2 , 10 , 42 ]. Previous studies showed variable levels of MPOX knowledge and attitude towards MPOX vaccination in different countries worldwide [ 23 , 26 , 37 , 39 , 43 , 44 , 45 , 46 ]. For example, a survey study among Italian physicians, which was conducted in May 2022, showed a generally favorable attitude towards MPOX vaccination [ 23 ].…”

“…For example, a survey study among HCWs in Czech Republic that was conducted in September 2022 showed that only 9% of the study sample agreed to receive MPOX vaccination [ 43 ]. Another recent study among Nigerian HCWs showed that only 31% of the study sample had confidence in MPOX vaccination [ 45 ]. The aforementioned study by Ghazy et al also showed complacency towards the disease can be an important factor in reluctance to receive MPOX vaccination [ 45 ].…”

“…Another recent study among Nigerian HCWs showed that only 31% of the study sample had confidence in MPOX vaccination [ 45 ]. The aforementioned study by Ghazy et al also showed complacency towards the disease can be an important factor in reluctance to receive MPOX vaccination [ 45 ]. In the current study, only 28% of the participants agreed that MPOX can cause death among the infected individuals, highlighting the widespread view of MPOX as a remotely dangerous disease.…”

Monkeypox Vaccine Acceptance among Ghanaians: A Call for Action

“…Unlike available tools that only implement the 3C model (confidence, complacency, and constraints), the 5C scale expands the measures’ effectiveness because it evaluates the five psychological antecedents that influence an individual’s vaccination decision as confidence, complacency, constraints, calculation, and collective responsibility [ 21 ]. The 5C has been extensively used before to assess VH toward influenzas [ 22 ], COVID-19 [ 23 ], and MPOX [ 24 ].…”