A study in Vaccine X presents a “comprehensive view of people’s opinions, fears, and behaviours” about mpox. The authors searched various sites for descriptive cross-sectional study designs from 2022 and 2023 addressing “knowledge, attitude, perception, preparedness, willingness to get vaccinated, and practices” against mpox infection. They conclude that there is a need to increase knowledge about mpox and spread awareness on the importance of preventive measures like vaccination.
Awareness, attitudes, and actions
“The public’s response to an epidemic is influenced by each person’s perceptions of the illness and their ability to change their behaviour as conditions change.”
The paper describes prevention and treatment of mpox as “challenging” in areas where it is endemic. Prevention measures include isolation and immunisation, with WHO recommending the use of MVA-BN or LC16 vaccines, or the ACAM2000 vaccine “when the others are not available”. Further preventive actions require “good understanding of the nature of the virus”. For example, environmental surveillance can identify the spread of pathogens within societies, shedding light on possible pathways of transmission.
A key challenge in controlling the spread of Mpox is a lack of knowledge in healthcare workers (HCWs).
“Therefore, there must be good awareness and appropriate attitudes and actions toward mpox among the HCWs and the general population.”
The study
The study was intended to provide an overview of “knowledge, attitudes, willingness to get vaccinated, level of awareness, worry, and perception of risk” among different populations. The researchers searched several databases in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Eligibility criteria included studies in any language, descriptive cross-sectional study designs conducted in 2022 and 2023, and studies addressing knowledge, attitude, perception, preparedness, willingness to get vaccinated, and practices against mpox infection. Studies measuring these outcomes were included through validated questionnaires. An overall score was calculated to determine the knowledge, attitude, perception, preparedness, worries, and practices as well as willingness to get vaccinated.
The search resulted in a total of 493 articles, reduced to 289 after the exclusion of duplicates. 37 articles were included in full-text screening, resulting in 30 eligible articles for the systematic review and meta-analysis. These were cross-sectional studies featuring healthcare workers (14), general population (10), medical students (4), and university students in different specialities (2).
Findings
The authors describe knowledge of the disease, attitudes to prevention, and intentions to follow advised practices as “major determinants” of the adoption of preventive measures. For many diseases for which vaccines currently exist, higher vaccination rates are “very important” to generate higher immunity rates. To create necessary demand, the authors highlight the need to develop safe and effective vaccines but also to “ensure that the necessary logistical issues, equitable distribution, and the population acceptance are addressed”.
The results show that “less than half had good knowledge, while the majority had good attitudes toward mpox”. Most respondents were willing to take the mpox vaccine, and the majority were reported to be aware of mpox. Less than half had worries and perception of risk toward mpox, and knowledge was highest in the general population, followed by HCWs. However, HCWs were the “most willing population” to be vaccinated against mpox.
Different characteristics had influences on knowledge about mpox but not always to the same effect; for example, “gender may have an impact on knowledge levels, but the direction of that influence may be determined by other factors, such as cultural or societal standards”. Although some studies suggested that “higher education levels and certain professional backgrounds were related with more knowledge”, professional experience was not always associated with high knowledge levels.
65% of participants expressed willingness to get vaccinated, which “can’t be considered a high percentage” as herd immunity demands more than 80% of population vaccination. A study that reported only 8.8% willingness for vaccination attributed this to “inadequate levels of factual knowledge”. Factors associated with not getting vaccinated were “various” including gender, age, income level, and education level.
Less than half of the participants were reported to be worried about mpox (42.7%), but one study found 33.2% of participants were more about mpox than COVID-19. Another study reported that male HCWs were “less worried” about mpox than females, medical students were “significantly more worried” compared to other participants, and HCWs who had experienced COVID-19 infection were “significantly less worried” about the mpox outbreak.
Conclusion
The paper concludes that mpox knowledge should be increased through awareness campaigns and social media. The importance of advice to take mpox vaccines is also highlighted, with a focus on vaccine efforts in “vulnerable groups”.
“If adequate management and prevention strategies are implemented in the early steps, the virus will be controlled adequately.”
After the declaration of mpox as a PHEIC in August 2024, how might these attitudes change? Do you think the study can be used to inform public awareness campaigns and vaccination drives? For more on encouraging vaccine confidence at the Congress in Barcelona this October get your tickets here, and don’t forget to subscribe to our weekly newsletters for the latest vaccine updates.
