IntroductionIn the 2022 multicountry mpox (formerly named monkeypox) outbreak, several countries offered primary preventive vaccination (PPV) to people at higher risk for infection. We study vaccine acceptance and its determinants, to target and tailor public health (communication-) strategies in the context of limited vaccine supply in the Netherlands.MethodsOnline survey in a convenience sample of gay, bisexual and other men who have sex with men, including transgender persons (22/07-05/09/2022, the Netherlands). We assessed determinants for being (un)willing to accept vaccination. We used multivariable multinominal regression and logistic regression analyses, calculating adjusted odds ratios (aOR) and 95 percent confidence-intervals. An open question asked for campaigning and procedural recommendations.ResultsOf respondents, 81.5% (n = 1,512/1,856) were willing to accept vaccination; this was 85.2% (799/938) in vaccination-eligible people and 77.7% (713/918) in those non-eligible. Determinants for non-acceptance included: urbanization (rural: aOR:2.2;1.2–3.7; low-urban: aOR:2.4;1.4–3.9; vs. high-urban), not knowing mpox-vaccinated persons (aOR:2.4;1.6–3.4), and lack of connection to gay/queer-community (aOR:2.0;1.5–2.7). Beliefs associated with acceptance were: perception of higher risk/severity of mpox, higher protection motivation, positive outcome expectations post vaccination, and perceived positive social norms regarding vaccination. Respondents recommended better accessible communication, delivered regularly and stigma-free, with facts on mpox, vaccination and procedures, and other preventive options. Also, they recommended, “vaccine provision also at non-clinic settings, discrete/anonymous options, self-registration” to be vaccinated and other inclusive vaccine-offers (e.g., also accessible to people not in existing patient-registries).ConclusionIn the public health response to the mpox outbreak, key is a broad and equitable access to information, and to low-threshold vaccination options for those at highest risk. Communication should be uniform and transparent and tailored to beliefs, and include other preventive options. Mpox vaccine willingness was high. Public health efforts may be strengthened in less urbanized areas and reach out to those who lack relevant (community) social network influences.

Introduction. In the global monkeypox outbreak primary preventive vaccination is offered to people at higher risk for infection. We study vaccine acceptance and its determinants, to target and tailor public health (communication-)strategies in the context of limited vaccine supply in the Netherlands. Methods. Online survey in a convenience sample of gay, bisexual and other men who have sex with men, including transgender persons (22/07-05/09/2022, the Netherlands). We assessed determinants (sociodemographic, social environment, medical, and behavioral factors, and beliefs) for being (un)willing to accept vaccination. We used multivariable multinominal regression and logistic regression analyses, calculating adjusted odds ratios (aOR) and 95 percent confidence-intervals. An open question asked for campaigning and procedural recommendations. Results. Of respondents, 81.5% (n=1,512/1,856) were willing to accept vaccination; this was 85.2% (799/938) in vaccination-eligible people (HIV-PrEP use, living with HIV, STI, or >3 partners) and 77.7% (713/918) in those non-eligible. Determinants for non-acceptance included: urbanization (rural: aOR:2.2;1.2-3.7; low-urban: aOR:2.4;1.4-3.9; versus high-urban), not knowing monkeypox-vaccinated persons (aOR:2.4;1.6-3.4), and lack of connection to gay/queer-community (aOR:2.0;1.5-2.7). Beliefs associated with acceptance were perception of higher risk/severity of monkeypox, higher protection motivation, positive outcome expectations post vaccination (effectiveness and side-effects), and perceived positive social norms regarding vaccination of their social network. Respondents recommended more accessible communication, delivered regularly, stigma-free, sex positive and with facts on monkeypox, vaccination benefits and procedures, and explain (other) preventive options. For vaccination, it was recommended to add self-registration, provision also at non-clinic settings, discrete/anonymous options, and more inclusive strategies to reach people (e.g., those not in existing patient-registries) at high risk for monkeypox. Conclusion. In the public health response to the monkeypox outbreak, key is a broad and equitable access to information, and low-threshold vaccination options for those at highest risk. Communication should be transparent and tailored to beliefs, such as perceived risks of monkeypox, benefits of vaccination, and social norms, and should include other preventive options. Public health efforts may be strengthened in less urbanized areas and reach out to those who lack relevant social network influences.

Background This study aimed to identify differences and similarities among adolescents and parents in various psychosocial factors influencing meningococcal ACWY (MenACWY) vaccination acceptance. Besides, the impact of the Covid-19 pandemic was assessed as well as resulting organizational adjustments. Methods We conducted a cross-sectional survey among adolescents that attended the appointment for the MenACWY vaccination in South Limburg between May and June 2020, and their parents. Independent t-tests and χ2 test were performed to explore differences in psychosocial and organisational factors between adolescents and parents. Results In total, 592 adolescents (20%) and 1197 parents (38%) filled out the questionnaire. Adolescents scored lower on anticipated negative affect towards MenACWY vaccination refusal [t (985.688) = − 9.32; ρ < 0.001], moral norm towards MenACWY vaccination acceptance [t (942.079) = − 10.38; ρ < 0.001] and knowledge about the MenACWY vaccination and meningococcal disease [t (1059.710) = − 11.24; ρ < 0.001]. Both adolescents and parents reported a social norm favouring accepting childhood vaccinations, but adolescent scored higher [t (1122.846) = 23.10; ρ < 0.001]. The Covid-19 pandemic did barely influence the decision to accept the MenACWY vaccination. Only 6% of the participants indicated that Covid-19 influenced their decision. In addition, the individual vaccination appointment was rated very positive. Most adolescents (71.5%) and parents (80.6%) prefer future vaccinations to be offered individually rather than having mass vaccinations sessions. Conclusions This study provides an indication of which psychosocial and organisational factors should be addressed in future MenACWY vaccination campaigns. Individual vaccination appointments for adolescents should be considered, taking the costs and logistical barriers into account.