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

In developed countries, vaccinations against hepatitis B (HBV), hepatitis A (HAV), and human papillomavirus (HPV) are often recommended to men who have sex with men (MSM) because of the risky sexual practices in which some engage. Vaccine coverage against these diseases is not optimal in France, probably due in part to vaccine hesitancy (VH). The overall aim of this survey among MSM was to estimate the prevalence of different grades of VH for these vaccines as well as of general VH (toward any vaccine). The specific objectives were to study the sociodemographic correlates of MSM specific and general VH and its association with vaccine uptake. A cross-sectional electronic survey (February–August 2022) collected information from 3,730 French MSM about their perceptions of HBV, HAV, and HPV and their related vaccines, to construct “specific VH” variables. Information about their past vaccination behaviors for any vaccine was used to construct a “general VH” variable, based on the World Health Organization definition. Almost 90% of MSM showed moderate or high specific VH for HBV, HAV, and/or HPV, and 54% general VH. A higher education level and comfortable financial situation were associated with lower grades of specific and general VH. Younger age was associated with less frequent specific VH and more frequent general VH. Specific VH, versus general, was more strongly associated with frequent self-reported non-vaccination against these three disease. Addressing their concerns about vaccines, improving their knowledge of vaccine-preventable sexually transmitted infections, and motivating them to get vaccinated are public health priorities.

Section: Discussioncontrasting

confidence: 65%

Gradient of vaccine hesitancy among French men having sex with men: An electronic cross-sectional survey in 2022

Brosset,

Fressard,

Cogordan

et al. 2023

“… 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 …”

Section: Discussionmentioning

confidence: 99%

“… 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.…”

Section: Discussionmentioning

confidence: 99%

“…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%.…”

Section: Methodsmentioning

confidence: 99%

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

Yang,

Jiang

et al. 2024

From July to September 2023, China reported over 1, 400 confirmed cases of mpox transmitted mainly through sexual contact between males. Meanwhile, the percentage of men who have sex with men at universities in southwestern China is increasing every year, which is likely to lead to a potential spread of mpox on campuses. Vaccination is an effective preventive measure against infectious diseases, this study examined the willingness of university students in Southwest China to receive the mpox vaccine and analyzed the factors influencing their decision. A cross-sectional survey was conducted among 7311 university students from 10 universities in Southwest China between August 13 and September 1, 2023. The survey revealed a hesitancy rate of 56.13% toward the mpox vaccine, with the most common reason being concerns about vaccine safety (1407/4104, 34.29%). Univariate analysis identified 13 variables that significantly differed between the vaccine acceptance and vaccine hesitancy groups. Multivariate logistic regression analyses indicated protective factors for vaccine hesitancy, such as sexually transmitted diseases, previous knowledge about mpox, frequent information about mpox, people can get reinfection of mpox, and worries about mpox endemic in China. Additionally, the confidence and convenience dimensions in the 3Cs model were identified as risk factors for mpox vaccine hesitancy. This study found a high rate of vaccine hesitancy among university students in Southwest China regarding the mpox vaccine. Collaboration between university and healthcare departments is recommended to address mpox vaccine hesitancy among college students, thereby promoting their willingness to receive the mpox vaccine.

“…Li et al found that PLWH expressed support for mpox vaccination promotion among MSM. 29 Third-generation mpox vaccines were safer for use in immunocompromised populations. 21 The vaccine effectiveness of the third-generation smallpox vaccine (MVA-BN) against mpox was 87% for one-dose vaccination and 89% for two-dose vaccination.…”

Section: Discussionmentioning

confidence: 99%

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

Zheng,

Du,

Yang

et al. 2023

This anonymous cross-sectional study aimed to investigate the relationships between HIV infection and mpox-related focus issues among Chinese men who have sex with men (MSM). This study involved in 27 MSM social organizations and was conducted from July 31 to August 4, 2023. Mpox vaccination hesitancy was defined as the proportion of participants who expressed unwillingness to receive self-funded and free vaccines. Logistic regression models were employed to estimate odds ratios (OR) and 95% confidence interval (95%CI). Of 7196 MSMs, the prevalence of mpox differed between people living with HIV (PLWH) (1.04%, 20/1920) and people living without HIV (PLWoH) (0.55%, 29/5276) ( P = .037). However, after adjusting for all covariates, there was no significant association between HIV status and mpox (aOR = 1.17; 95%CI = 0.58, 2.39; P = .658). Furthermore, the crude rates of vaccination hesitation (PLWoH: 5.91%, PLWH: 4.11%; P = .004) and consultation hesitation (PLWoH: 16.22%, PLWH: 10.78%; P < .001) were both lower in the PLWH. Compared with PLWoH, PLWH had lower odds ratios of vaccination hesitation (aOR = 0.70; 95%CI = 0.53, 0.92; P = .011) and consultation hesitation (aOR = 0.74; 95%CI = 0.60, 0.90; P = .003) among MSM. The estimate of association between HIV status and consultation hesitation was even smaller among MSM who reported hepatitis C infection or uncertainty (aOR = 0.30; 95%CI = 0.15, 0.56), compared with those without hepatitis C (aOR = 0.73; 95%CI = 0.60, 0.89) ( P for interaction = .037). MSM living with HIV in China demonstrated a greater willingness to accept mpox vaccination and medical consultation. In the future, it is recommended that medical institutions establish good medical environment to control the mpox epidemic, especially for PLWH.