Mpox vaccination willingness, determinants, and communication needs in gay, bisexual, and other men who have sex with men, in the context of limited vaccine availability in the Netherlands (Dutch Mpox-survey)

Abstract

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.

Perceptions and Intention to get vaccinated against Mpox among the LGTBIQ+ Community during the 2022 outbreak: A Cross-Sectional Study in Peru

“…This study was conducted before the start of targeted mpox vaccination in the Netherlands and included 394 MSM [29]. These ndings were in line with another Dutch study conducted around the early roll-out of pre-exposure mpox vaccination, which showed an 81.5% vaccination acceptance [20]. A large-scale European survey observed 85-90% (northern countries) and 83-88% (western countries) intention to get vaccinated.…”

“…There are few studies evaluating the association between the perception of safety and vaccination intent. In a study conducted in the Netherlands, it was reported that 45.1% of people eligible for pre-exposure vaccination (PPV) and 45% of people for non-pre-exposure vaccination (non-PPV) believed that the vaccine has no unpleasant adverse effects, and this factor increased the willingness to be vaccinated against mpox [20]. In a study conducted in Ghana on the general population, one of the main determinants of vaccine acceptance was con dence in the vaccine, which increased the odds of mpox vaccine acceptance (aOR: 2.45, 95% CI, 1.93-3.15, p < 0.001) [32].…”

“…Few studies have investigated the perception and acceptance of the vaccination against mpox in this high-risk group around the world. There is one study in the Netherlands in 2022 that reveals that 81.5% of gays, bisexuals, and MSM agreed with receiving the mpox vaccine [20] while another study made in China in the MSM population reports that 90,2% also agreed [21]. However, there are no studies in Latin America focusing on the acceptance of mpox vaccination in the MSM population, despite the high incidence reported in the Americas, making 87.8% of the cases worldwide by February 2023.…”

Perception of and Vaccine Readiness towards Mpox among Men Who Have Sex with Men Living with HIV in China: A Cross-Sectional Study

“…Similar to our findings, 59.8% of MSM living with HIV in France indicated their acceptance towards Mpox vaccination [ 41 ]. Dukers-Muijrers and colleagues found that 81.5% of the MSM surveyed in the Netherlands were willing to receive an Mpox vaccine [ 42 ]. However, the willingness rate of Mpox vaccination varied among different populations and regions [ 43 ].…”

Virus Identification for Monkeypox in Human Seminal Fluid Samples: A Systematic Review

“…Due to chronic underfunding, which has been exacerbated by the COVID-19 pandemic, sexual health clinics have served as a logical, low-barrier setting for individuals seeking MPX prevention. However, they may not be prepared for the challenge of responding to an emerging infectious disease while providing their usual services [ 58 ].…”