In a recent study published in BMC Public Health, a group of researchers assessed the global prevalence and regional differences in the intention to receive the monkeypox (Mpox) vaccine through a systematic review and meta-analysis.
Study: Prevalence of intentions to receive monkeypox vaccine. A systematic review and meta-analysis. Image Credit: angellodeco/Shutterstock.com
Background
In the current public health scenario, preventing and controlling emerging infectious diseases, including Mpox, has become crucial. Immunization is a key strategy in mitigating the spread of such diseases and protecting community health.
Mpox, caused by the Mpox virus and belonging to the Poxviridae family, was once rare but has recently prompted a global health emergency due to its expanding reach. With a mortality rate between 1 to 10%, understanding public willingness to vaccinate against Mpox is vital.
Various factors, including sociodemographic and psychological aspects, influence vaccine acceptance.
Further research is needed to understand the complex factors influencing vaccine acceptance, thereby enhancing communication strategies and public health policies for better prevention and response to Mpox and future outbreaks.
About the study
The present research, registered in International Prospective Register of Systematic Reviews (PROSPERO) and adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist guidelines, included cross-sectional studies that focused on the prevalence of intent to vaccinate against Mpox, without imposing limitations on language, time period, or geographic location. Studies that were incomplete or deviated from the research objectives were excluded.
The research involved extensive database searches in Web of Science, PubMed, Scopus, Embase, and ScienceDirect, utilizing key terms such as “Mpox,” “monkeypox,” “vaccine,” and “attitude.”
This initial search and subsequent updates were conducted between July 1 and July 24, 2023. Using the Rayyan tool, duplicates were removed, and articles were preliminarily selected based on titles and abstracts, followed by full report reviews to ensure compliance with inclusion criteria.
The study focused on two main outcomes: the intention to vaccinate against Mpox and the refusal to vaccinate. These were assessed based on participant responses regarding their willingness or likelihood to be vaccinated or to refuse vaccination.
The quality of the included studies was evaluated using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) method by two independent researchers, with discrepancies resolved by a third investigator.
Data from selected articles were carefully extracted by two researchers, including details such as publication year, country, sample size, primary author, study population, gender, prevalence of intent and refusal to vaccinate, survey type, and data collection date. A third researcher verified this data for accuracy.
Data analysis was performed using R software. Estimating the joint prevalence of vaccination intent employed a random-effects model with inverse variance weighting.
Heterogeneity among studies was assessed using the Cochrane Q statistic and I2 index, and publication bias was examined using funnel-shaped graphs and Egger’s regression test.
Subgroup analyses were based on the study population and continent, with pooled prevalence of vaccination intent presented in forest plot format, including 95% confidence intervals.
Study results
The present comprehensive study, 4,950 articles were identified through systematic searches across five databases. After duplicates were removed, 4,586 articles remained, and a thorough evaluation was conducted on 60 full-text articles from which, ultimately, 29 studies met the eligibility criteria.
The included studies encompassed cross-sectional research articles from 19 countries, published between 2020 and 2023, involving 52,658 participants. Most participants were men, 84.59%, while women accounted for 15.26%.
The studies targeted various populations, including the general public, healthcare professionals, and the intersex (LGBTI) community, utilizing online surveys tailored for each group.
The quality of these cross-sectional studies was assessed using the JBI-MAStARI tool, revealing a high level of quality.
However, Egger’s test for evaluating publication bias suggested potential asymmetry in results due to a significant p-value of 0.0005, indicating that while wide differences in reported prevalence values were evident, publication bias could not be conclusively demonstrated.
The primary outcome, the prevalence of the intention to vaccinate against Mpox, was found to be 61% (95% CI: 53–69%; 52,658 participants; 29 studies; I2 = 100%), which varied by continent.
In Asian countries, the intention to vaccinate was 64% (95% CI: 53–74%; 13,883 participants; 17 studies; I2 = 99%), in African countries 43% (95% CI: 39–47%; 1,538 participants; 3 studies; I2 = 53%), in European countries 62% (95% CI: 45–78%; 35,811 participants; 6 studies; I2 = 99%), and in American countries 63% (95% CI: 32–89%; 1,426 participants; 3 studies; I2 = 99%).
Different vaccination intention prevalences were observed when analyzing the data based on the target population.
These figures highlighted significant variations in the willingness to vaccinate against Mpox among different continents and populations, demonstrating the importance of understanding regional and demographic factors in vaccine uptake strategies.
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