Predictors of Willingness to Receive Monkeypox Vaccine in Palestine: A Cross-Sectional Study

Background/Objective: While no human monkeypox (MPXV) infections have been reported in Palestine, the rapid global increase in cases, including in neighboring countries, necessitates proactive public health preparedness. This study aimed to assess Palestinians' willingness to receive MPXV vaccination and to identify associated predictors in the context of a potential outbreak. Methods: A cross-sectional online survey was conducted in September 2024. The questionnaire gathered data on participants' sociodemographic characteristics, risk perceptions, Vaccine Trust Indicator (VTI) scores, vaccination history, and willingness to receive an MPXV vaccine. Bivariate analyses were performed using Pearson's chi-square test, and a multivariate logistic regression model was employed to identify the determinants of MPXV vaccination willingness. Results: The overall willingness to receive MPXV vaccination was low (28.8%). Key findings included significant public misconceptions and concerns: 33% of respondents believed that natural immunity from infection was sufficient, while 43% expressed concerns about potential adverse effects, similar to those associated with COVID-19 vaccines. Furthermore, nearly 60% of participants stated they would decline a free MPXV vaccine. Multivariate analysis revealed that prior COVID-19 vaccination (aOR = 3.07, p < 0.05), a moderate VTI score (aOR = 6.65, p < 0.05), and prior influenza vaccination (aOR = 4.00, p < 0.05) were significant predictors of MPXV vaccination willingness. Willingness to pay for the vaccine also positively influenced vaccination intent. One of the common misconceptions found was the belief that having received a smallpox vaccination prior reduces the need for an MPXV vaccination. Conclusions: The willingness to receive an MPXV vaccine in Palestine is suboptimal. Prior vaccination behaviors and general trust in vaccines are key determinants of acceptance. These findings underscore the critical need for public health strategies focused on strengthening trust in vaccine efficacy and safety, along with targeted health education to enhance community preparedness for a potential MPXV outbreak.