Knowledge, Attitudes, Practices, and Vaccination Willingness Toward Mpox (Monkeypox) Among Chinese Medical Students:...

Mpox (monkeypox) remains a global public health threat. However, data on mpox-related knowledge, attitudes, and practices (KAP) and vaccination willingness among Chinese medical students, who are key future health care practitioners, remain lacking.

This study aimed to investigate systematically the KAP and mpox vaccination willingness of Chinese medical students and identify the factors influencing their vaccination decisions.

A nationwide cross-sectional survey was conducted from November 2023 to March 2024. An anonymous self-designed questionnaire was used to assess basic information, KAP toward mpox, vaccination-related behaviors, and willingness. Categorical data were presented as frequency (constituent ratio). The normality of continuous variables was assessed using the Kolmogorov-Smirnov test. Continuous variables that did not conform to a normal distribution were presented as median (IQR). Data were analyzed using the chi-square test, 2-tailed t test, ANOVA, Kruskal-Wallis H test, and multinomial logistic regression.

Among the 4098 participants, 84.63% (n=3468) accepted mpox vaccination. The median scores of KAP toward mpox were 43 (IQR 33-50), 33 (IQR 32-36), and 20 (IQR 19-24), respectively, with a median score of 73 (IQR 68-79) for vaccination-related practices. Multinomial logistic regression showed that factors associated with vaccination hesitancy (vs acceptance) included male individuals (odds ratio [OR] 1.416, 95% CI 1.158-1.732), being an only child (OR 1.340, 95% CI 1.098-1.635), no history of COVID-19 in family or friends (OR 1.520, 95% CI 1.161-1.991), no influenza vaccination (OR 1.429, 95% CI 1.146-1.783), and low mpox knowledge (OR 0.948, 95% CI 0.941-0.955). Factors associated with vaccination rejection (vs acceptance) included male sex (OR 1.641, 95% CI 1.003-2.686), high academic grade (OR 1.442, 95% CI 1.154-1.802), family or friends working on COVID-19 frontlines (OR 2.243, 95% CI 1.337-3.764), no internship experience (OR 2.049, 95% CI 1.076-3.901), presence of organic diseases (OR 3.733, 95% CI 1.778-7.838), and low mpox knowledge (OR 0.954, 95% CI 0.938-0.971). Good self-reported health status was a protective factor against refusal (OR 0.748, 95% CI 0.580-0.965).

The high willingness to receive mpox vaccination among Chinese medical students and its determinants, as identified in this study, carry clear implications for both education and policy. These findings inform the design of targeted health education programs for students and guide the development of evidence-based prevention strategies on campuses during public health emergencies.