Leading by example: mpox vaccine attitudes and acceptability in nigeria's medical student community

The multi-country outbreak of Mpox has prompted the World Health Organisation to declare it a public health emergency of international concern. Considering the recent cases reported in Nigeria and the potential risk for medical students, this study investigated the awareness, attitude, acceptability, and willingness to pay for the Mpox vaccine among medical students in Northwest Nigeria. A cross-sectional survey was conducted among medical students across levels 100-600 at Bayero University Kano (BUK), Kano state, and Ahmadu Bello University (ABU), Zaria, Kaduna state, Northwest Nigeria. 301 responses were received using a convenience sampling approach. Data was collected via an online self-reported questionnaire, which included 6 items on socio-demographic data, 5 items on awareness, 6 items on attitude, 5 on acceptability, and 6 on willingness to pay (WTP). Data were presented as frequencies and percentages. The chi-square test and binary logistic regression were used to determine the predictive factors associated with WTP. A total of 301 medical students participated in this study. The majority were aged 21-25 years (n = 176, 58.6%) and male (n = 199, 66.1%). Bayero University Kano (BUK) contributed the largest proportion of respondents (n = 184, 61.1%), while 300 level students were the least represented (n = 25, 8.3%). With respect to religion and ethnicity, most participants identified as Muslim (n = 262, 87.0%) and Hausa (n = 168, 55.8%). Of 301 respondents, 203 (67.4%, 95% CI: 62.1% - 72.6%) were aware of the Mpox vaccine, and 95(31.6%) had a positive attitude towards vaccination. Vaccine acceptability was high, with 245 (81.4%, 95% CI: 77% - 85.6%) willing to be vaccinated against the disease. Willingness to pay (WTP) for the vaccine was significantly associated with age group (χ² (3) = 13.839, p = 0.003) and level of study (χ² (5) = 15.603, p = 0.008). Binary logistic regression identified three independent predictors of WTP: perceived affordability and accessibility (AOR = 0.379, 95% CI: 0.204-0.704, p = 0.002), awareness of vaccine significance (AOR = 0.444, 95% CI: 0.275-0.719, p = 0.001), and concern about side effects (AOR = 0.489, 95% CI: 0.244-0.979, p = 0.043). Despite high vaccine acceptability, financial barrier remains a key challenge to Mpox vaccine uptake among medical students in Northwest Nigeria. Targeted interventions addressing affordability, vaccine education, and safety communication are needed to improve willingness to pay and support vaccine uptake when the vaccine becomes widely available.