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Monkeypox Vaccination in Non-endemic Countries: Considerations for Public Health and...
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Monkeypox Vaccination in Non-endemic Countries: Considerations for Public Health and Policy

A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "Epidemiology".

Deadline for manuscript submissions: closed (31 August 2023) | Viewed by 11073

Special Issue Editor

Dr. Pietro Ferrara

E-Mail Website
Guest Editor
Center for Public Health Research, University of Milan-Bicocca, Via Pergolesi 33, 20900 Monza, Italy
Interests: epidemiology; public health; preventive medicine; vaccinology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

With the global rise in cases of monkeypox reported to the World Health Organization from multiple non-endemic member states, the disease was recently declared a global health emergency by the WHO International Health Regulations (2005) (IHR) Emergency Committee on 23 July 2022. While epidemiological investigations are still ongoing, vaccinia vaccines are being offered to people at major risk of infection and disease consequences, who currently include men who have sex with men, healthcare workers, and contacts of cases, with some differences according to the countries. Vaccination is also offered to individuals already exposed to monkeypox as post-exposure prophylaxis or a ring vaccination strategy.

With the start of vaccination campaigns, this Special Issue is intended to collect research articles and evidence summaries on this topic. Research areas may include (but are not limited to) the following:

  • Monkeypox vaccine acceptance, hesitancy, and refusal;
  • Monitoring of monkeypox vaccines, including safety, immunogenicity, and effectiveness, with assessments of differences according to the immune status of vaccines;
  • Policy issues, with reference to vaccine deployment, equitable access, and communication strategies for encouraging vaccine uptake.

Furthermore, as the monkeypox epidemiology evolves, other questions will arise.

Dr. Pietro Ferrara
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Vaccines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • monkeypox
  • monkeypox outbreak
  • vaccine uptake
  • vaccine acceptance
  • smallpox vaccine
  • immunogenicity
  • effectiveness
  • safety
  • vaccination policy
  • disease control
  • public health response
  • epidemiology

Published Papers (6 papers)

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Editorial

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3 pages, 196 KiB  
Editorial
Mpox Vaccination in Non-Endemic Countries: Considerations for Public Health and Policy
by Pietro Ferrara
Vaccines 2023, 11(9), 1406; https://doi.org/10.3390/vaccines11091406 - 23 Aug 2023
Viewed by 834
Abstract
The disease mpox (formerly monkeypox) is a zoonotic viral disease caused by a virus belonging to the Orthopoxvirus, the same genus as smallpox [...] Full article
(This article belongs to the Special Issue Monkeypox Vaccination in Non-endemic Countries: Considerations for Public Health and Policy)

Research

Jump to: Editorial

10 pages, 265 KiB  
Article
Evaluation of Smallpox Vaccination Coverage and Attitude towards Monkeypox Vaccination among Healthcare Workers in an Italian University Hospital
by Sergio Scarinci, Martina Padovan, Bianca Cosci, Armando Petillo, Vittorio Gattini, Francesca Cosentino, Aldo Mignani, Rudy Foddis and Giovanni Guglielmi
Vaccines 2023, 11(12), 1741; https://doi.org/10.3390/vaccines11121741 - 22 Nov 2023
Viewed by 765
Abstract
(1) Background: In 2022, monkeypox (Mpox) was declared a public health emergency. The European Medicines Agency has authorized the use of Imvanex/Jynneos, a smallpox vaccine, for coverage against pox. Healthcare workers (HCWs) are all considered by the European Centre for Disease Prevention and [...] Read more.
(1) Background: In 2022, monkeypox (Mpox) was declared a public health emergency. The European Medicines Agency has authorized the use of Imvanex/Jynneos, a smallpox vaccine, for coverage against pox. Healthcare workers (HCWs) are all considered by the European Centre for Disease Prevention and Control to be at risk, but in Italy, vaccination was offered only to laboratory personnel. The present study aims to investigate smallpox vaccination coverage (VC) that provides protection against Mpox among HCWs in an Italian university hospital and to assess HCWs’ attitudes towards the possibility of getting vaccinated against Mpox. (2) Methods: We conducted a cross-sectional survey. 336 HCWs from selected wards were asked to fill out a self-declaration to collect their sex, profession, ward, vaccination status, and attitude toward Mpox vaccination. (3) Results: 60.71% of HCWs involved provided the requested data; 38.7% of them were previously vaccinated against smallpox, which corresponds to 23.5% of the total HCWs in the wards considered. Considering those born before 1979 as vaccinated, VC increases from 23.5% to 41.7%; the percentage of HCWs who adhered to vaccination is 23%; laboratory technicians showed a lower willingness to be vaccinated. The ward with the highest willingness to vaccinate is proctological surgery. (4) Conclusions: Based on our experience, a variability in smallpox VC and in willingness to vaccination has emerged both among different job titles and age categories and across the wards analyzed. Additionally, our survey reveals that vaccination attitudes are higher among HCWs from wards that currently do not have free access to such vaccinations. Full article
(This article belongs to the Special Issue Monkeypox Vaccination in Non-endemic Countries: Considerations for Public Health and Policy)
17 pages, 852 KiB  
Article
Knowledge, Attitude and Worry in the Kurdistan Region of Iraq during the Mpox (Monkeypox) Outbreak in 2022: An Online Cross-Sectional Study
by Sirwan Khalid Ahmed, Salar Omar Abdulqadir, Rukhsar Muhammad Omar, Ardalan Jabbar Abdullah, Hawre Asaad Rahman, Safin Hassan Hussein, Halkawt Ismail Mohammed Amin, Deepak Chandran, Anil Kumar Sharma, Kuldeep Dhama, Malik Sallam, Harapan Harapan, Nader Salari, Chiranjib Chakraborty and Araz Qadir Abdulla
Vaccines 2023, 11(3), 610; https://doi.org/10.3390/vaccines11030610 - 08 Mar 2023
Cited by 13 | Viewed by 3074
Abstract
The rapid spread of monkeypox (mpox) has been declared as a public health emergency of international concern (PHEIC). The present study aimed to assess the knowledge, attitude, and worry levels of the general population in the Kurdistan region of Iraq regarding the ongoing [...] Read more.
The rapid spread of monkeypox (mpox) has been declared as a public health emergency of international concern (PHEIC). The present study aimed to assess the knowledge, attitude, and worry levels of the general population in the Kurdistan region of Iraq regarding the ongoing mpox multi-country outbreak. An online cross-sectional survey was conducted between 27–30 July 2022, using a convenience sampling method. The questionnaire was adapted from previous studies addressing the same topic. The independent Student’s t-test, one-way ANOVA, and logistic regression were used to assess possible factors associated with knowledge, attitude, and worry toward mpox. A total of 510 respondents were included in the final analysis. The participants showed a moderate level of mpox knowledge, a neutral attitude towards mpox, and a relatively moderate worry level. The logistic regression analysis showed that age, gender, marital status, religion, level of education, and place of residence were associated with mpox knowledge; however, the significant variables in the multivariate regression analysis were gender, religion, level of education, and residential area. Gender and residential area were associated with attitudes toward mpox; however, the significant variables in the multivariate regression analysis were gender and residential areas. The worry toward mpox was influenced by gender, marital status, religion, and place of residence, yet the significant variables in the multivariate regression analysis were gender, religion, educational level, and residential area. In conclusion, the Kurdish population had moderate knowledge, a neutral attitude, and a moderate level of worry about mpox. Considering the continuous rapid rise in mpox cases in several countries, and its possible risk as pandemic amid the ongoing COVID-19 pandemic, proactive control measures, adequate disease prevention strategies, and preparedness plans need to be formulated and immediately implemented to tackle the appearance of fears among people, and to safeguard the mental health of the public. Full article
(This article belongs to the Special Issue Monkeypox Vaccination in Non-endemic Countries: Considerations for Public Health and Policy)
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11 pages, 1693 KiB  
Communication
Estimating the Global Spread of Epidemic Human Monkeypox with Bayesian Directed Acyclic Graphic Model
by Ling-Chun Liao, Chen-Yang Hsu, Hsiu-Hsi Chen and Chao-Chih Lai
Vaccines 2023, 11(2), 468; https://doi.org/10.3390/vaccines11020468 - 17 Feb 2023
Cited by 5 | Viewed by 1319
Abstract
A “Public Health Emergency of International Concern (PHEIC)” monkeypox outbreak was declared by the World Health Organization on 23 June 2022. More than 16,000 monkeypox cases were reported in more than 75 countries across six regions as of July 25. The Bayesian SIR [...] Read more.
A “Public Health Emergency of International Concern (PHEIC)” monkeypox outbreak was declared by the World Health Organization on 23 June 2022. More than 16,000 monkeypox cases were reported in more than 75 countries across six regions as of July 25. The Bayesian SIR (Susceptible–Infected–Recovered) model with the directed acyclic graphic method was used to estimate the basic/effective reproductive number (R0/Re) and to assess the epidemic spread of monkeypox across the globe. The maximum estimated R0/Re was 1.16 (1.15–1.17), 1.20 (1.20–1.20), 1.34 (1.34–1.35), 1.33 (1.33–1.33) and 2.52 (2.41–2.66) in the United States, Spain, Brazil, the United Kingdom and the Democratic Republic of the Congo, respectively. The values of R0/Re were below 1 after August 2022. The estimated infectious time before isolation ranged from 2.05 to 2.74 days. The PHEIC of the global spreading of human monkeypox has been contained so as to avoid a pandemic in the light of the reasoning-based epidemic model assessment. Full article
(This article belongs to the Special Issue Monkeypox Vaccination in Non-endemic Countries: Considerations for Public Health and Policy)
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17 pages, 1298 KiB  
Article
Monkeypox Disease (MPOX) Perceptions among Healthcare Workers versus General Population during the First Month of the WHO Alert: Cross-Sectional Survey in Saudi Arabia
by Mohamad-Hani Temsah, Fadi Aljamaan, Shuliweeh Alenezi, Noura Abouammoh, Khalid Alhasan, Shereen A. Dasuqi, Ali Alhaboob, Mohammed A. Hamad, Rabih Halwani, Abdulkarim Alrabiaah, Sarah Alsubaie, Fatimah S. Alshahrani, Fahad AlZamil, Ziad A. Memish, Mazin Barry and Jaffar A. Al-Tawfiq
Vaccines 2022, 10(12), 2071; https://doi.org/10.3390/vaccines10122071 - 03 Dec 2022
Cited by 11 | Viewed by 2208
Abstract
Background: Monkeypox disease (MPOX) recently re-emerged in May 2022, causing international outbreaks in multiple non-endemic countries. This study demonstrates a novel comparison between the knowledge and perceptions of Saudi healthcare workers (HCWs) and the general public regarding MPOX. Methods: An online survey, conducted [...] Read more.
Background: Monkeypox disease (MPOX) recently re-emerged in May 2022, causing international outbreaks in multiple non-endemic countries. This study demonstrates a novel comparison between the knowledge and perceptions of Saudi healthcare workers (HCWs) and the general public regarding MPOX. Methods: An online survey, conducted from 27 May to 5 June 2022, assessing participants’ MPOX and monkeypox virus (MPV) knowledge in terms of transmission, vaccination, isolation precautions, and their attitudes toward seeking more information. Results: A total of 1546 members of the public and 1130 HCWs completed the survey. Briefly, 61.3% of the public and 74.2% of HCWs showed interest in seeking more information about MPOX. Both groups had average overall mean MPOX knowledge scores. Members of the public holding university degrees and those showing high levels of worry regarding MPOX had significantly higher knowledge scores. However, HCWs showed a poor vaccination knowledge score, while only 57% recognized that MPOX can present similarly to COVID-19 in the early stages. Female HCWs and those with high self-rated MPOX awareness had significantly high knowledge scores. HCWs in secondary and tertiary centers had significantly higher knowledge scores. Conclusion: Both groups showed a decent attitude in terms of seeking more MPOX knowledge, which correlated positively with their worry about and awareness of the disease. These observations are mostly as a consequence of the ongoing COVID-19 pandemic, which encouraged the public and HCW to acquire more information about any novel emerging disease. Policymakers should make the most of this attitude in their awareness campaigns to prevent the spread of the disease and encourage vaccination in cases where it is needed. The knowledge gaps among HCWs were most evident in terms of clinical presentation and vaccinations; this problem needs addressing if we are to avoid further emerging MPOX cases. Full article
(This article belongs to the Special Issue Monkeypox Vaccination in Non-endemic Countries: Considerations for Public Health and Policy)
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14 pages, 744 KiB  
Article
Monkeypox Vaccine Hesitancy in French Men Having Sex with Men with PrEP or Living with HIV in France
by David Zucman, Erwan Fourn, Pauline Touche, Catherine Majerholc and Alexandre Vallée
Vaccines 2022, 10(10), 1629; https://doi.org/10.3390/vaccines10101629 - 28 Sep 2022
Cited by 26 | Viewed by 2108
Abstract
People with pre-exposure prophylaxis (PrEP) or living with HIV are a high-risk population for monkeypox virus (MPXV) infection. It is important to achieve high MPXV vaccination coverage rates in this group. This project used self-reporting to assess vaccine hesitancy for the smallpox vaccine [...] Read more.
People with pre-exposure prophylaxis (PrEP) or living with HIV are a high-risk population for monkeypox virus (MPXV) infection. It is important to achieve high MPXV vaccination coverage rates in this group. This project used self-reporting to assess vaccine hesitancy for the smallpox vaccine and acceptance among men having sex with men with PrEP or living with HIV. In total, 52 (33.6%) participants among the 155 declared their hesitancy to be vaccinated against MPXV. Moreover, 20.7% patients with PrEP declared a hesitant attitude towards the smallpox vaccine compared to 40.2% of the HIV patients, p = 0.013. This difference remained not significant after adjustment for age (p = 0.119) and after adjustment for both age and number of different sexual partners (p = 0.406). Among PrEP people, those who expressed concerns about people getting more vaccines than needed (p = 0.012) were less likely to accept vaccination, whereas an increased number of different sexual partners during the previous month was significantly associated with acceptance of vaccination (p = 0.034). Among HIV people, those who expressed concerns about being infected by MPXV (p < 0.001), those who expressed that the smallpox vaccine should be compulsory for people at risk (p < 0.001) and those with an increased the number of different sexual partners the previous month (p = 0.018) were significantly associated with higher acceptance of MPXV vaccination. Our results suggest that vaccine strategy would be efficient in France with a communication strategy emphasizing the benefits of vaccination and the potential MPXV risk infection for health in PrEP and HIV people. Other preventive actions should be implemented, including reduction in sexual partners. Full article
(This article belongs to the Special Issue Monkeypox Vaccination in Non-endemic Countries: Considerations for Public Health and Policy)
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