News|Articles|January 3, 2025

Survey Reveals African Hesitancy to Get Mpox Vaccination

Over a third of respondents in 6 African countries were hesitant to get the vaccine themselves. And for parents, nearly 40% were reluctant to get their children immunized.

A new survey conducted amongst Africans across 6 countries found that 32.7% of respondents were hesitant to get vaccinated against mpox and for those who were parents, 38.9% were hesitant to get their children vaccinated.1

The results of the survey were published in eClinicalMedicine. “The weighted rates of mpox vaccination hesitancy among the six countries ranged from 21.9% (95% CI 17.5–26.9) to 47.1% (95% CI 41.5–52.8) for themselves and from 23.2% (95% CI 18.8–28.4) to 52.1% (95% CI 46.4–57.7) for children (both p < 0.0001),” the authors wrote.1

Additionally, the respondents who were the most hesitant were people with low vaccination readiness and no vaccination histories. Within these groups, 62.7% of respondents said they were hesitant to get the vaccine for themselves and for parents within these groups, 76.3% were reluctant to get their children vaccinated.1

This last point about vaccine hesitancy around parents to get their children immunized is particularly vexing as the authors point out that children are the most affected population related to mpox due to their high mortality rates.

The authors also noted that specific factors increased vaccine hesitancy. “We found that socioeconomic and sexual factors influenced hesitancy toward mpox vaccination. Populations with lower educational levels, those who were unemployed, unmarried individuals, those with lower household income levels, and individuals without children all exhibited higher rates of vaccination hesitancy,” they wrote.

The authors also point out the inconsistencies in the literature regarding vaccine hesitancy and socioeconomic factors and they write that the factors for this may include when the survey is taken and what population it is taken by.

Another factor may be where the surveys were conducted. The survey participants came from Uganda, Nigeria, Morocco, Egypt, Kenya, and South Africa. Interestingly, the survey did not include the Democratic Republic of Congo (DRC), which has been the epicenter of the outbreaks in recent years. The largest amount of reported cases of mpox have been seen in central and east Africa countries. The Centers for Disease Control and Prevention (CDC) posted the number of cases across each of the African countries. From January 1 -December 31, 2024, here are the confirmed cases and deaths throughout last year:

  • Egypt: no reported cases; no deaths
  • Kenya: 29 cases of Clade I; 1 death reported
  • Morocco: 3 cases of Clade II; no deaths reported
  • Nigeria: 167 cases of Clade II; no deaths reported
  • South Africa: 25 cases of Clade II; 3 deaths reported
  • Uganda: 1027 cases of Clade I; 1 death reported2

[To get a better understanding of the differences between clade I and clade II mpox, read this article.]

Of the surveyed countries, only Uganda has had over 1000 cases and South Africa has the highest mortality with 3 deaths.

The lack of cases and limited mortality may be factors in the public’s lack of awareness, and may bring about a diminished belief of the seriousness of the infectious disease.

References
1. Du M. et al. Mpox vaccination hesitancy, previous immunisation coverage, and vaccination readiness in the African region: a multinational survey. eClinicalMedicine.Volume 80Feb. 2025. DOI: 10.1016/j.eclinm.2024.103047
2. Clade I Mpox Outbreak Originating in Central Africa. CDC. December 31,2024. Accessed January 3, 2025. https://www.cdc.gov/mpox/outbreaks/2023/index.html

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