Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Nov 3, 2025
Date Accepted: Dec 30, 2025
Knowledge, Attitudes, Practices, and Vaccination Willingness Toward Mpox among Chinese Medical Students: A Cross-sectional Study
ABSTRACT
Background:
Monkeypox (mpox) 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 healthcare practitioners, remain lacking.
Objective:
This study aimed to investigate systematically the KAP and mpox vaccination willingness of Chinese medical students and identify the factors influencing their vaccination decisions.
Methods:
An anonymous self-designed questionnaire was used to assess basic information, KAP toward mpox, vaccination-related behaviors, and willingness. Data were analyzed using chi-square test, t-test, analysis of variance, Kruskal−Wallis H test, and multinomial logistic regression.
Results:
Among the 4,098 participants, 84.63% (3,468/4,098) accepted mpox vaccination. The median scores of KAP toward mpox were 43 (interquartile range [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 gender (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 gender (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).
Conclusions:
This study demonstrates high mpox vaccination acceptance among Chinese medical students. The identified influencing factors provide critical targets for developing targeted educational interventions and vaccination strategies, which are essential for enhancing preparedness against future mpox outbreaks and leveraging medical students’ role in public health promotion.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.