An Ensemble Fuzzy-MCDM Approach for Evaluation of Approved Monkeypox Vaccines

Abstract Objective : Monkeypox, a disease caused by a deoxyribonucleic acid (DNA) based virus (MPXV) has posed global health challenges to the entire populace. MPXV is a zoonotic disease with public health concerns, rapid prevalence, and geographical spread resulting in swift preventive techniques, especially for vulnerable nations (population). Its incidence and global widespread have necessitated immediate intervention thus the use of vaccination. This study analyzed three globally recommended monkeypox vaccines, LC16m8, ACAM2000, and JYNNEOS, by assessing their safety and effectiveness in controlling monkeypox. Methods : Multi-criteria decision-making (MCDM) methods; the fuzzy Preference Ranking Organization Method for Enrichment Evaluations (fuzzy PROMETHEE) and the fuzzy Technique for Order Preference by Similarities to Ideal Solution (fuzzy TOPSIS), were applied for the evaluation of these vaccines considering 20 different criteria, mainly focusing on the route of administration, dosage, safety, adverse effects, affordability, and overall effectiveness of the vaccine. Results : LC16m8 ranked the most preferable vaccine from both MCDM methods with a net outranking flow of 0.4365 and Closeness coefficient value of 0.7916 (95% CI, 0.242-0.894). In terms of safety, both LC16m8 and JYNNEOS vaccines showed equal performance in their profiles mostly in vulnerable populations like human immunodeficiency virus-positive populations, pregnant women, and children, as well as cardiovascular disease patients. Conclusion : The MCDM models could be flexibly applied to other areas of public health as it has shown their reliability in assessing the monkeypox vaccines and can provide a decision guide for different health policy agencies.