Knowledge and attitudes toward mpox among the Lebanese population during the second wave and their attitudes toward vaccination

Mpox has spread beyond endemic regions, with cases reported in Lebanon. Public knowledge, perceptions, and vaccine acceptability may have evolved due to increased media coverage and global outbreaks. This study assesses the Lebanese population's knowledge and attitudes toward mpox during the second wave, as well as their willingness to receive the vaccine. A cross-sectional online survey was conducted among 2343 Lebanese residents. Participants' knowledge and attitudes were assessed using a 26-point knowledge index and a Likert scale via an online validated questionnaire. Multiple linear regression analyses identified determinants influencing knowledge, attitudes, and vaccine acceptance. The mean knowledge index for the second wave was 9.36 with a standard deviation (SD) of 6.76, showing no significant improvement from the first wave. Key predictors of higher knowledge included healthcare worker status and the presence of comorbidities, while reliance on social media was associated with lower scores. Attitudes remained stable and moderately positive (mean: 11.76, SD: 2.62), yet vaccine acceptance declined from 56.4% to 37.1%. A correlation matrix revealed a weak negative link between knowledge and attitude, and a modest positive association between attitude and vaccine acceptability. Hesitancy was highest among women and rural residents. Targeted public health strategies and trusted communication channels are needed to improve vaccine confidence.