Decoding Vaccine Hesitancy in Mpox Across Multiple Middle Eastern Countries: Public Knowledge, Attitudes, Worry, Conspiracy Beliefs, and Acceptance

Background: The global outbreak of mpox (formerly known as monkeypox) has drawn significant attention due to its unexpected spread beyond endemic regions, including countries in the Middle East. However, public knowledge, attitudes, and perceptions toward the disease in this region remain underexplored. This study aimed to assess knowledge, attitudes, levels of worry, conspiracy beliefs, and vaccine acceptance regarding mpox among adults in the Middle East. Methods: A cross-sectional survey was conducted using purposive and snowball sampling methods. A total of 318 participants aged 18 years and above were recruited from outpatient departments and through social media platforms. The survey instrument included three sections: sociodemographic characteristics; knowledge, attitudes, and worry about mpox; and conspiracy beliefs and vaccine acceptance. Data were analyzed using SPSS version 27, applying descriptive statistics, Chi-square tests, and Pearson correlation analysis. Results: Nearly half of the participants (47.48%) demonstrated limited knowledge of mpox. Younger adults showed comparatively lower knowledge levels and higher levels of worry than older age groups. Overall, positive attitudes toward mpox prevention were more prevalent than negative attitudes. However, conspiracy beliefs were notably present, particularly among younger participants. Vaccine acceptance was moderate, with 77.36% of respondents expressing neutral to positive attitudes toward vaccination. The findings indicate a significant knowledge gap and the presence of misinformation, particularly among younger adults. Conclusion: The results highlight gaps in public knowledge, mixed attitudes, and moderate vaccine acceptance regarding mpox in the Middle East. The presence of conspiracy beliefs underscores the importance of targeted public health strategies to improve awareness and combat misinformation. Strengthening educational and awareness campaigns is essential to enhance preparedness and response to potential future outbreaks.