Mpox vaccine acceptance and its predictors among people who have risky sexual practices: A systematic review and meta-analysis

Acceptance of available mpox vaccines among high-risk groups with risky sexual exposure varies by country, complicating efforts to draw conclusions and design effective intervention strategies. Seventeen studies were reviewed using the Joanna Briggs Institute (JBI) appraisal checklist from various databases. Funnel plot and I2 test assessed publication bias and heterogeneity. DerSimonian and Laird random-effects model estimated the pooled mpox vaccine acceptance. Eggers and Beggs tests evaluated the small study effect, while subgroup and sensitivity analyses identified sources of heterogeneity. Globally, the pooled mpox vaccine acceptance rate among individuals with risky sexual practices was 75.22% (95% CI: 68.60, 81.84), indicating significant heterogeneity (I2 = 99.83%, p A PROSPERO registered systematic review and meta-analysis of literatures using PRISMA checklist on the global mpox vaccine acceptance and its predictors among people who have risky sexual practices. Vaccination is the key strategy, among multifaceted approaches, to ensure the safety of high-risk population groups, during outbreaks of international concern like mpox. However, vaccine acceptance among people who have risky sexual practices varies between nations. Therefore, making conclusions on their willingness to receive the mpox vaccine and designing intervention strategies is very difficult. The research team has used systematic collection and analysis of relevant findings reported by scholars globally to generate consolidated estimate of vaccine acceptance and identify influencing factors on which interventions are designed to increase vaccination coverage among people who have risky sexual practices. The total number of studies included in this review was 17, and all of them were conducted in countries where mpox cases are reported. Our analysis revealed that despite higher acceptance rates among people who have risky sexual practice, many remain hesitant, posing challenges for outbreak control. The current review identified and informed important focus areas of intervention including targeted vaccination campaigns and education on mpox vaccine.