Risk Awareness as a Key Determinant of Early Vaccine Uptake in the Mpox Vaccination Campaign in an Italian Region: A Cross-Sectional Analysis

background: we aim to investigate attitudes toward vaccination by analyzing empirical factors associated with vaccine acceptance in the Lazio region mpox vaccination (MpoxVax) campaign in Italy. methods: all subjects who accessed MpoxVax and signed the informed consent were prospectively enrolled in the MPOX-VAC study and were asked to fill out an anonymous survey. two endpoints were selected: 'delayed acceptance' and 'early acceptance', defined as access for vaccination >60 and <= 30 days from the vaccination campaign starting (VCS), respectively. results: over the study period, 1717 individuals underwent vaccination: 129 (7%) > 60 [1588 (92.5%) <= 60] and 676 (60%) <= 30 days from VCS. a bisexual orientation, a lower education level and a worse perceived physical and mental health were associated with delayed access to vaccination. being pre-exposure prophylaxis (PrEP) users and, marginally, HIV positive; having a high perceived risk for mpox infection; and reporting high-risk behaviors like the use of recreational drugs/chems, sex under the influence of drugs and/or alcohol and having a higher number of principal sexual partners, were associated with early access to vaccination. conclusions: according to our data, risk awareness was a major determinant of early MpoxVax acceptance. conversely, worse perceived health status and a low educational level were critical factors associated with delayed vaccination.