Determinants of Vaccine Uptake Against Mpox Among Key Populations in Goma-drc, 2024-2025

Background Mpox continues to pose a significant re-emerging health threat, especially among key population groups. In Goma, Democratic Republic of Congo, vaccine uptake within these communities has been notably high, despite the obstacles posed by ongoing humanitarian crises and widespread misinformation. This study sought to explore the sociocultural, organizational, and communication factors that contribute to this remarkable level of vaccination adherence. Methods Between September 2024 and January 2025, a cross-sectional study was carried out involving 420 participants from key populations including sex workers, men who have sex with men, transgender persons, and people who inject drugs across the Goma, Karisimbi, and Nyiragongo health zones. Data were gathered using structured questionnaires through proportional purposive sampling. Statistical analyses were performed in STATA and SPSS, applying logistic regression models with significance set at p ≤ 0.05. Results The study found an overall Mpox vaccine uptake of 81% among key populations. Key factors driving adherence included positive social acceptance (OR = 19.85), the influence of peer educators (OR = 42.91), viewing vaccination as a form of social protection (OR = 24.047), and the effect of information received (OR = 8.47). Intriguingly, certain beliefs traditionally deemed irrational such as perceiving Mpox as a community manipulation (OR = 84.9) were unexpectedly linked to higher vaccination rates. Engagement in welcoming health centers (99.7%) and living within 10 km of these facilities (82%) further facilitated uptake. Conversely, fear of side effects (43.8%) and insufficient information (28.7%) continued to hinder vaccination among those not yet immunized. Conclusion In Goma, vaccine adherence is shaped by community interactions, distinct cultural perceptions, and context-specific communication strategies. These findings underscore the importance of incorporating sociocultural approaches to enhance vaccination coverage, particularly in crisis-affected settings.