{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:40:04Z","timestamp":1760060404407,"version":"build-2065373602"},"reference-count":65,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behavioral Sciences"],"abstract":"<jats:p>This study examines the evolution of willingness to accept the monkeypox (Mpox) vaccine in Romania between 2022 and 2025. It explores key sociodemographic and behavioral predictors of vaccine acceptance and investigates how public perceptions\u2014particularly concerning disease severity and conspiracy beliefs\u2014have shifted across two independent cross-sectional samples. Two nationally distributed surveys were conducted in July 2022 (n = 820) and January\u2013February 2025 (n = 1029), targeting Romanian residents aged 18 and above. Data were analyzed using descriptive statistics, Chi-square tests, Kolmogorov\u2013Smirnov tests, and a Random Forest classification model to assess the relative importance of predictors of vaccine acceptance. Between 2022 and 2025, vaccine acceptance increased modestly, particularly among individuals aged 36\u201365 and those with prior experience of voluntary or COVID-19 vaccination. Random Forest analysis identified behavioral factors as the strongest predictors of acceptance in both years, while the influence of education and gender varied over time. Belief in conspiracy theories slightly declined and lost predictive relevance by 2025. Perceptions of pandemic potential and fear of infection also decreased, suggesting reduced risk salience and possible pandemic fatigue. Despite a slight upward trend, overall Mpox vaccine acceptance in Romania remains among the lowest in Europe. These findings highlight the need for targeted public health communication, particularly toward skeptical or demographically vulnerable groups. Prior vaccination behavior emerged as a key driver of acceptance, indicating that trust-building strategies should capitalize on existing pro-vaccination habits. Future research should adopt qualitative and longitudinal approaches to better capture the evolving psychosocial dynamics of vaccine hesitancy.<\/jats:p>","DOI":"10.3390\/bs15091175","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T12:25:57Z","timestamp":1756470357000},"page":"1175","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Evolution of Monkeypox Vaccination Acceptance in Romania: A Comparative Analysis (2022\u20132025), Psychosocial Perceptions, and the Impact of Anti-Vaccination Rhetoric on Societal Security"],"prefix":"10.3390","volume":"15","author":[{"given":"C\u0103t\u0103lin","family":"Peptan","sequence":"first","affiliation":[{"name":"Faculty of Educational Sciences, Law and Public Administration, \u201cConstantin Br\u00e2ncu\u0219i\u201d University of T\u00e2rgu Jiu, 210185 T\u00e2rgu Jiu, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0440-127X","authenticated-orcid":false,"given":"Flavius Cristian","family":"M\u0103rc\u0103u","sequence":"additional","affiliation":[{"name":"Faculty of Educational Sciences, Law and Public Administration, \u201cConstantin Br\u00e2ncu\u0219i\u201d University of T\u00e2rgu Jiu, 210185 T\u00e2rgu Jiu, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1129-2793","authenticated-orcid":false,"given":"Olivia-Roxana","family":"Alecsoiu","sequence":"additional","affiliation":[{"name":"Faculty of Educational Sciences, Law and Public Administration, \u201cConstantin Br\u00e2ncu\u0219i\u201d University of T\u00e2rgu Jiu, 210185 T\u00e2rgu Jiu, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dragos Mihai","family":"Panagoret","sequence":"additional","affiliation":[{"name":"Faculty of Science and Engineering Alexandria\u2014Valahia University of T\u00e2rgovi\u0219te, 140003 Alexandria, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marian Emanuel","family":"Cojoaca","sequence":"additional","affiliation":[{"name":"National Health Insurance House (CNAS), Titu Maiorescu University, 040051 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alina Magdalena","family":"Musetescu","sequence":"additional","affiliation":[{"name":"Victor Babe\u0219 Hospital for Infectious and Tropical Diseases, 030303 Bucharest, Romania"},{"name":"Faculty of Medicine, Titu Maiorescu University, 040051 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0045-7847","authenticated-orcid":false,"given":"Genu Alexandru","family":"C\u0103runtu","sequence":"additional","affiliation":[{"name":"Faculty of Economics, \u201cConstantin Br\u00e2ncu\u0219i\u201d University of T\u00e2rgu Jiu, 210185 T\u00e2rgu Jiu, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alina Georgiana","family":"Holt","sequence":"additional","affiliation":[{"name":"Faculty of Educational Sciences, Law and Public Administration, \u201cConstantin Br\u00e2ncu\u0219i\u201d University of T\u00e2rgu Jiu, 210185 T\u00e2rgu Jiu, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramona Mihaela","family":"Nedelcu\u021b\u0103","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor","family":"Gheorman","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"},{"name":"Department of Psychiatry I, Craiova Clinical Neuropsychiatry Hospital, 200473 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,29]]},"reference":[{"key":"ref_1","first-page":"e8513","article-title":"Respondent-driven sampling: Advantages and disadvantages from a sampling method","volume":"21","author":"Bachelet","year":"2022","journal-title":"Medwave"},{"key":"ref_2","first-page":"132","article-title":"Consultare public\u0103 privind m\u0103surile COVID-19 luate de guvernul Rom\u00e2niei \u00een sectorul s\u0103n\u0103t\u0103\u021bii","volume":"11","author":"Badea","year":"2021","journal-title":"Ars Aequi"},{"key":"ref_3","unstructured":"B\u00e2rg\u0103oanu, A. 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