{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T21:20:58Z","timestamp":1769203258596,"version":"3.49.0"},"reference-count":35,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T00:00:00Z","timestamp":1700611200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>(1) Background: In 2022, monkeypox (Mpox) was declared a public health emergency. The European Medicines Agency has authorized the use of Imvanex\/Jynneos, a smallpox vaccine, for coverage against pox. Healthcare workers (HCWs) are all considered by the European Centre for Disease Prevention and Control to be at risk, but in Italy, vaccination was offered only to laboratory personnel. The present study aims to investigate smallpox vaccination coverage (VC) that provides protection against Mpox among HCWs in an Italian university hospital and to assess HCWs\u2019 attitudes towards the possibility of getting vaccinated against Mpox. (2) Methods: We conducted a cross-sectional survey. 336 HCWs from selected wards were asked to fill out a self-declaration to collect their sex, profession, ward, vaccination status, and attitude toward Mpox vaccination. (3) Results: 60.71% of HCWs involved provided the requested data; 38.7% of them were previously vaccinated against smallpox, which corresponds to 23.5% of the total HCWs in the wards considered. Considering those born before 1979 as vaccinated, VC increases from 23.5% to 41.7%; the percentage of HCWs who adhered to vaccination is 23%; laboratory technicians showed a lower willingness to be vaccinated. The ward with the highest willingness to vaccinate is proctological surgery. (4) Conclusions: Based on our experience, a variability in smallpox VC and in willingness to vaccination has emerged both among different job titles and age categories and across the wards analyzed. Additionally, our survey reveals that vaccination attitudes are higher among HCWs from wards that currently do not have free access to such vaccinations.<\/jats:p>","DOI":"10.3390\/vaccines11121741","type":"journal-article","created":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T08:47:43Z","timestamp":1700642863000},"page":"1741","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Evaluation of Smallpox Vaccination Coverage and Attitude towards Monkeypox Vaccination among Healthcare Workers in an Italian University Hospital"],"prefix":"10.3390","volume":"11","author":[{"given":"Sergio","family":"Scarinci","sequence":"first","affiliation":[{"name":"Occupational Preventive Medicine Ward, Azienda Ospedaliero-Universitaria Pisana, 56124 Pisa, Italy"},{"name":"Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8461-1527","authenticated-orcid":false,"given":"Martina","family":"Padovan","sequence":"additional","affiliation":[{"name":"Occupational Preventive Medicine Ward, Azienda Ospedaliero-Universitaria Pisana, 56124 Pisa, Italy"},{"name":"Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bianca","family":"Cosci","sequence":"additional","affiliation":[{"name":"Occupational Preventive Medicine Ward, Azienda Ospedaliero-Universitaria Pisana, 56124 Pisa, Italy"},{"name":"Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armando","family":"Petillo","sequence":"additional","affiliation":[{"name":"Occupational Preventive Medicine Ward, Azienda Ospedaliero-Universitaria Pisana, 56124 Pisa, Italy"},{"name":"Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vittorio","family":"Gattini","sequence":"additional","affiliation":[{"name":"Occupational Preventive Medicine Ward, Azienda Ospedaliero-Universitaria Pisana, 56124 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Cosentino","sequence":"additional","affiliation":[{"name":"Occupational Preventive Medicine Ward, Azienda Ospedaliero-Universitaria Pisana, 56124 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aldo","family":"Mignani","sequence":"additional","affiliation":[{"name":"Occupational Preventive Medicine Ward, Azienda Ospedaliero-Universitaria Pisana, 56124 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1330-3863","authenticated-orcid":false,"given":"Rudy","family":"Foddis","sequence":"additional","affiliation":[{"name":"Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Guglielmi","sequence":"additional","affiliation":[{"name":"Occupational Preventive Medicine Ward, Azienda Ospedaliero-Universitaria Pisana, 56124 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,22]]},"reference":[{"key":"ref_1","unstructured":"Shchelkunov, S.N., Marennikova, S.S., and Moyer, R.W. (2005). Orthopoxviruses Pathogenic for Humans, Springer. [1st ed.]."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"5077","DOI":"10.1016\/j.vaccine.2020.04.062","article-title":"Human monkeypox\u2013After 40 years, an unintended consequence of smallpox eradication","volume":"38","author":"Simpson","year":"2020","journal-title":"Vaccine"},{"key":"ref_3","unstructured":"(2023, June 07). Multi-Country Monkeypox Outbreak: Situation Update. Available online: https:\/\/www.who.int\/emergencies\/disease-outbreak-news\/item\/2022-DON393."},{"key":"ref_4","unstructured":"(2023, June 09). Joint ECDC-WHO Regional Office for Europe Mpox Surveillance Bulletin. Available online: https:\/\/monkeypoxreport.ecdc.europa.eu\/."},{"key":"ref_5","unstructured":"(2023, June 10). Communicable Disease Threats Report Week 23, 5\u201311 June 2023 ECDC. Available online: https:\/\/www.ecdc.europa.eu\/en\/publications-data\/communicable-disease-threats-report-5-11-june-2023-week-23."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"106960","DOI":"10.1016\/j.actatropica.2023.106960","article-title":"Challenges in the treatment and prevention of Monkeypox infection; a comprehensive review","volume":"245","author":"Nyame","year":"2023","journal-title":"Acta Trop."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2520","DOI":"10.3201\/eid2812.221343","article-title":"Possible Occupational Infection of Healthcare Workers with Monkeypox Virus, Brazil","volume":"28","author":"Salvato","year":"2022","journal-title":"Emerg Infect Dis."},{"key":"ref_8","unstructured":"(2023, June 09). Monkeypox Multi-Country Outbreak\u2013Second Update. Available online: https:\/\/www.ecdc.europa.eu\/en\/publications-data\/monkeypox-multi-country-outbreak-second-update."},{"key":"ref_9","unstructured":"European Centre for Disease Prevention and Control (ECDC) (2023, June 11). Risk Assessment: Monkeypox Multi-Country Outbreak. Stockholm: ECDC. Available online: https:\/\/www.ecdc.europa.eu\/en\/publications-data\/risk-assessment-monkeypox-multi-country-outbreak."},{"key":"ref_10","unstructured":"(2023, June 06). Public Health Considerations for Mpox in EU\/EEA Countries. Available online: https:\/\/www.ecdc.europa.eu\/en\/publications-data\/public-health-considerations-mpox-eueea-countries."},{"key":"ref_11","unstructured":"European Medicines Agency (EMA) (2023, June 05). EMA Recommends Approval of Imvanex for the Prevention of Monkeypox Disease. Amsterdam: EMA. Available online: https:\/\/www.ema.europa.eu\/en\/news\/ema-recommends-approval-imvanex-prevention-monkeypox-disease."},{"key":"ref_12","unstructured":"European Medicines Agency (EMA) (2023, June 07). Imvanex\u2013EPAR\u2013Product Information. Amsterdam: EMA. Available online: https:\/\/www.ema.europa.eu\/en\/medicines\/human\/EPAR\/imvanex."},{"key":"ref_13","unstructured":"(2023, June 02). Circolare 5 Agosto 2022\u2013Indicazioni ad Interim Sulla Strategia Vaccinale Contro il Vaiolo Delle Scimmie (MPX). Available online: https:\/\/www.epicentro.iss.it\/mpox\/documentazione-italia."},{"key":"ref_14","unstructured":"(2023, June 12). Decreto-Legge 26 Giugno 1981, n 334. Available online: https:\/\/www.normattiva.it\/uri-res\/N2Ls?urn:nir:::1981;334."},{"key":"ref_15","unstructured":"(2023, June 14). Decreto legislativo 81\/08, Articolo n 39, Available online: https:\/\/www.ispettorato.gov.it\/files\/2023\/03\/TU-81-08-Ed-Gennaio-2023.pdf."},{"key":"ref_16","unstructured":"(2023, June 14). Monkeypox Strategic Preparedness, Readiness, and Response Plan (SPRP). Available online: https:\/\/www.who.int\/publications\/m\/item\/monkeypox-strategic-preparedness--readiness--and-response-plan-(sprp)."},{"key":"ref_17","unstructured":"(2023, June 14). ECDC Highlights Measures to Mitigate Possible Increase in Mpox Cases During Spring and Summer. Available online: https:\/\/www.ecdc.europa.eu\/en\/news-events\/ecdc-highlights-measures-mitigate-possible-increase-mpox-cases-during-spring-and-summer."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Yih, W.K., Lieu, T.A., R\u00eago, V.H., O\u2019Brien, M.A., Shay, D.K., Yokoe, D.S., and Platt, R. (2003). Attitudes of healthcare workers in U.S. hospitals regarding smallpox vaccination. BMC Public Health, 3.","DOI":"10.1186\/1471-2458-3-20"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Ricc\u00f2, M., Ferraro, P., Camisa, V., Satta, E., Zaniboni, A., Ranzieri, S., Baldassarre, A., Zaffina, S., and Marchesi, F. (2022). When a Neglected Tropical Disease Goes Global: Knowledge, Attitudes and Practices of Italian Physicians towards Monkeypox, Preliminary Results. Trop. Med. Infect. Dis., 7.","DOI":"10.3390\/tropicalmed7070135"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1091267","DOI":"10.3389\/fpubh.2023.1091267","article-title":"Knowledge and attitudes of health care workers about monkeypox virus infection in Southern Italy","volume":"11","author":"Folcarelli","year":"2023","journal-title":"Front. Public Health"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Lulli, L.G., Baldassarre, A., Mucci, N., and Arcangeli, G. (2022). Prevention, Risk Exposure, and Knowledge of Monkeypox in Occupational Settings: A Scoping Review. Trop. Med. Infect. Dis., 7.","DOI":"10.3390\/tropicalmed7100276"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1016\/j.puhe.2015.02.031","article-title":"Occupational vaccination of health care workers: Uptake, attitudes and potential solutions","volume":"129","author":"Little","year":"2015","journal-title":"Public Health"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1016\/j.vaccine.2022.12.023","article-title":"Vaccination against influenza, measles, pertussis and varicella in workers in healthcare facilities in France: A national cross-sectional study in 2019","volume":"41","author":"Vaux","year":"2023","journal-title":"Vaccine"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3351","DOI":"10.1016\/j.vaccine.2018.04.044","article-title":"Attitudes, believes, determinants and organisational barriers behind the low seasonal influenza vaccination uptake in healthcare workers\u2013A cross-sectional survey","volume":"36","author":"Boey","year":"2018","journal-title":"Vaccine"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1136\/oemed-2011-100134","article-title":"Predictors of seasonal influenza vaccination among healthcare workers in hospitals: A descriptive meta-analysis","volume":"69","author":"Gefenaite","year":"2012","journal-title":"Occup. Environ. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2522","DOI":"10.1080\/21645515.2015.1082014","article-title":"Vaccination of healthcare workers: A review","volume":"11","author":"Haviari","year":"2015","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Scardina, G., Ceccarelli, L., Casigliani, V., Mazzilli, S., Napoletano, M., Padovan, M., Petillo, A., Sironi, D., Brilli, C., and Gattini, V. (2021). Evaluation of Flu Vaccination Coverage among Healthcare Workers during a 3 Years\u2019 Study Period and Attitude towards Influenza and Potential COVID-19 Vaccination in the Context of the Pandemic. Vaccines, 9.","DOI":"10.3390\/vaccines9070769"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"651100","DOI":"10.3389\/fpubh.2021.651100","article-title":"Antimeningococcal Vaccination Coverage Among Healthcare Workers in an Italian University Hospital","volume":"9","author":"Gattini","year":"2021","journal-title":"Front. Public Health"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.jhin.2022.09.010","article-title":"Attitudes towards monkeypox vaccination among healthcare workers in France and Belgium: An element of complacency?","volume":"130","author":"Dauby","year":"2022","journal-title":"J. Hosp. Infect."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e28294","DOI":"10.1002\/jmv.28294","article-title":"The willingness of Chinese healthcare workers to receive monkeypox vaccine and its independent predictors: A cross-sectional survey","volume":"95","author":"Hong","year":"2023","journal-title":"J. Med. Virol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1016\/j.cegh.2020.04.024","article-title":"Physicians\u2019 willingness to be vaccinated with a smallpox vaccine to prevent monkeypox viral infection: A cross-sectional study in Indonesia","volume":"8","author":"Harapan","year":"2020","journal-title":"Clin. Epidemiol. Glob. Health"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Riad, A., Drobov, A., Rozmarinov\u00e1, J., Drap\u00e1\u010dov\u00e1, P., Klugarov\u00e1, J., Du\u0161ek, L., Pokorn\u00e1, A., and Klugar, M. (2022). Monkeypox Knowledge and Vaccine Hesitancy of Czech Healthcare Workers: A Health Belief Model (HBM)-Based Study. Vaccines, 10.","DOI":"10.3390\/vaccines10122022"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Ghazy, R.M., Okeh, D.U., Sallam, M., Hussein, M., Ismail, H.M., Yazbek, S., Mahboob, A., and Abd ElHafeez, S. (2022). Psychological Antecedents of Healthcare Workers towards Monkeypox Vaccination in Nigeria. Vaccines, 10.","DOI":"10.3390\/vaccines10122151"},{"key":"ref_34","unstructured":"WHO (2011). Meningococcal vaccines WHO position paper. Wkly. Epidemiol. Rec., 86, 521\u2013540. Available online: https:\/\/www.who.int\/publications\/i\/item\/WER8647."},{"key":"ref_35","unstructured":"Italian Ministry of Health (2023, September 23). National Vaccination Prevention Plan 2017\u20132019, Available online: https:\/\/www.salute.gov.it\/imgs\/C_17_pubblicazioni_2571_allegato.pdf."}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/11\/12\/1741\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:27:12Z","timestamp":1760131632000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/11\/12\/1741"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,22]]},"references-count":35,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["vaccines11121741"],"URL":"https:\/\/doi.org\/10.3390\/vaccines11121741","relation":{},"ISSN":["2076-393X"],"issn-type":[{"value":"2076-393X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,22]]}}}