Mpox knowledge, anxiety, and preventive behaviours in Jordan: a socio‑ecological perspective on vaccination and preparedness

Understanding how Jordanians perceive and respond to Mpox threat is vital for preventing future outbreaks. This study aims to assess the levels of Mpox-related knowledge, anxiety, and preventive behaviours among Jordanian adults, as well as to examine their willingness to accept Mpox vaccination. This is a cross-sectional questionnaire-based study that was carried out among adults in Jordan between July and November 2025. Composite knowledge, anxiety, and preventive practice scores were calculated by summing item responses. Scores were summarised using medians and interquartile ranges (IQRs). The study included 819 participants, of which 305 (37.2%) were adults aged 18-24 and 549 (67.0%) were females. The knowledge and anxiety median scores were 9 (IQR: 8-10) and 8 (IQR: 5-11), respectively. Having higher knowledge (coefficient = 0.120, 95% CI 0.082-0.158) and anxiety scores (coefficient = 0.090); not receiving a monkeypox Mpox vaccine compared to being vaccinated (coefficient = -1.247); and being 18-24 years old compared to those older than 65 (coefficient = -0.734) were statistically associated with differences in preventive‑measures scores. Our sample demonstrated moderate‑to‑high levels of mpox‑related knowledge and anxiety. Targeted risk communication and vaccination campaigns are needed to correct misconceptions and address vaccine hesitancy towards mpox.