It’s been two years since the World Health Organization declared a global health emergency over an outbreak of mpox, a disease endemic to Africa that had spread to dozens of countries. Now, in the summer of 2024, a deadlier version of the infectious disease has spread from the Democratic Republic of the Congo to other African nations, the strain that originally hit the United States has shown signs of resurgence, and this week the Centers for Disease Control and Prevention (CDC) issued a new alert about mpox for health care providers.
But while the American public quickly learned about the disease during the summer of 2022, as case numbers declined and media attention waned, much of that knowledge appears to have been lost, according to new survey data from the University of Pennsylvania’s Annenberg Public Policy Center.
In a nationally representative survey of about 1,500 American adults conducted in July 2024, the policy center found that knowledge about monkeypox (which increased between July and August 2022) has declined, along with fear of the disease (formerly called monkeypox). This wave of the Annenberg Science and Public Health (ASAPH) knowledge survey finds that:
- Only 1 in 20 Americans (5%) are worried about getting MPOX in the next three months, compared with 21% in August 2022. Additionally, less than 1 in 10 (9%) are worried about themselves or their family members getting MPOX.
- Less than 1 in 5 people (17%) know that mpox is less contagious than Covid-19, compared with 41% in August 2022. Nearly two-thirds (63%) are unsure.
- Only a third of people (34%) know that men who have sex with men are at higher risk of mpox infection, compared with almost two-thirds (63%) in August 2022.
- Less than half (45%) know that there is a vaccine against mpox, down from 61% in August 2022.
- Fewer people (58%) know it is false that getting a Covid-19 vaccine increases the chances of getting MPOX, compared to 71%.
“The speed with which the public learned the necessary information about mpox in the summer of 2022 was a tribute to effective communication by the public health community,” said Kathleen Hall Jamieson, director of the Annenberg Public Policy Center (APPC) and chair of the survey. “That same expertise should be deployed now to ensure that at-risk individuals are reminded of mpox symptoms, modes of transmission, and the protective power of vaccination.”
Mpox outbreaks in 2024 and 2022
Discovered in 1958, mpoxpox is a rare disease caused by an orthopox virus, and is a less deadly member of the family of viruses that cause smallpox, according to the CDC. Mpoxpox can cause fever, chills, headaches, muscle aches, swollen lymph nodes and a painful rash, especially on the hands, feet, face, chest, mouth or near the genitals. According to the CDC, the disease can spread through contact with infected wild animals, close contact (including sexual) with an infected person, including contact with scabs or bodily fluids, or contact with contaminated materials such as towels or bedding.
The current outbreak involves a strain of mpox known as clade I, which is especially virulent and dangerous to infants and children under 5, according to the World Health Organization (WHO), whose director-general announced this week that he was convening a panel of experts to advise him on whether the outbreak should be declared a global health emergency. (The WHO declared the 2022 mpox global health emergency over in May 2023.) The WHO says there have been more than 14,000 cases this year, with at least 511 deaths, according to STAT News. In the Democratic Republic of the Congo (DRC), 62% of deaths affected children under 5. The current subtype appears to spread through routine close contact between individuals, though in November 2023 the WHO confirmed that this strain was also being transmitted sexually.
This more deadly strain of monkeypox has not been reported outside of central and eastern Africa, the CDC said.
A different strain of mpox in the 2022 outbreak, known as clade II subtype, that swept through the United States, was less deadly and largely transmitted through sexual contact, with men who have sex with men at higher risk of contracting the disease. That earlier strain never completely disappeared, though new cases are occurring at a much lower rate, according to the CDC. Most cases are in people who are not vaccinated against mpox or who have received only one of the two recommended doses, the CDC reported.
Vaccination against mpox
While knowledge about mpox virus has declined significantly, there has been a less pronounced drop in people’s intentions to get vaccinated against the disease. CDC has urged people to get vaccinated with two doses of the Jynneos vaccine four weeks apart, both for people who have been exposed to the mpox virus to help prevent its spread and for people with risk factors for mpox, including men who have sex with men.
An earlier APPC survey in October 2022 found that 76% of respondents said they were “very likely” or “somewhat likely” to get the mpox vaccine if exposed to the virus. The current survey in July 2024 found a slight decline, with 70% of respondents reporting they were very likely or somewhat likely to get the mpox vaccine (68%) or had already gotten the mpox vaccine (2%). However, 3 in 10 (30%) said they were “slightly likely” or “not at all likely” to get the mpox vaccine if exposed to the virus. Additionally, 70% reported in July 2024 that they thought the benefits of mpox vaccination outweighed the risks.
ASAPH APPC Survey
The survey data comes from the year 20He wave of a nationally representative panel of 1,496 U.S. adults, first convened in April 2021, conducted for the Annenberg Public Policy Center by SSRS, an independent market research firm. This wave of the Annenberg Science and Public Health Knowledge (ASAPH) survey was fielded July 11–18, 2024, and has a margin of sampling error (MOE) of ±3.6 percentage points at the 95% confidence level. All figures are rounded to the nearest whole number and may not add up to 100%.