Hesitancy of Arab Healthcare Workers towards COVID-19 Vaccination: A Large-Scale Multinational Study
Abstract
:1. Introduction
2. Methods
3. Results
3.1. Demographics
3.2. COVID-19 Vaccination Acceptance and Related Factors
3.3. Barriers to Acceptance
3.4. Stances of HCWs on Vaccination Policies and Need
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Country | No | Not Sure | Will Wait for Others | Depending on Type | Yes | Total | |||||
---|---|---|---|---|---|---|---|---|---|---|---|
n | % | n | % | n | % | n | % | n | % | ||
Algeria | 287 | (60.2%) | 94 | (19.7%) | 55 | (11.5%) | 17 | (3.6%) | 24 | (5.0%) | 477 |
Egypt | 376 | (30.1%) | 298 | (23.8%) | 276 | (22.1%) | 169 | (13.5%) | 131 | (10.5%) | 1250 |
Europe | 98 | (24.7%) | 76 | (19.1%) | 92 | (23.2%) | 22 | (5.5%) | 109 | (27.5%) | 397 |
Iraq | 42 | (29.8%) | 25 | (17.7%) | 30 | (21.3%) | 13 | (9.2%) | 31 | (22.0%) | 141 |
Jordan | 379 | (34.7%) | 212 | (19.4%) | 184 | (16.8%) | 79 | (7.2%) | 238 | (21.8%) | 1092 |
Kuwait | 8 | (15.1%) | 10 | (18.9%) | 8 | (15.1%) | 1 | (1.9%) | 26 | (49.1%) | 53 |
Lebanon | 17 | (30.4%) | 11 | (19.6%) | 7 | (12.5%) | 6 | (10.7%) | 15 | (26.8%) | 56 |
Libya | 15 | (35.7%) | 10 | (23.8%) | 3 | (7.1%) | 3 | (7.1%) | 11 | (26.2%) | 42 |
Morocco | 87 | (38.7%) | 52 | (23.1%) | 35 | (15.6%) | 15 | (6.7%) | 36 | (16.0%) | 225 |
North America | 25 | (28.1%) | 15 | (16.9%) | 14 | (15.7%) | 4 | (4.5%) | 31 | (34.8%) | 89 |
Oman | 10 | (38.5%) | 7 | (26.9%) | 2 | (7.7%) | 1 | (3.8%) | 6 | (23.1%) | 26 |
Other Arab | 7 | (29.2%) | 6 | (25.0%) | 4 | (16.7%) | 0 | (0.0%) | 7 | (29.2%) | 24 |
Others | 17 | (29.3%) | 15 | (25.9%) | 8 | (13.8%) | 1 | (1.7%) | 17 | (29.3%) | 58 |
Palestine | 66 | (24.8%) | 76 | (28.6%) | 40 | (15.0%) | 30 | (11.3%) | 54 | (20.3%) | 266 |
Qatar | 23 | (35.4%) | 12 | (18.5%) | 7 | (10.8%) | 1 | (1.5%) | 22 | (33.8%) | 65 |
Saudi Arabia | 142 | (26.1%) | 126 | (23.2%) | 110 | (20.2%) | 12 | (2.2%) | 154 | (28.3%) | 544 |
Sudan | 45 | (31.9%) | 35 | (24.8%) | 22 | (15.6%) | 8 | (5.7%) | 31 | (22.0%) | 141 |
Syria | 103 | (29.9%) | 89 | (25.9%) | 67 | (19.5%) | 21 | (6.1%) | 64 | (18.6%) | 344 |
Tunisia | 30 | (49.2%) | 11 | (18.0%) | 8 | (13.1%) | 4 | (6.6%) | 8 | (13.1%) | 61 |
Turkey | 42 | (25.0%) | 44 | (26.2%) | 33 | (19.6%) | 9 | (5.4%) | 40 | (23.8%) | 168 |
UAE | 45 | (33.3%) | 32 | (23.7%) | 22 | (16.3%) | 12 | (8.9%) | 24 | (17.8%) | 135 |
Yemen | 22 | (40.7%) | 10 | (18.5%) | 7 | (13.0%) | 4 | (7.4%) | 11 | (20.4%) | 54 |
Label | Levels | No | Not Sure | Will Wait for Others | Depending on Type | Yes | |||||
---|---|---|---|---|---|---|---|---|---|---|---|
n | % | n | % | n | % | n | % | n | % | ||
Age | <30 | 876 | (28.9%) | 720 | (23.7%) | 624 | (20.6%) | 290 | (9.6%) | 523 | (17.2%) |
30–39 | 595 | (36.1%) | 345 | (20.9%) | 249 | (15.1%) | 105 | (6.4%) | 355 | (21.5%) | |
40–49 | 266 | (38.4%) | 142 | (20.5%) | 106 | (15.3%) | 26 | (3.8%) | 152 | (22.0%) | |
50–59 | 120 | (46.0%) | 49 | (18.8%) | 40 | (15.3%) | 10 | (3.8%) | 42 | (16.1%) | |
>59 | 29 | (39.7%) | 10 | (13.7%) | 15 | (20.5%) | 1 | (1.4%) | 18 | (24.7%) | |
Chronic Diseases | No | 1600 | (32.6%) | 1104 | (22.5%) | 883 | (18.0%) | 384 | (7.8%) | 937 | (19.1%) |
Yes | 286 | (35.8%) | 162 | (20.3%) | 151 | (18.9%) | 48 | (6.0%) | 153 | (19.1%) | |
Country | Arab countries | 1704 | (34.1%) | 1116 | (22.3%) | 887 | (17.8%) | 396 | (7.9%) | 893 | (17.9%) |
Other countries | 182 | (25.6%) | 150 | (21.1%) | 147 | (20.6%) | 36 | (5.1%) | 197 | (27.7%) | |
Academic Education | Higher education | 1388 | (35.8%) | 835 | (21.5%) | 607 | (15.7%) | 260 | (6.7%) | 785 | (20.3%) |
Lower education | 498 | (27.2%) | 431 | (23.5%) | 427 | (23.3%) | 172 | (9.4%) | 305 | (16.6%) | |
Had Covid | No | 809 | (31.4%) | 535 | (20.7%) | 481 | (18.7%) | 202 | (7.8%) | 552 | (21.4%) |
Not sure | 578 | (31.1%) | 451 | (24.3%) | 362 | (19.5%) | 148 | (8.0%) | 320 | (17.2%) | |
Yes | 499 | (39.3%) | 280 | (22.0%) | 191 | (15.0%) | 82 | (6.5%) | 218 | (17.2%) | |
Job | HCW | 1886 | (33.0%) | 1266 | (22.2%) | 1034 | (18.1%) | 432 | (7.6%) | 1090 | (19.1%) |
Gender | Male | 911 | (28.7%) | 623 | (19.6%) | 588 | (18.5%) | 285 | (9.0%) | 764 | (24.1%) |
Female | 975 | (38.4%) | 643 | (25.3%) | 446 | (17.6%) | 147 | (5.8%) | 326 | (12.8%) | |
Influenza Vaccine | Yearly | 45 | (14.0%) | 53 | (16.5%) | 45 | (14.0%) | 23 | (7.2%) | 155 | (48.3%) |
Some years | 149 | (21.9%) | 148 | (21.7%) | 105 | (15.4%) | 61 | (9.0%) | 218 | (32.0%) | |
Rarely | 201 | (28.2%) | 160 | (22.5%) | 141 | (19.8%) | 57 | (8.0%) | 153 | (21.5%) | |
Never | 1491 | (37.3%) | 905 | (22.7%) | 743 | (18.6%) | 291 | (7.3%) | 564 | (14.1%) | |
Vaccine type unknown | No | 1228 | (31.8%) | 800 | (20.7%) | 656 | (17.0%) | 326 | (8.5%) | 847 | (22.0%) |
Yes | 658 | (35.5%) | 466 | (25.2%) | 378 | (20.4%) | 106 | (5.7%) | 243 | (13.1%) |
Variable | Levels | Acceptance (%) | Hesitancy (%) | Univariable OR (CI) | Multivariable OR (CI) |
---|---|---|---|---|---|
Age | <30 | 813 (26.8) | 2220 (73.2) | − | − |
30–39 | 460 (27.9) | 1189 (72.1) | 0.95 (0.83–1.08) | 1.21 (1.03–1.42) | |
40–49 | 178 (25.7) | 514 (74.3) | 1.06 (0.88–1.28) | 1.41 (1.14–1.75) | |
50–59 | 52 (19.9) | 209 (80.1) | 1.47 (1.08–2.03) | 1.92 (1.37–2.73) | |
>59 | 19 (26.0) | 54 (74.0) | 1.04 (0.62–1.81) | 1.62 (0.93–2.94) | |
Chronic Diseases | No | 1321 (26.9) | 3587 (73.1) | − | − |
Yes | 201 (25.1) | 599 (74.9) | 1.10 (0.93-1.31) | 1.01 (0.84–1.22) | |
Country | Arab countries | 1289 (25.8) | 3707 (74.2) | − | − |
Other countries | 233 (32.7) | 479 (67.3) | 0.71 (0.60–0.85) | 0.87 (0.73-1.05) | |
Academic Education | Higher education | 1045 (27.0) | 2830 (73.0) | − | − |
Lower education | 477 (26.0) | 1356 (74.0) | 1.05 (0.93–1.19) | 0.97 (0.84–1.14) | |
Had Covid | No | 754 (29.2) | 1825 (70.8) | − | − |
Not sure | 468 (25.2) | 1391 (74.8) | 1.23 (1.07-1.41) | 1.25 (1.08–1.44) | |
Yes | 300 (23.6) | 970 (76.4) | 1.34 (1.15–1.56) | 1.34 (1.14-1.58) | |
Gender | Male | 1049 (33.1) | 2122 (66.9) | − | − |
Female | 473 (18.6) | 2064 (81.4) | 2.16 (1.91–2.44) | 2.04 (1.79–2.32) | |
Vaccine Type Unknown | No | 1173 (30.4) | 2684 (69.6) | − | − |
Yes | 349 (18.9) | 1502 (81.1) | 1.88 (1.64–2.16) | 1.69 (1.47–1.96) | |
Influenza Vaccine | Yearly | 178 (55.5) | 143 (44.5) | − | − |
Some years | 279 (41.0) | 402 (59.0) | 1.79 (1.37–2.35) | 1.70 (1.29–2.24) | |
Rarely | 210 (29.5) | 502 (70.5) | 2.98 (2.27–3.91) | 2.87 (2.17–3.81) | |
Never | 855 (21.4) | 3139 (78.6) | 4.57 (3.62–5.77) | 4.30 (3.37–5.49) |
Barriers | HCW | Not HCW | X2 Statistic | p-Value | ||
n | (%) | n | (%) | |||
Afraid of unknown side effects | 3313 | (58.0%) | 18,922 | (62.0%) | 20.31 | <0.0001 |
Not enough time to test vaccine safety | 3252 | (57.0%) | 16,920 | (55.5%) | 9.74 | 0.0018 |
Vaccine production was rushed | 2505 | (43.9%) | 14,193 | (46.5%) | 7.99 | 0.0047 |
Do not trust the healthcare policies | 2133 | (37.4%) | 12,018 | (39.4%) | 4.63 | 0.031 |
Insufficient numbers of studies | 1693 | (29.7%) | 8208 | (26.9%) | 23.58 | <0.0001 |
No value for new strains | 1569 | (27.5%) | 6475 | (21.2%) | 120.27 | <0.0001 |
Do not trust company/studies | 1541 | (27.0%) | 10,427 | (34.2%) | 99.31 | <0.0001 |
No published studies on vaccine | 1175 | (20.6%) | 5911 | (19.4%) | 6.61 | 0.010 |
Pandemic is exaggerated to benefit pharma | 1119 | (19.6%) | 7868 | (25.8%) | 89.01 | <0.0001 |
Most infected people recover | 979 | (17.2%) | 7036 | (23.1%) | 88.7 | <0.0001 |
Vaccine immunity is short | 976 | (17.1%) | 3637 | (11.9%) | 124.47 | <0.0001 |
Vaccines irreversibly alter DNA | 928 | (16.3%) | 6985 | (22.9%) | 114.28 | <0.0001 |
Afraid of SE mentioned in studies | 847 | (14.8%) | 5695 | (18.7%) | 42.19 | <0.0001 |
Coronavirus/vaccine are a conspiracy | 700 | (12.3%) | 5972 | (19.6%) | 160.99 | <0.0001 |
Vaccine can cause COVID19 | 695 | (12.2%) | 5939 | (19.5%) | 160.83 | <0.0001 |
I had/have COVID | 681 | (11.9%) | 2875 | (9.4%) | 38.01 | <0.0001 |
Vaccine may cause death | 630 | (11.0%) | 4257 | (14.0%) | 31.15 | <0.0001 |
Vaccines were not tested in Arabs | 543 | (9.5%) | 2209 | (7.2%) | 38.84 | <0.0001 |
Infection rate decreasing | 426 | (7.5%) | 3056 | (10.0%) | 32.87 | <0.0001 |
Do not believe in vaccines in general | 419 | (7.3%) | 4186 | (13.7%) | 168.53 | <0.0001 |
Most vaccinated people had SE | 416 | (7.3%) | 2608 | (8.5%) | 8.39 | 0.0038 |
Most people already had COVID | 373 | (6.5%) | 1898 | (6.2%) | 1.29 | 0.26 |
Vaccines contain aluminum | 326 | (5.7%) | 2896 | (9.5%) | 80.31 | <0.0001 |
May get COVID19 after vaccine | 267 | (4.7%) | 1370 | (4.5%) | 0.68 | 0.41 |
I do not like needles | 220 | (3.9%) | 1750 | (5.7%) | 30.91 | <0.0001 |
I am not eligible (pregnant or <16 old) | 147 | (2.6%) | 965 | (3.2%) | 4.89 | 0.027 |
I have a chronic disease | 136 | (2.4%) | 1266 | (4.1%) | 38.39 | 0 |
I have allergies to foods/drugs | 132 | (2.3%) | 716 | (2.3%) | 0 | 0.99 |
I do not think I will get COVID19 | 86 | (1.5%) | 674 | (2.2%) | 10.76 | 0.001 |
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Qunaibi, E.; Basheti, I.; Soudy, M.; Sultan, I. Hesitancy of Arab Healthcare Workers towards COVID-19 Vaccination: A Large-Scale Multinational Study. Vaccines 2021, 9, 446. https://doi.org/10.3390/vaccines9050446
Qunaibi E, Basheti I, Soudy M, Sultan I. Hesitancy of Arab Healthcare Workers towards COVID-19 Vaccination: A Large-Scale Multinational Study. Vaccines. 2021; 9(5):446. https://doi.org/10.3390/vaccines9050446
Chicago/Turabian StyleQunaibi, Eyad, Iman Basheti, Mohamed Soudy, and Iyad Sultan. 2021. "Hesitancy of Arab Healthcare Workers towards COVID-19 Vaccination: A Large-Scale Multinational Study" Vaccines 9, no. 5: 446. https://doi.org/10.3390/vaccines9050446