COVID-19 vaccine hesitancy and attitudes in Qatar: A national cross-sectional survey of a migrant-majority population

Prevalence and Drivers of COVID-19 Vaccine Hesitancy among Czech University Students: National Cross-Sectional Study

Background: university students are believed to retain the highest levels of health literacy. They are perceived as the opinion leaders within their communities; therefore, their health-related beliefs and attitudes are deemed important for public health campaigns. This study aimed to investigate the COVID-19 vaccine hesitancy drivers among university students in the Czech Republic. Methods: a cross-sectional study using a self-administered questionnaire was carried out in the weeks before the unrestricted vaccine deployment to Czech adults. The questionnaire had 21 multiple-choice items stratified in 4 categories; demographic characteristics, COVID-19-related anamnesis and influenza vaccine experience, attitudes towards COVID-19 vaccination, and the possible drivers of COVID-19 vaccine hesitancy suggested by the WHO-SAGE. Results: out of the 1351 included students, 66.8% were females, 84.5% were Czech nationals, and 40.6% enrolled in healthcare programs. The overall COVID-19 vaccine acceptance level was 73.3%, 19.3% of participants were vaccine-resistant, and only 7.4% were vaccine-hesitant. Trust in the pharmaceutical industry, trust in healthcare providers, and perceived knowledge sufficiency predicted higher odds of vaccine acceptance. In contrast, media and social media, personal beliefs, immunity misconception, previous COVID-19 infection, and suspicions about novel vaccines and the local availability predicted higher odds of vaccine hesitancy. Conclusions: The findings of this study predict a fair probability to achieve community immunity (herd immunity) among the target population group. The primary prevention strategies in the Czech Republic need to be culturally sensitive and inclusive for foreign nationals. As one-quarter of the participating students are dependent on vaccine safety data, this study findings support the call for independent studies evaluating the side effects of COVID-19 vaccines.

Acceptability of the COVID-19 Vaccine and Its Determinants among University Students in Saudi Arabia: A Cross-Sectional Study

COVID-19 vaccine hesitancy is a significant threat to the efforts that have been taken to combat the pandemic. This study assessed the acceptability of the COVID-19 vaccine among university students in Saudi Arabia. A cross-sectional online survey using a Google Form was conducted between 2 April and 23 April 2021. A snowball technique was used to recruit participants for this study. The final sample consisted of 407 participants. More than one-third of the participants (36.1%) had received the COVID-19 vaccine, and 13.3% had registered to receive the vaccine. Of the participants who were not yet vaccinated (n = 260), 90.4% indicated that they would like to be vaccinated when given the opportunity. Of the unvaccinated participants, 82.3% trusted the COVID-19 vaccines that had been provided in Saudi Arabia. The most reported reasons for the participants’ acceptance to receive the COVID-19 vaccine included preventive purposes (95.8%), a belief in the safety of the vaccines (84.3%), and the availability of public awareness information regarding the vaccines (77.3%). A small portion of participants (6.1%) were refusing to receive the vaccine due to the potential long-term side effects (92.0%) and expedited vaccine trials (80.0%). Acceptability of the COVID-19 vaccine was strongly associated with participants who regularly received the flu vaccine (p < 0.05). All other demographic variables were not statistically associated with the acceptability of the COVID-19 vaccine. In conclusion, it would be appropriate for universities to launch peer programs to urge reluctant students to receive the vaccine voluntarily. In terms of further research, it is valuable to follow up with unvaccinated participants to investigate if they received the vaccine since the data were collected, and their reasons for doing so. This research would reveal changes toward vaccine acceptability over time and any related determinants. Future research should consider students from non-Arabic speaking backgrounds.

COVID-19 Vaccine Hesitancy-A Scoping Review of Literature in High-Income Countries

Vaccine hesitancy forms a critical barrier to the uptake of COVID-19 vaccine in high-income countries or regions. This review aims to summarize rates of COVID-19 hesitancy and its determinants in high-income countries or regions. A scoping review was conducted in Medline®, Embase®, CINAHL®, and Scopus® and was reported in accordance with the PRISMA-SCr checklist. The search was current as of March 2021. Studies which evaluated COVID-19 vaccine hesitancy and its determinants in high-income countries (US$12,536 or more GNI per capita in 2019) were included. Studies conducted in low, lower-middle, and upper-middle income countries or regions were excluded. Factors associated with vaccine hesitancy were grouped into four themes (vaccine specific, individual, group, or contextual related factors). Of 2237 articles retrieved, 97 articles were included in this review. Most studies were conducted in U.S. (n = 39) and Italy (n = 9). The rates of vaccine hesitancy across high-income countries or regions ranged from 7-77.9%. 46 studies (47.4%) had rates of 30% and more. Younger age, females, not being of white ethnicity and lower education were common contextual factors associated with increased vaccine hesitancy. Lack of recent history of influenza vaccination, lower self-perceived risk of contracting COVID-19, lesser fear of COVID-19, believing that COVID-19 is not severe and not having chronic medical conditions were most frequently studied individual/group factors associated with increased vaccine hesitancy. Common vaccine-specific factors associated with increased vaccine hesitancy included beliefs that vaccine are not safe/effective and increased concerns about rapid development of COVID-19 vaccines. Given the heterogeneity in vaccine hesitancy definitions used across studies, there is a need for standardization in its assessment. This review has summarized COVID-19 vaccine hesitancy determinants that national policymakers can use when formulating health policies related to COVID-19 vaccination.

Hesitant or Not Hesitant? A Systematic Review on Global COVID-19 Vaccine Acceptance in Different Populations

Vaccination currently appears to be the only strategy to contain the spread of COVID-19. At the same time, vaccine hesitancy (VH) could limit its efficacy and has, therefore, attracted the attention of Public Health Systems. This systematic review aimed at assessing anti-COVID-19 vaccine acceptance rates worldwide and at identifying populations more prone to vaccine hesitancy, for which specific interventions should be planned. PubMed database was searched using a purposely formulated string. One hundred out of the 9243 studies retrieved were considered pertinent and thus included in the analyses. VH rate was analyzed according to patient geographical origin, ethnicity, age, study setting, and method used for data collection; data from specific populations were separately analyzed. Overall, this study demonstrated significant differences in terms of VH in the general population and in the specific subgroups examined according to geographical, demographic factors, as well as associated comorbidities, underlining the need for purposely designed studies in specific populations from the different countries, to design targeted programs aimed at increasing awareness for confidence and complacency toward COVID-19 vaccines.

COVID-19 vaccine hesitancy in perinatal women: a cross sectional survey

OBJECTIVES

To explore attitudes to COVID-19 vaccination among perinatal women.

METHODS

A nationwide online, cross-sectional survey was conducted in Qatar from 15th October 2020 to 15th November 2020 with voluntary participation open to all adult residents. Of the respondents, the population group for this study comprised the 341 pregnant and breastfeeding participants. The survey utilized a composite questionnaire incorporating a validated instrument to measure vaccine attitudes. The responses were recorded and analysed with statistical analysis being performed with SPSS software. Outcome measures included intentions towards vaccination and potential factors influencing vaccine hesitancy (contextual factors, vaccine specific concerns and group/individual influences).

RESULTS

Perinatal women exhibited a vaccine hesitancy rate of 25% towards COVID-19 immunisation. The main concerns of the group were of infection risks and main factor determining vaccine hesitancy was of vaccine specific safety concerns. Previous vaccine "acceptors" showed vaccine hesitancy to COVID-19 immunisation. A third of the group cited non availability of the vaccine as a concern.

CONCLUSIONS

COVID-19 vaccine trials amongst pregnant and lactating women have lagged behind those for general populations and this has compounded concerns around safety in this special group. Perinatal women constitute a vulnerable group and play an important role in vaccination of wider family members. This study highlights the need for trials and data for COVID-19 vaccine in this group to be able to achieve appreciable numbers needed for herd immunity and ultimately control of the pandemic.

Determinants of SARS-CoV-2 Vaccine Engagement in Algeria: A Population-based Study with Systematic Review of Studies from Arab Countries of the MENA Region.. [DOI: 10.1101/2021.07.17.21260662]

Background

The Algerian COVID-19 vaccination campaign, which started by the end of January 2021, is marked by a slowly ascending curve despite the deployed resources. To tackle the issue, we assessed the levels and explored determinants of engagement towards the COVID-19 vaccine among the Algerian population.

Methods

A nationwide, online-based cross-sectional study was conducted between March 27 and April 30, 2021. A two-stage stratified snowball sampling method was used to include an equivalent number of participants from the four cardinal regions of the country. A vaccine engagement scale was developed, defining vaccine engagement as a multidimensional parameter (5 items) that combined self-stated acceptance and willingness with perceived safety and efficacy of the vaccine. An Engagement score was calculated and the median was used to define engagement versus nonengagement. Sociodemographic and clinical data, perceptions about COVID-19 and levels of adherence to preventive measures were analyzed as predictors for nonengagement.

Results

We included 1,019 participants, 54% were female and 64% were aged 18-29 years. Overall, there were low rates of self-declared acceptance (26%) and willingness (21%) to take the vaccine, as well as low levels of agreement regarding vaccine safety (21%) and efficacy (30%). Thus, vaccine engagement rate was estimated at 33.5%, and ranged between 29.6-38.5% depending on the region (p>0.05). Nonengagement was independently associated with female gender (OR=2.31, p<0.001), low adherence level to preventive measures (OR=6.93p<0.001), private sector jobs (OR=0.53, p=0.038), perceived COVID-19 severity (OR=0.66, p=0.014), and fear from contracting the disease (OR=0.56, p=0.018). Concern about vaccine side effects (72.0%) and exigence for more efficacy and safety studies (48.3%) were the most commonly reported barrier and enabler for vaccine acceptance respectively; whereas beliefs in the conspiracy theory were reported by 23.4%.

Conclusions

The very low rates of vaccine engagement among the Algerian population probably explain the slow ascension of the vaccination curve in the country. Vaccine awareness campaigns should be implemented to address the multiple misconceptions and enhance the levels of knowledge and perception both about the disease and the vaccine, by prioritizing target populations and engaging both healthcare workers and the general population.

Risk, Trust, and Flawed Assumptions: Vaccine Hesitancy During the COVID-19 Pandemic

Background: The pace at which the present pandemic and future public health crises involving viral infections are eradicated heavily depends on the availability and routine implementation of vaccines. This process is further affected by a willingness to vaccinate, embedded in the phenomenon of vaccine hesitancy. The World Health Organization has listed vaccine hesitancy among the greatest threats to global health, calling for research to identify the factors associated with this phenomenon. Methods: The present cross-sectional study seeks to investigate the psychological, contextual, and sociodemographic factors associated with vaccination hesitancy in a large sample of the adult population. 4,571 Norwegian adults were recruited through an online survey between January 23 to February 2, 2021. Subgroup analyzes and multiple logistic regression was utilized to identify the covariates of vaccine hesitancy. Results: Several subgroups hesitant toward vaccination were identified, including males, rural residents, and parents with children below 18 years of age. No differences were found between natives and non-natives, across education or age groups. Individuals preferring unmonitored media platforms (e.g., information from peers, social media, online forums, and blogs) more frequently reported hesitance toward vaccination than those relying on information obtainment from source-verified platforms. Perceived risk of vaccination, belief in the superiority of natural immunity, fear concerning significant others being infected by the virus, and trust in health officials' dissemination of vaccine-related information were identified as key variables related to vaccine hesitancy. Conclusion: Given the heterogeneous range of variables associated with vaccine hesitancy, additional strategies to eradicate vaccination fears are called for aside from campaigns targeting the spread of false information. Responding to affective reactions in addition to involving other community leaders besides government and health officials present promising approaches that may aid in combating vaccination hesitation.

COVID-19 Vaccine Hesitancy in a Representative Education Sector Population in Qatar

Even though vaccination programs have now started in earnest across the globe and in Qatar, vaccine hesitancy remains a barrier to effectively tackling the pandemic. Many factors influence willingness to take vaccines including safety, efficacy, and side effects. Given their proximity to research and education, university students and employees represent an interesting cohort in which to investigate vaccine hesitancy. The aim of this study was to assess the attitudes of Qatar University employees and students towards the COVID-19 vaccine. In total, 231 employees and 231 students participated in an online cross-sectional study in February 2021. Of the sample, 62.6% were willing to take a vaccine against COVID-19. Participants with or taking postgraduate degrees were more willing to take the vaccine compared to participants with or taking a diploma or bachelor’s degree (p < 0.001). Males had a higher rate of vaccine acceptance (p < 0.001). In the group that regarded flu vaccination as important, 13% were unwilling to take COVID-19 vaccine. There were no associations between willingness to vaccinate and vaccine/virus knowledge and social media use. Participants showed a high level of concern regarding vaccine side effects in themselves or their children. Two-thirds agreed or strongly agreed that they would take the vaccine if it was mandatory for international travel. Our participants were neutral to the origin of vaccine development. These findings, which represent data collected after the start of the national vaccination program, show that vaccine hesitancy persists in the Qatari population and that some groups, such as undergraduate students, could benefit from specific, targeted public health campaigns.

Prevalence and Potential Determinants of COVID-19 Vaccine Hesitancy and Resistance in Qatar: Results from a Nationally Representative Survey of Qatari Nationals and Migrants between December 2020 and January 2021

Global COVID-19 pandemic containment necessitates understanding the risk of hesitance or resistance to vaccine uptake in different populations. The Middle East and North Africa currently lack vital representative vaccine hesitancy data. We conducted the first representative national phone survey among the adult population of Qatar, between December 2020 and January 2021, to estimate the prevalence and identify potential determinants of vaccine willingness: acceptance (strongly agree), resistance (strongly disagree), and hesitance (somewhat agree, neutral, somewhat disagree). Bivariate and multinomial logistic regression models estimated associations between willingness groups and fifteen variables. In the total sample, 42.7% (95% CI: 39.5-46.1) were accepting, 45.2% (95% CI: 41.9-48.4) hesitant, and 12.1% (95% CI: 10.1-14.4) resistant. Vaccine resistant compared with hesistant and accepting groups reported no endorsement source will increase vaccine confidence (58.9% vs. 5.6% vs. 0.2%, respectively). Female gender, Arab ethnicity, migrant status/type, and vaccine side-effects concerns were associated with hesitancy and resistance. COVID-19 related bereavement, infection, and quarantine status were not significantly associated with any willingness group. Absence of or lack of concern about contracting the virus was solely associated with resistance. COVID-19 vaccine resistance, hesitance, and side-effects concerns are high in Qatar's population compared with those globally. Urgent public health engagement should focus on women, Qataris (non-migrants), and those of Arab ethnicity.

COVID-19 Vaccine Hesitancy among Temporary Foreign Workers from Bangladesh

The COVID-19 pandemic poses an extraordinary threat to the health, safety, and freedom of temporary foreign workers (TFWs). Highly effective vaccines against COVID-19 may hold an outsized benefit for TFWs, particularly those living in congregate settings where protective measures such as social distancing are not possible. While some studies of migrant destination countries have included migrants, no study to date has sought to understand variations in vaccine hesitancy among individuals in a single migrant source population across different destinations. Such a design is critical for understanding how the context of immigration affects levels of hesitancy among migrants from similar conditions of origin. This observational study leverages longitudinal data from an ongoing monthly rapid-response survey of TFWs from Bangladesh (n = 360). Overall vaccine hesitancy was 25%, with significant variation by host country. Multivariate analyses confirmed that immigration system factors and threat perception are the strongest predictors of COVID-19 vaccine hesitancy for TFWs. The predicted probability of hesitancy for an undocumented TFW was 0.405, while the predicted probability for those with valid visas was 0.207 (p < .01). The probability of being hesitant for TFWs who were worried about getting COVID-19 was 0.129 compared to 0.305 (p < .01) for those who were not worried. Results reveal low vaccine hesitancy among TFWs from Bangladesh with differences in location, undocumented status, COVID-19 threat perception, and level of worry about side effects. There could be relatively high returns for targeting vaccine access and distribution to TFWs because of their high levels of vaccine acceptance.