Background Following the emergency approval of the coronavirus disease 2019 (COVID-19) vaccines, research into its vaccination hesitancy saw a substantial increase. However, the psychological behaviors associated with this hesitancy are still not completely understood. This study assessed the psychological antecedents associated with COVID-19 vaccination in the Arab population. Methodology The validated Arabic version of the 5C questionnaire was distributed online across various social media platforms in Arabic-speaking countries. The questionnaire had three sections, namely, socio-demographics, COVID-19 related infection and vaccination, and the 5C scale of vaccine psychological antecedents of confidence, complacency, constraints, calculation, and collective responsibility. Results In total, 4,474 participants with a mean age of 32.48 ± 10.76 from 13 Arab countries made up the final sample, 40.8% of whom were male. Around 26.7% of the participants were found to be confident about the COVID-19 vaccination, 10.7% indicated complacency, 96.5% indicated they had no constraints, 48.8% had a preference for calculation and 40.4% indicated they had collective responsibility. The 5C antecedents varied across the studied countries with the confidence and collective responsibility being the highest in the United Arab Emirates (59.0% and 58.0%, respectively), complacency and constraints in Morocco (21.0% and 7.0%, respectively) and calculation in Sudan (60.0%). The regression analyses revealed that sex, age, educational degrees, being a health care professional, history of COVID-19 infection and having a relative infected or died from COVID-19 significantly predicted the 5C psychological antecedents by different degrees. Conclusion There are wide psychological antecedent variations between Arab countries, and different determinants can have a profound effect on the COVID-19 vaccine’s psychological antecedents.

Background In the Arab countries, there has not been yet a specific validated Arabic questionnaire that can assess the psychological antecedents of COVID-19 vaccine among the general population. This study, therefore, aimed to translate, culturally adapt, and validate the 5C scale into the Arabic language. Methods The 5C scale was translated into Arabic by two independent bilingual co-authors, and then translated back into English. After reconciling translation disparities, the final Arabic questionnaire was disseminated into four randomly selected Arabic countries (Egypt, Libya, United Arab Emirates (UAE), and Saudi Arabia). Data from 350 Arabic speaking adults (aged ≥18 years) were included in the final analysis. Internal consistency was assessed by Cronbach’s alpha. Construct validity was determined by concurrent, convergent, discriminant, exploratory and confirmatory factor analyses. Results Age of participants ranged between 18 to 73 years; 57.14% were females, 37.43% from Egypt, 36.86%, from UAE, 30% were healthcare workers, and 42.8% had the intention to get COVID-19 vaccines. The 5 sub-scales of the questionnaire met the criterion of internal consistency (Cronbach’s alpha ≥0.7). The predictors of intention to get COVID-19 vaccines (concurrent validity) were young age and the 5C sub-scales. Convergent validity was identified by the significant inter-item and item-mean score of the sub-scale correlation (P<0.001). Discriminant validity was reported as inter-factor correlation matrix (<0.7). Kaiser-Meyer-Olkin sampling adequacy measure was 0.80 and Bartlett’s sphericity test was highly significant (P<0.001). Exploratory factor analysis indicated that the 15 items of the questionnaire could be summarized into five factors. Confirmatory factor analysis confirmed that the hypothesized five-factor model of the 15-item questionnaire was satisfied with adequate psychometric properties and fit with observed data (RMSEA = 0.060, GFI = 0.924, CFI = 0.957, TLI = 0.937, SRMR = 0.076 & NFI = 906). Conclusion The Arabic version of the 5C scale is a valid and reliable tool to assess the psychological antecedents of COVID-19 vaccine among Arab population.

Background and aim: Following emergency approval of vaccines, the amount of scientific literature investigating population hesitancy towards vaccination against the novel coronavirus disease (COVID-19) has increased exponentially. Nevertheless, the associated psychological behaviors with this phenomenon are still not clearly understood. This study aims to assess the psychological antecedents of the Arab population toward COVID-19 vaccines. Methods: A cross-sectional, online study using a validated Arabic version of the 5C questionnaire was conducted through different media platforms in different Arabic-speaking countries. The questionnaire included three sections: socio-demographics, COVID-19 related questions, and the 5C scale of vaccine psychological antecedents, namely confidence, complacency, constraints, calculation, and collective responsibility. Results: A total of 4,474 participants, 40.8% males from 13 Arab countries were included in the study. About 26.7% of participants had confidence in COVID-19 vaccination, 10.7% had complacency, 96.5% had no constraints, 48.8% had calculation and 40.4% had collective responsibility. The 5C antecedents showed variation among countries with confidence and collective responsibility being higher in the United Arab Emirates (UAE) (59% and 58%, respectively), complacency and constraints were higher in Morocco (21% and 7%, respectively) and calculation was higher in Sudan (60%). Regression analysis revealed that sex, age, educational degrees, being a health care professional, getting a COVID-19 infection, having a relative infected or died from COVID-19 can affect the 5C psychological antecedents by different degrees. Conclusion and recommendations: Wide variations of psychological antecedents between Arab countries exist. Different determinants can affect vaccine psychological antecedents.

Vaccine hesitancy is defined as a delayed in acceptance or refusal of vaccines despite availability of vaccination services. This multinational study examined user interaction with social media about COVID-19 vaccination. The study analyzed social media comments in 24 countries from five continents. In total, 5856 responses were analyzed; 83.5% of comments were from Facebook, while 16.5% were from Twitter. In Facebook, the overall vaccine acceptance was 40.3%; the lowest acceptance rates were evident in Jordan (8.5%), Oman (15.0%), Senegal (20.0%) and Morocco (20.7%) and the continental acceptance rate was the lowest in North America 22.6%. In Twitter, the overall acceptance rate was (41.5%); the lowest acceptance rate was found in Oman (14.3%), followed by USA (20.5%), and UK (23.3%) and the continental acceptance rate was the lowest in North America (20.5%), and Europe (29.7%). The differences in vaccine acceptance across countries and continents in Facebook and Twitter were statistically significant. Regarding the tone of the comments, in Facebook, countries that had the highest number of serious tone comments were Sweden (90.9%), United States (61.3%), and Thailand (58.8%). At continent level, serious comments were the highest in Asia (58.4%), followed by Africa (46.2%) and South America (46.2%). In twitter, the highest serious tone was reported in Egypt (72.2%) while at continental level, the highest proportion of serious comments was observed in Asia (59.7%), followed by Europe (46.5%). The differences in tone across countries and continents in Facebook and Twitter and were statistically significant. There was a significant association between the tone and the position of comments. We concluded that the overall vaccine acceptance in social media is relatively low and varied across the studied countries and continents consequently, more in-depth studies are required to address causes of such VH and combat infodemics.

Background: In the Arab countries, there has not been yet a specific validated questionnaire that can assess the psychological antecedents of COVID-19 vaccine among the general population. This study, therefore, aimed to translate, culturally adapt, and validate the 5C scale into the Arabic language. Methods: The 5C scale was translated into Arabic by two independent bilingual co-authors, and then subsequently translated back into English. After reconciling translation disparities, the final Arabic questionnaire was disseminated into four randomly selected Arabic countries (Egypt, Libya, United Arab Emirates (UAE), and Saudi Arabia ). Data from 350 Arabic speaking adults (aged ≥18 years) were included in the final analysis. Convergent, discriminant, exploratory and confirmatory factor analyses were carried out. Internal consistency was assessed by Cronbach alpha. Results: Age of participants ranged between 18 to 73 years; 57.14% were females, 37.43% from Egypt, 36.86%, from UAE, and 30% were healthcare workers. The 5 sub-scales of the questionnaire met the criterion of internal consistency (Cronbach alpha ≥0.7). Convergent validity was identified by the significant inter-item and item-total correlation (P<0.001). Discriminant validity was reported as inter-factor correlation matrix (<0.7). Exploratory factor analysis indicated that the 15 items of the questionnaire could be summarized into five factors. Confirmatory factor analysis confirmed that the hypothesized five-factor model of the 15-item questionnaire was satisfied with adequate psychometric properties and fit with observed data (RMSEA=0.060,GFI=0.924, CFI=0.957, TLI=0.937, SRMR=0.076 & NFI=906). Conclusion: the Arabic version of the 5C scale is a valid and reliable tool to assess the psychological antecedents of COVID-19 vaccine among Arab population.