Acceptance of COVID-19 vaccines in Palestine: a cross-sectional online study

Zawahrah, Hassan J; Saca-Hazboun, Hanan; Melhem, Shatha; Adwan, Rabee; Sabateen, Ali; Abu-Rmeileh, Niveen M E

doi:10.1136/bmjopen-2021-053681

Cited by 18 publications

(17 citation statements)

References 23 publications

(24 reference statements)

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“…We estimated the vaccine hesitant consist of 34.08% (95% CI: 28.14-40.56) of the adult population of Gaza, which is similar to the estimate from the web-based survey (37%) carried out in October 2020 [9]. Temporal data from VHS studies have generally found levels of hesitancy decreasing within countries over time corresponding to the roll-out of vaccines [3].…”

Section: Discussionsupporting

confidence: 72%

“…Gaza Strip, the 362 sq km Palestinian territory bordering Israel and Egypt, faces immense challenges with the vaccine roll-out given its fractured and poorly resourced health system and political obstacles to the importation of medical supplies [8,9]. By January 2022, it is estimated that 26% of the population has been vaccinated since the campaign started in February 2021 based on Palestinian Ministry of Health statistics [10].…”

Section: Introductionmentioning

confidence: 99%

“…It is also critical to understand drivers of vaccine hesitancy to address barriers to uptake among populations who remain skeptical, misinformed, or fearful of vaccine risks. Surveys conducted to date have identi ed factors such as government trust, sex, education level, risk perception, and use of social media for COVID-19 information, among others, to be associated with vaccine hesitancy [4, 6,7].Gaza Strip, the 362 sq km Palestinian territory bordering Israel and Egypt, faces immense challenges with the vaccine roll-out given its fractured and poorly resourced health system and political obstacles to the importation of medical supplies [8,9]. By January 2022, it is estimated that 26% of the population has been vaccinated since the campaign started in February 2021 based on Palestinian Ministry of Health statistics [10].…”

mentioning

confidence: 99%

“…By January 2022, it is estimated that 26% of the population has been vaccinated since the campaign started in February 2021 based on Palestinian Ministry of Health statistics [10]. Little data exists on vaccine hesitancy and its risk factors in Gaza; a web-based survey conducted in October 2020 found 63% of respondents would accept the vaccine, with women and young adults less likely to be vaccine hesitant [9]. However to our knowledge no recent data has been collected since the vaccination campaign began, and no population-representative study has been conducted.The international non-governmental organization International Medical Corps (IMC) commissioned an external consultant epidemiologist to conduct a mixed methods vaccine hesitancy study in the Gaza Strip.…”

mentioning

confidence: 99%

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COVID-19 Vaccination in the Gaza Strip: a Cross-sectional Study of Vaccine Coverage, Hesitancy, and Associated Risk Factors Among Community Members and Healthcare Workers

Majer

Elhissi

Mousa

et al. 2022

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Background: The Gaza Strip, like other settings of complex humanitarian emergencies, faces immense challenges in vaccinating its population against COVID-19. This study was conducted in October 2021 and aimed to estimate coverage of COVID-19 vaccination, levels of vaccine hesitancy, and associations with risk factors among the adult population and healthcare workers (HCWs). Methods: The study used a mixed methods design comprised of a cross-sectional survey of adults, purposive survey of HCWs, and qualitative discussions with key informants and community members. Quantitative data was summarized as univariable descriptive statistics with unweighted and weighted point estimates. Logistic regression was used to evaluate associations of risk factors with vaccination status and vaccine hesitancy.Results: A total of 1,075 individuals were reached in the survey, of whom 906 were community members. Population-weighted vaccine coverage was estimated to be 49.08% (95% CI: 43.10-55.08). 89.35% of HCWs were vaccinated. Population-weighted vaccine hesitancy was estimated to be 34.08% (95% CI: 28.14-40.56) among both vaccinated and unvaccinated respondents, and 67.24% (95% CI: 49.04-81.41) among the unvaccinated. In logistic regression vaccination was independently associated with male sex (aOR 1.88, 95% CI: 1.20-2.95), older age (40 or more years old) (aOR: 1.92, 95% CI: 1.73-2.13), higher education (aOR 2.19, 95% CI: 1.51-3.17), and confidence in the safety of the vaccine (aOR 13.8, 95% CI: 10.1-18.8). Risk factors for hesitancy were similar, however hesitant individuals were more likely to obtain vaccine information from family members (aOR: 1.20, 95% CI: 1.00-1.67) and less likely to trust healthcare providers (aOR: 0.58, 95% CI: 0.49-0.68). Qualitative interviews corroborated the survey results, although skepticism expressed by HCWs interviewed raises the possibility of hidden hesitancy.Conclusions: The continued emergence of SARS-CoV-2 variants reinforces the importance of achieving high levels of vaccination coverage globally – a uniquely challenging objective in Gaza. This study estimated half of Gaza’s adult population received at least one dose of any COVID-19 vaccine by October 2021, and the majority of unvaccinated individuals were hesitant. Disparities in vaccination across the territory’s demographic groups underscores the need for targeted outreach to these populations and messaging through community-based channels to permeate social networks of the unvaccinated.

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Section: Discussionsupporting

confidence: 72%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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COVID-19 Vaccination in the Gaza Strip: a Cross-sectional Study of Vaccine Coverage, Hesitancy, and Associated Risk Factors Among Community Members and Healthcare Workers

Majer

Elhissi

Mousa

et al. 2022

Preprint

View full text Add to dashboard Cite

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“…Hence, this could result in delaying vaccination and waning immunity against SARS-CoV-2 over time, after initial infection or vaccination [ 35 ], and subsequently, it may prolong the burden of the COVID-19 pandemic in the region. In contrast, good knowledge about the vaccines and their side effects were significantly associated with vaccination acceptance rate [ 36 ]. Therefore, refuting the rumors and conspiracy beliefs, by enriching knowledge about the COVID-19 vaccines and their real side effects, could strengthen public confidence in COVID-19 vaccines.…”

Section: Introductionmentioning

confidence: 99%

Reported Adverse Effects and Attitudes among Arab Populations Following COVID-19 Vaccination: A Large-Scale Multinational Study Implementing Machine Learning Tools in Predicting Post-Vaccination Adverse Effects Based on Predisposing Factors

et al. 2022

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Background: The unprecedented global spread of coronavirus disease 2019 (COVID-19) has imposed huge challenges on the healthcare facilities, and impacted every aspect of life. This has led to the development of several vaccines against COVID-19 within one year. This study aimed to assess the attitudes and the side effects among Arab communities after receiving a COVID-19 vaccine and use of machine learning (ML) tools to predict post-vaccination side effects based on predisposing factors. Methods: An online-based multinational survey was carried out via social media platforms from June 14 to 31 August 2021, targeting individuals who received at least one dose of a COVID-19 vaccine from 22 Arab countries. Descriptive statistics, correlation, and chi-square tests were used to analyze the data. Moreover, extensive ML tools were utilized to predict 30 post vaccination adverse effects and their severity based on 15 predisposing factors. The importance of distinct predisposing factors in predicting particular side effects was determined using global feature importance employing gradient boost as AutoML. Results: A total of 10,064 participants from 19 Arab countries were included in this study. Around 56% were female and 59% were aged from 20 to 39 years old. A high rate of vaccine hesitancy (51%) was reported among participants. Almost 88% of the participants were vaccinated with one of three COVID-19 vaccines, including Pfizer-BioNTech (52.8%), AstraZeneca (20.7%), and Sinopharm (14.2%). About 72% of participants experienced post-vaccination side effects. This study reports statistically significant associations (p < 0.01) between various predisposing factors and post-vaccinations side effects. In terms of predicting post-vaccination side effects, gradient boost, random forest, and XGBoost outperformed other ML methods. The most important predisposing factors for predicting certain side effects (i.e., tiredness, fever, headache, injection site pain and swelling, myalgia, and sleepiness and laziness) were revealed to be the number of doses, gender, type of vaccine, age, and hesitancy to receive a COVID-19 vaccine. Conclusions: The reported side effects following COVID-19 vaccination among Arab populations are usually non-life-threatening; flu-like symptoms and injection site pain. Certain predisposing factors have greater weight and importance as input data in predicting post-vaccination side effects. Based on the most significant input data, ML can also be used to predict these side effects; people with certain predicted side effects may require additional medical attention, or possibly hospitalization.

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