Psychological antecedents towards COVID-19 vaccination using the Arabic 5C validated tool: An online study in 13 Arab countries

Abstract

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.

Parental perceptions and the 5C psychological antecedents of COVID-19 vaccination during the first month of omicron variant surge: A large-scale cross-sectional survey in Saudi Arabia

“…The 5C Scale was previously used in the Arab population including KSA to explore vaccine acceptance and intentions during the COVID-19 pandemic (56). Results in the present study revealed that the highest mean score for any of the antecedents of vaccination was for collective responsibility.…”

“…In their analysis, the highest reported antecedent by category in KSA was confidence, followed by collective responsibility, calculation, complacency, and finally constraints. Their results suggested that respondents in KSA showed high confidence in COVID-19 vaccines, when compared to other countries, as was found in UAE and Kuwait (56). That pattern likely represented the active vaccination programs in these countries.…”

“…Cronbach's alpha test of reliability was applied to assess the internal consistency of the 5C scale constructs. Additionally, Confirmatory Factor Analysis with the maximum likelihood estimation was applied to the 5C items with Parallel Analysis and the tests of unidimensionality (56).…”

“…In the previous study conducted in the Arab world, the researchers used cut-off scores to divide respondents into two groups, labeled Yes and No, for each of the psychological antecedents of the 5C (56). In their analysis, the highest reported antecedent by category in KSA was confidence, followed by collective responsibility, calculation, complacency, and finally constraints.…”

“…Recently, the scale has been utilized to assess vaccine behavior amidst the currently evolving COVID-19 pandemic (53-55). A large multinational study in the Arab world demonstrated that gender, country of residence, and education amongst other factors were associated with changes in the psychological antecedents of vaccination against COVID-19 as assessed by the 5C scale (56).…”