It is essential to ensure the availability and efficacy of vaccines to control the COVID-19 pandemic successfully. Meanwhile, health authorities should ensure community trust and acceptance of the vaccine. Any hesitation and vaccination refusal could hinder the healthcare system's ability to control the pandemic.
The current study investigated factors associated with vaccine acceptance among studied residents. The reported background variables associated with a low acceptability rate are low education, non-employment, and female gender. This finding was inconsistent with Nehal et al., who found that gender, and education were not significant variables for vaccine acceptance [19].
However, a systematic review of 33 countries found that vaccine acceptance varies between countries with different socio-economic status. Low acceptance was reported in countries such as Kuwait (23.6%) and Jordan (28.4%), and moderate acceptance in countries such as Italy (53.7%), Poland (56.3%), and Russia (54.9%). In contrast, some countries exhibited high acceptance, especially in East Asia, such as Indonesia (93.3%), China (91.3%), and Malaysia (94.3%) [20].
Despite the misinformation and rumors about COVID-19 vaccines repeatedly shared on social media platforms [21], about half (51%) of the studied participants depended on social media as their primary source of knowledge. A study reported that vaccine hesitancy and refusal are associated with misinformation on social media [22]. This finding reflects the importance of educational interventions to address misinformation about vaccines.
Likewise, participants' perception of the vaccine as safe and effective was another significant factor in the high acceptance rate among studied participants. Conversely, the belief that COVID-19 disease will be controlled within two years and COVID-19 infection after vaccination were inversely associated with the vaccine acceptance rate. Similarly, a study in China found that 48% of respondents postponed vaccination because they were concerned about the safety of vaccines [23]. Also, a United States study found that 89% of participants assumed that COVID-19 vaccines could have some side effects which affected vaccine acceptance [24].
While a survey in Bangladesh found that about a quarter of participants thought that the COVID-19 was safe, only 60% were willing to be vaccinated, and about two-thirds will recommend it to family and friends [25]. It is believed that misinformation and lack of data on the seriousness of incidence and mortality of COVID-19 disease may reduce concerns about vaccine acceptability [26].
Inconsistent with the current study findings, Elhadi et al. found that having a family member or friend infected with COVID-19 was positively associated with the likelihood of vaccine acceptance (OR = 1.09 [1.02, 1.18]). While they found that having a friend or family member who died due to COVID-19 was negatively associated with it (OR = 0.89 [0.84, 0.97]) [27].
Likewise, a meta-regression analysis conducted by Kukreti et al. found that a COVID-19 death rate of 400 per million population or higher was significantly associated (p-value = 0.02) with the willingness rate for vaccination [28].
The variation in the acceptability rate between different studies reflects the interaction between vaccine perception and background variables, namely, age groups and educational levels.
Several factors affect the willingness to receive COVID-19 vaccines. Therefore, building good knowledge and health literacy through educational intervention programs, especially vaccine safety and effectiveness, is essential to enhance vaccination campaigns among the general population and ensure control of the COVID-19 pandemic.