The Covid-19 pandemic has reshaped our lives; therefore, it is considered that up till now, the vaccine is the best solution to eradicate the virus and stop its spread (21). The Pfizer-BioNTech Covid-19 Vaccine arrived in Lebanon on the 14th of February and was distributed to hospitals and vaccination centers (22). Thus, it was incumbent to conduct a study that aims to investigate the level of acceptance of the SARS COV-2 vaccine among the Lebanese population and the various factors that affect their decision. Hence, the importance of this study stems from the fact that it is among the first to discuss the acceptance in Lebanon, moreover, the big sample size that participated in this study can help to generalize the results of this study. Of our sample, over half of the population (58.8%) are willing to take the vaccine. This result is in direct contrast to the results of other studies since the acceptance observed in Lebanon is lower than the one in Iraq (77.6%), China (91.3%), Saudi Arabia (64.7%), and the United States of America (69%), however, a survey conducted in England revealed a lower tendency to take the vaccine (55.8%) (23–26).
The majority of the sample stated that they know someone who caught the coronavirus, and as a result, it is concluded that the virus poses major risks to society. The findings suggest that most of the participants who perceive the virus as a threat might be more inclined to protect themselves from the pandemic, this is consistent with the results of a longitudinal study concerning the first year of the H1N1 Pandemic which stated that the risk of infection is directly related to the acceptance of vaccination (27). This goes in line with the previous result that stated that 58.8% of the sample is willing to take the vaccine. However, this acceptance is related to the source of the vaccine for over two-thirds of the sample. The majority prefer to take the German-American vaccine (BioNTech- Pfizer) while the Chinese vaccine; Sinopharm was the second most trusted vaccine among the Lebanese population, and the Russian vaccine Sputnik V was the latest. This repartition might be due to the 95% efficacy of the Pfizer vaccine and its mode of action which could be reassuring (28). The preference for the Pfizer vaccine is consistent with the results of a cross-sectional study conducted in Indonesia in July 2020 which shows that higher acceptance towards vaccination was associated with the choice of a 95% effective vaccine (23). Also, the Pfizer vaccine is an RNA vaccine that introduces the RNA coding for the viral protein to generate the corresponding antibodies(28). In contrast, Sinopharm is an Inactivated Coronavirus vaccine that introduces the virus into the body (29) and Sputnik V is a double-stranded DNA vaccine that relies on a modified adenovirus(30). Both Chinese and Russian vaccines have lower effectiveness compared to the German Pfizer vaccine (30, 31). Based on these findings, the participants trust the Pfizer vaccine more than the others due to the difference in effectiveness and mode of action. The distribution of the Pfizer vaccine starting the 14th of February 2021 in Lebanon is in line with the participants’ preference which suggests that 73.4% might be amongst the people registering to get vaccinated.
The acceptance toward the vaccine among the Lebanese population is affected by the fear of the unknown and un-well-documented side effect of the vaccine and the uncertainty of its safety, similar results were found in other studies which concluded that the fast production of the vaccine resulted in worries among the people about the effectiveness and safety of the vaccine (24, 32–34), moreover, it is important to document that about one-fifth of the Lebanese population are convinced that there is a hidden agenda behind the fast development of the vaccine, which raises again the conspiracy theory about the COVID-19 pandemic, this results can be directly related to psychological status (35), political trust (36), religious beliefs (37), and social status of the population (38). In addition, the source of information can lead to misinformation regarding the vaccination and the spread of conspiracy theories. In fact, 26.4% of the sample rely on common conversation and words of mouth and 4.6% trust what is shared on social media platforms. However, the Lebanese population showed high responsibility towards the rules and restrictions applied during the pandemic in Lebanon, which might have been a key factor to prevent a further spread of the infection in the community (39–41).
Social determinants played a key role in the acceptance of the vaccine among the Lebanese population, gender, age, and higher socioeconomic status were significant factors affecting the willingness to take the vaccine, this can be explained as the following, COVID-19 pandemic affected seniors more than youth therefor, the older the person gets, the more willing to take the vaccine he/ she becomes (42–44), furthermore, the socioeconomic status is higher when the education level is higher, and the higher education level can be a protective factor against the wrong information about the vaccination programs (45), similar results were found in many other studies, in Saudi Arabia, older age groups and education level were significantly associated with the vaccine acceptance(32), in other Arab community, males were more willing to accept the vaccine (33). 15.8% of the sample stated that they would consider taking the vaccine only if it would be free of charge. In fact, the Pfizer vaccine which arrived in February is costless (reference). Therefore it is expected that more than the 51.8% of the participants who are willing to be vaccinated no matter the price will be taking the vaccine.
As stated earlier, the vaccination program is the only solution to pass the current pandemic and protect the communities around the world from a further speared of this virus and to protect the world economy from collapsing, therefore, the results of this study can be a cornerstone for the development and implications of the vaccination program in the Lebanese community, and it can give an in-depth overview for the groups that are least to accept the vaccine to start an awareness campaign aiming to raise the awareness toward COVID-19 vaccine.
Further research might investigate the reason why the number of active Covid-19 cases keeps on increasing even if the participants are claiming to respect the majority of the safety measurements. Another further study could assess the updated data once people start getting the vaccine.