scholarly journals Evidence Review: COVID-19 Vaccine Acceptance by Key Influencers in the MENA Region - Teachers and Healthworkers

2021 ◽  
Author(s):  
Nadia Butler ◽  
Soha Karam

As COVID-19 vaccines have been deployed and scaled, concerns about vaccine acceptance have emerged. Effective management of the virus requires that communities everywhere buy into the public health measures designed to protect them, including vaccines. Low acceptance presents a serious challenge for achieving sufficient coverage to reduce circulation of the virus and the risk of new variants emerging. Surveys conducted early in the pandemic showed that the Middle East region had one of the lowest COVID-19 vaccine acceptance rates globally. The low acceptance is driven by specific factors in the region and its different countries and populations; these factors need to be taken into account when formulating policy, programmes and interventions. This review synthesises evidence on vaccine acceptance among two key groups in the Middle East and North Africa (MENA) region: teachers and health workers. It draws from academic studies most of which were cross-sectional studies, largely conducted between February 2020 and June 2021, and grey literature reports, including social listening reports. This review is intended to inform strategies for risk communications and community engagement (RCCE) relating to COVID-19 vaccine uptake, with the aim of boosting confidence in and acceptance of the vaccines among these groups across the region. It is part of the Social Science in Humanitarian Action Platform (SSHAP) series on social science considerations relating to COVID-19 vaccines and was developed for SSHAP by Anthrologica (Nadia Butler and Soha Karam) at the request of the UNICEF MENA Regional Office. It was reviewed by Rose Aynsley (WHO) Amaya Gillespie (UNICEF) and Olivia Tulloch (Anthrologica). The evidence review is the responsibility of SSHAP.

Vaccines ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 798
Author(s):  
Sami H. Alzahrani ◽  
Mukhtiar Baig ◽  
Mohammed W. Alrabia ◽  
Mohammed R. Algethami ◽  
Meshari M. Alhamdan ◽  
...  

Vaccine uptake could influence vaccination efforts to control the widespread COVID-19 pandemic; however, little is known about vaccine acceptance in Saudi Arabia. The present study aimed to assess the Saudi public’s intent to get vaccinated against COVID-19 and explore the associated demographic determinants of their intentions as well as the reasons for vaccine hesitancy. A cross-sectional, web-based survey was distributed to public individuals in Saudi Arabia between 25 December 2020 and 15 February 2021. Participants were asked if they were willing to get vaccinated, and the responses, along with demographic data were entered into a multinomial logistic regression model to assess the relative risk ratio (RRR) for responding “no” or “unsure” versus “yes”. Among 3048 participants (60.1% female, 89.5% Saudi), 52.9% intend to get vaccinated, 26.8% were unsure, and 20.3% refused vaccination. Vaccine hesitancy was significantly higher among females (RRR = 2.70, p < 0.0001) and those who had not been recently vaccinated for influenza (RRR = 2.63, p < 0.0001). The likelihood was lower among Saudis (RRR = 0.49, p < 0.0001), those with less than a secondary education (RRR = 0.16, p < 0.0001), perceived risks of COVID-19, and residents of the southern region (RRR = 0.46, p < 0.0001). The most often cited reasons for hesitancy were short clinical testing periods and concerns about adverse events or effectiveness. Vaccine hesitancy is mediated by many demographic factors and personal beliefs. To address vaccine-related concerns and amend deeply rooted health beliefs, communication should provide transparent information.


2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S677-S677
Author(s):  
Marisa Orbea ◽  
Rachel Cunningham ◽  
C Mary Healy ◽  
Julie A Boom ◽  
Claire Bocchini

Abstract Background SARS-CoV-2 vaccine hesitancy (VH) is hindering nationwide vaccination efforts; little is known about caregiver SARS-CoV-2 vaccine acceptance for children. We aimed to identify associations with SARS-CoV-2 VH in caregivers of hospitalized children. Methods We conducted a prospective cross-sectional survey in English and Spanish of caregiver COVID-19 knowledge, attitudes, behaviors, and associated VH among hospitalized children 6 months - 18 years at a large pediatric medical institution. Parents were approached daily, averaging 4-5 days/week, from 12/8/2020--4/5/2021. VH was assessed using the Parent Attitudes about Childhood Vaccines (PACV) survey; PACV score ≥50 denoted VH. Descriptive statistics and multivariable logistic regression were used. Responses were categorized. Results 295/307 (96%) of approached caregivers enrolled; 79% were ≥ 30 years, 68% were married/ living with a partner, and 57% had at least some college. 36% identified as white, 19% Black, and 46% Hispanic/ Latino. 53% of caregiver children had public insurance. 91% of caregivers self-reported their children were up to date with routine vaccines. 17% of caregivers were vaccine-hesitant overall. 50% of caregivers were willing to receive COVID-19 vaccine themselves. Figure 1 shows intention to vaccinate their child by PACV score. 65% knew someone who was hospitalized for COVID-19. 67% were scared of their child getting COVID-19. However, 49% were scared of their child getting the vaccine, 28% did not want to vaccinate their child and 27% were neutral in the intention to vaccinate their child. Caregivers who did not intend to vaccinate their child were more likely to be Black (27% vs. 16%, p=0.04) and less likely to be Hispanic/ Latino (33% vs. 49%, p=0.02). Table 1 shows attitudes, beliefs, and behaviors surrounding the COVID-19 pandemic and vaccine in caregivers who did or did not intend to vaccinate their child. Figure 1 COVID-19 vaccine uptake by PACV score Table 1 Caregiver attitudes, beliefs, and behaviors surrounding the COVID-19 pandemic and the COVID-19 vaccine Conclusion The majority of caregivers believe that SARS-CoV-2 vaccine will help control the pandemic, but less than half plan to vaccinate their children. A quarter of caregivers expressed uncertainty regarding the vaccine and therefore may be amenable to education and discussion. COVID-19 VH is different from VH towards routine vaccinations. More research is needed to address COVID-19 specific VH. Disclosures C. Mary Healy, MD, Dexcom (Shareholder)Intuitive (Shareholder)Quidel Corporation (Shareholder)Up to Date (Other Financial or Material Support, Honorarium)Vapotherm (Shareholder)


2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Aharona Glatman-Freedman ◽  
Kanar Amir ◽  
Rita Dichtiar ◽  
Hila Zadka ◽  
Ifat Vainer ◽  
...  

Abstract Background Vaccinating children against influenza has shown both direct and indirect beneficial effects. However, despite being offered free of charge, childhood influenza vaccine coverage in Israel has been low. Our objective was to evaluate the factors associated with childhood influenza vaccination in Israel. Methods A cross-sectional language-specific telephone survey was conducted among adults 18 years or older, to examine childhood influenza vaccination practices and their associations with socio-demographic and relevant health variables. We further explored the reasons for these practices among parents. Multivariate logistic regression was used to identify factors associated with childhood influenza vaccine acceptance. Results Of a total of 6518 individuals contacted by mobile phone, 1165 eligible parents, ≥18 years old with children 1–18 years of age, were interviewed, and 1040 of them completed the survey successfully. Overall, factors associated with childhood influenza vaccination were younger child’s age, influenza vaccination of other family members and belonging to the Arab population group. No association was found between childhood influenza vaccination and routine childhood vaccine uptake. Several of the parents’ reasons for vaccine acceptance - preventing influenza or its transmission, awareness regarding the need for influenza vaccination and receipt of invitation to get vaccinated - differed significantly between Jewish and Arab parents. Several reasons reported by parents for not vaccinating children against influenza, indicated a likelihood to accept influenza vaccine outreach efforts. Such reasons were reported by 27.5% of Jewish parents and 37.5% of Arab parents. Conclusions We found that certain demographic factors were associated with childhood influenza vaccination in Israel. Several reasons described by the parent for not vaccinating their children indicate that outreach efforts are likely to increase childhood influenza vaccination. Addressing population group-specific needs is recommended to optimize the success of influenza vaccine outreach efforts.


2019 ◽  
Vol 2 (4) ◽  
pp. 202-207
Author(s):  
AM Jibo ◽  
RS Karaye ◽  
AU Gajida ◽  
AA Abulfathi

Nigeria is making effort to address the child mortality burden by increasing vaccine coverage rates, yet the vaccine coverage falls short of 90% target. Scaling up of new and under-used vaccines to 90% coverage could save more than 600,000 Nigerian children. Healthcare givers knowledge of vaccine used for immunization is essential to increase the vaccine uptake rates. This study assesses the knowledge of routine, underutilized and future vaccines among health workers. A cross sectional descriptive study was done among health care workers at a tertiary health facility in Nigeria. Using a pre-tested semi structured interviewer administered questionnaire, 220 respondents were selected by cluster sampling technique. The health workers’ knowledge of these vaccines was assessed using a scale developed for the study. Data collected were analyzed using SPSS version 22.The mean age of the respondents was 31.9 + 5.7 years . Doctors and nurses formed more than half of the respondents, 51.8% (n=114). About three quarters of respondents 72.3% (n=159) had good knowledge of vaccines used in routine immunizations. Knowledge of under-utilized and future vaccine was low with less than a fifth 18.6% (n=41) and one tenth 9.1% (n=20) having good knowledge scores respectively. Similarly, poor perception scores of future vaccines were observed in 90.1% (n=218) of the respondents. Only marital status was associated with knowledge of underutilized vaccines (p<0.05) and no association was observed between other sociodemographic variables and knowledge of these vaccines (P>0.05). The awareness level of health care workers on routine immunization is high. Their knowledge and perception of under-utilized and future vaccines were however low. There is, therefore, need for more training and retraining of health care workers on the vaccines.


2021 ◽  
Author(s):  
Neh Chang Ngasa ◽  
Stewart Ndutard Ngasa ◽  
Leticia Armelle Sani Tchouda ◽  
Eugénie Tanisso ◽  
Christabel Abanda ◽  
...  

Abstract Background: The production of the different COVID-19 vaccines has offered hope towards controlling the pandemic. Many governments around the world have been able to secure the number of doses required for the vaccination of their entire population. In Cameroon, the government’s strategy has been to secure the number of doses required to vaccinate frontline workers and other population at risk. A threat to this strategy could be vaccine hesitancy as demonstrated in previous studies. In this article we discussed the influence of spirituality on vaccine acceptance. We also examined other factors associated with vaccine acceptance amongst healthcare workers in Cameroon. Methods: This was a cross-sectional online survey of healthcare workers in Cameroon. Data was collected using Surveysparrow and then computed into Microsoft Excel. All analysis were done using Stata 14. Results: A total number of 371 healthcare workers took part in the survey and 45.38% indicated willingness to accept the vaccine if offered. The most common reason advanced for non-acceptance of the vaccine was negative perceptions about the efficacy of the vaccines. Independent factors associated with COVID-19 vaccine acceptance following a multivariate logistic regression included: being married (AOR 1.13, p< 0.01), presence of comorbidity (AOR:2.10, p<0.02), participants who had direct contact with covid patients (AOR: 3.34, p<0.01). Spirituality level was not independently associated with vaccine acceptance (AOR: 1.12, p<0.63). Conclusion: COVID-19 vaccine acceptance amongst healthcare workers in Cameroon is low. This is likely to reduce the vaccine uptake amongst healthcare workers. HCWs are in the best position to influence the uptake of these vaccines by the general population, therefore educating healthcare workers on the efficacy of these vaccines might improve their acceptance.


2020 ◽  
Author(s):  
Baldeep K. Dhaliwal ◽  
Riti Chandrashekhar ◽  
Ananya Rattani ◽  
Rajeev Seth ◽  
Svea Closser ◽  
...  

AbstractBackgroundIn India and other low- and middle-income countries, multiple family and community members are influential in caregivers’ perceptions of vaccination. Existing literature indicates the primary caregiver, typically the mother, is instrumental in vaccine decision-making, but this may vary in contexts. We investigated the role of stakeholders in India who influence caregivers’ vaccination perceptions, as this is essential to developing strategies to promote vaccine acceptance and improve uptake.MethodsThis research was conducted in 2019 in Mewat District in Haryana, an area in India with extremely low vaccination coverage. We conducted six focus group discussions with 60 participants in the following categories: fathers of children under-5 years old, expectant mothers, mothers-in-law, community health workers, and community influencers such as locally elected officials and religious leaders.ResultsOur results highlighted four themes that influence vaccine uptake. First, while caregivers associated vaccination with reductions in specific diseases, they also noted that vaccination services brought broad health gains, including improved nutrition, antenatal guidance, and social support. Second, community health workers critically influenced, positively or negatively, caregivers’ vaccination perceptions. Third, community health workers faced gaps in their education such as limited training on vaccine side-effects, placing them at a disadvantage when dealing with families. Finally, we found that mothers-in-law, fathers, and religious leaders influence caregivers’ perceptions of vaccination.ConclusionsCommunication of broader benefits of vaccines and vaccination services by community health workers could be impactful in increasing vaccine acceptance. Vaccine uptake could potentially be improved by facilitating community health workers’ ownership over vaccine acceptance and uptake by involving them in the design and implementation of interventions to target mothers and mothers-in-law. A ‘bottom-up’ approach, leveraging community health workers’ knowledge to design interventions, and giving a voice to key members of the household and society beyond mothers alone, may sustain health improvement in low vaccine coverage areas.


2020 ◽  
pp. 1-10
Author(s):  
Leila Cheikh Ismail ◽  
Tareq M. Osaili ◽  
Maysm N. Mohamad ◽  
Amina Al Marzouqi ◽  
Amjad H. Jarrar ◽  
...  

Abstract Coronavirus disease 2019 (COVID-19) has rapidly spread globally, forcing countries to apply lockdowns and strict social distancing measures. The aim of this study was to assess eating habits and lifestyle behaviours among residents of the Middle East and North Africa (MENA) region during the lockdown. A cross-sectional study among adult residents of the MENA region was conducted using an online questionnaire designed on Google Forms during April 2020. A total of 2970 participants from eighteen countries participated in the present study. During the pandemic, over 30 % reported weight gain, 6·2 % consumed five or more meals per d compared with 2·2 % before the pandemic (P < 0·001) and 48·8 % did not consume fruits on a daily basis. Moreover, 39·1 % did not engage in physical activity, and over 35 % spent more than 5 h/d on screens. A significant association between the frequency of training during the pandemic and the reported change in weight was found (P < 0·001). A significantly higher percentage of participants reported physical and emotional exhaustion, irritability and tension either all the time or a large part of the time during the pandemic (P < 0·001). Although a high percentage of participants reported sleeping more hours per night during the pandemic, 63 % had sleep disturbances. The study highlights that the lockdown due to the COVID-19 pandemic caused a variety of lifestyle changes, physical inactivity and psychological problems among adults in the MENA region.


2021 ◽  
Author(s):  
Samar Tharwat ◽  
Ahmed Mohammed Saad ◽  
Mohammed Kamal Nassar ◽  
Dalia Kamal Nassar

Abstract Background: The public's willingness to be vaccinated will determine the success of the COVID-19 vaccination programme. The aim of this study was to identify acceptance and hesitancy to receive COVID-19 vaccine among university students in Egypt, assess their level of knowledge about COVID-19 vaccine and identify barriers for hesitancy to uptake of COVID-19 vaccine.Methods: This cross-sectional survey study included 1071 university students. A standardized and self-administered questionnaire was constructed by the authors and distributed to university students allover Egypt.Results: Of the 1071 respondents, 739 (69%) were willing to get vaccinated against COVID-19 while 223 (20.8%) reported vaccine hesitancy. Median knowledge score of participants about COVID-19 vaccine was 4 out of 8 (IQR=8). While fear of getting infected (53.6%) and desire to get back to normal life (51%) were the main motives for intention to get vaccinated, fear of serious side effects (100%) and doubting the efficacy of COVID-19 vaccine (60.5%) were the main reasons for vaccine hesitancy and resistance. About 21% of students (n=225) reported voluntary uptake of COVID-19 vaccine. Conclusion: We identified rates of COVID-19 vaccine acceptance and hesitancy and detected poor knowledge scores among university students which may hinder vaccine acceptance. We also detected poor translation of vaccination intention into actual vaccine uptake. Educational campaigns and efforts aiming to raise awareness about safety and efficacy of COVID-19 vaccines need to be directed to this important population.


2020 ◽  
Author(s):  
Alaa Abd-Alrazaq ◽  
Noor Suleiman ◽  
Khaled Baagar ◽  
Noor Jandali ◽  
Ibrahem Abdalhakam ◽  
...  

BACKGROUND Diabetes mellitus (DM) is highly prevalent in Qatar and the Middle East and North Africa (MENA) region. Mobile health (m-health) can improve communications between diabetic patients and medical teams and this, in turn, may enhance engagement and self-management. Droobi is a multi-language mobile application designed to support self-management of patients with DM. OBJECTIVE The study aimed to explore experiences of patients and educators about their communication before and after implementation of Droobi, a diabetes management app. METHODS We interviewed a convenience sample consisting of 9 patients and 5 nurse educators. Before interviews, Droobi was downloaded to participants’ mobile phone, and their profile on the application was created. To ensure optimum usage experience, all participants received education on how to use Droobi. Participants used Droobi for 6 to 12 weeks. All interviews were audio recorded, transcribed by professionals, and thematically analyzed. RESULTS Two main themes were generated from participants’ responses. The first theme relates to experiences of patients and educators about their communication before Droobi and consists of 3 sub-themes: (1) how patients communicated with medical team before Droobi (previous methods), (2) adoption of previous communication methods, and (3) shortcomings of previous communication methods. The second theme relates to experiences of patients and educators about their communication after Droobi and consists of 4 sub-themes: (1) adoption of Droobi, (2) advantages of Droobi, (3) shortcomings of Droobi, and (4) improvements suggested by educators and patients. Findings suggest that Droobi provided a more efficient and convenient way for communication between health workers and patients, yet multiple shortcomings and several suggestions for improvements were noted. CONCLUSIONS Droobi has the potential to overcome disadvantages of previous communication methods, thereby increasing diabetic patient self-management. However, continuing use of Droobi is a factor for continuing its long-term viability and eventual success. Future work should continue on evaluating the Droobi app and to include a number of different stakeholders (e.g., diabetic patients, educators, doctors, researchers) when developing the upcoming Droobi version taking into account the limitations and suggestions put forth by the end-users. Further studies are needed to assess the clinical and cost effectiveness of Droobi in Qatar and the MENA region together with investigating factors affecting its initial and continued use.


2021 ◽  
pp. 1-12
Author(s):  
Samar Al-Hajj ◽  
Zeinab Hammoud ◽  
Jure Colnaric ◽  
Maya Ataya ◽  
Marie Michele Macaron ◽  
...  

<b><i>Objectives:</i></b> Traumatic brain injury (TBI) represents a major health concern worldwide with a large impact in the Middle East and North Africa (MENA) region as a consequence of protracted wars and conflicts that adversely affect the general population. Currently, systematic TBI studies in the MENA region are lacking, nonetheless they are immensely needed to enhance trauma management and increase survival rates among TBI patients. This systematic review aims to characterize TBI in the MENA region to guide future policy choices and research efforts and inform tailored guidelines capable of improving TBI management and patient treatment and outcome. Furthermore, it will serve as a road map to evaluate and assess knowledge of trauma impact on regional health systems that can be adopted by health-care providers to raise awareness and improve trauma care. <b><i>Methods:</i></b> We conducted a comprehensive search strategy of several databases including MEDLINE/Ovid, PubMed, Embase, Scopus, CINAHL, Google Scholar, and the grey literature in accordance with the PROSPERO systematic review protocol CRD42017058952. Abstracts were screened, and selected eligible studies were reviewed independently by 2 reviewers. We collected demographics information along with TBI characteristics, mortality rates, and regional distribution. Data were extracted using REDCap and checked for accuracy. <b><i>Results:</i></b> The search strategy yielded 23,385 citations; 147 studies met the eligibility criteria and were included in this review. Motor vehicle accident (MVA) was the leading cause of TBI (41%) in the MENA region, followed by the military- (15.6%) and fall- (8.8%) related TBI. Males predominantly suffer from TBI-related injuries (85%), with a high prevalence of MVA- and military-related TBI injuries. The TBI mortality rate was 12.9%. The leading causes of mortality were MVA (68%), military (20.5%), and assault (2.9%). The vast majority of reported TBI severity was mild (63.1%) compared to moderate (10.7%) and severe TBI (20.2%). Patients mainly underwent a Glasgow Coma Scale assessment (22.1%), followed by computed tomography scan (8.9%) and surgery (4.1%). <b><i>Conclusions:</i></b> Despite its clinical, social, and economic burden, the evidence of TBI research in the MENA region is scarce. Further research and high-quality epidemiological studies are urgently needed to gain a deep understanding of the TBI burden in the region, facilitate the allocation of adequate resources, implement effective preventive and intervention strategies and advise on the TBI patient management as reflective on the TBI patterns and modes.


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