Variations in COVID-19 Vaccine Attitudes and Acceptance among Refugees and Lebanese Nationals Pre- and Post-Vaccine Rollout in Lebanon

Zawar Ali · Shiromi M. Perera · Stephanie Chow Garbern · Elsie Abou Diwan · Nada Awada

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Vaccine Coverage and Hesitancy SARS-CoV-2 and COVID-19 Research COVID-19 and Mental Health

Abstract

Vaccine hesitancy among displaced populations is associated with inequitable access to services and mistrust of authorities, among other factors. This study evaluated variations in attitudes toward COVID-19 vaccines and factors associated with vaccine acceptance among refugees and Lebanese nationals accessing 60 International Medical Corps-supported health facilities through two cross-sectional surveys pre- (n = 3927; Survey 1) and post- (n = 4174; Survey 2) vaccine rollout. Logistic regression was used to assess predictors of vaccine acceptance using the health beliefs model. Refugees comprised 52.9% (Survey 1) and 54.2% (Survey 2) of respondents. Vaccine acceptance was low among both groups in Survey 1 (25.9% refugees vs. 23.1% Lebanese nationals), but higher in Survey 2 in Lebanese (57.6%) versus refugees (32.9%). Participants reported greater perceived benefits of vaccination, higher perceived COVID-19 susceptibility, and lower perceived vaccination barriers in Survey 2 versus Survey 1. Post-vaccine rollout, refugees had lower odds of vaccine acceptance compared to Lebanese (OR 0.50, 95%CI 0.41–0.60), while older age (OR 1.37, 95%CI 1.06–1.78, ≥51 years vs. 18–30 years) was associated with greater vaccine acceptance. Health beliefs model variables were associated with vaccine acceptance in both surveys. Tailored strategies to respond dynamically to changes in vaccine attitudes among vulnerable groups in Lebanon are essential for equitable vaccine uptake.

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2020The use of the health belief model to assess predictors of intent to receive the COVID-19 vaccine and willingness to pay 2020Understanding COVID-19 vaccine demand and hesitancy: A nationwide online survey in China 2021High Rates of COVID-19 Vaccine Hesitancy and Its Association with Conspiracy Beliefs: A Study in Jordan and Kuwait among Other Arab Countries 2021Acceptance of the COVID-19 vaccine based on the health belief model: A population-based survey in Hong Kong 2020Willingness to get the COVID-19 vaccine with and without emergency use authorization 2022World Report 2014 2020Assessing preventive health behaviors from COVID-19: a cross sectional study with health belief model in Golestan Province, Northern of Iran 2020Will they, or Won't they? Examining patients' vaccine intention for flu and COVID-19 using the Health Belief Model

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2023Determinants of influenza and COVID-19 vaccine intent or uptake in Lebanon: a scoping review of the literature 2024Predictors of COVID-19 vaccine acceptability among refugees and other migrant populations: A systematic scoping review 2023Vaccine Uptake and COVID-19 Frequency in Pregnant Syrian Immigrant Women 2023Hesitancy toward vaccination against COVID-19: A scoping review of prevalence and associated factors in the Arab world

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