Acceptability of the COVID-19 vaccine among patients with chronic rheumatic diseases and health-care professionals: a cross-sectional study in 19 Arab countries

Kibbi, Lina El; Metawee, Mona; Hmamouchi, Ihsane; Abdulateef, Nizar; Halabi, Hussein; Eissa, Mervat; Rakawi, Manal El; Masri, Basel; Abutiban, Fatemah; Hamdi, Wafa; Adnan, Asal; Najm, Antonella Abi; Felten, Renaud; Arnaud, Laurent; Ziadé, Nelly

doi:10.1016/s2665-9913(21)00368-4

Cited by 13 publications

(19 citation statements)

References 9 publications

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“…In this study, we found a higher vaccine acceptance rate among Mexican patients with RMDs using a Likert scale (94%), compared to previous reports for both the global and national general population and patients with RMDs in other countries [11][12][13][14][15][16]. High acceptance coincided with the high number of participants who had chosen to receive one or two doses of a COVID-19 vaccine at the time of C19VHQ COVID-19 Vaccine Hesitancy Among Patients with Rheumatic Diseases Questionnaire, HGCh Hospital General "Dr. Salvador Zubirán", HGM Hospital General de México "Dr. Eduardo Liceaga", HU Hospital Universitario "Dr. José Eleuterio Gonzalez", INCMNSZ Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán" the study.…”

Section: Discussioncontrasting

confidence: 63%

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The COVID-19 epidemic curve and vaccine acceptance among patients with rheumatic diseases: an ecological study

et al. 2023

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The attitudes toward emerging COVID-19 vaccines have been of great interest worldwide, especially among vulnerable populations such as patients with rheumatic and musculoskeletal diseases (RMDs). The aim of this study was to analyze the relationship between the nationwide number of COVID-19 cases and deaths, and vaccine acceptance or hesitancy of patients with RMDs from four patient care centers in Mexico. Furthermore, we explored differences in acceptance according to specific diagnoses: rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). This ecological study was a secondary analysis of a cross-sectional study using a validated questionnaire to measure vaccine acceptance. We generated a global Likert scale to evaluate overall attitudes toward the COVID-19 vaccine. We analyzed data from 1336 patients from March to September 2021: 85.13% (1169) were women, with a mean age of 47.87 (SD 14.14) years. The most frequent diagnoses were RA (42.85%, 559) and SLE (27.08%, 393). 635(47.52%) patients were unvaccinated, 253(18.93%) had one dose and 478(35.77%) had two doses. Of all participating patients, 94% were accepting toward the COVID-19 vaccine. Vaccine acceptance remained consistently high throughout the study. However, differences in vaccine acceptance are identified when comparing diagnoses. The peak of the national epidemic curve coincided with an increase in hesitancy among patients with RA. Contrastingly, patients with SLE became more accepting as the epidemic curve peaked. Mexican patients show high acceptance of the COVID-19 vaccine, influenced in part by a patient’s specific diagnosis. Furthermore, vaccine acceptance increased mirroring the curve of COVID-19 cases and deaths in the country. This should be taken into consideration when updating recommendations for clinical practice.

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Section: Discussioncontrasting

confidence: 63%

“…In Mexico, for example, a recent study reported 72.2% acceptance among patients [ 10 ]. Meanwhile, vaccine acceptance is 85% for patients in the United States and Italy [ 11 , 12 ], 65% in Australia [ 13 ], 63% in Arab countries [ 14 ], 54% in Western India [ 15 ] 29.2% in Turkey [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

The COVID-19 epidemic curve and vaccine acceptance among patients with rheumatic diseases: an ecological study

et al. 2023

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“…Our qualitative interviews also suggest there may be more skepticism of vaccines among clinicians than is readily apparent in the survey data. Recent articles by El Kibbi et al and Heyerdahl et al raised concerns on "unspoken vaccine hesitancy" among HCWs in the Middle East, which our own study's ndings modestly support as a subject worth monitoring [23,24].…”

Section: Discussionsupporting

confidence: 46%

COVID-19 Vaccination in the Gaza Strip: a Cross-sectional Study of Vaccine Coverage, Hesitancy, and Associated Risk Factors Among Community Members and Healthcare Workers

Majer

Elhissi

Mousa

et al. 2022

Preprint

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Background: The Gaza Strip, like other settings of complex humanitarian emergencies, faces immense challenges in vaccinating its population against COVID-19. This study was conducted in October 2021 and aimed to estimate coverage of COVID-19 vaccination, levels of vaccine hesitancy, and associations with risk factors among the adult population and healthcare workers (HCWs). Methods: The study used a mixed methods design comprised of a cross-sectional survey of adults, purposive survey of HCWs, and qualitative discussions with key informants and community members. Quantitative data was summarized as univariable descriptive statistics with unweighted and weighted point estimates. Logistic regression was used to evaluate associations of risk factors with vaccination status and vaccine hesitancy.Results: A total of 1,075 individuals were reached in the survey, of whom 906 were community members. Population-weighted vaccine coverage was estimated to be 49.08% (95% CI: 43.10-55.08). 89.35% of HCWs were vaccinated. Population-weighted vaccine hesitancy was estimated to be 34.08% (95% CI: 28.14-40.56) among both vaccinated and unvaccinated respondents, and 67.24% (95% CI: 49.04-81.41) among the unvaccinated. In logistic regression vaccination was independently associated with male sex (aOR 1.88, 95% CI: 1.20-2.95), older age (40 or more years old) (aOR: 1.92, 95% CI: 1.73-2.13), higher education (aOR 2.19, 95% CI: 1.51-3.17), and confidence in the safety of the vaccine (aOR 13.8, 95% CI: 10.1-18.8). Risk factors for hesitancy were similar, however hesitant individuals were more likely to obtain vaccine information from family members (aOR: 1.20, 95% CI: 1.00-1.67) and less likely to trust healthcare providers (aOR: 0.58, 95% CI: 0.49-0.68). Qualitative interviews corroborated the survey results, although skepticism expressed by HCWs interviewed raises the possibility of hidden hesitancy.Conclusions: The continued emergence of SARS-CoV-2 variants reinforces the importance of achieving high levels of vaccination coverage globally – a uniquely challenging objective in Gaza. This study estimated half of Gaza’s adult population received at least one dose of any COVID-19 vaccine by October 2021, and the majority of unvaccinated individuals were hesitant. Disparities in vaccination across the territory’s demographic groups underscores the need for targeted outreach to these populations and messaging through community-based channels to permeate social networks of the unvaccinated.

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“…Uptake is particularly low for under 65s and those without comorbidities that qualify them for invitation for vaccination [12,13]. People with IMID are also less likely to have been vaccinated against COVID-19 compared to those with non-inflammatory rheumatic diseases [14] with 37-46% IMID patients uncertain or unwilling to get vaccinated [15,16]. As effective drug treatments for COVID-19 are found, and less-serious SARS-CoV-2 variants emerge, the perceived benefit from booster doses may diminish.…”

Section: Introductionmentioning

confidence: 99%

Barriers and facilitators to vaccination uptake against COVID-19, influenza, and pneumococcal pneumonia in immunosuppressed adults with immune-mediated inflammatory diseases: A qualitative interview study during the COVID-19 pandemic

et al. 2022

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Objectives To explore barriers and facilitators to COVID-19, influenza, and pneumococcal vaccine uptake in immunosuppressed adults with immune-mediated inflammatory diseases (IMIDs). Methods Recruiting through national patient charities and a local hospital, participants were invited to take part in an in-depth, one-to-one, semi-structured interview with a trained qualitative researcher between November 2021 and January 2022. Data were analysed thematically in NVivo, cross-validated by a second coder and mapped to the SAGE vaccine hesitancy matrix. Results Twenty participants (75% female, 20% non-white) were recruited. Barriers and facilitators spanned contextual, individual/group and vaccine/vaccination-specific factors. Key facilitators to all vaccines were higher perceived infection risk and belief that vaccination is beneficial. Key barriers to all vaccines were belief that vaccination could trigger IMID flare, and active IMID. Key facilitators specific to COVID-19 vaccines included media focus, high incidence, mass-vaccination programme with visible impact, social responsibility, and healthcare professionals’ (HCP) confirmation of the new vaccines’ suitability for their IMID. Novel vaccine technology was a concern, not a barrier. Key facilitators of influenza/pneumococcal vaccines were awareness of eligibility, direct invitation, and, clear recommendation from trusted HCP. Key barriers of influenza/pneumococcal vaccines were unaware of eligibility, no direct invitation or recommendation from HCP, low perceived infection risk, and no perceived benefit from vaccination. Conclusions Numerous barriers and facilitators to vaccination, varying by vaccine-type, exist for immunosuppressed-IMID patients. Addressing vaccine benefits and safety for IMID-patients in clinical practice, direct invitation, and public-health messaging highlighting immunosuppression as key vaccination-eligibility criteria may optimise uptake, although further research should assess this.

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Acceptability of the COVID-19 vaccine among patients with chronic rheumatic diseases and health-care professionals: a cross-sectional study in 19 Arab countries

Cited by 13 publications

References 9 publications

The COVID-19 epidemic curve and vaccine acceptance among patients with rheumatic diseases: an ecological study

The COVID-19 epidemic curve and vaccine acceptance among patients with rheumatic diseases: an ecological study

COVID-19 Vaccination in the Gaza Strip: a Cross-sectional Study of Vaccine Coverage, Hesitancy, and Associated Risk Factors Among Community Members and Healthcare Workers

Barriers and facilitators to vaccination uptake against COVID-19, influenza, and pneumococcal pneumonia in immunosuppressed adults with immune-mediated inflammatory diseases: A qualitative interview study during the COVID-19 pandemic

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