Determinants of COVID-19 Vaccine Engagement in Algeria: A Population-Based Study With Systematic Review of Studies From Arab Countries of the MENA Region

Abstract

BackgroundThe Algerian COVID-19 vaccination campaign, which started at the end of January 2021, is marked by a slowly ascending curve despite the deployed resources. To tackle the issue, we assessed the levels and explored determinants of engagement toward the COVID-19 vaccine among the Algerian population.MethodsA nationwide, online-based cross-sectional study was conducted between March 27 and April 30, 2021. A two-stage stratified snowball sampling method was used to include an equivalent number of participants from the four cardinal regions of the country. A vaccine engagement scale was developed, defining vaccine engagement as a multidimensional parameter (5 items) that combined self-stated acceptance and willingness with perceived safety and efficacy of the vaccine. An Engagement score was calculated and the median was used to define engagement vs. non-engagement. Sociodemographic and clinical data, perceptions about COVID-19, and levels of adherence to preventive measures were analyzed as predictors for non-engagement.ResultsWe included 1,019 participants, 54% were female and 64% were aged 18–29 years. Overall, there were low rates of self-declared acceptance (26%) and willingness (21%) to take the vaccine, as well as low levels of agreement regarding vaccine safety (21%) and efficacy (30%). Thus, the vaccine engagement rate was estimated at 33.5%, and ranged between 29.6-38.5% depending on the region (p > 0.05). Non-engagement was independently associated with female gender (OR = 2.31, p < 0.001), low adherence level to preventive measures (OR = 6.93, p < 0.001), private-sector jobs (OR = 0.53, p = 0.038), perceived COVID-19 severity (OR = 0.66, p = 0.014), and fear from contracting the disease (OR = 0.56, p = 0.018). Concern about vaccine side effects (72.0%) and exigence for more efficacy and safety studies (48.3%) were the most commonly reported barrier and enabler for vaccine acceptance respectively; whereas beliefs in the conspiracy theory were reported by 23.4%.ConclusionsThe very low rates of vaccine engagement among the Algerian population probably explain the slow ascension of the vaccination curve in the country. Vaccine awareness campaigns should be implemented to address the multiple misconceptions and enhance the levels of knowledge and perception both about the disease and the vaccine, by prioritizing target populations and engaging both healthcare workers and the general population.

Knowledge, attitude, and perception towards COVID-19 vaccinations among the adults in Rwanda: a cross-sectional study

“…Respondents between 30 and 39 were found to be more likely to have positive perceptions of COVID-19 vaccines, these findings align with those of a study conducted in multiple African countries, which found that South Africans in this age group had more favorable perceptions towards COVID-19 vaccines than participants of other age groups [ 42 ]. Moreover, single participants were more likely to have positive vaccine perceptions compared to married participants; a study conducted in Singapore reported nearly the same results [ 43 , 44 ]; however, in their multivariate analysis, they discovered that this association was non-significant [ 45 , 46 ], our analysis found that males were more likely to have a positive perception toward COVID-19, however, there was no significantly impact shaping COVID-19 vaccine perceptions. This deviation could be attributed to shifting gender roles and the shared responsibility of healthcare decision-making between genders, suggesting a lack of apparent gender-based disparities in vaccine hesitancy.…”

Improving Nutritional Status Was Associated with Decreasing Disease Severity and Shortening of Negative Conversion Time of PCR Test in Non-ICU Patients with COVID-19

“…Reasons for refusing to accept vaccinations are complex, including concerns about side effects of vaccines, perceived need for more clinical studies on the effectiveness and safety of the vaccines, and personal beliefs. 27 Clearly, vaccination is an important preventive measure for symptomatic and severe COVID-19. Vaccine promotion activities should be carried out, and the elderly and other high-risk groups should be encouraged to participate in the vaccination programs.…”

“…As far as we know, there are only a few studies that have evaluated the nutritional risk and the severity of COVID-19 in Chinese patients. 27 Due to different immunization strategies in different countries, the basic health status of the population also varies. It is undoubtedly of great significance to understand the correlation between the nutritional status of Chinese people and the severity of COVID-19 and to carry out nutritional intervention research in the future.…”

Barriers toward xenotransplantation in Arab World

“…124 For example, studies done during the pandemic showed that one of the causes of vaccine hesitancy and refusal are conspiracy theories created concerning the origin of infection. [127][128][129] Another study conducted in Morocco by Lohiniva et al showed that a part of vaccination hesitancy could be linked to spreading rumors. 130 Hence, the potential increased risk of zoonotic infection transmission during xenotransplant can be partly due to public misinformation in the Arab region, which can be a limitation to necessary vaccination.…”

“…Many false or misinterpreted information has been spread worldwide, particularly the Arab region 124 . For example, studies done during the pandemic showed that one of the causes of vaccine hesitancy and refusal are conspiracy theories created concerning the origin of infection 127–129 . Another study conducted in Morocco by Lohiniva et al.…”