Experiences and perceptions of COVID-19 infection and vaccination among Palestinian refugees in Jerash camp and Jordanian citizens: a comparative cross-sectional study by face-to-face interviews

Abstract

Background During the COVID-19 vaccination, the access to vaccines has been unequal among countries and individuals, for example low-income countries displayed significant low levels of vaccination. Furthermore, most refugees are living in developing low-income countries which struggling to access the essential health-care services including vaccination. Thus, the objective of this study was to assess the experiences and perceptions of COVID-19 infection and vaccination among Palestine refugees in Jerash camp compared to resident Jordanian citizens. Methods A face-to-face interview-based comparative cross-sectional study was carried out among Palestine refugees in Jerash camp located in northern Jordan and Jordanian citizens from different cities in Jordan from October, 2021 to March, 2022. A Chi-square test was used to determine the differences in the experiences and perceptions of COVID-19 infection and vaccination between Palestinian refugees and resident Jordanian citizens. Logistic regression analysis was performed to predict factors associated with the beliefs, barriers and hesitancy towards COVID-19 vaccines. Results The total number of participants was 992, with 501 (50.5%) Palestinian refugees and 491 (49.5%) Jordanian citizens. Most participants (64.1%) who have never been tested for COVID-19 were from the refugees (P < 0.001), whereas about 80.3% of the participants tested for COVID-19 at private healthcare institutions were citizens (P < 0.001). While 70.0% of the participants who tested positive for COVID-19 (n = 303) were from the refugees (P < 0.001). Compared to the citizens, the refugees had significantly lower levels of beliefs about the safety (P = 0.008) and efficiency (P < 0.001) of COVID-19 vaccines. They also had lower rates of vaccine hesitancy (P = 0.002) and vaccine uptake (P < 0.001), and a higher rate of facing difficulties during registration for COVID-19 vaccination (P < 0.001). Furthermore, refugees have more negative attitudes toward the importance and implementation of COVID-19 precautionary activities, including wearing face masks, practicing social distancing and following proper prevention hygiene compared to citizens (P < 0.001). The regression analysis showed that gender (P < 0.001), age (P < 0.001) and level of education (P = 0.001) were significantly associated with COVID-19 vaccine hesitancy. Also, being a refugee (P < 0.001) and being a male (P = 0.012) were significantly associated with facing more difficulties upon the registration to receive a COVID-19 vaccine. Conclusions This study showed that, compared to citizens, refugees had lower attitudes and practices toward COVID-19 infection and vaccination. They also had and a lower rate of COVID-19 vaccine hesitancy and uptake with limited access to vaccines. Government sectors and non-government organizations should implement policies and regulations to raise the awareness of refugees towards COVID-19 infection, testing, preventive measures, and the safety and efficacy of vaccines.

Predictors of COVID-19 Vaccine Acceptability Among Refugees and Other Migrant Populations: A Systematic Scoping Review

“…According to the 118 literature review and based on the conceptual framework used (10) 4). Female gender (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21), younger age (14,15,17,(22)(23)(24)(25)(26)(27)(28)(29), lower level of education (12,16,17,19,20,22,26,(30)(31)(32), and being single (11,13,26) were associated with lower vaccine acceptance in most studies. Some of the other sociodemographic influencers of COVID-19 vaccine acceptance were sexual orientation (19),income (26,33), region of origin (11,17,21), religion (11,17), migratory background (20,30,34,…”

“…Most common sociodemographic factors associated with COVID-19 acceptance were gender, age, level of education, and marital status (Table 4). Female gender (11-21), younger age (14, 15, 17, 22-29), lower level of education (12, 16, 17, 19, 20, 22, 26, 30-32), and being single (11, 13, 26) were associated with lower vaccine acceptance in most studies.…”

Combined Impact of Omicron Vaccination and Environmental Risk Exposure: A Thailand Case Study

“…Various studies [ 56 , 57 ] implied that population groups having experience with COVID-19 infections were more likely to accept the COVID-19 vaccination. Al-Hatamleh Mohammad A. I. et al [ 58 ] reported that many symptoms, including general fatigue, headache, fever, anosmia, and cough, were the most frequent health burdens of COVID-19 infection. Populations were willing to take the COVID-19 booster dose vaccinations for reducing the suffering of COVID-19 infections [ 59 ].…”

Psychological distress among unemployed migrants settling in southwestern Spain: A cross-sectional study

“…[11] Equally, a low COVID-19 testing rate in these settlements was a contributing factor for a low rate of reported cases, and the refugees who were infected with COVID-19 may have gone unnoticed by this issue. [12] On the other hand, the impact of the COVID-19 pandemic on settled migrants' has intensified preexisting social inequalities in these settings, such as forced displacement, disruptions of necessary health services and reduction of social networks, thus affecting their mental health status. [13,14] In the general population, the course of the pandemic has worsened mental health levels, leading in some cases to an increase in the demand for psychological care.…”

“…[ 11 ] Equally, a low COVID-19 testing rate in these settlements was a contributing factor for a low rate of reported cases, and the refugees who were infected with COVID-19 may have gone unnoticed by this issue. [ 12 ]…”