Measuring the Factors Influencing the Acceptance of COVID-19 Vaccines in the Western Region of Saudi Arabia

Understanding key factors of the acceptance of COVID-19 vaccines by the community could aid governmental agencies, medical practitioners, and other entities in reducing the impact of vaccine avoidance. The study aimed to assess the factors influencing people’s acceptance and refusal to receive the COVID-19 vaccination in the Western Region of Saudi Arabia. A cross-sectional study using an e-questionnaire was used to collect responses from consenting participants aged over 12 who are residents in the Western Region of Saudi Arabia. A validated and pre-tested questionnaire was used that recorded socio-demographic details, awareness about COVID-19 vaccines, attitudes toward vaccination in general, and factors influencing the decision of COVID-19 vaccine compliance.

The COVID-19 vaccine administration rate was 96.5%, and the most commonly administered vaccine was Pfizer-BioNTech (78%). The most widely reported influencing factor was intrinsic influences. Vaccine administration was significantly higher among those who believed COVID-19 vaccines are safe (p<0.001) and those who believed vaccines could help in controlling in pandemic (p<0.001). The public’s trust in vaccines can be increased by distributing information about the vaccine’s safety and undertaking health education initiatives.

1.      Salmon DA, Dudley MZ, Brewer J, Kan L, Gerber JE, Budigan H, et al. COVID-19 vaccination attitudes, values and intentions among United States adults prior to emergency use authorization. Vaccine. 2021;39(19):2698-711. doi:10.1016/j.vaccine.2021.03.034

2.      Elhadi M, Alsoufi A, Alhadi A, Hmeida A, Alshareea E, Dokali M, et al. Knowledge, attitude, and acceptance of healthcare workers and the public regarding the COVID-19 vaccine: a cross-sectional study. BMC Public Health. 2021;21(1):1-21. doi:10.1186/s12889-021-10987-3

3.      Alfageeh EI, Alshareef N, Angawi K, Alhazmi F, Chirwa GC. Acceptability of a COVID-19 Vaccine among the Saudi Population. Vaccines. 2021;9(3):226. doi:10.3390/vaccines9030226

4.      Schmid P, Rauber D, Betsch C, Lidolt G, Denker ML. Barriers of influenza vaccination intention and behavior–a systematic review of influenza vaccine hesitancy, 2005–2016. PloS One. 2017;12(1):e0170550. doi:10.1371/journal.pone.0170550

5.      Chilamakuri R, Agarwal S. COVID-19: characteristics and therapeutics. Cells. 2021;10(2):206. doi:10.3390/cells10020206

6.      Wang J, Peng Y, Xu H, Cui Z, Williams RO. The COVID-19 vaccine race: challenges and opportunities in vaccine formulation. AAPS Pharm Sci Tech. 2020;21(6):1-2. doi:10.1208/s12249-020-01744-7

7.      Setbon M, Raude J. Factors in vaccination intention against the pandemic influenza A/H1N1. Eur J Public Health. 2010;20(5):490-4. doi:10.1093/eurpub/ckq054

8.      Nguyen T, Henningsen KH, Brehaut JC, Hoe E, Wilson K. Acceptance of a pandemic influenza vaccine: a systematic review of surveys of the general public. Infect Drug Resist. 2011:197-207. doi:10.2147/IDR.S23174

9.      Halpin C, Reid B. Attitudes and beliefs of healthcare workers about influenza vaccination. Nurs Older People. 2019;31(2). doi:10.7748/nop.2019.e1154

10.   Bai W, Cai H, Liu S, Liu H, Qi H, Chen X, et al. Attitudes toward COVID-19 vaccines in Chinese college students. Int J Biol Sci. 2021;17(6):1469-75. doi:10.7150/ijbs.58835

11.   Graffigna G, Palamenghi L, Boccia S, Barello S. Relationship between citizens’ health engagement and intention to take the COVID-19 vaccine in Italy: a mediation analysis. Vaccines. 2020;8(4):576. doi:10.3390/vaccines8040576

12.   Reiter PL, Pennell ML, Katz ML. Acceptability of a COVID-19 vaccine among adults in the United States: How many people would get vaccinated?. Vaccine. 2020;38(42):6500-7. doi:10.1016/j.vaccine.2020.08.043

13.   Tyson A, Johnson C, Funk C. For Media or Other Inquiries. 2020. Available from: www.pewresearch.org.

14.   Al-Mohaithef M, Padhi BK. Determinants of COVID-19 vaccine acceptance in Saudi Arabia: a web-based national survey. J Multidiscip Healthc. 2020;13:1657-63. doi:10.2147/JMDH.S276771

15.   Pogue K, Jensen JL, Stancil CK, Ferguson DG, Hughes SJ, Mello EJ, et al. Influences on attitudes regarding potential COVID-19 vaccination in the United States. Vaccines. 2020;8(4):582. doi:10.3390/vaccines8040582

16.   El-Elimat T, AbuAlSamen MM, Almomani BA, Al-Sawalha NA, Alali FQ. Acceptance and attitudes toward COVID-19 vaccines: A cross-sectional study from Jordan. Plos one. 2021;16(4):e0250555. doi:10.1371/journal.pone.0250555

17.   Riad A, Pokorná A, Antalová N, Krobot M, Zviadadze N, Serdiuk I, et al. Prevalence and drivers of COVID-19 vaccine hesitancy among Czech university students: National cross-sectional study. Vaccines. 2021;9(9):948. doi:10.3390/vaccines9090948

18.   Lazarus JV, Ratzan SC, Palayew A, Gostin LO, Larson HJ, Rabin K, et al. A global survey of potential acceptance of a COVID-19 vaccine. Nat Med. 2021;27(2):225-8. doi:10.1038/s41591-020-1124-9

19.   Ministry of Health. COVID-19 & Vaccine FAQs. [online]. 2022. Available from: https://www.moh.gov.sa/en/Ministry/HotTopics/Pages/COVID-19-Vaccine.aspx [Accessed 14 May 2022].

20.   Kumari A, Ranjan P, Chopra S, Kaur D, Kaur T, Upadhyay AD, et al. Knowledge, barriers and facilitators regarding COVID-19 vaccine and vaccination programme among the general population: a cross-sectional survey from one thousand two hundred and forty-nine participants. Diabetes Metab Syndr. 2021;15(3):987-92. doi:10.1016/j.dsx.2021.04.015

21.   McAteer J, Yildirim I, Chahroudi A. The VACCINES Act: deciphering vaccine hesitancy in the time of COVID-19. Clin Infect Dis. 2020;71(15):703-5. doi:10.1093/cid/ciaa433

22.   Lucia VC, Kelekar A, Afonso NM. COVID-19 vaccine hesitancy among medical students. J Public Health. 2021;43(3):445-9. doi:10.1093/pubmed/fdaa230

23.   Alqahtani YS. Acceptability of the COVID-19 vaccine among adults in Saudi Arabia: a cross-sectional study of the general population in the southern region of Saudi Arabia. Vaccines. 2021;10(1):41. doi:10.3390/vaccines10010041

24.   Dror AA, Eisenbach N, Taiber S, Morozov NG, Mizrachi M, Zigron A, et al. Vaccine hesitancy: the next challenge in the fight against COVID-19. Eur J Epidemiol. 2020;35(8):775-9. doi:10.1007/s10654-020-00671-y

25.   Fisher KA, Bloomstone SJ, Walder J, Crawford S, Fouayzi H, Mazor KM. Attitudes toward a potential SARS-CoV-2 vaccine: a survey of US adults. Ann Intern Med. 2020;173(12):964-73. doi:10.7326/M20-3569

26.   Assiri A, Al-Tawfiq JA, Alkhalifa M, Al Duhailan H, Al Qahtani S, Dawas RA, et al. Launching COVID-19 vaccination in Saudi Arabia: Lessons learned, and the way forward. Travel Med Infect Dis. 2021;43:102119. doi:10.1016/j.tmaid.2021.102119

27.   Schwartz JL. Evaluating and deploying COVID-19 vaccines—The importance of transparency, scientific integrity, and public trust. N Engl J Med. 2020;383(18):1703-5. doi:10.1056/NEJMoa2022483

28.   Buttenheim AM, Asch DA. Making vaccine refusal less of a free ride. Hum Vaccin Immunother. 2013;9(12):2674-5. doi:10.4161/hv.26676

29.   Verelst F, Kessels R, Delva W, Beutels P, Willem L. Drivers of vaccine decision-making in South Africa: a discrete choice experiment. Vaccine. 2019;37(15):2079-89. doi:10.1016/J.VACCINE.2019.02.056

30.   Kaplan RM, Milstein A. Influence of a COVID-19 vaccine’s effectiveness and safety profile on vaccination acceptance. Proc Natl Acad Sci. 2021;118(10):e2021726118.

31.   Chapman LA, Shukla P, Rodríguez-Barraquer I, Shete PB, León TM, Bibbins-Domingo K, et al. Risk factor targeting for vaccine prioritization during the COVID-19 pandemic. Sci Rep. 2022;12(1):1-2. doi:10.1038/s41598-022-06971-5

32.   Rodríguez-Blanco N, Montero-Navarro S, Botella-Rico JM, Felipe-Gómez AJ, Sánchez-Más J, Tuells J. Willingness to be vaccinated against COVID-19 in Spain before the start of vaccination: a cross-sectional study. Int J Environ Res Public Health. 2021;18(10):5272. doi:10.3390/ijerph18105272

33.   Wang J, Jing R, Lai X, Zhang H, Lyu Y, Knoll MD, et al. Acceptance of COVID-19 Vaccination during the COVID-19 Pandemic in China. Vaccines. 2020;8(3):482. doi:10.3390/vaccines8030482

34.   Cheung EW, Zachariah P, Gorelik M, Boneparth A, Kernie SG, Orange JS, et al. Multisystem inflammatory syndrome related to COVID-19 in previously healthy children and adolescents in New York City. Jama. 2020;324(3):294-6.