Attitudes toward Receiving COVID-19 Booster Dose in the Middle East and North Africa (MENA) Region: A Cross-Sectional Study of 3041 Fully Vaccinated Participants

Mohamed Abouzid; Alhassan Ali Ahmed; Dina M El-Sherif; Wadi B Alonazi; Ahmed Ismail Eatmann; Mohammed M Alshehri; Raghad N Saleh; Mareb H Ahmed; Ibrahim Adel Aziz; Asmaa E Abdelslam; Asmaa Abu-Bakr Omran; Abdallah A Omar; Mohamed A Ghorab; Sheikh Mohammed Shariful Islam

doi:10.3390/vaccines10081270

Attitudes toward Receiving COVID-19 Booster Dose in the Middle East and North Africa (MENA) Region: A Cross-Sectional Study of 3041 Fully Vaccinated Participants

Vaccines (Basel). 2022 Aug 6;10(8):1270. doi: 10.3390/vaccines10081270.

Authors

Mohamed Abouzid^{1

2}, Alhassan Ali Ahmed^{2

3}, Dina M El-Sherif⁴, Wadi B Alonazi⁵, Ahmed Ismail Eatmann⁶, Mohammed M Alshehri⁷, Raghad N Saleh⁸, Mareb H Ahmed⁹, Ibrahim Adel Aziz¹⁰, Asmaa E Abdelslam¹¹, Asmaa Abu-Bakr Omran¹¹, Abdallah A Omar¹², Mohamed A Ghorab¹³, Sheikh Mohammed Shariful Islam¹⁴

Affiliations

¹ Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland.
² Doctoral School, Poznan University of Medical Sciences, 61-701 Poznan, Poland.
³ Department of Bioinformatics and Computational Biology, Poznan University of Medical Sciences, 61-701 Poznan, Poland.
⁴ National Institute of Oceanography and Fisheries (NIOF), Cairo 11694, Egypt.
⁵ Health Administration Department, College of Business Administration, King Saud University, P.O. Box 71115, Riyadh 11587, Saudi Arabia.
⁶ Department of Cell Biophysics, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University in Kraków, 31-007 Krakow, Poland.
⁷ Physical Therapy Department, Jazan University, P.O. Box 114, Jazan 45142, Saudi Arabia.
⁸ Oral Health and Promotion Unit, Faculty of Dentistry, Al-Quds University, Jerusalem P.O. Box 89, Palestine.
⁹ Dental College, AlNoor University College, Bartella 46476, Iraq.
¹⁰ Faculty of Medicine, Al Neelain University, Khartoum P.O. Box 12702, Sudan.
¹¹ Faculty of Medicine for Girls, Al-Azhar University, Cairo 71524, Egypt.
¹² Department of Pharmaceutical Services and Sciences, Children's Cancer Hospital Egypt (CCHE-57357), Cairo 11617, Egypt.
¹³ Wildlife Toxicology Laboratory, Department of Animal Science, Institute for Integrative Toxicology (IIT), Michigan State University, East Lansing, MI 48824, USA.
¹⁴ Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC 3125, Australia.

Abstract

COVID-19 vaccines are crucial to control the pandemic and avoid COVID-19 severe infections. The rapid evolution of COVID-19 variants such as B.1.1.529 is alarming, especially with the gradual decrease in serum antibody levels in vaccinated individuals. Middle Eastern countries were less likely to accept the initial doses of vaccines. This study was directed to determine COVID-19 vaccine booster acceptance and its associated factors in the general population in the MENA region to attain public herd immunity. We conducted an online survey in five countries (Egypt, Iraq, Palestine, Saudi Arabia, and Sudan) in November and December 2021. The questionnaire included self-reported information about the vaccine type, side effects, fear level, and several demographic factors. Kruskal−Wallis ANOVA was used to associate the fear level with the type of COVID-19 vaccine. Logistic regression was performed to confirm the results and reported as odds ratios (ORs) and 95% confidence intervals. The final analysis included 3041 fully vaccinated participants. Overall, 60.2% of the respondents reported willingness to receive the COVID-19 booster dose, while 20.4% were hesitant. Safety uncertainties and opinions that the booster dose is not necessary were the primary reasons for refusing the booster dose. The willingness to receive the booster dose was in a triangular relationship with the side effects of first and second doses and the fear (p < 0.0001). Females, individuals with normal body mass index, history of COVID-19 infection, and influenza-unvaccinated individuals were significantly associated with declining the booster dose. Higher fear levels were observed in females, rural citizens, and chronic and immunosuppressed patients. Our results suggest that vaccine hesitancy and fear in several highlighted groups continue to be challenges for healthcare providers, necessitating public health intervention, prioritizing the need for targeted awareness campaigns, and facilitating the spread of evidence-based scientific communication.

Keywords: SARS-CoV-2; coronavirus; mRNA vaccines; vaccine hesitancy; vector vaccines.

Grants and funding

This research was fully funded by Researchers Supporting Project number (RSP-2021/332), King Saud University, Riyadh, Saudi Arabia.