Mapping the situation of coronavirus disease 2019 vaccine hesitancy in the eastern mediterranean region: A cross-sectional study

Background: Coronavirus disease 2019 (COVID-19) vaccination coverage in countries of the Eastern Mediterranean Region (EMR) remains challengeable with a larger proportion of vaccine hesitancy (VH) among the population. The aim is to provide a situational analysis of COVID-19 immunization and VH determinants. Methods: An online questionnaire was conducted via social media platforms among people in low-, middle-, and high-income countries in the EMR. The present COVID-19 vaccination status of participants was assessed. Binary logistic regression analysis was used to identify determinants of VH among EMR population. Results: Only 32% out of 2,345 participants were fully vaccinated and received booster doses of COVID-19 vaccines, whereas 69.0% received or intended to receive the second dose, 3.5% were not planning to get the second dose, 16.7% did not get the booster shots, and 27.0% rejected vaccination. About 7% of participants accepting vaccination lacked confidence in the benefits and adverse effects of the vaccines. Participants who accepted versus refused the COVID-19 vaccine differed significantly in their socio-demographic characteristics, their history of infection or having an infected relative, and in where they obtained information about vaccination. Predictors of rejecting COVID-19 vaccines were age, living in low- and middle-income countries, having a COVID-19-infected relative, and getting vaccine information from literature, Ministries of Health websites, and the World Health Organization. Conclusion: Nearly half of the surveyed EMR citizens are still refusing COVID-19 vaccination, which makes it more difficult to control the spread of the pandemic. Countries must address people’s hesitancy to get vaccinated in order to complete vaccination courses and build public trust, thereby reducing the negative consequences of low vaccination uptake.