COVID-19 vaccination in the Gaza Strip: a cross-sectional study of vaccine coverage, hesitancy, and associated risk factors among community members and healthcare workers

Majer, Jennifer; Elhissi, Jehad H.; Mousa, Nabil; Kostandova, Natalya

doi:10.1186/s13031-022-00477-7

Conflict and Health

Table 11 Factors associated with vaccine hesitancy, non-vaccinated community members only (n = 449)

From: COVID-19 vaccination in the Gaza Strip: a cross-sectional study of vaccine coverage, hesitancy, and associated risk factors among community members and healthcare workers

Characteristic	N	Vaccine hesitant (unweighted)			Vaccine hesitant (weighted)
Characteristic	N	No, N = 149 (%)	Yes, N = 300 (%)	p value^a	No (%)	Yes (%)	p value^a
Age	449			0.88			0.41
18–39		63.09	62.33		56.69	62.58
40+		36.91	37.67		43.31	37.42
Sex	449			0.033			0.68
Female		59.73	49.00		48.40	49.89
Male		40.27	51.00		51.60	50.11
Highest education level	449			0.018			0.41
Primary or none		5.37	13.33		5.98	14.97
Secondary or College/Vocational		49.66	40.00		44.79	41.85
University		44.97	46.67		49.24	43.18
Have enough information about COVID-19 vaccine	449			0.58			0.30
Yes		30.87	28.33		37.74	28.76
No or don't know		69.13	71.67		62.26	71.24
Information needed	449
Eligibility criteria		33.56	37.00	0.47	46.59	53.75	0.58
Timeline for vaccine roll-out		8.05	7.67	0.89	17.02	12.82	0.35
When it's my turn to get the vaccine		9.40	8.33	0.71	14.14	12.06	0.59
Doses needed		19.46	23.00	0.39	25.10	30.53	0.50
Risks and side effects		90.60	88.33	0.47	94.12	89.80	0.12
Effectiveness of the vaccines		76.51	74.33	0.62	84.62	81.19	0.27
How to register for the vaccine		10.74	12.00	0.69	11.05	12.47	0.75
Common source of information about health and vaccines	448
Health care providers		59.73	57.53	0.66	62.75	53.21	0.16
Community health care workers		20.81	20.74	0.99	12.33	13.66	0.54
Radio		10.07	16.39	0.073	8.61	16.61	0.067
Television		28.19	33.11	0.29	27.28	35.24	0.43
Newspapers		0.67	3.01	0.12	0.05	1.71	0.018
Mass events		10.07	9.36	0.81	9.16	9.03	0.97
Family		26.17	29.10	0.52	29.06	43.28	0.15
Neighbors, friends, colleagues		34.90	43.48	0.083	44.04	52.29	0.51
Local leaders		2.68	1.67	0.47	3.36	1.38	0.51
Religious leaders		2.68	2.68	> 0.99	4.55	3.41	0.63
Social media		68.46	56.52	0.015	66.73	58.32	0.058
Organizations		14.09	8.36	0.061	15.36	10.30	0.17
Trusted source of information	449
Health care providers		71.14	58.33	0.009	73.03	58.60	0.14
Community health care workers		23.49	23.33	0.97	22.87	26.79	0.69
Local leaders		2.01	0.33	0.075	1.12	0.02	0.012
Religious leaders		0.00	1.67	0.11	0.00	1.20	0.35
Family members		2.01	7.33	0.021	4.05	9.51	0.075
Neighbors, friends, colleagues		3.36	9.00	0.029	4.72	10.81	0.082
Organizations		14.77	9.67	0.11	14.47	9.17	0.45
Media		14.77	18.00	0.39	13.40	15.69	0.40
Radio		1.34	3.00	0.29	0.82	4.70	0.012
Television		9.40	11.00	0.60	9.12	12.88	0.58
Other		4.70	8.67	0.13	2.81	7.78	0.069
Trust health providers and CHWs to provide with accurate information about the COVID-19 vaccine	448			< 0.001			0.001
No or don't know		5.37	23.75		6.66	25.71
Yes		71.14	38.13		67.87	33.96
Somewhat		23.49	38.13		25.48	40.33
Follow social media platforms to get info about vaccine	449			0.20			0.15
No or don't know		20.81	26.33		15.69	22.34
Yes		79.19	73.67		84.31	77.66
Social media platforms used to get info about vaccine	339
Facebook		99.15	99.10	0.96	99.67	99.93	0.25
Twitter		13.56	16.74	0.44	15.49	12.84	0.49
Instagram		41.53	38.91	0.64	44.09	47.97	0.78
YouTube		16.10	26.24	0.034	18.32	21.91	0.45
Shares information related to vaccine on social media network	421	17.86	13.17	0.20	16.82	6.94	0.005
How do you know info about vaccine from social media is true	449			< 0.001			0.16
I do not verify		20.13	41.67		24.76	46.56
Other		14.09	17.67		13.72	15.54
Verify from reputable website or health care provider		65.77	40.67		61.52	37.90
Do leaders (religious, political, teachers, health care workers) in your community support the COVID-19 vaccines?	257			0.082			0.45
No or don't know		23.40	33.74		24.83	32.43
Yes		76.60	66.26		75.17	67.57
Most people you know interested in getting the COVID-19 vaccine	449			< 0.001			0.036
No or don't know		22.82	45.00		27.78	43.95
Yes		38.93	14.67		39.38	14.48
Somewhat		38.26	40.33		32.83	41.57
How many people in your community are concerned about COVID-19 in the community	356			0.003			0.17
Few or some people, less than half		11.97	26.36		15.20	31.45
Most people		46.15	31.80		40.77	26.16
Some people—more than half		41.88	41.84		44.03	42.39
COVID-19 vaccines will or are being rolled out equitably in community	447			0.23			0.63
No or don't know		18.79	23.83		23.28	26.78
Yes		81.21	76.17		76.72	73.22
Knows somebody that had a serious negative reaction to a vaccine that makes them reluctant to get COVID-19 vaccine	449			0.056			0.26
Yes		31.54	40.67		34.84	42.93
Somewhat		12.08	15.00		14.85	21.93
No or don't know		56.38	44.33		50.31	35.14
Consider COVID-19 vaccines safe	448			< 0.001			0.074
No or don't know		42.95	76.25		49.16	74.25
Yes		17.45	3.34		17.38	2.08
Somewhat		39.60	20.40		33.46	23.67
Concerned about risks or side effects with COVID-19 vaccines	449			0.009			0.14
No or don't know		15.44	7.67		19.21	7.48
Yes		71.14	83.33		69.81	83.79
Somewhat		13.42	9.00		10.97	8.73
Types of risks or side effects concerned about	402
Fever		57.94	51.81	0.25	58.26	58.56	0.95
Body aches		66.67	61.23	0.30	73.25	66.99	0.17
Infertility		19.05	30.43	0.017	16.85	36.95	0.068
Physical disability		23.02	33.33	0.037	23.34	31.23	0.090
Death		49.21	65.58	0.002	47.90	64.35	0.17
Other		15.08	17.39	0.56	23.16	21.99	0.74
Type of COVID vaccine preferred	448
Other		0.00	0.00		0.00	0.00
No preference		12.75	49.83		17.25	53.89
Pfizer		49.66	25.75		47.01	27.47
Sputnik		28.19	10.37		27.00	9.54
Moderna		0.00	1.67		0.00	1.73
Unsure		6.71	11.37		5.48	6.75
Sinopharm		2.68	1.00		3.26	0.63
Believe there are other (better) ways to prevent COVID-19 instead of vaccine	449			< 0.001			0.039
No or don't know		30.20	16.33		28.51	15.14
Yes		53.69	71.33		51.93	67.67
Somewhat		16.11	12.33		19.56	17.19
Better ways to prevent COVID-19 instead of vaccine	294
Social distance		85.00	82.24	0.58	86.75	84.33	0.67
Handwashing		78.75	75.70	0.58	75.60	81.53	0.45
Infection prevention and control		41.25	47.20	0.36	57.90	55.56	0.83
Ventilation		47.50	47.66	0.98	52.95	59.28	0.60
Wearing face masks		78.75	75.70	0.58	73.25	79.59	0.25
Know any person with a serious disease/disability that happened because they were NOT vaccinated	449			0.006			0.13
Yes		20.13	10.67		26.73	10.22
No or don't know		79.87	89.33		73.27	89.78
Think it is better to get COVID-19 and develop natural immunity than to get the vaccine	448			< 0.001			0.18
No		39.19	19.00		39.21	17.81
Don't know		7.43	9.67		2.94	7.63
Yes		39.19	57.33		43.45	57.73
Somewhat		14.19	14.00		14.39	16.83
Remember past events that would discourage them from getting COVID-19 vaccine	449	32.89	37.33	0.36	35.22	40.21	0.47
Think you are at risk to get COVID-19	449			0.001			0.22
No		4.70	10.33		7.73	9.80
Don't know		2.68	10.33		0.89	11.49
Yes		92.62	79.33		91.38	78.72
Think you can get seriously ill, hospitalized or die if you get COVID-19	449			0.004			0.010
No		34.90	37.33		34.33	41.62
Don't know		25.50	37.33		23.76	35.17
Yes		39.60	25.33		41.90	23.20
Barriers for receiving COVID-19 vaccine	448
Availability		2.70	3.33	0.72	3.39	1.75	0.11
Distance to vaccination point		6.08	5.67	0.86	2.88	1.62	0.21
Cost		0.00	0.00		0.00	0.00
Not a priority group		6.08	6.67	0.81	2.52	7.11	0.27
Lack of information about how/where to get it		20.95	22.33	0.74	19.50	19.06	0.90
Too stressful		35.14	37.33	0.65	43.82	50.20	0.091
Staff attitude		3.38	3.33	0.98	3.55	3.39	0.95
Not socially acceptable		11.49	36.33	< 0.001	11.07	30.41	0.078
None		10.81	11.00	0.95	19.09	14.42	0.39
Would get/have gotten the vaccine if employer recommended	449			< 0.001			0.092
No		19.46	43.33		22.43	40.43
Unsure		6.71	19.33		4.12	21.32
Yes		73.83	37.33		73.44	38.25

Values in bold indicate statistically significant results at p value < 0.05
^aChi-squared test with Rao & Scott's second-order correction

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