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Psychological antecedents toward COVID-19 vaccination explain the high rates of vaccine rejection among the Libyan population 2 years after starting vaccination campaigns

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Abstract

Background

Libya has one of the lowest rates of coverage of the coronavirus diseases 2019 (COVID-19) vaccination in the Eastern Mediterranean Region. This study aims to explore the attitudes of the Libyan population toward COVID-19 vaccines and identify the psychological factors that influence their decision-making process regarding vaccination.

Methods

An anonymous online survey was distributed among the Libyan population, utilizing the validated English and Arabic versions of the 5C scale. The survey was distributed through various social media platforms. The snowball and convenience sampling methods were used to collect data from participants, who were categorized as either vaccine acceptors or vaccine rejectors.

Results

Of the 1838 participants, 39.2% fell within the age range of 25 to 34 years and 68.2% were female. Only 26% of the respondents had either received the COVID-19 vaccination or had a plan to do so. Four-fifths (80.0%) of the participants expressed confidence in COVID-19 vaccines, 91.1% felt complacent about vaccination, 78.4% faced constraints, 93.9% made calculations to receive the COVID-19 vaccine, and 93.6% felt collective responsibility toward getting vaccinated. Significant statistical differences were identified in the various 5C domains between vaccine acceptors and rejectors. Specifically, there were notable disparities in confidence (95.65% vs. 68.64%, p < 0.001), constraints (51.39% vs. 80.29%, p < 0.001), calculation (92.86% vs. 72.83%, p < 0.001), and collective responsibility (95.73% vs. 72.57%, p < 0.001) between the two groups. Multivariate analysis showed that older age [35–49 years or 50–65 years], being male, having confidence, and having collective responsibility positively affected COVID-19 vaccination [odds ratio (OR) = 0.61, 95% confidence interval (CI), 0.41–0.89, OR = 0.31 (95% CI, 0.15–0.62), OR = 0.54 (95%CI, 0.42–0.70), OR = 0.14, (95%CI, 0.08–0.23), OR = 0.19 (95%CI, 0.06 – 0.48)], respectively], while working in crafts and related trade work and constraints negatively affected COVID-19 vaccination [OR = 1.86 (95%CI, 1.10–3.22), OR = 4.98 (95%CI, 3.77–6.60.27), respectively].

Conclusions

Vaccine rejection can be influenced by various non-modifiable factors such as age and sex. However, psychological factors, including confidence, constraints, and collective responsibility, play a significant role and can be targeted and modified to reduce vaccine rejection among Libyans.

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Abbreviations

COVID-19 :

Coronavirus disease 2019

EMR :

East Mediterranean Region

WHO :

World Health Organization

aOR :

Adjusted odds ratio

cOR :

Crude odds ratio

SARS-CoV-2 :

Severe acute respiratory syndrome coronavirus 2

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Acknowledgments

We express our sincere gratitude to all the study participants for their valuable contribution to this research. Additionally, we extend our thanks to the Global Researcher Club for their assistance in data collection, which greatly facilitated the progress of this study.

Author information

Authors and Affiliations

  1. Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia

    Ramy Mohamed Ghazy

  2. Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt

    Ramy Mohamed Ghazy

  3. Clinical Research Department, Ministry of Health and Population, Faiyum, Egypt

    Mahmoud M. Tolba

  4. Medical Agency for Research and Statistics-MARS, Cairo, Egypt

    Marina R. Abdelmessih Saleeb

  5. Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt

    Fatimah Saed Alabd Abdullah

  6. Almarj Teaching Hospital, Ministry of Health, Almarj City, Libya

    Fatimah Saed Alabd Abdullah

  7. Faculty of Public Health, Lebanese University, Beirut, Lebanon

    Saja Yazbek

  8. Department of Medical-Surgical Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia

    Naglaa Youssef

  9. Alexandria Clinical Research Administration, Alexandria Health Affairs Directorate, Alexandria, Egypt

    Mai Hussein

  10. Ministry of Health and Population, Cairo, Egypt

    Mai Hussein

  11. Occupational Health and Industrial Medicine Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt

    Mohamed Fakhry Hussein

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  1. Ramy Mohamed Ghazy
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Correspondence to Mai Hussein.

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Ethical approval

The study received approval from the Faculty of Medicine, Alexandria University, Alexandria, Egypt (IRB No. 00012098/FWA No. 00018699). Ethical consent was obtained and presented as an initial requirement in the questionnaire.

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Ghazy, R.M., Tolba, M.M., Abdelmessih Saleeb, M.R. et al. Psychological antecedents toward COVID-19 vaccination explain the high rates of vaccine rejection among the Libyan population 2 years after starting vaccination campaigns. J Public Health (Berl.) (2024). https://doi.org/10.1007/s10389-023-02178-8

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