High Rates of COVID-19 Vaccine Hesitancy and Its Association with Conspiracy Beliefs: A Study in Jordan and Kuwait among Other Arab Countries

"The association of conspiracy beliefs regarding the prospective vaccines and the origin of the virus with vaccine hesitancy should raise a red flag and alert policy makers, governments and different media platforms to the serious harmful effects of spreading misinformation."

Conspiracy beliefs can fester in situations of fear, anxiety, and uncertainty. Conspiracy beliefs surrounding COVID-19 in the early days of the pandemic have since extended to include notions about vaccines against SARS-CoV-2, and they have spread quickly on social media. Such beliefs can lead to vaccine hesitancy through igniting mistrust in governments, healthcare providers, and the pharmaceutical industry. This study aimed to assess the overall acceptance rates for COVID-19 vaccines in several Arab countries and the harmful effects of belief in conspiracy in relation to prospective COVID-19 vaccination.

The study used an online survey completed from December 14-18 2020 by 3,414 respondents aged 16 and above who were residents of Jordan (n = 2,173, 63.6%), Kuwait (n = 771, 22.6%), or Saudi Arabia (n = 154, or 4.5%). Items assessing conspiracies regarding COVID-19's origin and vaccination; attitudes towards COVID-19 vaccines were assessed using the Vaccine Conspiracy Belief Scale (VCBS), with higher scores indicating a greater belief in vaccine conspiracy.

The acceptance rates for COVID-19 and influenza vaccines were 29.4% and 30.9%, respectively. COVID-19 vaccine acceptance was the highest in Saudi Arabia (31.8%), followed by Jordan (28.4%) and Kuwait (23.6%). (A higher rate of belief in conspiracy was seen in Kuwait in addition to more dependence on social media platforms to obtain knowledge about the vaccine. This can partly explain the lower acceptance rate for COVID-19 vaccines in Kuwait.) Overall, males, respondents with higher educational levels, and those with histories of chronic disease had higher rates of COVID-19 vaccine acceptance.

Slightly more than 40% of the study respondents believed that COVID-19 is a man-made disease made to force everyone to get the vaccine (n = 1,376), and 27.7% (n = 947) of the respondents believed that the COVID-19 vaccine is a way to implant microchips into people to control them. In addition, 23.4% of the respondents stated that COVID-19 vaccines will cause infertility (n = 800). Higher VCBS scores were found among females and respondents with lower educational levels.

Regarding the main source of information about COVID-19 vaccines, lower belief in vaccine conspiracy was seen among those who relied on medical doctors, scientists, and scientific journals (mean = 23.9, standard deviation (SD) = 11.4), compared to those who relied on TV programmes and news releases (mean = 25.7, SD = 10.0), and those who relied on YouTube (mean = 26.1, SD = 10.7). The highest VCBS was seen among those who relied on social media platforms (mean = 27.4, SD = 10.2).

Willingness to get a COVID-19 vaccine was the highest among the respondents who relied on medical doctors, scientists, and scientific journals (36.1%), and the lowest among the respondents who relied on social media platforms (22.1%). A similar result was seen for the willingness to get flu vaccinations (36.7% vs. 26.0%).

Reflecting on the findings, the researchers note that most Arab countries have a high burden of COVID-19; hence, the low rate of 29.4% of the respondents in the survey who said they would get vaccinated "is alarming, since it appears to be among the lowest acceptance rates globally". The high rates of vaccine hesitancy in Jordan and Kuwait, among other Arab countries, could hinder the proper control of COVID-19 in the region. The fact that reliance on social media as the main source of information about COVID-19 vaccines was associated with vaccine hesitancy "should alert governments, policy makers and the general public to the importance of vigilant fact checking."