Misinformation, Perceptions Towards COVID-19 and Willingness to be Vaccinated: A Population-Based Survey in Yemen

  1. Ahmad Naoras Bitar
  2. Mohammed Zawiah
  3. Fahmi Y. Al-Ashwal
  4. Mohammed Kubas
  5. Ramzi Mukred Saeed
  6. Rami Abduljabbar
  7. Ammar Ali Saleh Jaber
  8. Syed Azhar Syed Sulaiman
  9. Amer Hayat Khan

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Abstract

Since the beginning of the COVID-19 outbreak, many pharmaceutical companies were racing to develop a safe and effective COVID-19 vaccine. Simultaneously, rumors and misinformation about COVID-19 were and still widely spreading. Therefore, this study aimed to investigate the prevalence of COVID-19 misinformation among the Yemeni population and its association with vaccine acceptance and perceptions.

Methods

A cross-sectional online survey was conducted in four major cities in Yemen. The constructed questionnaire consisted of four main sections (sociodemographic data, misinformation, perceptions (perceived susceptibility, severity and worry), and vaccination acceptance evaluation). Subject recruitment and data collection were conducted online utilizing social websites and using the snowball sampling technique. Descriptive and inferential analyses were performed using SPSS version 27.

Results

The total number of respondents was 484. Over 60% of them were male and had a university education, more than half had less than 100$ monthly income and were Khat chewers, while only 18% were smokers. Misinformation prevalence ranged from 8.9% to 38.9%, depending on the statement being asked. Men, university education, higher income, employment, and living in urban areas were associated with a lower misinformation level ( p <0.05). Statistically significant association ( p <0.05) between university education, living in urban areas, and being employed with perceived susceptibility were observed. The acceptance rate was 61.2% for free vaccines, but it decreased to 43% if they had to purchase it. Females, respondents with lower monthly income, and those who believed that pharmaceutical companies made the virus for financial gains were more likely to reject the vaccination ( p <0.05).

Conclusion

The study revealed that the acceptance rate to take a vaccine was suboptimal and significantly affected by gender, misinformation, cost, and income. Furthermore, being female, Nonuniversity educated, low-income, and living in rural areas were associated with higher susceptibility to misinformation about COVID-19. These findings show a clear link between misinformation susceptibility and willingness to vaccinate. Focused awareness campaigns to decrease misinformation and emphasize the vaccination’s safety and efficacy might be fundamental before initiating any mass vaccination in Yemen.

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  1. ScreenIT

    SciScore for 10.1101/2021.02.25.432838: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: The project was registered with the ethical committee of the Medical Research, University of Science and Technology, Sana’a, Yemen, with the following number: ECA/UST189.
    Consent: An electronic consent statement to be ticked by all participants who agreed to participate, those who did not tick it will not be able to fill the questionnaire.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical analysis was done using the Statistical Package for the Social Sciences (SPSS) (Version 27.0; IBM corp).
    Statistical Package for the Social Sciences
    suggested: (SPSS, RRID:SCR_002865)
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Strength and limitations of the study: There are a few limitations to the conducted study. Responses were received mainly from four major cities in Yemen, limiting the generalization of the whole country’s findings. An online snowballing sampling technique has been used, which can impact the neutrality of subjects’ selection and recruitment in the study. Furthermore, in cross-sectional studies, the results represent only a point when the data has been collected; thus, the public’s misinformation, perceptions, vaccination acceptance can be changed over time. Despite the presented limitations, the sample size was adequate, and the participants were from the largest cities in Yemen, which gives a close enough image and a realistic idea about the presented topic in Yemen at the first two weeks of the outbreak in Yemen. The conducted study provides a good insight into the misinformation, perceptions, and acceptance of the vaccine among Yemenis, opening the door for more comparative research and investigations to be conducted in the future or after awareness campaigns and educational interventions. The study also provides a good insight into COVID-19 vaccine acceptance in a low-income, less-developed country like Yemen. Importantly, the study findings provide useful insight for policymakers, healthcare planners, and international organizations planning to support or donate vaccines to Yemen.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • No conflict of interest statement was detected. If there are no conflicts, we encourage authors to explicit state so.
    • No funding statement was detected.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2021.02.25.432838v1 on bioRxiv