Determinants of COVID-19 Vaccine Engagement in Algeria: A Population-Based Study With Systematic Review of Studies From Arab Countries of the MENA Region
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Abstract
The Algerian COVID-19 vaccination campaign, which started at the end of January 2021, is marked by a slowly ascending curve despite the deployed resources. To tackle the issue, we assessed the levels and explored determinants of engagement toward the COVID-19 vaccine among the Algerian population.
Methods
A nationwide, online-based cross-sectional study was conducted between March 27 and April 30, 2021. A two-stage stratified snowball sampling method was used to include an equivalent number of participants from the four cardinal regions of the country. A vaccine engagement scale was developed, defining vaccine engagement as a multidimensional parameter (5 items) that combined self-stated acceptance and willingness with perceived safety and efficacy of the vaccine. An Engagement score was calculated and the median was used to define engagement vs. non-engagement. Sociodemographic and clinical data, perceptions about COVID-19, and levels of adherence to preventive measures were analyzed as predictors for non-engagement.
Results
We included 1,019 participants, 54% were female and 64% were aged 18–29 years. Overall, there were low rates of self-declared acceptance (26%) and willingness (21%) to take the vaccine, as well as low levels of agreement regarding vaccine safety (21%) and efficacy (30%). Thus, the vaccine engagement rate was estimated at 33.5%, and ranged between 29.6-38.5% depending on the region ( p > 0.05). Non-engagement was independently associated with female gender (OR = 2.31, p < 0.001), low adherence level to preventive measures (OR = 6.93, p < 0.001), private-sector jobs (OR = 0.53, p = 0.038), perceived COVID-19 severity (OR = 0.66, p = 0.014), and fear from contracting the disease (OR = 0.56, p = 0.018). Concern about vaccine side effects (72.0%) and exigence for more efficacy and safety studies (48.3%) were the most commonly reported barrier and enabler for vaccine acceptance respectively; whereas beliefs in the conspiracy theory were reported by 23.4%.
Conclusions
The very low rates of vaccine engagement among the Algerian population probably explain the slow ascension of the vaccination curve in the country. Vaccine awareness campaigns should be implemented to address the multiple misconceptions and enhance the levels of knowledge and perception both about the disease and the vaccine, by prioritizing target populations and engaging both healthcare workers and the general population.
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SciScore for 10.1101/2021.07.17.21260662: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: The study was approved by the institutional review board of the University of Tlemcen [14/2021 EDCTU].
Consent: All participants provided informed consent prior to their participation.Sex as a biological variable It involved adult (aged 18 years and older) males and females of all regions, who were permanently residing inside the country during the study period. Randomization not detected. Blinding not detected. Power Analysis Sample size and sampling technique: The sample size (N=385) was calculated using the single proportion sample size calculation formula, to detect an unknown vaccine acceptance rate (P=50%) with 95% confidence interval (95%CI), 80% statistical power and 5% margin error, … SciScore for 10.1101/2021.07.17.21260662: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: The study was approved by the institutional review board of the University of Tlemcen [14/2021 EDCTU].
Consent: All participants provided informed consent prior to their participation.Sex as a biological variable It involved adult (aged 18 years and older) males and females of all regions, who were permanently residing inside the country during the study period. Randomization not detected. Blinding not detected. Power Analysis Sample size and sampling technique: The sample size (N=385) was calculated using the single proportion sample size calculation formula, to detect an unknown vaccine acceptance rate (P=50%) with 95% confidence interval (95%CI), 80% statistical power and 5% margin error, among the total Algerian population. Table 2: Resources
Software and Algorithms Sentences Resources Statistical analysis was performed by means of IBM’s SPSS for Windows, Version 25.0 (SPSS Inc., Chicago, IL, USA). SPSSsuggested: (SPSS, RRID:SCR_002865)Medline was searched through PubMed database using the following search terms: COVID-19, SARS-CoV-2, hesitancy, acceptance, vaccine, and vaccination, to retrieve related studies published from the database inception to May 16th, 2021. Medlinesuggested: (MEDLINE, RRID:SCR_002185)PubMedsuggested: (PubMed, RRID:SCR_004846)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: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.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:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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