Perceptions of COVID-19 Vaccines Among the Arab Minority in Israel: A Qualitative Study

Background The COVID-19 pandemic posed substantial challenges globally, with minority populations often disproportionately affected. In Israel, while the national vaccination campaign was widely implemented, vaccination rates among the Arab minority remained notably low. This disparity is attributed to a combination of socio-economic disadvantage, cultural barriers, and deep-seated mistrust in governmental institutions. Despite these challenges, limited qualitative research has explored the specific perceptions and lived experiences of this population regarding COVID-19 vaccination. Methods This qualitative study employed semi-structured, in-depth interviews with 36 Arab citizens of Israel, selected via snowball sampling across diverse regions. Data collection adhered to a rigorously developed interview protocol and was conducted by trained interviewers. Analysis was based on a combined approach of thematic analysis and content analysis to identify both nuanced themes and frequency-based patterns. The analytical process followed Braun and Clarke’s framework and included measures to ensure validity, including peer debriefing, reflexivity, and back-translation of quotes. Results Three distinct perception profiles emerged from the data. The first group held highly positive views of vaccination, citing trust in medical authorities and a sense of civic responsibility. The second group expressed ambivalence, driven by concerns over vaccine safety, the speed of development, and mixed public messaging. The third group displayed overtly negative perceptions, rooted in mistrust toward state institutions, cultural influences, and misinformation. These attitudes were shaped by demographic factors such as age, education, and socio-economic status. Conclusions The findings highlight a continuum of vaccine perceptions among the Arab minority in Israel, shaped by intersecting cultural, structural, and informational factors. Trust—both institutional and interpersonal—emerged as a key determinant of vaccine acceptance. To enhance public health outcomes, future interventions must incorporate culturally sensitive strategies, ensure Arabic-language accessibility, and engage trusted community leaders. This study underscores the need for inclusive, equity-focused public health policies that address systemic barriers to vaccination in minority populations.