COVID-19 Vaccine Hesitancy among Young Adults in Saudi Arabia: A Cross-Sectional Web-Based Study

"...provides a snapshot into COVID-19 vaccination hesitancy among Saudi adults..."

In an attempt to curb the spread of COVID-19 throughout Saudi Arabia, the Ministry of Health (MOH) launched a mobile application called Sehaty on December 17 2020 to facilitate registration for COVID-19 vaccination. As of this writing, the number of people who had registered to take the vaccine through Sehaty, just over 1 million, was far below the number required to develop herd immunity. Since vaccine distribution in the country was rescheduled due to the manufacturer's delay, the current study was conducted to investigate the adult population's hesitancy towards the vaccine.

The study used a prospective cross-sectional design. Data were collected between January 15 2021 and February 7 2021, just after the second wave of COVID-19 pandemic hit the country. A total of 862 Saudi adults completed the online self-administered questionnaire. Information was gathered on the participants' perspectives towards the severity and susceptibility of the COVID-19 infection, reasons for their hesitancy to receive the vaccine, perceived benefits, and reasons for action.

Just under a quarter of participants (19.6%) had previously tested positive for COVID-19. Very few participants had already received the vaccine (2.1%), while 20.3% had registered in the Sehaty app to receive it.

More than half of the participants (55.9%) agreed or strongly agreed that COVID-19 is a serious condition and requires vaccination. A minority of participants agreed or strongly agreed that developing a natural immunity is not enough to prevent COVID-19 infection (12.4%).

Just under half (48%) will take the vaccine when mass vaccination is achieved, and approximately the same number (46.7%) will only take it if it is made mandatory. Almost half (49.9%) agreed or strongly agreed that vaccine effectiveness is among the reasons for their hesitancy. Only one-third (33.1%) of participants agreed or strongly agreed that news on social media was the reason for their refusal of the vaccine, while 39% of participants agreed or strongly agreed that receiving the vaccine would make them less worried. Just under half (48%) agreed or strongly agreed that vaccination would reduce the likelihood of catching the infection.

Overall, the findings could be interpreted as indicating a high level of COVID-19 vaccine hesitancy toward vaccination in Saudi Arabia, especially with the vaccine being offered free of charge for all residents of the country. However, two-thirds of the respondents (64.3%) are young adults between the ages of 18-29; hence, they are not particularly vulnerable to COVID-19 complications and are not a high-priority group to receive the vaccine at the beginning of the national vaccination campaign.

The finding that many are aware of a high likelihood of getting the infection could be due to communication efforts on the part of the government. "The media awareness campaign provided by the MOH in the form of a daily detailed report of the number of active cases, number of recovered cases, number of critical cases, and number of deaths per city since the beginning of the pandemic, had definitely raised population awareness about the severity and susceptibility of COVID-19. The government has also raised awareness through an electronic health system in the form of social distancing apps (Tawaklna) that provide health services such as Caution Mode of confirmed cases and COVID-19 test results, as well as Permit Services to be used during quarantine. Another app is Tabaud that shows exposure to COVID-19 active cases."

However, only 39% of participants agreed or strongly agreed they were being provided with sufficient information about the vaccine's efficacy and safety, which would encourage them to take the step to register for the vaccine. Thus, the researchers suggest that vaccine literacy programmes should be offered and should be tailored, depending on the level of health, scientific, and general literacy of the high-priority groups. Strategies to tackle vaccination reluctance should be designed to eradicate community-specific anti-vaccination misconceptions. Also, the researchers advise that policymakers should incentivise scientific research to demonstrate vaccine safety in the mid and long term.