Testing Arab attitudes towards COVID vaccines

Published online 14 December 2021

Around two-thirds of survey respondents from Jordan, Syria and the Palestinian West Bank were unwilling or hesitant about COVID-19 vaccination.

Rieko Kawabata

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A study based on a survey of 8,619 adults living in Jordan, the West Bank and Syria conducted in December 2020, when COVID-19 cases were at peak levels there, has revealed that 67.8% of participants were unwilling or hesitant to get vaccinated against COVID-19. 

Widespread acceptance of COVID-19 vaccines is essential to combat the ongoing global pandemic. The World Health Organization recognizes that reluctance or refusal of people to receive vaccines, presents a major challenge for public health. 

Analysis of the survey responses showed that 32.2% of participants intended to be vaccinated, 41.6% did not, and 26.2% were hesitant. 

When asked for reasons behind refusal or hesitancy, a large proportion of respondents (49.1% and 67.3% respectively) cited concerns about the rigour of the US Food and Drug Administration’s vaccine evaluation process. Many of the respondents (33.1% and 66.9% respectively) were also concerned about potential long-term health effects. 

Groups of participants identified by the study who were more willing to get vaccinated included those who were female, aged 18 to 35, from a large family, had received a flu vaccine within the last year, and who had a high school diploma or less. Notably, those aged 18–35 were around 7.5 times more likely to get vaccinated than those aged 36–55 years old.

The most surprising aspect of the study, the researchers say, was that respondents with higher levels of education were less willing to be vaccinated. Respondents with a high-school diploma or less were found to be 10 times more willing to get vaccinated than graduate-degree holders. 

Corresponding author, Sima Zein, of the American University of Madaba, Jordan, points out that attitudes towards vaccination may have also been negatively impacted by the decline of healthcare systems caused by political and economic instability in Syria and the West Bank. 

Jeffrey Lazarus of the Barcelona Institute for Global Health, Spain, who was not involved in the study, says that claims about the “lack of rigorous evaluation of the vaccine by the FDA” and “long-term health effects” amount to “disinformation that is now largely mitigated given that there is so much real-world evidence, including from nearby Israel.” Given that the survey was conducted in December 2020 when the vaccines were just starting to get approved, he adds that, “most should now be willing to be vaccinated, yet they are still not, which likely implies an access issue.” 

Going forward, the researchers plan to examine the effects of social media on the rate of vaccination in the same three regions. To help increase vaccine acceptance, Zein suggests that governing bodies “can reach people better by hosting doctors on TV who answer questions, instead of using pamphlets or sending text messages with links to websites with very few answers to people’s concerns.”


Zein, S. et al. Factors associated with the unwillingness of Jordanians, Palestinians and Syrians to be vaccinated against COVID-19. PLoS Negl. Trop. Dis. 15(12), e0009957 (2021).