COVID-19 Vaccination Acceptance in Iran, a Nationwide Survey on Factors Associated with the Willingness toward Getting Vaccinated

Mehrdad Askarian; Linda Y Fu; Mohammad Hossein Taghrir; Roham Borazjani; Zahra Shayan; Ehsan Taherifard; Erfan Taherifard; Hossein Akbarialiabad; Yves Longtin; Ardalan Askarian; Shahin Kavousi

doi:10.4103/ijpvm.ijpvm_261_21

COVID-19 Vaccination Acceptance in Iran, a Nationwide Survey on Factors Associated with the Willingness toward Getting Vaccinated

Int J Prev Med. 2022 Oct 11:13:130. doi: 10.4103/ijpvm.ijpvm_261_21. eCollection 2022.

Authors

Affiliations

¹ Department of Community Medicine, School of Medicine, Shiraz, Iran.
² Health Behavior Science Research Center, Shiraz, Iran.
³ General and Community Pediatrics, Children's National Hospital, 111 Michigan Ave., NW, Washington, DC 20010, USA.
⁴ Student Research Committee, School of Medicine, Shiraz University of Medical Sciences and Health Services, Shiraz, Iran.
⁵ Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
⁶ Trauma Research Center, Department of Biostatistics, School of Medicine, Shiraz, Iran.
⁷ Medical Student, School of Medicine, Shiraz University of Medical Sciences and Health Services, Shiraz, Iran.
⁸ Department of Medicine, Jewish General Hospital, McGill University, Montreal, Canada.
⁹ Student, College of Arts & Science, University of Saskatchewan, Saskatoon, Canada.

Abstract

Background: In the name of extensive vaccine uptake, understanding the public's attitude, perception, and intent toward COVID-19 vaccination is a significant challenge for public health officials.

Methods: A cross-sectional survey via an online questionnaire rooted in the Health Belief Model and Integrated Behavioral Model was conducted to evaluate COVID-19 vaccination intent and its associated factors. Factor analysis and multivariate logistic regression were operated to be satisfactory.

Results: Among the 4,933 respondents, 24.7% were health care workers, and 64.2% intended to accept COVID-19 vaccination. The adjusted odds (aOR) of COVID-19 vaccination intent was higher for individuals with greater exposure to social norms supportive of COVID-19 vaccination (aOR = 3.07, 95% Confidence Interval (CI) = 2.71, 3.47) and higher perceived benefits of COVID-19 vaccination (aOR = 2.9, 95% CI = 2.49, 3.38). The adjusted odds of vaccination intent were lower for individuals with greater COVID-19 vaccine safety concerns (aOR = 0.28, 95%CI = 0.25, 0.31). Lower vaccination intent was also associated with increasing age ((aOR = 0.99, 95% CI = 0.98, 0.999), female sex (aOR = 0.76, 95% CI = 0.65, 0.88), and working in the health care field (aOR = 0.75, 95% CI = 0.63, 0.9).

Conclusions: The odds of COVID-19 vaccination intent were higher three or more times among those with a greater belief in vaccine effectiveness, lower concerns about vaccine safety, and greater exposure to cues to vaccinate, including from doctors. This last finding is concerning as vaccine acceptance was surprisingly lower among health care workers compared to others. The remarkable results of factor analysis and reliability of the questionnaire may encourage local health authorities to apply it to their regional population.

Keywords: Attitudes and beliefs; COVID-19 vaccine; knowledge; social norms; vaccination.