key: cord-0257174-lqvkizq7
authors: Kerdoun, M. a.; Henni, H. A.; Yamoun, A.; Rahmani, A.; Kerdoun, R. M.; Elouar, N.
title: COVID-19 vaccine hesitancy among Algerian medical students: a cross-sectional study in five universities.
date: 2021-08-31
journal: nan
DOI: 10.1101/2021.08.29.21261803
sha: 1cd1185ebced50bca4e6a4cad66cb031fa4dd08f
doc_id: 257174
cord_uid: lqvkizq7

Vaccine hesitancy is a limiting factor in global efforts to contain the current pandemic, wreaking havoc on public health. As today's students are tomorrow's doctors, it is critical to understand their attitudes toward the COVID-19 vaccine. To our knowledge, this study was the first national one to look into the attitudes of Algerian medical students toward the SARS-CoV-2 vaccine using an electronic convenience survey. 383 medical students from five Algerian universities were included, with a mean age of 21.02. 85.37% (n=327) of respondents had not taken the COVID-19 vaccine yet and were divided into three groups; the vaccine acceptance group (n=175, 53.51%), the vaccine-hesitant group (n=75, 22.93%), and the vaccine refusal group (n=77, 23.54%). Gender, age, education level, university, and previous experience with COVID-19 were not significant predictors for vaccine acceptance. The confirmed barriers to the COVID-19 vaccine concern available information, effectiveness, safety, and adverse effects. This work highlights the need for an educational strategy about the safety and effectiveness of the COVID-19 vaccine. Medical students should be educated about the benefits of vaccination for themselves and their families and friends. The Vaccine acceptant students' influence should not be neglected with a possible ambassador role to hesitant and resistant students.

The COVID-19 crisis is a major health pandemic first detected in November 2019 57 and is a severe acute respiratory disease caused by SARS-CoV-2 Concerns about the vaccine's efficacy or safety, the country of manufacture, 78 antivaccine movements, and the belief in rushed vaccine research were vaccination 79 hesitation causes, in addition to rumors and misinformation [11] [12] [13] . 80

In Algeria, the government has approved the Sinopharm and Sinovac Chinese 81 vaccines and the Sputnik Russian vaccine. The national vaccination campaign 82 started by the end of January 2021 for healthcare workers and vulnerable groups. 83

The current local policy targets all the population of the country. 84 . CC-BY-NC-ND 4.0 International license It is made available under a perpetuity.

is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint Today's medical students are tomorrow's doctors, and they are the future providers 92 of health care and essential influencers of individuals and communities. 93

Additionally, they will be responsible for making vaccination recommendations and 94 counseling vaccine-positive individuals. 95

At the heart of this COVID-19 pandemic, we need to know and better understand 96 the motivations and hesitations of medical students in the face of vaccination. 97

Documenting the perception and attitude of students towards a vaccination, 98 therefore, appears essential. 99

The current study targeted medical students from five Algerian universities to 100 explore the level of COVID-19 vaccine hesitancy and determine the factors and 101 barriers that may affect their vaccination decision-making. 102

An observational cross-sectional study was conducted among medical students of 105 five universities in Algeria (Ouargla, Algiers, Annaba, Setif, and Tizi Ouzou) from 106 23 to 31 July 2021 with a convenience sample and then closed when not receiving 107 any new responses for 24 h. 108

The questionnaires were electronically distributed via social networks. Volunteer 109 students filled in an anonymous online questionnaire. The inclusion criteria were 110 medical students aged 18 years or older and willing to participate in the study. is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint

The copyright holder for this this version posted August 31, 2021. ; https://doi.org/10.1101/2021.08.29.21261803 doi: medRxiv preprint Table 2 shows the characteristics of the non-vaccinated students and factors 157 associated with the COVID-19 vaccine decision. 158

. CC-BY-NC-ND 4.0 International license It is made available under a perpetuity.

is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint No available information, severe side effects, and inefficacity of vaccine were 167 significantly associated with a higher risk of vaccine hesitancy and refusal (p< 168 0.001). 169 The results of our research revealed that only 14.62% of students got the COVID-19 185 vaccine. The proportion of the population that must be vaccinated against COVID-186 19 to initiate herd immunity is unknown. However, a modeling study determined 187 that vaccines must have an efficacy rate of at least 80% and coverage of at least 75% 188 to end this ongoing epidemic [19] . 189

The low vaccination rates for students can be transposed to the general Algerian 190 population and demonstrate the need for additional efforts to achieve immunization. is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint

The copyright holder for this this version posted August 31, 2021. ; https://doi.org/10.1101/2021.08.29.21261803 doi: medRxiv preprint Despite their critical role in vaccine promotion and patient counseling, medical 220 students are also concerned about vaccine hesitancy. Of the 327 respondents who 221

had not yet received the vaccine, more than half (53.51%) were willing to take it, a 222 quarter was hesitant (22.93%), and a quarter was resistant (23.54%). 223

The acceptance rate of our work is lower than a survey of American (75%) [32] and 224

Italian students (86%) [33] conducted in December 2020, comparable to that of 225

French students (57%) in January 2021 [34] , and higher than that of Egyptian 226 students (35%) in January 2021 [35] . Also, several studies show that Vaccine 227 hesitancy and refusal among healthcare workers is a veritable concern and mainly 228 originate from the safety and effectiveness of COVID-19 vaccines [36] [37] [38] . 229

The respondents who chose not to be vaccinated did not differ significantly in 230 demographic and social characteristics from the rest. However, senior students have 231 more intention of getting vaccinated. According to Barello et is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint

The copyright holder for this this version posted August 31, 2021. is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint The institutional review board of Ouargla University has approved this work. 286

All necessary participant consent has been obtained and the appropriate institutional 287 forms have been archived. 288

The authors declare that the research was conducted without any commercial or 290 financial relationships that could be construed as a potential conflict of interest. 291

Acknowledgments 292

The first author would like to thank all the students who participated in this study, 293 particularly Kasdi Merbah University. "I am very proud to be one of our teachers". 294 is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint

The copyright holder for this this version posted August 31, 2021. ; https://doi.org/10.1101/2021.08.29.21261803 doi: medRxiv preprint

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