Prevalence and Potential Determinants of COVID-19 Vaccine Hesitancy and Resistance in Qatar: Results from a Nationally Representative Survey of Qatari Nationals and Migrants between December 2020 and January 2021

Background: Effective public health measures in tackling the global COVID-19 pandemic necessitate understanding risk of hesitance or resistance to vaccine uptake in different populations. The Middle East and North Africa currently lacks vital representative vaccine hesitancy data. Methods: We conducted the first representative national phone survey using probability sampling among the adult population of Qatar, between December 2020 and January 2021, to identify the prevalence and potential determinants of vaccine willingness. This was categorized into: vaccine acceptance (strongly agree), vaccine resistance (strongly disagree) and vaccine hesitance (somewhat agree, neutral, somewhat disagree). Bivariate and multinomial logistic regression models estimated associations between vaccine willingness and fifteen sociodemographic, work-, and health-related variables. Findings: In the total sample, 42.7% (95%CI: 39.5-46.1) were classified as accepting, 45.2% (95%CI: 41.9-48.4) hesitant, and 12.1% (95%CI: 10.1-14.4) resistant. Those in the vaccine resistance group reported no source of endorsement will increase their confidence in accepting the vaccine (58.9% vs. 5.6% vs. 0.2%, respectively). Hesitancy and resistance were explained by female gender, Arab ethnicity, migrant status/type, and concerns about vaccine side-effects. COVID-19 related bereavement, personal infection, and quarantine status were not significantly associated with any group. Absence of or lack of concern about contracting the virus was solely associated with resistance. Interpretation: COVID-19 vaccine resistance, hesitance, and concern about side-effects is high in Qatar’s population compared with those globally. Urgent public health engagement should focus on women, Qataris (non-migrants) and those of Arab ethnicity. Funding: This study was funded by the Emergency Response Grant at Qatar University (QUERG-CAS-2020-1). Declaration of Interests: P.M.H. reports personal fees from Janssen, Lundbeck, Otsuka, New Bridge Pharmaceuticals and Sunovion, outside the submitted work. All other authors report no conflicts of interest. Ethics Approval Statement: The study was reviewed and approved by the Institutional Review Boards at Qatar University (QU-IRB 1338-EA/20) and Hamad Medical Corporation (MRC-05-089).