Experiences and perceptions of COVID‑19 infection and vaccination among Palestinian refugees in Jerash camp and Jordanian citizens: a comparative cross‑sectional study by face‑to‑face interviews

Mohammad A. I. Al‑Hatamleh
Ma’mon M. Hatmal
Sulaf H. F. Mustafa
Mohammad Alzu’bi
Ali F. AlSou’b
Shahed N. S. Abughanam
Amin N. Olaimat
Elham T. Kateeb
Rohimah Mohamud
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Background: During the COVID‑19 vaccination, the access to vaccines has been unequal among countries and indi‑viduals, for example low‑income countries displayed significant low levels of vaccination. Furthermore, most refugees are living in developing low‑income countries which struggling to access the essential health‑care services including vaccination. Thus, the objective of this study was to assess the experiences and perceptions of COVID‑19 infection and vaccination among Palestine refugees in Jerash camp compared to resident Jordanian citizens. Methods: A face‑to‑face interview‑based comparative cross‑sectional study was carried out among Palestine refu‑gees in Jerash camp located in northern Jordan and Jordanian citizens from different cities in Jordan from October, 2021 to March, 2022. A Chi‑square test was used to determine the differences in the experiences and perceptions of COVID‑19 infection and vaccination between Palestinian refugees and resident Jordanian citizens. Logistic regres‑sion analysis was performed to predict factors associated with the beliefs, barriers and hesitancy towards COVID‑19 vaccines. Results: The total number of participants was 992, with 501 (50.5%) Palestinian refugees and 491 (49.5%) Jordanian citizens. Most participants (64.1%) who have never been tested for COVID‑19 were from the refugees (P < 0.001), whereas about 80.3% of the participants tested for COVID‑19 at private healthcare institutions were citizens (P < 0.001). While 70.0% of the participants who tested positive for COVID‑19 (n = 303) were from the refugees (P < 0.001). Com‑pared to the citizens, the refugees had significantly lower levels of beliefs about the safety (P = 0.008) and efficiency (P < 0.001) of COVID‑19 vaccines. They also had lower rates of vaccine hesitancy (P = 0.002) and vaccine uptake (P < 0.001), and a higher rate of facing difficulties during registration for COVID‑19 vaccination (P < 0.001). Furthermore, refugees have more negative attitudes toward the importance and implementation of COVID‑19 precautionary activi‑ties, including wearing face masks, practicing social istancing and following proper prevention hygiene compared to citizens (P < 0.001). The regression analysis showed that gender (P < 0.001), age (P < 0.001) and level of education (P = 0.001) were significantly associated with COVID‑19 vaccine esitancy. Also, being a refugee (P < 0.001) and being a male (P = 0.012) were significantly associated with facing more difficulties upon the registration to receive a COVID‑19 vaccine. Conclusions: This study showed that, compared to citizens, refugees had lower attitudes and practices toward COVID‑19 infection and vaccination. They also had and a lower rate of COVID‑19 vaccine hesitancy and uptake with limited access to vaccines. Government sectors and non‑government organizations should implement policies and regulations to raise the awareness of refugees towards COVID‑19 infection, testing, preventive measures, and the safety and efficacy of vaccines.
MAIA‑H would like to acknowledge the Universiti Sains Malayisa (USM) Fellow‑ship Scheme for providing financial support. The authors would like to thank the valuable comments and suggestions from Mr Ayman Ahmed, Dr Emma‑nuel Siddig and Dr Abanoub Riad. SHFM, MA, AFA and SNSA are affiliated to the International Federation of Medical Students Associations (IFMSA).
Al-Hatamleh, M.A.I., Hatmal, M.M., Mustafa, S.H.F. et al. Experiences and perceptions of COVID-19 infection and vaccination among Palestinian refugees in Jerash camp and Jordanian citizens: a comparative cross-sectional study by face-to-face interviews. Infect Dis Poverty 11, 123 (2022). https://doi.org/10.1186/s40249-022-01047-y