Introduction: The coronavirus disease (COVID-19) vaccines provided renewed hope in the fight against the COVID-19 pandemic. To promote extensive vaccination coverage, it is imperative to assess the inclination towards receiving vaccines and examine the influencing factors among healthcare workers (HCWs). This study evaluated COVID-19 vaccine acceptance and hesitancy among HCWs at a Teaching Hospital in Zambia. Materials and Methods: This cross-sectional study was conducted among 200 HCWs at the University Teaching Hospital in Lusaka, Zambia from August 2022 to October 2022 using a structured questionnaire. Data analysis was performed using IBM SPSS version 23.0. Statistical significance was determined at a 95% confidence level. Results: A total of 200 participants were enrolled in the study of which 71.5% (n = 143) were female and 57% (n = 114) were aged between 20 and 30 years. The overall vaccine acceptance was 73% and was higher among medical doctors and nurses than pharmacists. Of the 146 HCWs that had been vaccinated, 69.2% had received the Johnson and Johnson vaccine. Vaccine hesitancy was due to the fear of side effects, concerns about vaccine effectiveness, and rushed development of the COVID-19 vaccines. Vaccine acceptance was influenced by age (p = 0.037), profession (p = 0.001) and providing direct care to COVID-19 patients (p = 0.001). Conclusion: This study found a high acceptance and uptake of the COVID-19 vaccines among frontline HCWs, especially among medical doctors and nurses which is key due to their clinical role of providing direct care to COVID-19 patients. There is a need to address the factors that cause vaccine hesitancy among some HCWs.
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Mudenda, S. , Moonga, B. , Kasanga, M. , Daka, V. , Muzondo, N. V. , Mfune, R. L. , Mohamed, S. , Mugenyi, N. , Kanaan, M. H. G. and Chabalenge, B. (2024). COVID-19 Vaccine Acceptance and Hesitancy among Healthcare Workers at a Teaching Hospital in Zambia: Findings and Implications. Open Access Library Journal, 11, e1827. doi: http://dx.doi.org/10.4236/oalib.1111827.
Sohrabi, C., Alsafi, Z., O’Neill, N., Khan, M., Kerwan, A., Al-Jabir, A., et al. (2020) World Health Organization Declares Global Emergency: A Review of the 2019 Novel Coronavirus (Covid-19). International Journal of Surgery, 76, 71-76. https://doi.org/10.1016/j.ijsu.2020.02.034
Pollard, C.A., Morran, M.P. and Nestor-Kalinoski, A.L. (2020) The COVID-19 Pandemic: A Global Health Crisis. Physiological Genomics, 52, 549-557. https://doi.org/10.1152/physiolgenomics.00089.2020
Adžić, S. and Al-Mansour, J. (2021) The Negative Impact of Covid-19 on Firms: Insights from Serbia. Eastern European Economics, 59, 472-486. https://doi.org/10.1080/00128775.2021.1953387
Godber, K.A. and Atkins, D.R. (2021) COVID-19 Impacts on Teaching and Learning: A Collaborative Au-toethnography by Two Higher Education Lecturers. Frontiers in Education, 6, Arti-cle ID: 647524. https://doi.org/10.3389/feduc.2021.647524
Gudina, E.K., Siebeck, M. and Eshete, M.T. (2021) Evidence Gaps and Challenges in the Fight against COVID-19 in Africa: Scoping Review of the Ethiopian Experience. Risk Management and Healthcare Policy, 14, 4511-4521. https://doi.org/10.2147/rmhp.s333545
El-Khodary, B., Veronese, G. and Di-ab, M. (2022) Fear of COVID-19 and Academic Stress among Palestinian University Students during the Pandemic: The Mediating Role of Mental Health. British Journal of Guidance & Counselling, 51, 715-726. https://doi.org/10.1080/03069885.2022.2080805
Miyah, Y., Benjelloun, M., Lairini, S. and Lahrichi, A. (2022) COVID-19 Impact on Public Health, Environment, Human Psychology, Global Socioeconomy, and Education. The Scientific World Journal, 2022, Article ID: 5578284. https://doi.org/10.1155/2022/5578284
Abubakar, L., Salemcity, A.J., Abass, O.K. and Olajuyin, A.M. (2021) The Impacts of COVID-19 on Environmental Sus-tainability: A Brief Study in World Context. Bioresource Technology Reports, 15, Article ID: 100713. https://doi.org/10.1016/j.biteb.2021.100713
Chileshe, M., Mulenga, D., Mfune, R.L., Nyirenda, T.H., Mwanza, J., Mukanga, B., et al. (2020) Increased Number of Brought-In-Dead Cases with COVID-19: Is It Due to Poor Health-Seeking Behaviour among the Zambian Population? Pan African Medical Journal, 37, Article No. 136. https://doi.org/10.11604/pamj.2020.37.136.25967
Helle, K.B., Sadiku, A., Zelleke, G.M., Ibrahim, T.B., Bouba, A., Tsoungui Obama, H.C., et al. (2021) Is In-creased Mortality by Multiple Exposures to COVID-19 an Overseen Factor When Aiming for Herd Immunity? PLOS ONE, 16, e0253758. https://doi.org/10.1371/journal.pone.0253758
World Health Organization (2020) COVID-19 Strategy Update—14 April 2020. 1-15. https://www.who.int/publications/i/item/covid-19-strategy-update---14-april-2020
Mudenda, S., Botha, M., Mukosha, M., Daka, V., Chileshe, M., Mwila, K., et al. (2022) Knowledge and Attitudes towards COVID-19 Prevention Measures among Residents of Lusaka District in Zambia. Aquademia, 6, ep22005. https://doi.org/10.21601/aquademia/12210
Gabrovec, B., Selak, Š., Crn-kovič, N., Šorgo, A., Cesar, K., Fafangel, M., et al. (2022) Compliance with Preventive Measures and COVID-19 Vaccination Intention among Medical and Other Healthcare Students. International Journal of Environmental Research and Public Health, 19, Article No. 11656. https://doi.org/10.3390/ijerph191811656
Deressa, W., Worku, A., Abebe, W., Gizaw, M. and Amogne, W. (2021) Risk Perceptions and Preventive Practices of COVID-19 among Healthcare Professionals in Public Hospitals in Addis Ababa, Ethiopia. PLOS ONE, 16, e0242471. https://doi.org/10.1371/journal.pone.0242471
Rodríguez-González, R., Gal-loza, A., Medina, E.J., Oliver, V., Rodríguez, N.I., Ramos-Colón, E., et al. (2023) Pre-ventive Measures among Healthcare Workers (HCWs) during the COVID-19 Pan-demic. International Journal of Environmental Research and Public Health, 20, Ar-ticle No. 4434. https://doi.org/10.3390/ijerph20054434
Astete-Cornejo, J., Burgos-Flores, M. and Mayma-Aguirre, K.J. (2022) Preventive Measures for Health Workers Exposed to COVID-19 (SARS-CoV-2). Revista Brasileira de Medicina do Trabalho, 20, 140-146. https://doi.org/10.47626/1679-4435-2022-781
Zhang, J., Yang, H., Yang, M. and Tan, H. (2022) The Role of Vaccines in COVID-19 Control Strategies in Singa-pore and China. Health Policy and Technology, 11, Article ID: 100620. https://doi.org/10.1016/j.hlpt.2022.100620
Tibbels, N.J., Dosso, A., Fordham, C., Benie, W., Brou, J.A., Kamara, D., et al. (2022) “On the Last Day of the Last Month, I Will Go”: A Qualitative Exploration of COVID-19 Vaccine Confidence among Ivoirian Adults. Vaccine, 40, 2028-2035. https://doi.org/10.1016/j.vaccine.2022.02.032
Dubé, E., Laberge, C., Guay, M., Bramadat, P., Roy, R. and Bettinger, J.A. (2013) Vaccine Hesitancy: An Over-view. Human Vaccines & Immunotherapeutics, 9, 1763-1773. https://doi.org/10.4161/hv.24657
Smith, T.C. (2017) Vaccine Rejection and Hesitancy: A Review and Call to Action. Open Forum Infectious Diseases, 4, ofx146. https://doi.org/10.1093/ofid/ofx146
Sallam, M., Dababseh, D., Eid, H., Hasan, H., Taim, D., Al-Mahzoum, K., et al. (2021) Low COVID-19 Vaccine Acceptance Is Correlated with Conspiracy Beliefs among University Students in Jordan. Interna-tional Journal of Environmental Research and Public Health, 18, Article No. 2407. https://doi.org/10.3390/ijerph18052407
Baral, P., Ahmed, T., Amor Fer-nandez, P., Peters, M.A., Drouard, S.H.P., Muhoza, P., et al. (2023) Vaccine Hesitancy among Healthcare Workers in Low- and Middle-Income Countries during the COVID-19 Pandemic: Results from Facility Surveys across Six Countries. PLOS ONE, 18, e0288124. https://doi.org/10.1371/journal.pone.0288124
Kabamba Nzaji, M., Kabamba Ngombe, L., Ngoie Mwamba, G., Banza Ndala, D.B., Mbidi Miema, J., Luhata Lungoyo, C., et al. (2020) Acceptability of Vaccination against COVID-19 among Healthcare Workers in the Democratic Republic of the Congo. Pragmatic and Observational Research, 11, 103-109. https://doi.org/10.2147/por.s271096
Jain, J., Saurabh, S., Kumar, P., Verma, M.K., Goel, A.D., Gupta, M.K., et al. (2021) COVID-19 Vaccine Hesitancy among Medical Students in India. Epidemiology and Infection, 149, e132. https://doi.org/10.1017/s0950268821001205
Nizam, A., Iqbal, T., Mashood, H. and El Nebrisi, E. (2022) Analyzing COVID-19 Vaccine Hesitancy among University Students in UAE: A Cross-Sectional Study. Dubai Medical Journal, 5, 182-193. https://doi.org/10.1159/000523993
Potgieter, N., Kim-mie-Dhansay, F., Meyer, A., Marais, S., Mansoor, I., Mkololo, Y., et al. (2022) COVID-19 Vaccine Hesitancy and Its Drivers among Dental Students at University of the Western Cape, South Africa. Health SA Gesondheid, 27, a1950. https://doi.org/10.4102/hsag.v27i0.1950
Mudenda, S. (2022) COVID-19 Vaccine Hesitancy in Zambia: A Qualitative Study among Pharmacy Students at the University of Zambia. Scholars Academic Journal of Pharmacy, 11, 200-208. https://doi.org/10.36347/sajp.2022.v11i11.003
Osuagwu, U.L., Mashige, K.P., Ovenseri-Ogbomo, G., Envuladu, E.A., Abu, E.K., Miner, C.A., et al. (2023) The Im-pact of Information Sources on COVID-19 Vaccine Hesitancy and Resistance in Sub-Saharan Africa. BMC Public Health, 23, Article No. 38. https://doi.org/10.1186/s12889-022-14972-2
Kricorian, K., Civen, R. and Equils, O. (2021) COVID-19 Vaccine Hesitancy: Misinformation and Perceptions of Vaccine Safety. Human Vaccines & Immunotherapeutics, 18, Article ID: 1950504. https://doi.org/10.1080/21645515.2021.1950504
Nzaji, M.K., Kamenga, J.d.D., Lungayo, C.L., Bene, A.C.M., Meyou, S.F., Kapit, A.M., et al. (2024) Factors As-sociated with COVID-19 Vaccine Uptake and Hesitancy among Healthcare Workers in the Democratic Republic of the Congo. PLOS Global Public Health, 4, e0002772. https://doi.org/10.1371/journal.pgph.0002772
Adambekov, S., Bongers, A., Hare, J., Popovic, D., Rajashekharaiah, H., Lawson, S.M., et al. (2023) Understanding COVID-19 Vaccine Hesitancy in Health Care Professionals in Central and West Asia: Lessons for Future Emergency Mass Vaccination Campaigns. Frontiers in Public Health, 11, Article ID: 1196289. https://doi.org/10.3389/fpubh.2023.1196289
Yoda, T. and Katsuyama, H. (2021) Willingness to Receive COVID-19 Vaccination in Japan. Vaccines, 9, Article No. 48. https://doi.org/10.3390/vaccines9010048
Rizwan, W., Rana, M.N., Bukhari, M.H., Mushtaq, A. and Sadiq, M. (2021) Reasons of Vaccine Hesitancy among Pakistanis with Available COVID-19 Vaccine: The Next Challenge in the Fight against Covid-19. Natural Science, 13, 211-217. https://doi.org/10.4236/ns.2021.136018
Blake, H., Fecowycz, A., Star-buck, H. and Jones, W. (2022) COVID-19 Vaccine Education (CoVE) for Health and Care Workers to Facilitate Global Promotion of the COVID-19 Vaccines. Interna-tional Journal of Environmental Research and Public Health, 19, Article No. 653. https://doi.org/10.3390/ijerph19020653
Abubakar, A.T., Suleiman, K., Ah-mad, S.I., Yahaya, S.S., Bello, U.I., Suleiman, B.A., et al. (2023) Acceptance of COVID-19 Vaccine and Associated Factors among Healthcare Workers in Katsina State: A Cross-Sectional Study in Northwest Nigeria. BMJ Open, 13, e063281. https://doi.org/10.1136/bmjopen-2022-063281
Mudenda, S., Daka, V., Matafwali, S.K., Skosana, P., Chabalenge, B., Mukosha, M., et al. (2023) COVID-19 Vaccine Acceptance and Hesitancy among Healthcare Workers in Lusaka, Zambia; Findings and Implications for the Future. Vaccines, 11, Article No. 1350. https://doi.org/10.3390/vaccines11081350
Dzieciolowska, S., Hamel, D., Gadio, S., Dionne, M., Gagnon, D., Robitaille, L., et al. (2021) Covid-19 Vaccine Acceptance, Hesitancy, and Refusal among Canadian Healthcare Workers: A Multicenter Survey. American Journal of Infection Control, 49, 1152-1157. https://doi.org/10.1016/j.ajic.2021.04.079
Xu, B., Gao, X., Zhang, X., Hu, Y., Yang, H. and Zhou, Y. (2021) Real-World Acceptance of COVID-19 Vaccines among Healthcare Workers in Perinatal Medicine in China. Vaccines, 9, Article No. 704. https://doi.org/10.3390/vaccines9070704
Mando, M., Khansa, A.A., Zaitoun, Y., Chokor, M., Elchehimi, B., Dweik, R., et al. (2022) COVID-19 Vaccine Hesitancy in Lebanon. OALIB, 9, e9331. https://doi.org/10.4236/oalib.1109331
Shekhar, R., Sheikh, A.B., Upadhyay, S., Singh, M., Kottewar, S., Mir, H., et al. (2021) COVID-19 Vaccine Acceptance among Health Care Workers in the United States. Vaccines, 9, Article No. 119. https://doi.org/10.3390/vaccines9020119
Ackah, M., Ameyaw, L., Gazali Salifu, M., Afi Asubonteng, D.P., Osei Yeboah, C., Narkotey Annor, E., et al. (2022) COVID-19 Vaccine Acceptance among Health Care Workers in Af-rica: A Systematic Review and Meta-Analysis. PLOS ONE, 17, e0268711. https://doi.org/10.1371/journal.pone.0268711
Agyekum, M.W., Af-rifa-Anane, G.F., Kyei-Arthur, F. and Addo, B. (2021) Acceptability of COVID-19 Vaccination among Health Care Workers in Ghana. Advances in Public Health, 2021, Article ID: 9998176. https://doi.org/10.1155/2021/9998176
Getachew, T., Lami, M., Eyeberu, A., Balis, B., Debella, A., Eshetu, B., et al. (2022) Acceptance of COVID-19 Vaccine and Associated Factors among Health Care Workers at Public Hospitals in Eastern Ethiopia Using the Health Belief Model. Frontiers in Public Health, 10, Article ID: 957721. https://doi.org/10.3389/fpubh.2022.957721
Algabbani, F., Alomeir, O., Alhussayen, M. and Algabbani, A. (2022) Vaccine Hesitancy among Healthcare Providers at the Beginning of a Pandemic: The Case of COVID-19 Vaccines. Saudi Journal of Health Systems Research, 2, 98-106. https://doi.org/10.1159/000524251
Jarrett, C., Wilson, R., O’Leary, M., Eck-ersberger, E. and Larson, H.J. (2015) Strategies for Addressing Vaccine Hesitan-cy—A Systematic Review. Vaccine, 33, 4180-4190. https://doi.org/10.1016/j.vaccine.2015.04.040
Eskola, J., Duclos, P., Schus-ter, M. and MacDonald, N.E. (2015) How to Deal with Vaccine Hesitancy? Vaccine, 33, 4215-4217. https://doi.org/10.1016/j.vaccine.2015.04.043
Kasanga, M., Mudenda, S., Gondwe, T., Chileshe, M., Solochi, B. and Wu, J. (2020) Impact of COVID-19 on Blood Donation and Transfusion Services at Lusaka Provincial Blood Transfusion Centre, Zambia. The Pan African Medical Journal, 35, 74. https://doi.org/10.11604/pamj.supp.2020.35.2.23975
Mudenda, S., Chileshe, M., Mukosha, M., Hikaambo, C.N., Banda, M., Kampamba, M., et al. (2022) Zambia’s Response to the COVID-19 Pandemic: Exploring Lessons, Challenges and Implica-tions for Future Policies and Strategies. Pharmacology & Pharmacy, 13, 11-33. https://doi.org/10.4236/pp.2022.131002
Ogunleye, O., Godman, B., Fadare, J., Mudenda, S., Adeoti, A., Yinka-Ogunleye, A., et al. (2022) Coronavirus Disease 2019 (COVID-19) Pandemic across Africa: Current Status of Vaccinations and Im-plications for the Future. Vaccines, 10, Article No. 1553. https://doi.org/10.3390/vaccines10091553
Mudenda, S., Tembo, G., Mfune, R.L., Banda, P., Kasanga, M., Phiri, M., et al. (2024) Knowledge, Attitude, Acceptance, and Perceived Risks of COVID-19 Vaccines among Pregnant Women: Findings and Implications. SAS Journal of Medicine, 10, 9-19. https://doi.org/10.36347/sasjm.2024.v10i01.002
Mudenda, S., Mukosha, M., Hikaambo, C.N., Meyer, J.C., Fadare, J., Kampamba, M., et al. (2022) Awareness and Acceptance of COVID-19 Vaccines and Associated Factors among Pharmacy Stu-dents in Zambia. Malawi Medical Journal, 34, 273-280. https://doi.org/10.4314/mmj.v34i4.8
Mudenda, S., Meyer, J.C., Fadare, J.O., Ogunleye, O.O., Saleem, Z., Matafwali, S.K., et al. (2023) COVID-19 Vaccine Uptake and Associated Factors among Adolescents and Youths: Findings and Implications for Future Vaccination Programmes. PLOS Global Public Health, 3, e0002385. https://doi.org/10.1371/journal.pgph.0002385
Mudenda, S., Mukosha, M., Godman, B., Fadare, J.O., Ogunleye, O.O., Meyer, J.C., et al. (2022) Knowledge, Atti-tudes, and Acceptance of COVID-19 Vaccines among Secondary School Pupils in Zambia: Implications for Future Educational and Sensitisation Programmes. Vac-cines, 10, Article No. 2141. https://doi.org/10.3390/vaccines10122141
Mudenda, S., Hikaambo, C.N., Daka, V., Chileshe, M., Mfune, R.L., Kampamba, M., et al. (2022) Prevalence and Factors Associated with COVID-19 Vaccine Acceptance in Zambia: A Web-Based Cross-Sectional Study. Pan African Medical Journal, 41, Article No. 112. https://doi.org/10.11604/pamj.2022.41.112.31219
Chiyangi, H., Muma, J.B., Malama, S., Manyahi, J., Abade, A., Kwenda, G., et al. (2017) Identification and Anti-microbial Resistance Patterns of Bacterial Enteropathogens from Children Aged 0-59 Months at the University Teaching Hospital, Lusaka, Zambia: A Prospective Cross Sectional Study. BMC Infectious Diseases, 17, Article No. 117. https://doi.org/10.1186/s12879-017-2232-0
Charan, J. and Biswas, T. (2013) How to Calculate Sample Size for Different Study Designs in Medical Re-search? Indian Journal of Psychological Medicine, 35, 121-126. https://doi.org/10.4103/0253-7176.116232
Kessy, S.J., Wei, T., Zhou, Y., Zhang, W., Alwy Al-Beity, F.M., Zhang, S., et al. (2023) Vaccination Willingness, Vac-cine Hesitancy, and Estimated Coverage of Sars-Cov-2 Vaccine among Healthcare Workers in Tanzania: A Call for Action. Immunity, Inflammation and Disease, 11, e1126. https://doi.org/10.1002/iid3.1126
Alhassan, R.K., Owusu-Agyei, S., Ansah, E.K. and Gyapong, M. (2021) COVID-19 Vaccine Uptake among Health Care Workers in Ghana: A Case for Targeted Vaccine Deployment Campaigns in the Global South. Human Resources for Health, 19, Article No. 136. https://doi.org/10.1186/s12960-021-00657-1
Mena, G., Blanco, B., Casas, I., Huer-tas, A., Sánchez, M., Auñón, M., et al. (2021) Attitudes of Spanish Hospital Staff to-wards COVID-19 Vaccination and Vaccination Rates. PLOS ONE, 16, e0257002. https://doi.org/10.1371/journal.pone.0257002
Sirikalyanpaiboon, M., Ousi-rimaneechai, K., Phannajit, J., Pitisuttithum, P., Jantarabenjakul, W., Chaiteerakij, R., et al. (2021) COVID-19 Vaccine Acceptance, Hesitancy, and Determinants among Physicians in a University-Based Teaching Hospital in Thailand. BMC Infectious Diseases, 21, Article No. 1174. https://doi.org/10.1186/s12879-021-06863-5
Youssef, N.J., Tfaily, N.K., Moumneh, M.B.M., Boutros, C.F., Elharake, J.A., Malik, A.A., et al. (2023) COVID-19 Vaccine Acceptance and Hesitancy among Health Care Workers in Leb-anon. Journal of Epidemiology and Global Health, 13, 55-66. https://doi.org/10.1007/s44197-023-00086-4
Lindner-Pawłowicz, K., Myd-likowska-Śmigórska, A., Łampika, K. and Sobieszczańska, M. (2021) COVID-19 Vaccination Acceptance among Healthcare Workers and General Population at the Very Beginning of the National Vaccination Program in Poland: A Cross-Sectional, Exploratory Study. Vaccines, 10, Article No. 66. https://doi.org/10.3390/vaccines10010066
Majid, U., Ahmad, M., Zain, S., Akande, A. and Ikhlaq, F. (2022) COVID-19 Vaccine Hesitancy and Acceptance: A Comprehensive Scoping Review of Global Literature. Health Promotion International, 37, daac078. https://doi.org/10.1093/heapro/daac078
Puri, N., Coomes, E.A., Haghbayan, H. and Gunaratne, K. (2020) Social Media and Vaccine Hesitancy: New Updates for the Era of COVID-19 and Globalized Infectious Diseases. Human Vaccines & Im-munotherapeutics, 16, 2586-2593. https://doi.org/10.1080/21645515.2020.1780846
Njoga, E.O., Awoyomi, O.J., Onwumere-Idolor, O.S., Awoyomi, P.O., Ugochukwu, I.C.I. and Ozioko, S.N. (2022) Persisting Vaccine Hesitancy in Africa: The Whys, Global Public Health Consequences and Ways-Out—Covid-19 Vaccination Acceptance Rates as Case-in-Point. Vaccines, 10, Article No. 1934. https://doi.org/10.3390/vaccines10111934
Biswas, N., Mustapha, T., Khub-chandani, J. and Price, J.H. (2021) The Nature and Extent of COVID-19 Vaccination Hesitancy in Healthcare Workers. Journal of Community Health, 46, 1244-1251. https://doi.org/10.1007/s10900-021-00984-3
Holzmann-Littig, C., Frank, T., Schmaderer, C., Braunisch, M.C., Renders, L., Kranke, P., et al. (2022) COVID-19 Vaccines: Fear of Side Effects among German Health Care Workers. Vaccines, 10, Article No. 689. https://doi.org/10.3390/vaccines10050689
Ghare, F., Meckawy, R., Moore, M. and Lomazzi, M. (2023) Determinants of Acceptance of COVID-19 Vaccination in Healthcare and Public Health Professionals: A Review. Vaccines, 11, Article No. 311. https://doi.org/10.3390/vaccines11020311
Yilma, D., Mohammed, R., Abdela, S.G., Enbiale, W., Seifu, F., Pareyn, M., et al. (2022) COVID-19 Vaccine Ac-ceptability among Healthcare Workers in Ethiopia: Do We Practice What We Preach? Tropical Medicine & International Health, 27, 418-425. https://doi.org/10.1111/tmi.13742
Alya, W.A., Maraqa, B., Nazzal, Z., Odeh, M., Makhalfa, R., Nassif, A., et al. (2022) COVID-19 Vaccine Uptake and Its Associ-ated Factors among Palestinian Healthcare Workers: Expectations Beaten by Real-ity. Vaccine, 40, 3713-3719. https://doi.org/10.1016/j.vaccine.2022.05.026
Elharake, J.A., Galal, B., Alqahtani, S.A., Kattan, R.F., Barry, M.A., Temsah, M., et al. (2021) COVID-19 Vaccine Acceptance among Health Care Workers in the Kingdom of Saudi Arabia. Interna-tional Journal of Infectious Diseases, 109, 286-293. https://doi.org/10.1016/j.ijid.2021.07.004
Tolossa, T., Fetensa, G., Ayala, D. and Wakuma, B. (2022) Health Professionals’ COVID-19 Vaccine Acceptance and Associated Factors in Wollega University Referral Hospital, Western Ethiopia: A Cross-Sectional Study. Human Vaccines & Immunotherapeutics, 18, Article ID: 2069960. https://doi.org/10.1080/21645515.2022.2069960
Sahebi, A., Ghomian, Z., Tahernejad, A. and Sadeghi, M. (2023) Acceptance Rate of COVID-19 Vaccine among Healthcare Workers: A Systematic Review and Meta-Analysis. Nursing Practice Today, 10, 286-304. https://doi.org/10.18502/npt.v10i4.14075
Narapureddy, B.R., Muzam-mil, K., Alshahrani, M.Y., Alkhathami, A.G., Alsabaani, A., AlShahrani, A.M., et al. (2021) COVID-19 Vaccine Acceptance: Beliefs and Barriers Associated with Vac-cination among the Residents of KSA. Journal of Multidisciplinary Healthcare, 14, 3243-3252. https://doi.org/10.2147/jmdh.s340431