Covid-19 vaccination reported side effects and hesitancy among the Syrian population: a cross-sectional study

Abstract

Introduction

Studying post-vaccination side effects and identifying the reasons behind low vaccine uptake are pivotal for overcoming the pandemic.

Methods

This cross-sectional study was distributed through social media platforms and face-to-face interviews. Data from vaccinated and unvaccinated participants were collected and analyzed using the chi-square test, multivariable logistic regression to detect factors associated with side effects and severe side effects.

Results

Of the 3509 participants included, 1672(47.6%) were vaccinated. The most common reason for not taking the vaccine was concerns about the vaccine’s side effects 815(44.4). The majority of symptoms were mild 788(47.1%), followed by moderate 374(22.3%), and severe 144(8.6%). The most common symptoms were tiredness 1028(61.5%), pain at the injection site 933(55.8%), and low-grade fever 684(40.9%). Multivariable logistic regression analysis revealed that <40 years (vs. ≥40; OR: 2.113, p-value = 0.008), females (vs. males; OR: 2.245, p-value< .001), did not receive influenza shot last year (vs. did receive Influenza shot last year OR: 1.697, p-value = 0.041), AstraZeneca (vs. other vaccine brands; OR: 2.799, p-value< .001), co-morbidities (vs. no co-morbidities; OR: 1.993, p-value = 0.008), and diabetes mellitus (vs. no diabetes mellitus; OR: 2.788, p-value = 0.007) were associated with severe post-vaccine side effects. Serious side effects reported were blood clots 5(0.3%), thrombocytopenia 2(0.1%), anaphylaxis 1(0.1%), seizures 1(0.1%), and cardiac infarction 1(0.1%).

Conclusion

Our study revealed that most side effects reported were mild in severity and self-limiting. Increasing the public’s awareness of the nature of the vaccine’s side effects would reduce the misinformation and improve the public’s trust in vaccines. Larger studies to evaluate rare and serious adverse events and long-term side effects are needed, so people can have sufficient information and understanding before making an informed consent which is essential for vaccination.

KEY MESSAGES

• Age < 40 years, females, not receiving influenza shot, AstraZeneca vaccine, co-morbidities, and diabetes mellitus were factors significantly associated with severe post-vaccination side effects.

• Although most of the reported vaccine side effects were mild in severity and well-tolerated, larger prospective studies to understand the causes of rare serious adverse events and long-term side effects are needed to overcome vaccine hesitancy among people and enable them to have sufficient information and understanding before making an informed consent which is essential for vaccination.

Keywords:

• War
• crisis
• low-income
• immunization
• adverse effects

Acknowledgments

We are thankful to all who participated in the study. We would like to specifically thank the data collection group. We would also like to thank Batoul Bakkar, and Wassim Gharz Edine for their contibution by publishing the survey on social media applications.

Ethical approval and consent to participate

This study was approved by the Institutional Review Board (IRB) at the Syrian Private University (SPU). The IRB at SPU did not provide us with a number. This research has been performed in accordance with the Declaration of Helsinki. All methods were carried out in accordance with relevant guidelines and regulations. Informed consent was obtained from all subjects and/or their legal guardian(s). Participation in the study was voluntary and participants were assured that anyone who was not inclined to participate or decided to withdraw after giving informed consent would not be victimized. All information collected from this study was kept strictly confidential. All study methods were performed in accordance with the relevant guidelines and regulations in accordance with the Declaration of Helsinki.

Authors’ contributions

MN and SA conceptualised the study, participated in the design, participated in data collection, wrote the study protocol, performed the statistical analysis, interpreted the results, did a literature search, and drafted the manuscript. MF participated in data collection, participated in data encoding, and designed the figures. DCG were involved in the collection of data. FM revised the final draft of the paper. All authors read and approved the final draft.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are openly available in [repository name ‘zenodo’] at https://doi.org/10.5281/zenodo.7425817 .

Additional information

Funding

This study was not funded.