Beliefs and barriers of COVID-19 vaccination hesitancy among Sudanese healthcare workers in Sudan: A cross sectional study

Figures & data

Table 1. Baseline characteristics of health care workers. (n = 930).

Characteristics	N	Overall, N = 930^1	Gender		p-value^2
			Female, N = 626^1	Male, N = 304^1
Age, years	929	28.7 ± 6.7	28.7 ± 6.6	28.7 ± 6.8	>0.9
Residency	930				<0.001
Inside Khartoum state		762 (81.9%)	534 (85.3%)	228 (75.0%)
Outside Khartoum state		168 (18.1%)	92 (14.7%)	76 (25.0%)
Profession	930
Anesthesiologist		2 (0.2%)	2 (0.3%)	0 (0.0%)
Dentist		92 (9.9%)	66 (10.5%)	26 (8.6%)
Doctor		585 (62.9%)	386 (61.7%)	199 (65.5%)
Medical laboratory scientist		70 (7.5%)	46 (7.3%)	24 (7.9%)
Nurse		27 (2.9%)	21 (3.4%)	6 (2.0%)
Pharmacist		118 (12.7%)	78 (12.5%)	40 (13.2%)
Physiotherapist		4 (0.4%)	4 (0.6%)	0 (0.0%)
Radiologist		6 (0.6%)	4 (0.6%)	2 (0.7%)
Staff in medical university		26 (2.8%)	19 (3.0%)	7 (2.3%)
Average monthly income	930				<0.001
Less than 10,000 SDG		315 (33.9%)	247 (39.5%)	68 (22.4%)
10,000–30,000 SDG		361 (38.8%)	256 (40.9%)	105 (34.5%)
31,000–50,000 SDG		120 (12.9%)	64 (10.2%)	56 (18.4%)
51,000–70,000 SDG		53 (5.7%)	29 (4.6%)	24 (7.9%)
more than that		81 (8.7%)	30 (4.8%)	51 (16.8%)
Do you have a chronic illness (Yes)	930	144 (15.5%)	96 (15.3%)	48 (15.8%)	0.9
How do you evaluate your health condition in general?	930				0.002
Bad		71 (7.6%)	48 (7.7%)	23 (7.6%)
Very bad		37 (4.0%)	24 (3.8%)	13 (4.3%)
Neutral		275 (29.6%)	188 (30.0%)	87 (28.6%)
Good		368 (39.6%)	267 (42.7%)	101 (33.2%)
Very good		179 (19.2%)	99 (15.8%)	80 (26.3%)
Have you been diagnosed with Corona virus previously?	930				0.5
I have no idea		74 (8.0%)	47 (7.5%)	27 (8.9%)
No, I have not had COVID-19		478 (51.4%)	331 (52.9%)	147 (48.4%)
Yes, a confirmed case		132 (14.2%)	84 (13.4%)	48 (15.8%)
Infection not confirmed		246 (26.5%)	164 (26.2%)	82 (27.0%)
Has someone in your close circle (such as a family member or close friend) been infected with the COVID-19 previously?	930				0.3
I have no idea		34 (3.7%)	19 (3.0%)	15 (4.9%)
No, I have not had COVID-19		194 (20.9%)	130 (20.8%)	64 (21.1%)
Yes, a confirmed case of medical examinations		518 (55.7%)	345 (55.1%)	173 (56.9%)
Yes, but infection is not confirmed		184 (19.8%)	132 (21.1%)	52 (17.1%)
What is your percentage of risk of exposure to the infection with COVID-19?	930	7.0 ± 2.6	6.8 ± 2.6	7.2 ± 2.4	0.029
Describe your attitude toward Evidence based practice	930				0.2
I don’t know about it		113 (12.2%)	75 (12.0%)	38 (12.5%)
I find it difficult to keep up with all changes happening now.		282 (30.3%)	201 (32.1%)	81 (26.6%)
I’m aware of it and know how to search for evidence-based information.		535 (57.5%)	350 (55.9%)	185 (60.9%)
Do you think there is enough information about the safety of vaccination against COVID-19?	930	239 (25.7%)	153 (24.4%)	86 (28.3%)
How would you rate the level of your knowledge about COVID-19?	852				0.004
Bad		61 (7.2%)	37 (6.4%)	24 (8.9%)
Good		392 (46.0%)	280 (48.2%)	112 (41.3%)
Neutral		273 (32.0%)	195 (33.6%)	78 (28.8%)
Very bad		16 (1.9%)	8 (1.4%)	8 (3.0%)
Very good		110 (12.9%)	61 (10.5%)	49 (18.1%)

¹Mean ± SD; n (%)

²Two Sample t-test; Pearson’s Chi-squared test; Fisher’s exact test

Table 2. Beliefs surrounding COVID-19 vaccination importance (n = 930).

Statements	Strongly disagree	Disagree	Not sure	Agree	Strongly agree
How important do you believe the COVID-19 vaccine is?	34 (3.7%)	39 (4.2%)	178 (19.1%)	294 (31.6%)	385 (41.4%)
In your opinion, how important do you think it is for all members of the society to obtain the COVID-19 vaccine?	35 (4.1%)	56 (6.6%)	149 (17.5%)	257 (30.2%)	355 (41.7%)
Do you see that the COVID-19 vaccine should be mandatory	80 (9.4%)	111 (13.0%)	191 (22.4%)	200 (23.5%)	270 (31.7%)
How much do you care about the COVID-19 vaccine?	52 (6.1%)	64 (7.5%)	186 (21.8%)	250 (29.3%)	300 (35.2%)
Is it a must for all health care workers to obtain the COVID-19 vaccination?	40 (4.7%)	46 (5.4%)	130 (15.3%)	145 (17.0%)	491 (57.6%)

Data were presented as n (%)

Table 3. Personal perception toward the vaccine .(n = 930).

Statements	Strongly disagree	Disagree	Neutral	Agree	Strongly agree
I think the vaccine’s validation and its provision ensure that it is safe for users.	44 (4.7%)	93 (10.0%)	223 (24.0%)	382 (41.1%)	188 (20.2%)
Mass vaccination will result in overcoming the COVID-19 pandemic.	40 (4.3%)	113 (12.2%)	202 (21.7%)	356 (38.3%)	219 (23.5%)
The best way to beat COVID-19 effects and complications is the vaccination.	39 (4.2%)	109 (11.7%)	182 (19.6%)	355 (38.2%)	245 (26.3%)
I think that the preparation of the COVID-19 vaccine was rushed without enough trials conducted.	45 (4.8%)	131 (14.1%)	221 (23.8%)	325 (34.9%)	208 (22.4%)
I have concerns about the potential side effects of the vaccine.	46 (4.9%)	100 (10.8%)	200 (21.5%)	361 (38.8%)	223 (24.0%)
I have some doubts about the vaccine’s effectivity against COVID-19	102 (11.0%)	181 (19.5%)	190 (20.4%)	288 (31.0%)	169 (18.2%)
I had bad experiences with side effects from previous vaccinations.	235 (25.3%)	260 (28.0%)	177 (19.0%)	156 (16.8%)	102 (11.0%)
I am against all vaccinations absolutely.	498 (53.5%)	186 (20.0%)	84 (9.0%)	84 (9.0%)	78 (8.4%)
I am fearful to get infected with the COVID-19 via the vaccine itself	315 (33.9%)	201 (21.6%)	149 (16.0%)	145 (15.6%)	120 (12.9%)
I don’t need to get vaccinated because if I were to get infected I would be treated and recover with no complications.	337 (36.2%)	228 (24.5%)	151 (16.2%)	123 (13.2%)	91 (9.8%)
I don’t need to get vaccinated because I think I am not among those who are immunocompromised	363 (39.0%)	236 (25.4%)	125 (13.4%)	114 (12.3%)	92 (9.9%)

Data were presented as n (%)

Table 4. Rating the dependence on source of information among health care workers (n = 930).

Statements	Strongly low	Low	Neutral	High	Strongly high
Television programs and news outlets	172 (18.5%)	209 (22.5%)	251 (27.0%)	186 (20.0%)	112 (12.0%)
Newspapers and magazines	238 (25.6%)	280 (30.1%)	258 (27.7%)	112 (12.0%)	42 (4.5%)
Medical sites on the internet	49 (5.3%)	97 (10.4%)	218 (23.4%)	334 (35.9%)	232 (24.9%)
Social media	83 (8.9%)	83 (8.9%)	223 (24.0%)	288 (31.0%)	253 (27.2%)
Government sources	186 (20.0%)	224 (24.1%)	287 (30.9%)	154 (16.6%)	79 (8.5%)
Doctors and Health care providers	55 (5.9%)	147 (15.8%)	272 (29.2%)	286 (30.8%)	170 (18.3%)
Family, relatives and friends	180 (19.4%)	249 (26.8%)	260 (28.0%)	145 (15.6%)	96 (10.3%)

Data were presented as n (%)

Table 5. Acceptance of vaccination, reasons for not taking the vaccine and motivation for taking the vaccine among health care workers (n = 930).

Characteristics	Overall, N = 930^1	Gender		p-value^2
		Female, N = 626^1	Male, N = 304^1
Choose what expresses your hesitation of vaccination with the Corona vaccine				0.003
I accept vaccination absolutely	375 (40.3%)	228 (36.4%)	147 (48.4%)
I accept, but with some delay and a little bit of rejection	151 (16.2%)	116 (18.5%)	35 (11.5%)
I accept, but with some hesitation	292 (31.4%)	205 (32.7%)	87 (28.6%)
I refuse to be vaccinated absolutely	48 (5.2%)	30 (4.8%)	18 (5.9%)
I refuse vaccination with some hesitation	64 (6.9%)	47 (7.5%)	17 (5.6%)
Do you accept taking vaccine (Yes)	818 (88.0%)	549 (87.7%)	269 (88.5%)	0.7
What are the reasons for your concerns/worries about the new Corona virus vaccine? (You can choose more than one)
You are not worried about getting vaccinated.	330 (35.5%)	205 (32.7%)	125 (41.1%)	0.012
Lack of sufficient confidence in the source of the vaccine.	343 (36.9%)	253 (40.4%)	90 (29.6%)	0.001
Lack of sufficient information about the vaccine.	371 (39.9%)	257 (41.1%)	114 (37.5%)	0.3
Lack of sufficient information about the side effects.	396 (42.6%)	293 (46.8%)	103 (33.9%)	<0.001
Others.	39 (4.2%)	31 (5.0%)	8 (2.6%)	0.1
If you agree to obtain it; What are your motivations for receiving the vaccination? (You can choose more than one answer)
Fear of getting infected	346 (37.2%)	242 (38.7%)	104 (34.2%)	0.2
Fear for the members of my family especially my parents who are susceptible	593 (63.8%)	409 (65.3%)	184 (60.5%)	0.2
My belief in the safety and effectiveness of the vaccination	308 (33.1%)	204 (32.6%)	104 (34.2%)	0.6
Free vaccination and availability	215 (23.1%)	146 (23.3%)	69 (22.7%)	0.8
Others	52 (5.6%)	39 (6.2%)	13 (4.3%)	0.2

¹Mean ± SD; n (%)

Table 6. Factors related to acceptance of vaccine (n = 930).

Variables	N	Overall, N = 930^1	Acceptance of vaccine		p-value^2
			No, N = 112^1	Yes, N = 818^1
Age, years	929	28.7 ± 6.7	28.6 ± 6.9	28.7 ± 6.7	>0.9
Gender	930				0.7
Female		626 (67.3%)	77 (68.8%)	549 (67.1%)
Male		304 (32.7%)	35 (31.2%)	269 (32.9%)
Residency	930				0.5
Inside Khartoum state		762 (81.9%)	89 (79.5%)	673 (82.3%)
Outside Khartoum state		168 (18.1%)	23 (20.5%)	145 (17.7%)
Profession	930
Anesthesiologist		2 (0.2%)	0 (0.0%)	2 (0.2%)
Dentist		92 (9.9%)	10 (8.9%)	82 (10.0%)
Doctor		585 (62.9%)	55 (49.1%)	530 (64.8%)
Medical laboratory		70 (7.5%)	17 (15.2%)	53 (6.5%)
Nurse		27 (2.9%)	8 (7.1%)	19 (2.3%)
Pharmacist		118 (12.7%)	11 (9.8%)	107 (13.1%)
Physiotherapist		4 (0.4%)	1 (0.9%)	3 (0.4%)
Radiologist		6 (0.6%)	4 (3.6%)	2 (0.2%)
Staff in medical university		26 (2.8%)	6 (5.4%)	20 (2.4%)
Average monthly income:	929				0.2
Less than 10,000 SDG		314 (33.8%)	42 (37.5%)	272 (33.3%)
10,000–30,000 SDG		361 (38.9%)	47 (42.0%)	314 (38.4%)
31,000–50,000 SDG		120 (12.9%)	7 (6.2%)	113 (13.8%)
51,000–70,000 SDG		53 (5.7%)	8 (7.1%)	45 (5.5%)
More than that		81 (8.7%)	8 (7.1%)	73 (8.9%)
Do you have a chronic illness (Yes)	930	144 (15.5%)	24 (21.4%)	120 (14.7%)	0.064

¹Mean ± SD; n (%)

²Two Sample t-test; Pearson’s Chi-squared test; Fisher’s exact test