Arab Peoples' Positions on COVID-19 Vaccines

Greetings and Introduction to the Topic of Vaccines

Peace be upon you, dear audience.

Introduction and Clarification on the Topic of Vaccines

We had conducted a survey on the attitudes of Arab peoples towards the COVID-19 vaccine, and I would like to present its results with you. Firstly, we apologize for the delay in announcing the results due to our engagement in research and writing scientific papers, including one related to this topic that we will tell you about at the end of the meeting, God willing.

Before I present the results with you, I would like to clarify something. Each of us, dear audience, has central issues in life that we defend and dedicate our time and effort to, and on the other hand, there are issues that should not form side battles that distract us from the greatest tasks. The topic of vaccines has caused a severe dispute among people, some of whom treat it as a matter of right and wrong, but it is not so. Rather, it is an issue of ijtihad that should not spoil the cause of love. It is unreasonable that we, as Muslims, protect our blood and argue and blame each other over every issue.

Those who see taking the vaccine does not mean that they trust foreign companies and Western countries, nor that they believe they are kind to us and want our best interest, nor that they trust health authorities and international organizations. The matter has many factors, my brothers, and forgive me for the expression if I say: even one who has sheep may take care of their health to benefit from them, and God is the one we seek help from, not for their black eyes.

The existence of the pandemic in a country threatens to spread to other countries with travel and trade movements. Will pharmaceutical companies seek to benefit from this situation? Certainly and without a doubt. Are other factors besides the people's interest involved in choosing the type of vaccine and vaccination policies in a country? Very, very possible.

So, does this mean not taking the vaccine? This has no relation to that. If we have a health interest in taking the vaccine, we will not leave it out of spite and provocation to the companies that want to ride the wave, nor to those in charge of health policies, but we review the scientific evidence, verify it, and act in what is in our best interest as Muslims.

Personal Stance on Vaccines

One of the virtuous people whom I respect told me: "Your words, Dr. Iyad, about vaccines were an encouragement to people to take them, and you rushed in that, go out and apologize for it and correct your mistake." And another virtuous man tells me: "I see that it may be a religious duty upon you to talk to people about the vaccine and encourage them to take it, perhaps it will be a relief and the ban will be lifted and people will return to their lives." Meaning, everyone has their own opinion, and I do not see this nor that.

As for me, the topic of vaccines is not one of the issues that I accept to exhaust my time and effort on, even though it is an important issue, but it is not one of the major issues that I fight for, positively or negatively. And I do not want my call to the clear, categorical, and certain matters to be mixed with my stance on vaccines. I, dear audience, speak about faith against disbelief and atheism, about the greatness of the Sharia and the necessity of adopting it, about true science against false science. In such issues, I am ready to be firm, adopt the stance, and defend it with all the strength I have.

As for the topic of the vaccine, on the other hand, it first requires from me a lot of time and effort to follow its developments, stand on the accuracy of studies, the truth of news, and compare between the different types of vaccines, especially since until today there are ninety-three vaccines being studied, twelve of which have been approved. And the appearance of new mutations of the virus is not hidden from you, are the vaccines effective against these new forms of the virus or not? I do not have the time to follow all of this and make comparisons.

Secondly, I do not want my stance on this topic to distract from my call to the categorical and certain matters. So, is the health of Muslims not something important? Yes, and we have lost dear people to this disease, and Jordan, in particular, is suffering more than other countries at this time, and many people's livelihoods have been disrupted, and the situation, we ask God to relieve it. But it is not required of me to speak about every important matter. This topic has its people and its specialists. Encouraging people to take the vaccine is a responsibility, and so is discouraging them, even though it may be a cause of protecting lives. This discouragement is a responsibility, a responsibility before God and then before people. And it is not my duty to bear any of these responsibilities.

Those who advise me privately about the vaccine, I sometimes advise them. There are people who ask me: "So, I am such and such age, my condition is such and such, my health is such and such, should I take the vaccine or not, Doctor?" I advise them, or my father or mother, I sometimes advise them, but I do not want to take a general stance.

About the Survey and Methodology

The survey we published for you helps in knowing people's attitudes towards the vaccine and the reasons for their attitudes, which helps researchers in spreading awareness about medical issues and separating truth from rumors, so that people can make their decisions with knowledge and on a scientific basis. And we ask God for success and guidance and that He guides people to learn from what is happening and repent to their Lord, perhaps He will lift this affliction.

Now, regarding the results of the survey, let us review them together. The survey was published on the "Survey Planet" website, and the advantage of this website is that it does not allow filling out more than once from the same IP address, so we ensure, God willing, that no one tries to disrupt the results by entering, for example, two or more entries. So, we used this website and put for you, as you remember, a set of questions. I will review with you the most important ones. And whoever wants to go back to the detailed answers, 37,000.

And to inform you, in the past period, I reviewed the surveys published on the topic, especially since this topic has a lot of research, more than 200 research papers have been published so far on people's acceptance of COVID-19 vaccines. The other studies did not exceed the number of 20,000 participants. Our study, thanks to God Almighty, includes approximately 37,000 participants and covered an area that was neglected to a large extent, which is the Arab region, and also Arabs outside the Arab region. So, we have a large number of participants.

The countries that participated: most of the countries of the world, all the Arab countries and European countries, North and South America, meaning diverse participation from all over the world. Most of the participants were men, about sixty percent. The ages were diverse, but the majority were young people more than the elderly, but there was also representation, meaning a representative sample, albeit relatively simple, of the elderly.

Initial Survey Results

There are questions, as I said, that may not mean much to you, such as the issue of what percentage are affected by chronic diseases. Most were not affected, most, but there is also a number, for example, those affected by let's say various diseases around 10%, pressure around 4 and 14%.

Do you think you have been infected with the coronavirus? The majority or about half said no, and about a third said they were not sure, and some said yes. Has the infection been verified by a laboratory test? There is a percentage of about 15.3% who verified it and the result was the presence of the virus.

We also have academic achievement: most participants or about half of the participants hold a bachelor's degree or equivalent. And we have about 15%, meaning about 5600 participants in the study, hold advanced degrees such as master's or doctorate or equivalent such as medical fellowship and others.

What is the nature of your work? We have about 16% working in the health field, meaning about 6000 participants in the survey work in the health field, and the others work in other fields.

Okay, do you take the flu vaccine annually? The vast majority do not.

Do you have an idea about the type of vaccine? We have about a third who said I do not know the type of vaccine approved in my country. 27% said Pfizer or Moderna, the two American vaccines. 26% the Chinese vaccine Sinovac and Sinopharm. We have a smaller percentage for the Russian vaccine Sputnik, and also a small percentage 7.7%, but also a number that is not small, meaning about 3700 said the approved vaccine Oxford, which is Oxford and AstraZeneca.

Okay, of course, and you know that the participant is available to choose more than one option if there are many types of vaccines available in his country or approved in his country.

Have you taken the vaccine until the time of the survey? The vast majority have not, but we also have a number, meaning a few hundred about 644 took the first dose, and some took the second dose.

Okay, have you experienced side effects? 58% did not experience side effects, of course 58% of those who took the vaccine one or two doses. 40% said moderate symptoms. We have 13 people who said severe symptoms appeared.

Intention to Take the Vaccine and Deal with It

Do you intend to take the vaccine when it is available? This is one of the most important questions in the survey. Now, gentlemen, of course, part of those who answered the survey in general did not answer this question because they originally took the vaccine. The rest, who are 36,220 people, said some said no, a large part said no, about forty percent said I do not want to take the vaccine. About 22% said I am not sure. About four percent said it depends on the type, meaning I will base my decision to take the vaccine or not on the type of vaccine. About 21% said I will wait to see the result with others, meaning I want to see what will happen to people, and based on the result, the effectiveness, the side effects, many things, will decide whether to take the vaccine or not. We have a percentage of about 12.5% who said yes. So, those who said yes with confidence 12.5%. There are people waiting to see the results, and there are people who link their decision based on the type of vaccine.

Okay, now what is the best way in your opinion to deal with or deal with the vaccine in your country? The majority said that the choice should be left to each person to take it or not. And there are other percentages that you can review.

Okay, in your opinion, to what extent do others in your country need the vaccine? The answers also vary between those who say it is needed for specific categories of people who are not the majority, and those who say it is needed for everyone who has proven the vaccine's effectiveness and safety in clinical studies. There are those who say they do not know, and there are those who say no one needs it.

The Scientific Paper Based on the Survey

The question, meaning it can be the second most important question 29. It is better that we review it with you from the scientific paper that we wrote from this survey. We published a scientific paper entitled: "A high rate of COVID-19 vaccine hesitancy among Arabs: results of a large-scale survey". I cooperated in writing this paper with Dr. Muhammad Helmy, who is a doctor in biological and information systems at the University of Toronto in Canada, Professor Dr. Iman Al-Bishiti, Dean of the Faculty of Pharmacy at Luminus University in Jordan, and Dr. Iyad Sultan, who is a doctor at the Hussein Cancer Center in Jordan as well.

This paper, gentlemen, is now published in "MedRxiv", meaning "Preprint" has not been officially accepted in a journal, but the idea of Preprint is that you publish temporarily until the global journals review your research and decide to accept or reject it. So we sent the research to one of the journals but it is currently published as Preprint in the journal MedRxiv.

Okay, now of course we presented an introduction, or let me mention to you before the introduction, we have in the Abstract a summary of the research, we have a link that takes you to a page with details for each country hopefully we will review it at the end after we review the most important details of the scientific paper. Of course, there is numbering on the side so that any person who wants to give his opinion and criticism of the paper can say in the following line at the following observation.

We started with an introduction that explains the importance of the topic as I mentioned to you. Now in the global trend about the subject of acceptance or non-acceptance of vaccines, but there are not enough studies in the Arab region. We presented details that talk about the importance of this topic and the research conducted around it, then the scientific methodology that we followed in the survey and also in the analysis of the results. Then we have the results and the "tables" (Tables) and the "figures" (Figures) that we will review with you, the tables and shapes we will review at the end inshallah. Then we have the "discussion" (Discussion) which is the discussion of these results and final conclusions.

Detailed Results Presentation

Now let us go directly to the "figures" because these details can be accessed by anyone. We will put the link for you in the comments, God willing. However, let us say that many people are interested in the summary, and the summaries are available in the "figures" and "tables" in the illustrations as well as in the charts.

In the first figure, we present you with a map of the Arab world. Of course, the survey is in Arabic, otherwise, we always emphasize that this is your nation, one nation, and I am your Lord, so fear Me. We always speak with the spirit of the Islamic nation. However, this survey is in Arabic and covers the Arab region, as I mentioned, where studies are weak or few, let us say, and in very limited numbers. The map shows the extent of acceptance according to the country. You will notice that there is acceptance of the vaccine and a willingness to take it in the Gulf Arab countries in general, in addition to Libya and Sudan, although the numbers participating from Libya and Sudan are less than those participating from the Gulf Arab countries. In addition, this "figure" also shows how there is great hesitation or refusal to take the vaccine in the region of Morocco, Tunisia, Mauritania, and Algeria. In this region, there is hesitation in accepting the vaccine.

These "figures" clarify the percentages within and outside the Arab countries. We also investigated the acceptance of the vaccine among Arabs living outside the Arab countries, which is detailed here. We considered, dear guests, that those who said yes, I want to take the vaccine, are acceptors, and those who said according to the type, we considered them acceptors because they do not object to the vaccine in principle, but according to the type, meaning they want to make sure of the type if it has sufficient studies or not. These two categories we considered them as acceptors of the vaccine. While there are categories of people whom we considered non-acceptors or hesitant to take the vaccine, such as those who said they will wait to see the result with others, those who said they are not sure, and those who said decisively no, they do not want the vaccine.

As you notice, for example, Qatar has a relatively high acceptance, while Algeria is the least accepting country. The people in Algeria are the least accepting of the vaccine. Regarding Arabs living outside the Arab countries, there is relatively higher acceptance in North America, then Turkey, then Europe, and others, which are other countries not mentioned before, meaning outside the Arab countries, outside North America, Turkey, and Europe, such as the Far East, etc.

Factors Affecting Acceptance

In these figures, we review the factors affecting the extent of acceptance, such as comparing Arabs inside and outside the Arab countries, males and females. Generally, males are more accepting. According to academic degree, according to working in the health field and outside the health field. As expected, those working in the health field are more accepting and ready to take it as well. According to whether the person believes they have been infected with COVID-19, and we notice that those who believe they have not been infected yet are also more accepting. According to age groups, and according to whether the patient is someone who usually takes the flu vaccine. Those who take the flu vaccine annually are much more accepting of the idea of taking the COVID-19 vaccine.

Now, dear guests, in this "figure" we review the "odds ratios" for different factors and their relationship with "hesitancy." The specialists understand these issues, how the more the shift from the mean, the more it means "hesitancy" or resistance or hesitation to take the vaccine. For example, "not healthcare workers," people outside the health profession are more hesitant than those working in the health field. Females are more hesitant than males, and so on.

Reasons for Hesitation to Take the Vaccine

Now this "figure" is also of interest to you, and although there is an overlap from the "Med Archives" site between the speech and the "figure," otherwise, our "figures" do not have overlaps, but this "figure" is of interest to you because it summarizes the most important reasons for hesitation to take the vaccine. You remember question 17 was: if you object or even choose to take the vaccine but you have reservations, what are the reservations that make you less enthusiastic about taking the vaccine? The number one reason was: I am afraid of the existence of side effects that have not been discovered yet. This was a high percentage of around 61%.

The next reason: that not enough time has passed to ensure the safety of the vaccine, not enough time has passed to ensure the safety of the vaccine. Then: I believe that the vaccine was produced quickly, and this makes me doubt its credibility. This was the fourth reason in terms of percentage: that the person does not trust the health policies followed in his country, and so on. The least reasons, for example: I do not believe that I will be infected with COVID-19.

There are other "figures" that you can review regarding people's conviction about policies, policies of imposing the vaccine or not imposing it. We said the majority say that the choice should not be left to each person to choose what they want.

Interactive and Concluding Data Platform

Now, dear audience, let me return to what I mentioned earlier. There is a website called "Shiny" where we have placed information so that you, for example, living in Algeria, Tunisia, Egypt, and wanting to know about the situation in your country, the acceptance rate, the rejection rate for males, females, healthcare workers, non-healthcare workers, the reasons in your country for rejecting the vaccine, etc. It is a very useful website.

You will notice here that we provide you with an overview of the project and its idea, from the team behind it. The poor servant is the author, by the way, meaning the responsible author. If you go to the section titled "COVID-19 Questionnaire," you can find details about the survey. Or if you go to "COVID-19 Statistics," meaning the statistics. The statistics will only appear if you select the country. For example, if I am in Jordan, I choose "Jordan," and the results will appear, showing the fluctuation in case numbers, the cumulative number of cases, and several other statistics.

If we go to the "Questionnaire" section, to the survey questions, and choose Jordan for example, you will notice, dear audience, that it provides detailed information about Jordan, the acceptance rate of the vaccine by age, by "Males and Females," and so on. It reviews the results regarding Jordan. You can also review the "Barriers for COVID-19" in Jordan, the obstacles to taking the vaccine in Jordan specifically. You might find, for example, that the majority or the number one reason is "Afraid of unknown side effects," that I am afraid of side effects that have not yet been discovered. And also, not enough time has passed since the vaccine was tested, etc. So, you see the information regarding Jordan, and for each country, there are its own statistics.

Now, I invite the academic brothers, especially those interested in this field, to read the scientific paper. We can put their comments on it if they wish on the "Med Archives" website, and we will provide the link for that, God willing. Also, the specialists can contact us if they are interested in this topic, if they have comments and suggestions. And we ask Allah, the Most High, to guide everyone to what He loves and is pleased with, and to guide us to sincere repentance. I return and say, I ask Allah to guide us to sincere repentance, so that He, the Most High, may lift this affliction from us and heal us and all of you. Peace be upon you and the mercy of Allah.