| Summary: | Eiman AlAwadhi,1 Dina Zein,2 Fatmah Mallallah,3 Nour Bin Haider,1 Anower Hossain4 1Faculty of Public Health, Department of Epidemiology and Biostatistics, Kuwait University, Kuwait City, Kuwait; 2Faculty of Public Health, Department of Health Policy and Management, Kuwait University, Kuwait City, Kuwait; 3Ministry of Health, Hanoi, Kuwait; 4Institute of Statistical Research and Training, University of Dhaka, Dhaka, BangladeshCorrespondence: Eiman AlAwadhiFaculty of Public Health, Kuwait University, PO Box 24923, Safat, 13110, KuwaitTel +965 246-34380Email eiman.alawadhi@ku.edu.kwBackground: With COVD-19 cases on the rise globally and two approved vaccines, determining vaccine acceptance is imperative to avoid low inoculation rates. The aim of this study was to evaluate the changes and determinants of vaccine acceptance among citizens and non-citizens, over time during the pandemic in Kuwait.Methods: Data were obtained from the COVID-19 Snapshot Monitoring (COSMO Kuwait) study that was implemented according to the WHO tool for behavioral insights on COVID-19. Data was collected online, every two weeks throughout the pandemic. Individuals living in Kuwait during the pandemic were surveyed, representing an independent sample of the population during each data collection wave.Results: A total of 7241 adults living in Kuwait participated. Sixty-seven percent of those participating agreed to take a vaccine if it was available and recommended. However, the proportion of vaccine acceptance drastically dropped overtime as COVID-19 related restrictions were eased, among citizens (73 to 47%) and noncitizens (80 to 60%). Some factors associated with increased odds of agreeing to take the COVID-19 vaccine, among citizens and non-citizens, included increased frequency of informing oneself about the virus (OR, 1.34– 1.83; 95% confidence interval 1.16– 2.55), having high versus low confidence in doctors (OR, 1.79– 2.11; CI 1.17– 3.80), increased agreement with containment policies (OR, 1.11– 1.27; CI 1.05– 1.41), expressing more fears and worries (OR, 1.05– 1.12; 1.01– 1.24), and the increased perceived likelihood of getting infected with influenza (OR, 1.3– 1.4; CI 1.03– 1.84). Decreased odds of agreement were associated with increased age (OR, 0.37– 0.61; CI 0.26– 0.95), being female (OR, 0.56– 0.62; CI 0.43– 0.73), and not taking the influenza vaccine in 2019 (OR, 0.61; CI 0.43– 0.87).Conclusion: Vaccine acceptance was multifactorial, heterogenous among citizens and non-citizens, and changed over time. While acceptance was relatively high, it decreased throughout the pandemic and as restrictions in the country loosened. This increase in vaccine hesitancy reveals a challenge in achieving high inoculation levels, and the need for effective vaccine-promotion campaigns and increased health education in the country.Keywords: vaccine acceptance, coronavirus, Kuwait, COVID-19 vaccine
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