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Despite global efforts towards more inclusive national deployment vaccination plans, COVID-19 vaccine acceptance among refugees in the Arab region remains low. This study aimed to examine the prevalence, reasons and predictors of COVID-19 vaccine refusal among older Syrian refugees in Lebanon.

This study developed and internally validated a model of intention to refuse vaccination against COVID-19 in older Syrian refugees. Predictors of intention to refuse the vaccine include age, education, living outside informal tented settlements, sex, perceiving COVID-19 as not a serious infection and vaccines as not safe or effective, and using social media as a source of information on COVID-19. The primary reasons for vaccine refusal were: preference to follow preventive measures, concerns that the vaccine is too new, and belief that the vaccine is not essential.

This study highlights the need for targeted interventions to enhance vaccine acceptance and uptake among older Syrian refugees, and address barriers to vaccine registration. Predictors of COVID-19 vaccine refusal among older Syrian refugees will inform humanitarian programming and public health campaigns, and guide resource allocation and deployment planning. Findings can also inform future research to better understand the predictors of vaccine refusal.

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