Beliefs about Covid-19 and the Covid-19 vaccine in Saudi Arabia: a cross-sectional cohort study

<bold>Aim:</bold> To compare the beliefs about Covid-19 and the Covid-19 vaccine between vaccinated and unvaccinated individuals in Saudi Arabia and explore how these beliefs influence vaccine acceptance. <bold>Method:</bold> Between March and October 2022 adult members of the public in Saudi Arabia were invited to complete an online survey using validated questionnaires to assess their beliefs about Covid 19 (Covid-19 Misinformation Scale-MIS) and (Brief Illness Perceptions Questionnaire-BIPQ) and Covid-19 Vaccination (Vaccine Necessity beliefs and Concerns). Logistic regression analysis to examine whether beliefs about Covid-19 and Covid-19 vaccination were associated with vaccine acceptance/refusal. <bold>Results:</bold> In total, 1012 individuals (mean age=37.5±, 25% male) completed the on-line survey. 903 respondents reported that had been offered and accepted a Covid vaccine, with 109 refusing a vaccination offer. The refusal of Covid-19 vaccination was associated with beliefs Covid-19 vaccination and perceptions of Covid-19. Patients who refused vaccination were significantly more likely to doubt their personal need for the vaccine (t=17.488, p=<0.001) and to have concerns about the current and future harms of vaccination (t=-14.488, p=<0.001). Those who refused vaccination were significantly more likely to believe misinformation about Covid-19 (e.g. Covid-19 conspiracies, Covid-19 only affects older people and not younger people) (t=-7.262, p=<0.001), and to be sceptical about the seriousness and consequences of Covid-19 infection (t=3.957, t=6.514, respectively, p=<0.001 for all). <bold>Conclusion:</bold> The findings identify beliefs about Covid-19 and Covid-19 vaccination that are associated with vaccine refusal.