Attitudes regarding COVID-19 vaccine among Ukrainian refugees in Poland in the 4th year of pandemic

Abstract Background Positive attitudes towards COVID-19 vaccine can lead to an increase in immunization uptake. Objectives To assess attitudes and related factors among Ukrainian refugees (UR) in Poland in the 4th year of the pandemic. Methods A cross-sectional survey was conducted between July and August 2023 in Zielona Gora, Poland. Consecutive UR registering at the Regional Refugee Center were invited. An investigator-developed, self-administered questionnaire was used. The dependent variable was the total score of attitude statements related to the COVID-19 vaccine. Descriptive statistics and bi-variate analysis were used for data processing. Results Response rate was 88.1%; 837 UR (45.2% females) consented to participate. Social media, government websites and TV were the main sources of knowledge about COVID-19 vaccine. The mean attitude score was 26.2%; 13.3% of UR scored >50%, almost 1/3 did not mark any pro-vaccination statement, only 2% identified all pro-vaccination claims. Only 21.4% respondents believed that SARS-CoV-2 infection is harmful, 84.1% claimed that their natural immunity to this infection is sufficient so they do not need to be vaccinated. A higher percentage of pro-vaccination attitudes was recorded among UR who had been vaccinated against COVID-19 (17.9% vs 10.2%; p = 0.002), did not search for information in social media (14.9% vs 9.9%; p = 0.045) and in co-workers (15.0% vs 6.6%, p = 0.004). The relationship between the level of knowledge and the intensity of pro-vaccination attitudes was weak, positive, statistically significant (rS = 0.15). Only 6% of UR self-reported vaccination with the 3rd dose of COVID-19 vaccine. Conclusions UR's attitudes towards COVID-19 vaccine are disturbingly poor. The most frequent factors influencing vaccine hesitancy are lack of awareness and concerns about vaccine efficacy. Tailored vaccination campaigns should be implemented to raise awareness, which will increase the acceptance rate for the COVID-19 vaccine.