Introduction
In Denmark, COVID-19 vaccination coverage was lower in areas with many residents from ethnic minority backgrounds.
Aim
This project aimed to investigate vaccination hesitancy among the native and Arabic minority populations in Denmark.
Methods
A cross-sectional questionnaire survey was conducted, utilizing validated versions of the Danish and Arabic translations of the Vaccination Attitudes Examination (VAX) scale, which in this study referred separately to COVID-19 and all other vaccines. The VAX scale includes four subscales addressing: 1) mistrust of vaccine benefits, 2) concerns about unforeseen future effects, 3) worries about commercial profiteering, and 4) preference for natural immunity. Participants express their level of agreement using a 6-point Likert scale, where higher scores indicate more hesitancy. Data were collected in January 2023 through selected Facebook groups using an online survey system. Descriptive and multivariate linear regression analyses (the latter with attitude scores as outcome variables and ethnicity alongside sociodemographic variables as covariates) were performed.
Results
Out of a total of 124 respondents, 35% were of Danish, 51% of Arabic and 14% of other ethnic heritage; 56% were females, 83% were fully vaccinated. Danish respondents were younger than Arabic (mean age, respectively, 35 vs. 48 years, p<0.001). Hesitancy toward both COVID-19 and all other vaccines was higher among Arabic respondents compared to Danish. The mean overall score for COVID-19 VAX was, respectively, 2.1 vs. 3.4 (adjusted p<0.001); the mean overall score for all other vaccines’ VAX was, respectively, 2.0 vs. 3.1 (adjusted p<0.001). In all groups, the highest scores concerned unforeseen future events, the lowest scores were related to concerns about commercial profiteering.
Discussion
There is greater hesitancy towards vaccination among the Arabic minority compared to the native population in Denmark, which may partly explain variations in COVID-19 vaccination coverage. More efforts are needed to understand and address negative vaccination attitudes among ethnic minorities in Denmark.