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The objectives of this study were to review the literature covering the perceptions about influenza vaccines in the Middle East and to determine factors influencing the acceptance of vaccination using Health Belief Model (HBM). A comprehensive literature search was performed utilizing PubMed and Google Scholar databases. Three keywords were used: Influenza vaccine, perceptions and Middle East. Empirical studies that dealt with people/healthcare worker (HCW) perceptions of influenza vaccine in the Middle East and written in English were included. The search covered articles published between January 2015 and November 2020. A total of 34 cross-sectional studies covering a total of 35 518 participants from 22 countries were included in this review. The overall influenza vaccination rates were generally low (<50%) among general population, particularly among pregnant women and children. HCWs had relatively higher vaccination rates compared with general population. Old age, health comorbidities or working in high-risk environments were noted as major motivators to receive the vaccine. Concerns about adverse reactions and the lack of vaccine efficacy were the most predominant reported barriers to receiving the vaccines. Lastly, cues to actions included receiving advice from HCWs, influence of institutional requirement, awareness/educational pamphlets and influence from the media. The HBM can be helpful in identifying and analysing motivators and barriers to vaccination. Additionally, by looking at the root causation, this model can help plan campaigns to increase vaccination rates in the region. Finally, we recommend empowering HCWs to proactively advocate for vaccination as part of preventive care. © The Author(s) 2021. Published by Oxford University Press on behalf of the Royal Pharmaceutical Society. All rights reserved. For permissions, please e-mail:


Zahraa Adel Alalag, Ali Azeez Al-Jumaili, Fadya Yaqoob Al-Hamadani. A comprehensive review of drivers influencing flu vaccine acceptance in the Middle East over the last six years: using Health Belief Model. The International journal of pharmacy practice. 2022 Jan 07;30(1):5-16

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PMID: 34791260

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