Vaccine hesitancy among Syrian refugee parents in Canada: A multifaceted challenge in public health.

Vaccine hesitancy presents a significant public health challenge, particularly among Syrian refugee parents in Canada, who navigate unique barriers to vaccination. This cross-sectional study explores the determinants of vaccine hesitancy, considering socio-demographic factors, resettlement conditions, health assessments, and healthcare system interactions. The study involved 540 Syrian refugee parents residing in Ontario with at least one child under 18, interviewed from March 2021 to March 2022. Participants were asked about their willingness to take the COVID-19 vaccine, with those uncertain or unwilling categorized as "Hesitant" and others as "Non-hesitant." Stepwise multivariable logistic regression assessed various factors associated with vaccine hesitancy. Among respondents, 15.2% expressed hesitancy toward taking the COVID-19 vaccine. Findings indicated that individuals who reported very good or good mental health had decreased odds of being vaccine hesitant (OR = 0.46, 95% CI: 0.27-0.80). Also, individuals without a family doctor and those needing an interpreter but sometimes or never offered one were more likely to be hesitant (OR = 3.61, 95% CI: 1.42, 9.19; OR = 2.14, 95% CI: 1.19-3.84, respectively). These results highlight the complex interplay of factors affecting vaccine decisions, emphasizing the need for culturally sensitive public health strategies to improve vaccine uptake in this population. While vaccine acceptance is low among Syrians (36%), the higher rate among Syrian refugees in Canada (84.7%) reflects the positive impact of healthcare access and resettlement support. This contrast highlights the role of such systems in shaping vaccine attitudes among vulnerable populations, informing targeted public health efforts to boost vaccine acceptance and support the health of Syrian refugees.