Quality of life is associated with vaccine reluctance via mental health and fear of covid-19: an exploratory investigation on a Palestinian sample

Quality of life (QoL) has been studied as an antecedent of good mental health in contexts characterized by extreme poverty and acute conflict. The covid-19 crisis exacerbated the risks of health-related consequences in such contexts. Vaccination campaigns have been started worldwide to contain the virus outbreak with high rates of hesitancy and refusal. Our exploratory study sheds light on the relationship between QoL and vaccine reluctance via mental health and fear of covid-19 in a Palestinian population affected by military occupation or socioeconomic marginalization. Who-QolBref, Fcov-19, and Dass were administered to 1122 Palestinian adults living in the occupied territories and Israel. Structural equation modelling was applied to test the relations between variables. Results showed that fear of COVID-19, stress, anxiety and depression mediated the association between QoL and vaccination reluctance with a good model fit (χ2(5) = 828.37; p =.001; GFI=.93; AGFI=.94; RMSEA=.046; NFI=.94; CFI=.95). QoL and mental health were negatively associated with stress (βX, Y = -.35; p <.001), depression (βX, Y = −.37; p <.001), and anxiety (βX, Y = −.36; p <.001). QoL and fear of COVID- 19 (βX, Y = −.16; p <.001) were inversely correlated. A positive effects was found between stress (βM, Y =.17; p <.001), anxiety (βM, Y =.18; p <.001), and depression (βM, Y =.17; p <.001), fear of COVID-19 and vaccination reluctance (βX, Y =.23; p <.001). According to our findings, Public health measures to ease the social suffering of people with low QoL due to conflict and social marginality might favour the acceptance of the vaccine.