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| ORIGINAL ARTICLE |
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| Year : 2022 | Volume
: 8
| Issue : 3 | Page : 201-206 |
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Acceptance of COVID-19 Vaccine and Its Related Determinants Among the Residents of Western Uttar Pradesh
Aprajita Panwar1, P.K. Tyagi2, Apoorva Bhargava2, Rakesh K Gupta3
1 Department of Physiology, Government Institute of Medical Sciences, Greater Noida, Uttar Pradesh, India
2 Department of Community Medicine, Government Institute of Medical Sciences, Greater Noida, Uttar Pradesh, India
3 Department of Pediatrics, Government Institute of Medical Sciences, Greater Noida, Uttar Pradesh, India
| Date of Submission | 09-Feb-2022 |
| Date of Decision | 08-Jul-2022 |
| Date of Acceptance | 23-Aug-2022 |
| Date of Web Publication | 07-Dec-2022 |
Correspondence Address:
Aprajita Panwar
Associate Professor, Department of Physiology, Government Institute of Medical Sciences, Greater Noida, Uttar Pradesh
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/mamcjms.mamcjms_9_22
Background and Objectives: Amidst multiple waves of the coronavirus disease 2019 (COVID-19) pandemic, numerous vaccines are being used worldwide to provide immunity against the coronavirus. Knowledge, attitudes, and perceptions of the community toward COVID-19 vaccination could influence vaccine acceptance. This study aimed to evaluate the knowledge, attitudes, and perceptions toward COVID-19 vaccination and assess its determinants. Material and Methods: A web-based cross-sectional study was conducted as a structured 27-item questionnaire through Google Forms. Qualitative data were processed by categorizing responses for an item according to intended objectives, and data were coded numerically. The associations between variables were explored by using a modified Poisson regression to determine adjusted prevalence ratios and their 95% confidence intervals. Results: The vaccine acceptance rate among the respondents was 72% and was more among those involved in the health care sector. The participants feared vaccine-related side effects and were less willing to accept the vaccination. The participants who believed adults also require vaccination against diseases accepted the COVID-19 vaccine. We found that the subjects with comorbid conditions, urban areas, and those who had contacted COVID-19 infection or family members were more willing to get vaccinated (P < 0.001). Conclusions: We concluded that a considerable majority (72%) of residents exhibit good vaccine acceptability. Health care providers, social media, and community influencers can design awareness campaigns to address perceived safety concerns and achieve a 100% acceptance rate in the community.
Keywords: Acceptance, COVID-19, knowledge, perceptions, SARS-CoV-2, vaccine
How to cite this article:
Panwar A, Tyagi P, Bhargava A, Gupta RK. Acceptance of COVID-19 Vaccine and Its Related Determinants Among the Residents of Western Uttar Pradesh. MAMC J Med Sci 2022;8:201-6 |
How to cite this URL:
Panwar A, Tyagi P, Bhargava A, Gupta RK. Acceptance of COVID-19 Vaccine and Its Related Determinants Among the Residents of Western Uttar Pradesh. MAMC J Med Sci [serial online] 2022 [cited 2023 Mar 25];8:201-6. Available from: https://www.mamcjms.in/text.asp?2022/8/3/201/362901 |
| Introduction | |  |
Coronavirus disease 2019 (COVID-19) cases caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were first reported in Wuhan, China, in December 2019.[1] The infection spread like wildfire, posing a global threat to >220 countries in no time.[2] As of January 22, 2022, there have been three waves of the coronavirus pandemic, with around 338 million cumulative cases and >4.8 million deaths worldwide.
India, a densely populated nation, is highly susceptible to coronavirus infection. The first imported case in India was reported on January 30, 2020.[2] Presently, India is witnessing the third COVID-19 wave infecting >18 lakh active cases. However, fortunately, the third COVID-19 wave is associated with less mortality rate than the previous two waves of coronavirus disease.
India and other countries have developed several mitigation policies to curb viral transmission and reduce the severity of illness.[3] These include nonpharmaceutical interventions like wearing masks, hand hygiene and sanitization, physical distancing, travel regulations, school shutdowns, and imposing lockdowns. The measures flattened the COVID-19 epidemic curve, but the number of COVID-19 cases rose when phase-wise unlocking was done.[4]
However, population vaccination is the most effective way to control a pandemic.[5] It is reported that 82% of the community should be vaccinated to develop herd immunity, defined as the immunity level in a community that prevents further spread through natural infection; however, it is practically unattainable.[6],[7] Therefore, scientists worldwide have made untiring efforts to decipher the genomic sequence of SARS-CoV-2 and invent the COVID-19 vaccine.[8] Amidst multiple waves of the coronavirus pandemic, phase 3 trials of vaccines were conducted, giving the entire world a ray of hope to fight the pandemic.[9]
India is globally acknowledged for its well-structured immunization strategy with phenomenal vaccination coverage. Several approved vaccines are being distributed in the whole country. More than 55% of people are vaccinated with the first dose, and 62% have received both doses in Uttar Pradesh. Government Institute of Medical Sciences (GIMS), Greater Noida, Uttar Pradesh, under the flagship of Dr (Brig) Rakesh Gupta, has been at the forefront of combating the battle against COVID-19 by delivering the best vaccination drive in the western Uttar Pradesh region. A dedicated team of doctors and staff are working round the clock to provide the best possible vaccination experience. As of December 2021, 240,856 vaccines have been delivered to the people by the Institute, and the journey continues.
Acceptance toward a COVID-19 vaccine was taken as “yes” if the participants had already taken one or two doses of the vaccine or had registered themselves for vaccination and would recommend it further to friends and family.[4] False perceptions regarding COVID-19 vaccines may significantly lower vaccine acceptance in western Uttar Pradesh.[10],[11] Fake news and rumors disseminated via social media could also influence the decision to get vaccinated.[12],[13]
To date, there has been no prior study among the western Uttar Pradesh general population investigating their knowledge, attitudes, and perceptions toward the COVID-19 vaccine. Hence, this study has been planned to determine their knowledge, attitudes, and perceptions toward the COVID-19 vaccine.
| The rationale of the study | | |
Vaccination of the community against coronavirus is a matter of national priority today, bearing regional and global impacts. False information, spreading through social media, may considerably affect the acceptance of the COVID-19 vaccine. To effectively implement the vaccination drive in western Uttar Pradesh, we need to investigate people’s knowledge, attitudes, and perceptions about COVID-19 vaccinations and assess the determinants as this would help the Indian Government and policymakers to address all barriers relating to vaccine acceptance.
Research questions
- What is the knowledge of the western Uttar Pradesh residents about the need and safety of COVID-19 vaccination?
- What are their attitude and perceptions about COVID-19 vaccination?
- Which determinants are affecting the community acceptance of the COVID-19 vaccine?
| Material and Methods | | |
This study was conducted in the GIMS, Greater Noida, after obtaining permission from the Institutional Ethics Committee and the respondents’ informed consent.
Study design
The study employed a cross‐sectional research design. The survey was conducted online between July 6, 2020 and December 5, 2022, during the ongoing COVID-19 vaccination drive in the country.
Sampling: We used the chain‐referral sampling method. A total of 1095 responded to the e-survey.
Study tool: A 27-item questionnaire was used with questions about (i.e., sociodemographics, knowledge, attitudes, and perceptions) the COVID-19 vaccination.
Validity and reliability of the study tool: A total of 27 questions were given to a panel of 10 experts consisting of the doctors at GIMS, Greater Noida, who provided valuable feedback on the readability and appropriateness of the survey items. Cronbach alpha score was 0.89, which inferred high internal consistency of the items used.
Data collection method
The prevalidated questionnaire (27 items) covered under four sections (i.e., sociodemographics, knowledge, attitudes, and perceptions) were included in Google Forms. The shareable link to the e-survey was created and disseminated publicly on various social media platforms (e.g., Facebook, WhatsApp, and e-mail), and the recipients were requested to disseminate the link further to their family members or acquaintances. Likewise, the QR code to the link was generated and shared in the newspaper. The online survey for data collection ensured physical distancing and safety precautions during the pandemic.
Inclusion and exclusion criteria
The inclusion criteria were (a) being a resident of western Uttar Pradesh, (b) an adult (≥18 years old), (c) having internet access, and (d) voluntary informed consent.
The exclusion criteria included (a) aged <18 years old and (b) incomplete surveys. The study followed the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) guidelines.
Statistical analysis
The data were checked thoroughly for comprehensiveness, exported to Statistical Package of the Social Sciences version 20 (SPSS), and analyzed for descriptive statistics with frequencies and proportions. Qualitative data were processed by categorizing responses for an item according to intended objectives, and data were coded numerically. The associations between variables were explored by using a modified Poisson regression.
| Results | | |
A total of 1095 responded out of 1200 to the survey. The response rate was 91% and deemed adequate for data analysis.
[Table 1] shows the sociodemographic profile of the respondents (n = 1095) and their acceptance of the COVID-19 vaccine. | Table 1 Sociodemographic profile of the respondents (n = 1095) and acceptance of the COVID-19 vaccine
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[Table 2] depicts the knowledge, attitude, and perceptions of the respondents toward COVID-19 vaccination. | Table 2 Knowledge, attitude, and perceptions of the respondents toward COVID-19 vaccination
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[Figure 1] reveals the most trusted source of information for the community regarding COVID-19 vaccination. | Figure 1 Revealing the most trusted source of information for the community regarding COVID-19 vaccination.
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[Figure 2] illustrates the people’s perceptions about the need for the COVID-19 vaccine. | Figure 2 Illustrates the people’s perceptions about the need for the COVID-19 vaccine.
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[Figure 3] reveals people’s perceptions about who are the suitable candidates for receiving COVID-19 vaccination. | Figure 3 Revealing people’s perceptions about who are the suitable candidates for receiving COVID-19 vaccination.
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| Discussion | | |
Vaccination of the Indian community against COVID-19 is the most effective intervention to curtail the successive waves of the ongoing pandemic. The acceptance of the COVID-19 vaccine was related to many factors like sociodemographic characteristics, comorbid conditions, death of a family member or friend due to COVID-19, fear of side effects, and beliefs about natural immunity. This study has been conducted to assess the knowledge, attitudes, and perceptions toward COVID-19 vaccinations in the residents of western Uttar Pradesh.
According to the Ministry of Health and Family Welfare officials, as of December 2021, 55.2% of the eligible population has been fully vaccinated, with 87% of people receiving the first dose of the vaccine. India ranks second in the world in delivering the maximum number of doses per day. This level is considered good, according to the magnitude of the COVID-19 pandemic, and the efforts are to boost the vaccination drive further and achieve the target.
Overall, the vaccine acceptance rate among the respondents of our study was 72% and was more in participants working in the health care sector than those working in other occupations. This credit for good vaccine acceptance is attributed to the online campaigns by political leaders, doctors, and stakeholders in emphasizing the need to get vaccinated through social media. This high acceptance was similar to the study done in China and Indonesia.[14],[15] However, these high acceptability levels differed from studies done in other countries like Kuwait[6] and Bangladesh,[2] where the vaccine acceptability was as low as 54% and 60%, respectively.
We found that male subjects expressed more willingness to accept a COVID-19 vaccine than females (65.3% versus 60.9%, P = 0.04). This finding is corroborative with the study done in Kuwait[6] and Oman,[13] where males were more willing to be vaccinated but, in opposition with the research conducted in Bangladesh,[2] which showed no gender-wise difference in awareness about COVID-19.
According to our study, respondents with a higher education level were more knowledgeable about COVID-19 vaccination, which can be corroborated by previous research. A similar finding was found in research conducted in Bangladesh,[2] illustrating that persons with a higher educational background had more knowledge regarding COVID-19. It may be that well-educated people are more cautious about their health due to their interaction with doctors and health care professionals.
We found that 53.5% of the participants feared minor side effects of the vaccine (like fever, pain at the site, body pains, and allergy), and they were reluctant to take a second dose of the vaccination (adjusted prevalence ratio, aPR = 0.39, 95% confidence interval, CI: 0.35–0.44). This finding was similar to the study done in Kuwait, where subjects who believed vaccines to have health-related risks were reluctant to accept the vaccine shots.[6]
A majority (86.8%) of the participants believed that adults also require vaccination to prevent diseases; hence, they were more willing to take the COVID-19 vaccine than those who did not believe in the concept of adult vaccination (aPR = 1.44, 95% CI: 1.31–1.58). This conclusion supported the study done in Jordan, which found that people who took influenza shots during adulthood displayed a higher acceptance of COVID-19 vaccination.[4]About 61.7% of the respondents who tested positive for COVID-19 at least once in their lifetimes were willing to vaccinate themselves. Also, 52.4% had family members or friends who tested positive for COVID-19 and 65.6% claimed that they experienced the unfortunate death of their family member. Hence, they were self-motivated to take the vaccine doses. These findings were similar to studies in other parts of the world.[2],[4],[6]
About 90.8% believed COVID-19 vaccination is safe, and 86.8% believed that COVID-19 vaccination reduces the chances of severe infection/ICU admission/death. Most subjects with comorbid conditions, urban areas, and those who had contacted COVID-19 infection or family members were more willing to get vaccinated (P = 0.002). This was similar to findings in Malaysia.[9]
The study proved that the source of information about COVID-19 for a majority of the respondents were the health care providers (73.2%) and social media (71.3%), followed by the internet (58%). A minority of the population (9.1%) relied on reading scientific articles to gain access to information about the COVID-19 vaccine, and nearly 5% discussed their queries with their family members.
According to our study, most (83.5%) of the population believed they should take jabs of COVID-19 vaccine to prevent COVID-19 infection, avoid transmission in the community, and avoid complications. In comparison, 75.5% of the participants in the study believed that everyone should take a vaccine jab irrespective of whether they have been infected with COVID-19. A minority (5%) believed only persons who recently recovered from COVID-19 should take the vaccine.
Study limitations
A quick KAP web-based survey was done at the time of the vaccination drive during the pandemic. Hence, the sample size was low. The study may be extrapolated to other regions of Uttar Pradesh for generalization. The responses were in English, so language bias may be a limitation for a few participants.
| Conclusion | | |
We concluded that the residents of western Uttar Pradesh exhibit good vaccine acceptability where a majority (72%) of the population was willing to get vaccinated against COVID-19. Vaccines perceived safety concerns need to be addressed to achieve a 100% acceptance rate. The health care providers, social media, and community influencers can design awareness campaigns to spread transparent information about the vaccine’s safety and efficacy among the population.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
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| 13. | Al-Marshoudi S, Al-Balushi H, Al-Wahaibi A et al. Knowledge, attitudes, and practices (KAP) toward the COVID-19 vaccine in Oman: a pre-campaign cross-sectional study. Vaccines 2021;9:602. https://doi.org/10.3390/vaccines9060602. |
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[Figure 1], [Figure 2], [Figure 3]
[Table 1], [Table 2]
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