Factors Influencing The Acceptance Of Corona-Virus Vaccination Among Health Care Workers

Project and Seminar Material for Public Health

Factors Influencing The Acceptance Of Corona-Virus Vaccination Among Health Care Workers


Abstract


Developing an effective and safe COVID-19 vaccine is a global public health necessity in containing the pandemic. The survey was conducted to assess the Factors influencing the acceptance of Corona virus vaccination among health workers.

A 39-item survey instrument (questionnaire),was developed and validated and distributed randomly to consenting participants from the health workers in Ado odo otta. Descriptive statistics were carried out using Statistical Package for the Social Sciences Software-Version 25 (SPSS-25) to measure frequencies and percentages of the variables.

A total of 470 responses were gathered from adult respondents (aged 18 years and above; median age: 34.5 years). A higher proportions of the respondents were Christians by religion (84.5%) and were health workers (48.6%), followed by medical professionals (20.2%). Most of the participants used the social media (80.2%) as their source of COVID-19 information. 96.0% of them had poor knowledge of the disease, while 39.0% had poor perception of the COVID-19 Vaccine trial. 22.6% were indifferent to the initiation of COVID-19 vaccine trial in Nigeria, 59.8% were in support, while 17.6% were not in support. A higher proportion of the respondents (80%) were unwilling to participate in the COVID-19 vaccine trial, while 20% were willing. Misinformation and disinformation strengthen vaccine skepticism and could undermine efforts to end the coronavirus pandemic. The outcome of this study further underscores the need for adequate public health enlightenment on the role of vaccine in curbing the COVID-19 pandemic. This will ensure adequate deployment and acceptance of the vaccine when it finally arrives.


Table of Content


Chapter One:

Introduction

  • 1.1 Background of the study
  • 1.2 Statement of the problem
  • 1.3 Objective of the study
  • 1.4 Research questions
  • 1.5 Significance of the study
  • 1.6 Scope of the study
  • 1.7 Limitation of the study
  • 1.8 Definition of terms
  • 1.9 Organizations of the study

Chapter Two:

Review of Literature

  • 2.1 Conceptual Framework
  • 2.2 Theoretical Framework
  • 2.3 Empirical Review

Chapter Three:

Research Methodology

  • 3.1 Research Design
  • 3.2 Population of the study
  • 3.3 Sample size determination
  • 3.4 Sample size selection technique and procedure
  • 3.5 Research Instrument and Administration
  • 3.6 Method of data collection
  • 3.7 Method of data analysis
  • 3.8 Validity of the study
  • 3.9 Reliability of the study
  • 3.10 Ethical consideration

Chapter Four:

Data Presentation and Analysis

  • 4.1 Data Presentation
  • 4.2 Analysis of Data
  • 4.3 Answering Research Questions
  • 4.4 Discussion of Findings

Chapter Five:

Summary, Conclusion and Recommendation

  • 5.1 Conclusion
  • 5.2 Recommendation
  • References
  • APPENDIX
  • QUESTIONNAIRE

Chapter One


Introduction

1.1 Background to the Study

A massive global human disaster has been created by a recent contagious respiratory infectious disease caused by a novel coronavirus (SARS-CoV-2) which holds the same veiled RNA structure resembling SARS-CoV-1 that caused the Severe Acute Respiratory Syndrome (SARS) outbreak.1 Classified by the World Health Organization (WHO) as a pandemic On March 12, 2020. The first cases of COVID-19 were identified in Wuhan, China at the end of December 2019. The virus has now affected virtually every country across the world and the number of deaths continues to rapidly increase.2 As of May 3rd, 2020, over 3.5million cases and 245,258 deaths have been reported globally. At the time of the study, the African continent was the least affected with 43,909 cases and 1764 deaths, but the numbers were increasing. In the Democratic Republic of the Congo (DCR), located in Central Africa, cases havebeen reported since March 8th, 2020. As of July 03, 2020, the DRC has had 7379 cases and 182 deaths. Knowing that social distancing and quarantine may slow the spread of the virus and flatten the epidemic curve; it may not be sufficient to completely halt the spread of COVID-19, herd immunity gained by infection or vaccination will need to be well established within the population.3 The most effective way of controlling infectious diseases is often vaccination, while success is challenged by individuals and groups who choose to delay or refuse vaccines.4 Although immunization has successfully reduced the global burden of illness and death, public confidence in vaccines can be affected by various concerns. As such, vaccine hesitancy can lead to delays and refusal and sometimes contribute to disease outbreaks.5 The most serious example is the 2003–04 northern Nigeria boycott of polio vaccination, which led to a resurgence of the disease6.6–8 The fundamental breakdown in public trust still affects polio eradication efforts in Nigeria.9 But, Nigeria has officially wiped out wild polio. Maintaining confidence in vaccination depends on the interaction between patients and providers.10,11 Attitude and utilization of vaccination by healthcare professionals (HCP) is a major factor that is consistently associated with patient acceptance and vaccination, adherence to vaccination schedules, and reduced hesitation/aversion.12 In addition, vaccinated HCPs also have a noticeable effect on patients’ decision to take a vaccine. Health professionals’ intention to use and to recommend the vaccine to their patients depends on their knowledge and attitudes about vaccines. It is well reported that healthcare professionals who have an unfavorable attitude, aversion or hesitation towards vaccinations transmit these hostile attitudes to vaccination to patients and tend to recommend vaccination less frequently. 13 Furthermore, vaccine hesitancy observed in the general population has been consistently linked to the level of vaccine hesitancy among HCPs.14 In addition, the quality, content and dissemination of educational information about vaccines by healthcare professionals have been shown to be useful in improving patient acceptance of vaccinations, reducing reluctance, and guiding informed decisions about vaccination.15 Indeed, patients often trust and rely on healthcare professionals for information about vaccines and vaccine preventable diseases, as well as the therapeutic and public health benefits associated with immunization. The major challenge for public health experts is the waning of public confidence in vaccines worldwide. Public confidence in vaccines worldwide is a cause for concern and a major challenge for public health experts. While there are a number of influencers, healthcare workers (HCWs) are an important group to consider. For example, nurses in South Africa felt that adolescents and young adults who accepted HPV vaccination were more likely to recommend it. The development of COVID-19 vaccines is a crucial challenge. At the time of the study, many were in “preclinical testing”, with a number already in Phase 1 Trials with promising results from animal studies. However, even with rapid development and experimentation, the estimated fastest time to develop a new vaccine will be at least 1 to 1.5 years. After its clinical development, another challenge is the distribution and acceptance of the vaccine in general population. The impact of the current pandemic on the intention to be vaccinated against COVID-19 with an approved vaccine has not made it unanimously accepted that if it were available it would be obviously adopted.

Two candidates are currently being tested in the United States. A Phase 1 clinical trial evaluating mRNA-1273 (a candidate vaccine developed by Moderna Inc.) has begun at Kaiser Permanente Washington Health Research Institute (KPWHRI) in Seattle. The trial is being funded by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health [23]. The second candidate, which is being developed by an American Biotech Firm (Inovio Pharmaceuticals) has begun in Philadelphia and Kansas City. The trial is being funded by the Bill & Melinda Gates Foundation in collaboration with the Coalition for Epidemic Preparedness Innovations (CEPI). Trials for four other candidates are taking place in China under the umbrella of the Biotech Firm CanSino Biologics and the Medical Research Arm of the People’s Liberation Army. The first human trial of a candidate vaccine (made from a weakened version of adenovirus from chimpanzees) developed by a team of researchers at Oxford University has begun in Europe involving 800 volunteers. The Beijing and Wuhan Institutes of Biological Products, arms of state-run Sinopharm, are also carrying out trials on another two candidates, and trials for a vaccine developed by Biotech Firm Sinovac are also underway.

The trial will rapidly enroll and individually randomize very large numbers of adult participants in many different populations. Each participant will be contacted weekly for information as to whether any potentially relevant symptoms have arisen. Cases suggestive ofCOVID-19 will be confirmed by laboratory testing using real-time reverse transcription-PCR (RT-PCR) assay (Gold standard). By using a shared placebo/control group and a common core protocol to evaluate multiple candidate vaccines in the trial, resources allocated to the evaluation of each candidate vaccine are judiciously saved, while a high standard scientific protocol is ensured. These trials are powered to provide sufficient evidence of vaccine safety and efficacy against COVID-19 to support decision-making about global vaccine deployment. Together with global health actors and partners, the WHO has launched the access to COVID-19 tools ACT accelerator, a global collaboration to accelerate development for equitable access to new COVID-19 diagnostics, therapeutics and vaccines. Nothing less than 89 vaccines are being developed globally, including seven in clinical evaluation. More than 100 countries have joined the solidarity trial and to date, over 1,200 patients have been randomized from the first five countries to evaluate the safety and efficacy of full drug and drug combinations. By comparing the results from many separate studies that adhere to the same protocol, the WHO hopes to obtain strong evidence as a result of a large sample size.

Recruiting volunteers can be challenging in a clinical trial phase primarily because of ethical issues and safety concerns. History shows that in the past most clinical trials were carried out in the developed countries mostly, but of recent there is a shift to the low and middle income countries. Nigeria with a total of 14,554 confirmed cases and 387 deaths as at June 11, 2020, like her African counterparts (Zambia, Tunisia and Egypt) has indicated interest to participate in the WHO clinical COVID-19 vaccine trial; even though the Government is committed to make fund available for Nigerian made vaccines [29]. To this end, the Federal government has enrolled some states (Lagos, Ogun, Kano, Kaduna and Sokoto), as well as the Federal Capital Territory (FCT) in the “Solidarity Trials”. This move however has been met with some public criticism and opposition as obtainable elsewhere in the world. Nearly 1 in 5 Americans say they would not take a vaccine to prevent the disease. This is partly because the COVID-19 era has generated a lot of fears, fake news and conspiracy theories that are likely to impact negatively on the success of recruitment of volunteers for the COVID-19 vaccine clinical trials.

Fears expressed by an average concerned Nigerian regarding the candidate vaccine trial include: fear of adverse effects/complications, disruption of daily routine, potential mutation, implantation of a microchip, racism, foreign attack, dominance and depopulation of the black race, as well as fear of death. It is shocking that till date; many do not believe that COVID-19 exists. Others are of the opinion that the pandemic was caused by installation of the 5G Network. Worst still, some think that COVID-19 is a myth, joke, political scam, fall- out of economic war between world powers, a biological weapon, a laboratory escape or vaccine trial that went wrong.

All these negative perceptions among the Nigerian populace will no doubt militate against the successful deployment and acceptance of the COVID-19 vaccine when it finally arrives. Generally, knowledge is thought to influence perception, and perception in turn influences readiness to participate in any clinical trial. Paucity of data on the knowledge, perception and readiness of Nigerians to participate in the COVID-19 vaccine trials necessitate this study. The aim of this study was therefore to assess the All these negative perceptions among the Nigerian populace will no doubt militate against the successful deployment and acceptance of the COVID-19 vaccine when it finally arrives. Generally, knowledge is thought to influence perception, and perception in turn influences readiness to participate in any clinical trial. Paucity of data on the knowledge, perception and readiness of Nigerians to participate in the COVID-19 vaccine trials necessitate this study. The aim of this study was therefore to assess the Factors influencing the acceptance of Corona virus vaccination among health workers in Ado odo otta LGA.


1.2 Statement of the Problem

Vaccines are the most important public health measure and most effective strategy to protect the population from COVID‐19, since SARS‐CoV‐2 is highly contagious virus and affects populations widely and globally. The competition for COVID‐19 vaccine invention and development against the spread and catastrophic effects of the disease is ongoing, and new, more effective vaccines are likely to be developed as we move through the pandemic. With the distribution of vaccines underway, it is very important to examine community acceptance of COVID-19 vaccinations. Bangladeshi authorities for instance agreed to use the Covidshield vaccine from India on 27 January 2021 and Runu (A Nurse) became the first COVID-19 vaccine recipient. But there is a great controversy about COVID-19 vaccinations among the general population of Nigeria. A proportion of the Nigeria population are hesitating to take the vaccine lest they should be infected. A global survey of potential COVID-19 vaccine acceptance shows that 48% of their study population were confused about the COVID-19 vaccinations and remained unsure about whether they would have the vaccination. Similarly, a Chinese study found that only just over half of their participants (54.%) said that they intended to have the vaccination. These relatively low proportions of people willing to have the vaccine are potentially worrying, since although the most effective measure of controlling the spread of the virus is to protect oneself from being exposed to COVID-19, it is also necessary to vaccinate the vulnerable group of people as soon as possible.

In order implement the most effective vaccination strategy in Nigeria, we need to know the knowledge, attitudes and perceptions of health workers Nigeria people about COVID-19 vaccinations. In such a scenario, these people’s knowledge, attitudes and perceptions towards COVID-19 are crucial for Government and policy makers to address all barriers to vaccine distribution. To date, there has been no prior study among the general population of health workers investigating their knowledge, attitudes and perceptions towards COVID-19 vaccine.


1.3 Objective of the Study

The main objective of the study is to examine the factors influencing the acceptance of corona-virus vaccination among health care workers in Ado odo otta LGA.

Specifically, the study aims to

  1. Examine the knowledge and perception of health workers in Ado odo otta LGA about coronavirus vaccine
  2. Evaluate the attitude of health workers in Ado odo otta LGA about coronavirus
  3. Examine the factors influencing the acceptance of Corona virus vaccination among health workers in Ado odo otta LGA.

1.4 Research Question

In order to achieve the set research objectives, the study will answer the following questions

  1. What is the knowledge and perception of health workers in Ado odo otta LGA about coronavirus vaccine?
  2. What is the attitude of health workers in Ado odo otta LGA about coronavirus vaccine?
  3. What are the factors influencing the acceptance of Corona virus vaccination among health workers in Ado odo otta LGA ?

1.5 Significance of the Study

To the best of our knowledge, this study is the first of its kind in Nigeria and we do hope data provided in this study will serve the benefit of the scientific community, particularly researchers who would undertake similar studies on a larger scale in the future.


1.6 Scope of the study

The study on the Factors influencing the acceptance of Corona virus vaccination among health workers will be based on the knowledge, perception and attitudes of health workers towards the acceptance of Corona virus vaccination in Ado odo otta LGA.


1.7 Limitations

Due to financial situation of the research, the time frames for completion and the sampling constraints the following are identified:

Financial constraints:

Financial constraints meant that the study could not be conducted on a State scale.

Time constraints:

The study has strict deadline which had to be met in order to fulfill the completion requirement. If there were no time limit and financial constraints, or time frame in which to complete the study, the researcher would done a national level survey in order to get a more effective sample of the population.


1.9 Organizations of the Study

The chapter one consist of the introductory part of the study which includes the study background, the statement of the research problem, the study objective and scope of the study.

The second chapter is a critical review of other literatures relevant to the study and its objectives including the theoretical framework for the study. While the third chapter is methods of data collection, sampling and data analysis used in conducting the study. The fourth chapter centres around the research findings including an analysis of how it relates to previous findings. The fifth chapter consists of the summary of findings, conclusion and recommendations base on the study objectives.


Chapter Five


Conclusions and Recommendation

5.2 Conclusion

Misinformation and disinformation strengthen vaccine skepticism and rejection. This could undermine efforts to end the coronavirus pandemic. The outcome of this study further underscores the need for adequate public health enlightenment on the role of safe and potent vaccine in curbing the COVID-19 pandemic. This will ensure adequate deployment and acceptance of the vaccine when it finally arrives. It would be a tragedy for the deadly virus to continue to escalate due to poor knowledge, negative perception and outright rejection of vaccine by the people. To this end, first, there is need for continuous tracking of false rumours about COVID-19 in hopes of curbing their spread. The social media companies must come up with effective strategies to ‘flatten the curve’ of false information regarding the COVID-19 vaccines. They must be deliberate and continuously step up efforts to flag or remove misinformation and to guide people to reliable sources. Also, they must take responsibilities for the nature and authenticity of information been circulated on their platforms. The sources of false information must be identified and nipped at the bud. Facts must be promoted above false information using appropriate fact-checking and regulatory mechanisms. Efforts to raise the profile of good information, and place a warning label on the bad must be intensified. Credible evidence must be available to counter any fake news that went viral. Second, more engagement and collaborations among research institutions, pharmaceutical companies and regulatory agencies is needed, hence the creation of the “Accelerating COVID-19 Therapeutic Intervention and Vaccine (ACTIV) Program”.

The private sector should also be fully supported in their drive towards development and production of COVID-19 vaccine. The World Health Organization and other multilateral institutions such as the World Bank, World Economic Forum, International Monetary Fund, Global Vaccine Alliance, Coalition for Epidemic Preparedness Innovation, Wellcome Trust, Bill and Mellinda Gates Foundations, African Vaccine Manufacturing Initiative and other Corporate bodies (Governmental and Non-governmental), too numerous to mention here should remain focused and unrelenting in financing and deploying vaccine for global use. They must ensure fair distribution among all countries when it becomes available. Finally, testing of vaccine safety and efficacy must follow global best practices, devoid of any form of political, religious or racial bias. The pursuit for vaccines to curb the COVID-19 pandemic is on and should not be at the expense of ethical principles such as informed consent and medical privacy. The COVID-19 vaccines must be safe and effective, and once this is proven, a comprehensive immunization campaign would be needed to achieve maximum acceptance by the general public.


5.2 Recommendations

Our recommendations are as follow:

  1. Future researchers conducting similar survey should extend the duration of the survey longer than we did to receive more responses (larger sample size) that will give a clearer picture of the knowledge, perception and readiness of Nigerians to accept the COVID-19, with respect to the socio-demographic characteristics. A correlation analysis between various criteria is highly commended.
  2. They should also consider using a non-web-based approach in their survey in order to accommodate participants without access to internet.
  3. Further study should be undertaken to explore the potential relationship between the various socio-demographic characteristics of the study participants and their willingness to participate in the COVID-19 vaccine trial.
  4. Using the polio vaccine as a reference point, the southerners were more receptive to vaccine and vaccination, than the northerners. Therefore, we would recommend that potential vaccine investigators should consider conducting COVID-19 vaccine trial first in the southern parts of the country, before extending it to other parts of the country.
  5. An aggressive campaign at the grass root to debunk the conspiracy theories surrounding COVID-19 is needed to ensure acceptance and deployment of the vaccine when it becomes available.
  6. The Federal Government of Nigeria should be more intentional in committing more resources (funds, manpower etc) to public health awareness programs to enlighten the masses about the benefits of receiving safe and effective COVID-19 vaccines, even before one becomes available.

Factors Influencing The Acceptance Of Corona-Virus Vaccination Among Health Care Workers


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