Knowledge, Attitude And Acceptance Of Covid 19 Vaccine Among People

Project and Seminar Material for Public Health

Abstract

Several vaccines have been approved for use against coronavirus disease (COVID-19) and distributed globally in different regions. However, general community knowledge, attitudes and perceptions towards COVID-19 vaccinations are poorly understood. In this study, our focus was on the knowledge, attitude and acceptance of covid 19 vaccine among people in Calabar-south cross River State, Calabar-south cross River State as case study.

The study is was specifically focused on examining the knowledge and perception of coronavirus vaccine among adults in Calabar-south Cross River State; Evaluating the attitude of adults in Calabar-south Cross River State Towards coronavirus vaccination; and examining the level of utilization of Corona virus vaccination among adults in Calabar-south Cross River State.The study adopted the survey research design and randomly enrolled participants in the study. A total of 261 responses were validated from the enrolled participants where all respondent are residents of Calabar-south local Government Area of Cross-River State.

The findings reflect adequate knowledge and more positive attitudes towards COVID-19 vaccine among the general population in Calabar-south local Government Area. In order to improve knowledge, immediate health education programs need to be initiated before mass vaccination are scheduled.

Chapter One

Introduction

1.1 Background to the Study

Coronavirus disease (COVID-19) is a deadly disease which continues to affect many countries in the world. This is caused by the new coronavirus strain severe acute respiratory syndrome coronavirus-2(SARS-CoV-2) which has become a serious public health concern worldwide, Pal M, (2020). The World Health Organization (WHO) declared the COVID-19 out- break as a pandemic on 11thMarch 2020, Cucinotta D (2020). At the time of writing (6 February 2021), this pandemic has affected 223 countries, with over 104.37 million con- firmed cases and 22.71 million deaths recorded globally, WHO (2021). The incidence is higher in the Americas (46,313,540 cases and 1,072,244 deaths) and Europe (35,003,091 cases and 767,235 deaths) than in South East Asia (12,982,540 cases and 199,668deaths), Africa (2,616,892 cases and 64,473 deaths) and the Western Pacific (1,466,248 cases and 25,526 deaths) WHO (2021). The first COVID-19 case in Bangladesh was re- ported on 8 March 2020, Islam MS,(2020). Since then, the numbers of new cases have been rising rapidly in the country. As of 6 February 2021, the country has recorded 537,465 positive cases of COVID-19 and 8182 deaths domestically, Islam MS,(2021).

Many countries, including Nigeria experienced a second wave of the viral infection. The total number of COVID-19 infected persons is almost reaching 100,000. This becomes complicated because of new variants of the virus has also been discovered in Nigeria, which was first isolated in the United Kingdom (UK), said to be about 56% more transmissible, with a large number of mutation and virulence. Since the beginning of December there has been an astronomical increase in the number of new cases and deaths recorded on daily basis. Experts have linked this with non-adherence to the infection control recommendations. These recommendations are focused on disease prevention and control measures to minimise the spread as well as the burden on the healthcare system. These measures include frequent hand hygiene using soap and water or an alcohol-based sanitizer, keeping a physical distance of about 6 feet from others, quarantine for those who are exposed, use of face masks, and avoiding the touch of the face with unwashed hands. However, many Nigerians still do not adhere to these preventive measures. Good knowledge, and risk perception which refers to the way the diseases is understood/interpreted, is important in pre-empting the way a person would react to an occurrence of the infection in their own lives as well as the lives of others. An understanding of the perception of people regarding COVID-19 is crucial because perception can act as a trigger for precautionary action, engagement in preventive health behaviour and reporting of suspected cases of COVID-19. Knowledge and perception of risk is influenced by both individual and societal factors which are based on experiences, beliefs, attitudes, social, cultural and institutional processes. Risk perception is also largely mediated by the information and knowledge that an individual has. Bhagavathula et al, in their study assessed the awareness of COVID-19 among health care workers reported that knowledge of transmission (60%) and disease onset (64%) was poor among the health care workers.

Vaccines are the most important public health measure and most effective strategy to protect the population from COVID-19, since SARS-CoV-2 is a highly contagious virus and affects populations globally. The competition for COVID-19vaccineinvention and development against the spread and catastrophic effects of thedisease is ongoing , and new, more effective vaccines are likely to be developed as we move through the pandemicWorldometer (2021). With the distribution of vaccines underway, it is very important to examine community acceptance of COVID-19 vac cinations Justics (2021).

A recent study by Lawal et al explored the reasons the fatality of COVID-19 in Africa is ironically lower than that of other advanced countries which have better healthcare systems. He observed that factors such as low pre-COVID-19 era ‘65yr + mortality %, population median age, and relatively lower life expectancy in Africa were associated with lower fatality. Unfortunately, in spite of the daily exponential increases in recorded cases in Nigeria, there is a growing body of anecdotal evidence that many Nigerians do not believe in the existence of the pandemic. This is due in part from low trust levels in government and a plethora of conspiracy theories surrounding the virus and vaccine development by influential Nigerian political and religious leaders.The surprisingly low CFR has also contributed to the attitude of Nigerians and Africa at large towards the existence of this virus.

A vaccine is a life or attenuated antigen used to stimulate antibody production to provide immunity against disease causing pathogens like bacteria and viruses. Vaccination is considered to be one of the most potent preventive strategies against infectious diseases However, acceptance and coverage are vital determinants for a successful immunization or vaccination program. Globally, with the approval and rollout of several efficacious and safe vaccines against SARS-Cov-2, there have been an attendant epidemic of misleading information surrounding potential vaccines candidates. This is not limited to Nigeria alone, several media reports suggests distrust in the United States and some countries in the European Union has become a major obstacle to wider vaccine coverage. 10–12 Researchers at Yale University found that only 67% of the Americans they surveyed are willing to be vaccinated against COVID-19 prior to any vaccine was approved. However in Nigeria, there is mixed feeling, so much distrust, apathy and disbelief in the course of the evolution of this pandemic also same with vaccine related issues. Despite these reactions, an online survey in Nigeria conducted just before the first ever vaccine was approved reported that 58.2% of respondents would receive the vaccine once available while 19.2% and 22.6% respectively were not willing to accept and indecisive. Male gender and favourable perception towards the vaccine positive determinant for uptake in the study.

The purpose of this study is to assess the knowledge, attitude and acceptance of covid 19 vaccine among people, provide education on the scientific basis of a coronavirus vaccine and guide policy makers and other stakeholders as the work towards vaccinating their population.

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, WHO (2020). 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, Julius (2021). 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 Covid shield 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, perceptions and utilization of covid-19 vaccination among adult in Calabar south cross River State. 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 adults investigating their knowledge, and perceptions of covid 19 vaccination among adult in Calabar south cross River State.

1.3 Objective of the Study

The main objective of the study is to examine the knowledge, attitude and acceptance of covid-19 vaccine among people in Calabar-south Cross River State.

Specifically, the study aims to

Examine the knowledge and perception of coronavirus vaccine among adults in Calabar-south Cross River State.
Evaluate the attitude of adults in Calabar-south Cross River State Towards coronavirus vaccination.
Examine the level of utilization of Corona virus vaccination among adults in Calabar-south Cross River State.

1.4 Significance of the Study

The result of the study will be relevant to the rural people, government agencies such as NCDC and as well be relevant for academic purposes. To health workers, findings from the study will aid them to see the need as well recognize that they have an important role to play in the fight to minimize misinformation in Nigeria and as well persuade the audience to take the Covid-19 vaccination. To NCDC, findings from the study will compel the immediate need for them to sponsor more radio jingles on the Covid-19 vaccine as this will help the audience to take the message more serious. Finally the study will contribute empirically to the body of Knowledge and as well serve as a reference material for student and scholars who wishes to conduct further studies in related field.

1.5 Research Questions

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

What is the knowledge and perception of coronavirus vaccine among adults in Calabar-south Cross River State?
What is the attitude of adults in Calabar-south Cross River State Towards coronavirus vaccination ?
What is the level utilization of Corona virus vaccination among adults in Calabar-south Cross River State ?

1.6 Scope of the study

The study on the knowledge, attitude and acceptance of covid 19 vaccine among people in Calabar south cross River State. The study explored Perception and utilization of covid 19 vaccination among adult in Calabar south cross River State. The study is however delimited to Adults in Calabar-South Local government area of Cross-River State.

1.7 Limitations of the Study

This research project, like all human endeavors, had some challenges that threatened to derail the study’s completion. One of the reasons is that the time allotted for this work was so limited that the researcher did not have enough time to complete the task thoroughly. During data collection, the researcher also had to put forth extra effort to understand the respondents’ interview schedules, several of whom fell into the incomprehensible age group. Also, there were financial and transportation constraints to deal with. Insufficient funds tend to impede the efficiency of the researcher in sourcing the relevant materials, literature, or information and in the process of data collection (internet, questionnaire, interview).

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.

Chapter Five

Summary, Conclusions and Recommendations:

5.1 Introduction

This chapter summarizes the findings on the knowledge, attitude and acceptance of covid-19 vaccine among people in Calabar-south cross River State, Calabar-south cross River State as case study. The chapter consists of summary of the study, conclusions, and recommendations.

5.2 Summary of the Study

In this study, our focus was on the knowledge, attitude and acceptance of covid-19 vaccine among people in Calabar-south cross River State, Calabar-south cross River State as case study. The study is was specifically focused on examining the knowledge and perception of coronavirus vaccine among adults in Calabar-south Cross River State; Evaluating the attitude of adults in Calabar-south Cross River State Towards coronavirus vaccination; and examining the level of utilization of Corona virus vaccination among adults in Calabar-south Cross River State.

The study adopted the survey research design and randomly enrolled participants in the study. A total of 261 responses were validated from the enrolled participants where all respondent are residents of Calabar-south local Government Area of Cross-River State.

5.3 Conclusions

With respect to the analysis and the findings of this study, the following conclusions emerged;
The COVID-19 pandemic continues to wreak global havoc on lives and livelihoods, and the COVID-19 vac- cine represents a possible light of hope for the future. The present study revealed adequate knowledge and more positive attitudes towards COVID-19 vaccinations in Calabar-south local Government Area of Cross-River State. The findings suggest immediate health education programs and more accurate information should be distributed and advertised by respective health authorities. Policy makers should take steps to ensure adequate knowledge, positive attitudes and perceptions towards COVID-19 vaccinations in order to reduce the vaccine hesitancy facilitated and encouraged by misinformation in the media.

5.3 Recommendation

From the findings of the study, the following recommendations are made:

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.
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.
Government and private sector support are also necessary for radio to function effectively in Africa. Sadly, many radio stations are underfunded.
Policymakers and Government should ensure they build the confidence and trust of the masses toward accepting the novel vaccine and as well ensure that government provides it in large quantity to reach the rural dweller.
Civil societies should endeavor to collaborate with knowledgeable healthcare workers to go on outreach and enlighten the masses on the need to take the vaccine.
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.
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.
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.