Understanding COVID-19 vaccine hesitancy in Pakistan: The paradigm of confidence, convenience, and complacency; A cross-sectional study
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Abstract
Vaccine hesitancy is a big obstacle for vaccination programs, as is anticipated for the COVID-19 vaccination program, resulting in low uptake of vaccines thereby hindering the process of reaching herd immunity. Bearing this in mind the current study was aimed to explore the determinants of vaccine hesitancy amongst the Pakistani population.
Methodology
A cross-sectional study was carried out from November 2020 to March 2021. The conceptual framework of the study was based on the 3Cs (Confidence, Convenience, Complacency) model. The google-forms-based questionnaire was disseminated amongst the general population. Data collected were entered into SPSS version 26 and analyzed.
Results
Of the 421 participants, 68.4% were women. Non-healthcare workers were 55.8% of respondents. Of vaccine-hesitant individuals, 26.13% reported they were very unlikely to get vaccinated. Perception of COVID-19 vaccine was explored, which revealed 12.6% of individuals agreed the vaccine was not safe as it came out too fast, 50.6% were worried about experiencing side-effects, 18% believed the vaccine will not offer protection and 5.9% believed the vaccine would cause death. Low Practice of standard operating procedure (SOP) in non-Healthcare workers was the strongest contributor to vaccine hesitancy (OR: 5.338, p = 0.040, 95% CI: 1.082–26.330) followed by High complacency (p = 0.026) and Moderate Complacency (OR: 0.212, p = 0.007, 95% CI: 0.069–0.654) towards COVID-19 vaccination. In Healthcare workers the strongest contributor to vaccine hesitancy was having a Moderate Confidence (OR: 0.323, p = 0.042, 95% CI: 0.109–0.958) in the vaccine followed by Moderate Convenience (OR: 0.304, p = 0.049, 95% CI: 0.093–0.993) for vaccination.
Conclusion
Campaigning and communication strategies to reaffirm confidence in the COVID-19 vaccine and educating the general population about the vaccine could lead to increased perception of vaccine safety and effectiveness thereby restoring confidence in vaccine and decreasing vaccine hesitancy. Likewise, working to increase vaccine convenience and decreasing complacency towards the COVID-19 vaccine would translate into high vaccine uptake.
MeSH words
Vaccine hesitancy; vaccination intention, COVID-19 vaccine, vaccine confidence, complacency, convenience.
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SciScore for 10.1101/2021.07.12.21260409: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics Consent: Informed electronic consent was the first part of the questionnaire.
IRB: The research was approved by the Institutional Review Board of CMH Lahore Medical College and Institute of Dentistry (Case#539/ERC/CMH/LMC).Sex as a biological variable The tool included questions, about knowledge of vaccine existence, government’s initial plan of vaccination, re-infection, vaccination helping decrease spread of coronavirus infection, the demographic to which it could be given (children, pregnant and breastfeeding women), dose count, vaccine effectivity, and route of administration, framed in an approach similar to previous studies (23)(24)(25)(26). Randomization not detected. Blinding not detected. SciScore for 10.1101/2021.07.12.21260409: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics Consent: Informed electronic consent was the first part of the questionnaire.
IRB: The research was approved by the Institutional Review Board of CMH Lahore Medical College and Institute of Dentistry (Case#539/ERC/CMH/LMC).Sex as a biological variable The tool included questions, about knowledge of vaccine existence, government’s initial plan of vaccination, re-infection, vaccination helping decrease spread of coronavirus infection, the demographic to which it could be given (children, pregnant and breastfeeding women), dose count, vaccine effectivity, and route of administration, framed in an approach similar to previous studies (23)(24)(25)(26). Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
Software and Algorithms Sentences Resources The data collected was analyzed using Statistical Package for the Social Sciences (SPSS) version 26. Statistical Package for the Social Sciencessuggested: (SPSS, RRID:SCR_002865)SPSSsuggested: (SPSS, RRID:SCR_002865)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:This research is not without its limitations and warrants enhancements. The data is cross-sectional making it difficult to disentangle causality of whether vaccine hesitancy is due to a lack of knowledge of vaccine and health information or due to the propensity to believe in conspiracy theories. The sample size is adequate, but it may not be truly representative of the entire Pakistani population, respondents were approached via convenience sampling through social networks of the data collectors, and considering that the authors belonged to only two provinces of the country, they were unable to collect equal responses from all the provinces. Furthermore, only 35% of the 224 million population of the country is urban and the country’s literacy rate is 60% with a mean of 5.2 years of schooling. While cellphone access is more than 50%, among youth, access to the internet is still however low (15%)(38). So the generalization of the results for the entire country should be done with caution. Vaccine hesitancy is a multifaceted problem, for which a better evaluation could be done via having a larger sample size with a longitudinal sampling approach and open-ended questions.
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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