https://orcid.org/0000-0003-4375-8834
ABSTRACT
A cross-section pilot study was done to determine the knowledge and belief toward new COVID-19 vaccines among a small sample size group of people. A new Vaccine Acceptability Questionnaire (VAQ) consists of 31 questions that were concerned about three elements: underlying factors, knowledge, and beliefs. The study included 96 people from the different regions of Saudi Arabia who had accepted to participate in this pilot study. Around 31% of the included people had low to very low acceptability toward COVID-19 vaccines; however, the other 69% had moderate to high acceptability. The new simple designed questionnaire (VAQ) could be effective in assessing knowledge, beliefs, and acceptability toward COVID-19 vaccination among a specific group of population.
Dear Editor,
Vaccine acceptance is complex in nature and context-specific, varying across time, place, and perceived behavioral nature of the community.Citation1–3 A vaccination rate of 55–82% of the population is required to achieve herd immunity.Citation4 Numerous studies have shown several factors responsible for vaccine acceptancy when a new vaccine is introduced including demographics and geographical disparities.Citation5–7 A global survey reported by Lazarus et al. showed that the likelihood of new vaccine acceptance in 19 countries ranged from nearly 90% to less than 55%.Citation8–11 The acceptance rate was reported to be 64% in the United States,Citation12 56% in the United Kingdom,Citation13 60% in Hong Kong,Citation14 and 60% in China.Citation15
Identifying community apprehensions toward vaccination needs to be understood in detail. These include the safety and efficacy of the vaccine, knowledge, and misconceptions about vaccination, and trust in the health system. Knowledge is one of the elements that play a crucial role in understanding pandemic threats. Misinformation about new vaccines could lead to vaccine hesitancy and put public health at risk in responding to the current crisis.Citation16
Effective community intervention relating to COVID-19 vaccination could increase the awareness of the community, instill public confidence about the vaccine and improve vaccine acceptability.Citation8 People should be updated with the latest information about COVID-19 vaccination through popular channels of information. Television and social media are likely to have the ability to deliver faster updating of information to the community. However, public awareness toward COVID-19 vaccine is still low.Citation17
Therefore, it is essential to investigate individuals’ knowledge, beliefs, and acceptability of a COVID-19 vaccine to ensure having available and sufficient health system capacity and strategies, thus enhancing the community’s trust toward COVID-19 vaccination.
A cross-section pilot study was done during August 2021 to determine the knowledge, belief and acceptability among a small sample size (N = 96). A new Vaccine Acceptability Questionnaire (VAQ) was designed and developed by the researchers and reviewed for its validity and reliability by experts working at the Assistant Deputyship of Primary Healthcare, Saudi Ministry of Health, Riyadh. The basis of designing this VAQ was to develop a simpler, clearer, more concerned on COVID-19 vaccines, and rapidly answered questions compared to some previously published surveys that were used to assess the COVID-19 vaccines’ acceptability.Citation18,Citation19
The VAQ consists of 31 questions that included three elements: underlying factors, knowledge, and beliefs that determine the acceptability toward COVID-19 vaccines (see ). The VAQ was based on a 14 points score that ranged from 0–14 points. A score of 11–14 points was considered as high acceptability, 8–10.9 points = moderate acceptability, 5–7.9 = low acceptability, and less than 5 points = very low acceptability. The VAQ was shared online publicly through social media “Twitter” to avoid selection bias. Answering and submitting the online form of the VAQ was regarded as approval for participation.
Table 1. The three elements of vaccine acceptability questionnaire (VAQ): underlying factors, knowledge, and beliefs
The mean age of the participants was 33.8 ± 9.8 years, and the female to male ratio was 2:1. The majority of the included people were Saudis, graduated from universities, employed, and received the tozinameran vaccine (an mRNA based COVID-19 vaccine). Although most of the participants had not been infected with SARS-CoV-2, about 43% of them had at least one of their relatives or colleagues infected or died because of COVID-19. Around 31% of the included participants had low to very low acceptability rate toward COVID-19 vaccines; however, the remaining 69% had moderate to high acceptability. This pilot study revealed that the participants with lower acceptability toward COVID-19 vaccines were younger, more educated, and unemployed. In addition, this group was less advised by healthcare providers regarding COVID-19 vaccination. Conversely, they were more infected with SARS-CoV-2 after vaccination and had less relatives or colleagues infected or died due to SARS-CoV-2. The researchers did not show any significant difference (p > .05) between this group of subjects and those with higher acceptability regarding all tested aspects (see ). Therefore, based on this pilot study, the acceptability to receive COVID-19 vaccines was not affected by the variation of demographic characteristics, COVID-19 vaccination status, and knowledge and beliefs about COVID-19 vaccines.
Table 2. The results of underlying factors, knowledge, and beliefs among participants with high and low acceptability
However, these results were inconsistent with some previous studies,Citation18,Citation20 as they found that age, gender, and knowledge and beliefs about COVID-19 and its immunization were substantial factors in determining the peoples’ acceptability to receive COVID-19 vaccines. These differences with our findings could be related to the small sample size.
The newly simple designed questionnaire (VAQ) could be effective in assessing knowledge, beliefs, and acceptability toward COVID-19 vaccination among a specific group of population. Besides, with a suitable sample size, it could be useful to estimate barriers for under-acceptability for any other new vaccines.
Acknowledgments
The authors would like to thank Dr. Mustafa Hassanein and Dr. Elfadil Elkagam (Assisting Deputyship for Primary Healthcare, Saudi Ministry of Health) for reviewing of the VAQ and the manuscript.
Disclosure statement
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
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References
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