COVID-19 Vaccine Hesitancy and Emerging Variants: Evidence from Six Countries.

Sherry Mangla,Kranthi Swaroop Koonisetty,Uyen-Sa D.T Nguyen,Alfonso J Rodriguez-Morales,Fatima Tuz Zohra Makkia,Jorge A Sanchez-Duque,Nasrin Aghamohammadi,Renee Robinson,Ashok Kumar Pathak,Ajlina Karamehic-Muratovic,Nargis Sultana,Ubydul Haque,Patrick T Zamba,Fong Cs

doi:10.3390/bs11110148

Abstract

As the world tries to cope with the devastating effects of the COVID-19 pandemic and emerging variants of the virus, COVID-19 vaccination has become an even more critical tool toward normalcy. The effectiveness of the vaccination program and specifically vaccine uptake and coverage, however, is a function of an individual’s knowledge and individual opinion about the disease and available vaccines. This study investigated the knowledge, attitudes, and resulting community practice(s) associated with the new COVID-19 variants and vaccines in Bangladesh, Colombia, India, Malaysia, Zimbabwe, and the USA. A cross-sectional web-based Knowledge, Attitudes, and Practices (KAP) survey was administered to respondents living in six different countries using a structured and multi-item questionnaire. Survey questions were translated into English, Spanish, and Malay to accommodate the local language in each country. Associations between KAP and a range of explanatory variables were assessed using univariate and multiple logistic regression. A total of 781 responses were included in the final analysis. The Knowledge score mean was 24 (out of 46), Attitude score 28.9 (out of 55), and Practice score 7.3 (out of 11). Almost 65% of the respondents reported being knowledgeable about COVID-19 variants and vaccination, 55% reported a positive attitude toward available COVID-19 vaccines, and 85% reported engaging in practices that supported COVID-19 vaccination. From the multiple logistic models, we found post-graduate education (AOR = 1.83, 95% CI: 1.23–2.74) and an age range 45–54 years (AOR = 5.81, 95% CI: 2.30–14.69) to be significantly associated with reported COVID-19 knowledge. In addition, positive Attitude scores were associated with respondents living in Zimbabwe (AOR = 4.49, 95% CI: 2.04–9.90) and positive Practice scores were found to be associated with people from India (AOR = 3.68, 95% CI: 1.15–11.74) and high school education (AOR = 2.16, 95% CI: 1.07–4.38). This study contributes to the identification of socio-demographic factors associated with poor knowledge, attitudes, and practices relating to COVID-19 variants and vaccines. It presents an opportunity for collaboration with diverse communities to address COVID-19 misinformation and common sources of vaccine hesitancy (i.e., knowledge, attitudes, and practices).

Highlights

Over 20-million deaths worldwide have been directly attributed to infectious diseases such as influenza, Severe Acute Respiratory Syndrome (SARS), H5N1 influenza, and, most recently, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19) and variants of interest (VOIs): Epsilon (B.1.427 and B.1.429); Zeta (P.2); Eta (B.1.525); Theta (P.3); Iota (B.1.526); Kappa (B.1.617.1); Lambda (C.37) and Mu (B.1.621); as well as variants of concern (VOCs), such as Alpha (B.1.1.7), Beta (B.1.351), Gamma (P.1), and Delta (B.1.617.2) [1,2,3]
We examined the proportions of those who were concerned about side effects, those who did not believe in the vaccine, or those who did not believe its effectiveness to gauge vaccine hesitancy
Understanding the threat posed by anti-vaccination efforts on social media and the impact they have on individual attitudes is critical to ensuring the success of worldwide COVID-19 vaccination programs

Summary

Introduction

Over 20-million deaths worldwide have been directly attributed to infectious diseases such as influenza, Severe Acute Respiratory Syndrome (SARS), H5N1 influenza (bird flu), and, most recently, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19) and variants of interest (VOIs): Epsilon (B.1.427 and B.1.429); Zeta (P.2); Eta (B.1.525); Theta (P.3); Iota (B.1.526); Kappa (B.1.617.1); Lambda (C.37) and Mu (B.1.621); as well as variants of concern (VOCs), such as Alpha (B.1.1.7), Beta (B.1.351), Gamma (P.1), and Delta (B.1.617.2) [1,2,3]. For as long as vaccines have been in existence, vaccine hesitancy has coexisted and hinders the success of immunization [5]. According to the WHO SAGE group, “vaccine hesitancy refers to a delay in acceptance or refusal of vaccination despite the availability of vaccination services.” [6,7]. Similar to the recent experiences with the COVID-19 vaccine hesitancy, there were misinformation, skeptics, and doubters of the effectiveness of smallpox and influenza vaccines worldwide. Similar studies worldwide showed vaccine hesitancy that manifested from doubt on the efficacy of a vaccine, to lack of general knowledge about disease and effectiveness of vaccines, as well as misconceptions and false statements about vaccines [9]. A survey of the US population in 2009 showed that the greater the trust in the government, the more likely people will be vaccinated while those with the least confidence in government will be more likely to have vaccine hesitancy; policymakers must build trust to have greater compliances in vaccine uptake [10]

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