IDF21-0557 Factors affecting Covid-19 Vaccine Attitude: Results from People Living with Chronic Conditions in Ibadan, Nigeria

Abstract

Background: Although the number of reported cases of Covid-19 infection reduced substantially in Nigeria at the beginning of the year 2021, the easily transmissible delta variant has caused a significant increase in the prevalence. Persons with chronic conditions such as diabetes, hypertension, stroke, sickle cell disease and renal failure are expected to receive the Covid-19 vaccine first, as they are more susceptible to the infection. However, it remains unclear what factors could influence their attitude towards the uptake of COVID-19 vaccination. Aim: The study was carried out to determine factors affecting vaccine attitude among people living with chronic illnesses. Method: A descriptive cross-sectional study was conducted at the medical outpatient clinic of University College Hospital, Ibadan, Oyo State, Nigeria; before Covid-19 vaccination commencement. The Vaccine Attitude Scale (Vax) was used in data collection from the 423 participants using Open Data Kit (ODK). The scale comprises four subscales: (1) mistrust of vaccine benefit, (2) worries about unforeseen future effects, (3) concerns about commercial profiteering, and (4) preference for natural immunity. Data was also collected on sociodemographic and COVID-19 related characteristics. Data were analysed using Chi-square and logistic regression analyses at 5% significance level. Results: Hypertension (23.6%), diabetes mellitus (19.4%) and heart conditions/diseases (18.4%) were the top three conditions being managed by the patients. The overall proportion of patients with a positive attitude towards the uptake of COVID-19 vaccination was 50.6%; while 67.1% had a positive attitude against mistrust of the vaccine benefit, 36.6% were not worried about the aftermath effect of the vaccine. Factors associated with overall vaccine attitude were level of education, income, knowledge of Covid-19, living room arrangement, and confidence in government (p<0.05). The main influential factor on general vaccine positive attitude and the four subscales was confidence in the government. While religion and income status were peculiar associated factors of positive attitude against mistrust of the vaccine’s benefit; living room arrangement, confidence in government, confidence in healthcare workers and adherence to COVID-19 prevention protocols were associated with positive attitude against concerns about commercial profiteering and preference for natural immunity. Discussion: In this study involving people living with chronic conditions, the percentage of participants with a positive attitude towards Covid-19 vaccine uptake was lower than the 65.2% reported by Lazarus et al (2021) among a general population of Nigerians. The percentage is also lower than the average reported for most countries, which, according to Sallam (2021) was about 70%, although higher than that among Congolese. Similar to the findings of Freeman et al (2020) and Paul et al (2021) among UK citizens, income was associated with vaccine attitude; so also age, as reported by Fisher et al (2020). Further, as observed in this study, lower educational attainment and poor COVID-19 knowledge were associated with a positive attitude towards the vaccine, as reported by Paul et al. It is therefore pertinent to plan a well-detailed educational intervention to improve the attitude of people living with chronic conditions towards the Covid-19 vaccine. This should take into consideration various contextual factors.