VACCINE ACCEPTANCE AMONG LATE RECIPIENTS OF COVID-19 VACCINATION IN KEDAH, MALAYSIA: AN EXPLORATORY STUDY
DOI:
https://doi.org/10.37268/mjphm/vol.23/no.2/art.2176Keywords:
Keywords: COVID-19 Vaccine, Acceptance, Malaysia, QualitativeAbstract
COVID-19 vaccine availability has helped many countries around the world in alleviating the health and economic crisis caused by the pandemic. However, the smoothness of its implementation was slightly affected due to several issues such as hesitancy and even total refusal, due to several specific factors. To establish herd immunity, an adequate amount of immunization is necessary, and this issue needs to be addressed appropriately to avoid failure in efforts to curb the spread of the disease. In identifying appropriate and effective strategies to deal with this, it is important to know the factors that can influence such individuals to change their minds and eventually agree to be vaccinated. This study explores the reasons behind COVID-19 vaccine acceptance among nineteen (n=19) late vaccine recipients who initially delay or refuse to be vaccinated, using an in-depth interview method and thematic analysis. Four themes and eight subthemes were identified, emphasizing the significant role of real evidence, health risk-related perceptions, peer recommendations, and higher authority enforcement in influencing the participants to finally make a U-turn. The findings of this study can be used to formulate strategies to increase vaccine acceptance rates, especially among individuals who are still reluctant.
References
Jamaludin S, Azmir NA, Mohamad Ayob AF, Zainal N. COVID-19 exit strategy: Transitioning towards a new normal. Annals of Medicine and Surgery. 2020 Nov 1;59:165–70.
ElBagoury M, Tolba MM, Nasser HA, Jabbar A, Elagouz AM, Aktham Y, et al. The find of COVID-19 vaccine: Challenges and opportunities. Journal of Infection and Public Health. 2021 Mar 1;14(3):389–416.
World Health Organization. COVID-19 vaccine tracker and landscape [Internet]. 2022 [cited 2022 Apr 10]. Available from: https://www.who.int/publications/m/item/draft-landscape-of-covid-19-candidate-vaccines
Graham BS. Rapid COVID-19 vaccine development. Science. 2020 May 29;368(6494):945–6.
Lamb YN. BNT162b2 mRNA COVID-19 Vaccine: First Approval. Drugs. 2021 Mar;81(4):495–501.
World Health Organization. WHO issues its first emergency use validation for a COVID-19 vaccine and emphasizes need for equitable global access [Internet]. 2020 [cited 2022 Apr 11]. Available from: https://www.who.int/news/item/31-12-2020-who-issues-its-first-emergency-use-validation-for-a-covid-19-vaccine-and-emphasizes-need-for-equitable-global-access
Coronavirus disease (COVID-19): Vaccines [Internet]. 2022 [cited 2022 Apr 11]. Available from: https://www.who.int/news-room/questions-and-answers/item/coronavirus-disease-(covid-19)-vaccines
Brenzel L, Wolfson LJ, Fox-Rushby J, Miller M, Halsey NA. Vaccine-preventable Diseases. In: Jamison DT, Breman JG, Measham AR, Alleyne G, Claeson M, Evans DB, et al., editors. Disease Control Priorities in Developing Countries [Internet]. 2nd ed. Washington (DC): World Bank; 2006 [cited 2022 Apr 11]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK11768/
World Health Organization. Ten health issues WHO will tackle this year [Internet]. 2019 [cited 2022 Apr 11]. Available from: https://www.who.int/news-room/spotlight/ten-threats-to-global-health-in-2019
Harapan H, Wagner AL, Yufika A, Winardi W, Anwar S, Gan AK, et al. Acceptance of a COVID-19 Vaccine in Southeast Asia: A Cross-Sectional Study in Indonesia. Front. Public Health. 2020;8:381.
Sallam M. COVID-19 Vaccine Hesitancy Worldwide: A Concise Systematic Review of Vaccine Acceptance Rates. Vaccines. 2021 Feb;9(2):160.
Wang J, Jing R, Lai X, Zhang H, Lyu Y, Knoll MD, et al. Acceptance of COVID-19 Vaccination during the COVID-19 Pandemic in China. Vaccines. 2020 Aug 27;8(3):482.
Al-Qerem WA, Jarab AS. COVID-19 Vaccination Acceptance and Its Associated Factors Among a Middle Eastern Population. Front Public Health. 2021;9:632914.
Neumann-Böhme S, Varghese NE, Sabat I, Barros PP, Brouwer W, van Exel J, et al. Once we have it, will we use it? A European survey on willingness to be vaccinated against COVID-19. Eur J Health Econ. 2020 Sep;21(7):977–82.
Lau JFW, Woon YL, Leong CT, Teh HS. Factors influencing acceptance of the COVID-19 vaccine in Malaysia: a web-based survey. 2021;
Marzo RR, Ahmad A, Abid K, Khatiwada AP, Ahmed A, Kyaw TM, et al. Factors influencing the acceptability of COVID-19 vaccination: A cross-sectional study from Malaysia. Vacunas [Internet]. 2021 Sep 1 [cited 2021 Sep 26]; Available from: https://europepmc.org/articles/PMC8407950
Syed Alwi SAR, Rafidah E, Zurraini A, Juslina O, Brohi IB, Lukas S. A survey on COVID-19 vaccine acceptance and concern among Malaysians. BMC Public Health. 2021 Dec;21(1):1129.
Wong LP, Alias H, Wong PF, Lee HY, AbuBakar S. The use of the health belief model to assess predictors of intent to receive the COVID-19 vaccine and willingness to pay. Hum Vaccin Immunother. 2020 Jul 30;16(9):2204–14.
Zahiid SJ. Health Ministry survey shows a third of Malaysians still fear, doubt Covid-19 vaccine | Malay Mail [Internet]. 2020 [cited 2022 Apr 10]. Available from: https://www.malaymail.com/news/malaysia/2020/12/31/health-ministry-survey-shows-a-third-of-malaysians-still-fear-doubt-covid-1/1936319
Tang KHD. Vaccination Coverage as a Predictor of COVID-19 Case Fatality Rates in Malaysia. International Journal of Epidemiology and Health Sciences. 2022 Feb 5;3(2):1.
Vaccinations in Malaysia [Internet]. COVIDNOW. 2021 [cited 2022 Apr 9]. Available from: https://covidnow.moh.gov.my/vaccinations
Syed Alwi SAR, Rafidah E, Zurraini A, Juslina O, Brohi IB, Lukas S. A survey on COVID-19 vaccine acceptance and concern among Malaysians. BMC Public Health. 2021 Dec;21(1):1129.
Battarbee A. Attitudes toward COVID-19 illness and COVID-19 vaccination among pregnant women: a cross-sectional multicenter study during August-December 2020. :22.
Bono SA, Faria de Moura Villela E, Siau CS, Chen WS, Pengpid S, Hasan MT, et al. Factors Affecting COVID-19 Vaccine Acceptance: An International Survey among Low-and Middle-Income Countries. Vaccines 2021, 9, 515. s Note: MDPI stays neutral with regard to jurisdictional claims in published …; 2021.
Harapan H, Wagner AL, Yufika A, Winardi W, Anwar S, Gan AK, et al. Acceptance of a COVID-19 Vaccine in Southeast Asia: A Cross-Sectional Study in Indonesia. Front. Public Health. 2020;8:381.
Yoda T, Katsuyama H. Willingness to Receive COVID-19 Vaccination in Japan. Vaccines. 2021 Jan;9(1):48.
Ali SM, Ahmad F. COVID-19 Vaccine Hesitancy in Kedah, Malaysia: A Qualitative Study. 2022;5(3):5.
Mahmud S, Mohsin M, Khan IA, Mian AU, Zaman MA. Knowledge, beliefs, attitudes and perceived risk about COVID-19 vaccine and determinants of COVID-19 vaccine acceptance in Bangladesh. PloS one. 2021;16(9):e0257096.
Wang J, Jing R, Lai X, Zhang H, Lyu Y, Knoll MD, et al. Acceptance of COVID-19 Vaccination during the COVID-19 Pandemic in China.
Al-Qerem WA, Jarab AS. COVID-19 Vaccination Acceptance and Its Associated Factors Among a Middle Eastern Population. Front. Public Health. 2021;9:632914.
Salomoni MG, Di Valerio Z, Gabrielli E, Montalti M, Tedesco D, Guaraldi F, et al. Hesitant or Not Hesitant? A Systematic Review on Global COVID-19 Vaccine Acceptance in Different Populations. Vaccines 2021, 9, 873. s Note: MDPI stays neutral with regard to jurisdictional claims in published …; 2021.
Zanesco J, Tipura E, Posada A, Clément F, Pegna AJ. Seeing is believing: Early perceptual brain processes are modified by social feedback. Social Neuroscience. 2019 Sep 3;14(5):519–29.
Ionescu TC, Fetecau BI, Giurgiuca A, Tudose C. Acceptance and Factors Influencing Acceptance of COVID-19 Vaccine in a Romanian Population. Journal of Personalized Medicine. 2022 Mar;12(3):452.
Scrima F, Miceli S, Caci B, Cardaci M. The relationship between fear of COVID-19 and intention to get vaccinated. The serial mediation roles of existential anxiety and conspiracy beliefs. Personality and Individual Differences. 2022 Jan 1;184:111188.
Phases of National COVID-19 Immunisation Programme [Internet]. 2022 [cited 2022 Apr 4]. Available from: https://www.pmo.gov.my/2021/02/phases-of-national-covid-19-immunisation-programme/
Singh AK, Gillies CL, Singh R, Singh A, Chudasama Y, Coles B, et al. Prevalence of co-morbidities and their association with mortality in patients with COVID-19: A systematic review and meta-analysis. Diabetes, Obesity and Metabolism. 2020;22(10):1915–24.
Al-Jayyousi GF, Sherbash MAM, Ali LAM, El-Heneidy A, Alhussaini NWZ, Elhassan MEA, et al. Factors Influencing Public Attitudes towards COVID-19 Vaccination: A Scoping Review Informed by the Socio-Ecological Model. Vaccines. 2021 Jun;9(6):548.
Institute for Health Metrics and Evaluation. COVID-19 vaccine efficacy summary [Internet]. Institute for Health Metrics and Evaluation. 2022 [cited 2022 Apr 24]. Available from: https://www.healthdata.org/covid/covid-19-vaccine-efficacy-summary
Tanveer S, Rowhani-Farid A, Hong K, Jefferson T, Doshi P. Transparency of COVID-19 vaccine trials: decisions without data. BMJ Evidence-Based Medicine [Internet]. 2021 Aug 8 [cited 2022 May 17]; Available from: https://ebm.bmj.com/content/early/2021/08/08/bmjebm-2021-111735
Godlee F. Covid-19: Transparency and communication are key. BMJ. 2020 Dec 10;371:m4764.
Mahase E. Covid-19: Vaccine trials need more transparency to enable scrutiny and earn public trust, say experts. BMJ. 2020 Oct 22;371:m4042.
Lau JFW, Woon YL, Leong CT, Teh HS. Factors influencing acceptance of the COVID-19 vaccine in Malaysia: a web-based survey. 2021;
Hussein AAM, Galal I, Makhlouf NA, Makhlouf HA, Abd-Elaal HK, Kholief KM, et al. A national survey of potential acceptance of COVID-19 vaccines in healthcare workers in Egypt [Internet]. medRxiv; 2021 [cited 2022 May 17]. p. 2021.01.11.21249324. Available from: https://www.medrxiv.org/content/10.1101/2021.01.11.21249324v1
Demi?r Y, Oruç P, Dünder E, Özpinar S. Vaccine Attitude of Healthcare Professionals Towards Covid19: Samsun/Turkey Example. International Journal of Academic Medicine and Pharmacy. 2021 Aug 20;Volum: 3, Issue: 3.
Merkley E, Loewen PJ. The correlates and dynamics of COVID-19 vaccine-specific hesitancy [Internet]. OSF Preprints; 2021 [cited 2022 May 18]. Available from: https://osf.io/ng9qh/
Stöckli S, Spälti AK, Phillips J, Stoeckel F, Barnfield M, Thompson J, et al. Which vaccine attributes foster vaccine uptake? A cross-country conjoint experiment. PLOS ONE. 2022 May 4;17(5):e0266003.
Kamal A, Hodson A, Pearce JM. A Rapid Systematic Review of Factors Influencing COVID-19 Vaccination Uptake in Minority Ethnic Groups in the UK. Vaccines. 2021 Oct;9(10):1121.
Brand CO, Stafford T. Covid-19 vaccine dialogues increase vaccination intentions and attitudes in a vaccine-hesitant UK population [Internet]. PsyArXiv; 2021 [cited 2022 May 22]. Available from: https://psyarxiv.com/kz2yh/
Sipalan J. Malaysia launches COVID-19 vaccination drive as PM gets first shot. Reuters [Internet]. 2021 Feb 24 [cited 2022 Apr 5]; Available from: https://www.reuters.com/business/healthcare-pharmaceuticals/malaysia-launches-covid-19-vaccination-drive-pm-gets-first-shot-2021-02-24/
Malaysia imposes emergency law to clamp down on Covid-19 fake news. The Straits Times [Internet]. 2021 Mar 11 [cited 2022 Mar 9]; Available from: https://www.straitstimes.com/asia/se-asia/malaysia-imposes-emergency-law-to-clamp-down-on-covid-19-fake-news
Malaysian govt will make life tough for those who refuse Covid-19 vaccinations: Health minister Khairy. The Straits Times [Internet]. 2021 Oct 17 [cited 2022 Apr 5]; Available from: https://www.straitstimes.com/asia/se-asia/malaysian-govt-to-make-life-tough-for-those-who-refuse-vaccinations-minister
Reuters. Malaysia makes COVID-19 vaccinations compulsory for government employees. Reuters [Internet]. 2021 Sep 30 [cited 2022 Apr 5]; Available from: https://www.reuters.com/world/asia-pacific/malaysia-makes-covid-19-vaccinations-compulsory-government-employees-2021-09-30/
Hagan K, Forman R, Mossialos E, Ndebele P, Hyder AA, Nasir K. COVID-19 vaccine mandate for healthcare workers in the United States: a social justice policy. Expert Review of Vaccines. 2022 Jan 2;21(1):37–45.
McKee M, Schalkwyk MCI van. England’s U turn on covid-19 vaccine mandate for NHS staff. BMJ. 2022 Feb 10;376:o353.
Wolf SM, Hodge JG Jr. Designing COVID-19 vaccine mandates in colleges and universities: a roadmap to the 10 key questions. Journal of Law and the Biosciences. 2022 Jan 1;9(1):lsab035.
Druml C, Czech H. A pandemic is no private matter: the COVID-19 vaccine mandate in Austria. The Lancet Respiratory Medicine. 2022 Apr 1;10(4):322–4.
Mandate vaccination with care [Internet]. [cited 2022 May 18]. Available from: https://www.nature.com/articles/d41586-019-02232-0
Schmelz K. Enforcement may crowd out voluntary support for COVID-19 policies, especially where trust in government is weak and in a liberal society. Proceedings of the National Academy of Sciences. 2021 Jan 5;118(1):e2016385118.
