Research Article
Austin J Pulm Respir Med. 2021; 8(3): 1077.
Eagerness to Acceptance of Covid-19 Vaccine among Health Care Workers in Oromia Regional State, Ethiopia. An Online Based Cross-Sectional Study, 2021
Gudisa Bereda* and Gemechis Bereda
Department of Pharmacy, Negelle Health Science College, Guji, Ethiopia
*Corresponding author: Gudisa Bereda, Department of Pharmacy, Negelle Health Science College, Guji, Ethiopia, Tel:+251919622717, Email: [email protected]
Received: July 19, 2021; Accepted: August 03, 2021; Published: August 10, 2021
Abstract
Background: The COVID-19 pandemic is expected to continue to impose enormous burdens of morbidity and mortality while severely disrupting societies and economies worldwide. Vaccines are a key strategy to stop the escalation of the COVID-19 pandemic. Vaccines are the effective way to control and prevent a several diseases, save lives, and reducing current health emergency, as well as increasing the immunity of the population.
Objective: To find out eagerness to acceptance of COVID-19 vaccine among health care workers in oromia regional state, Ethiopia: An online-based cross-sectional study.
Methods: An online based cross sectional study design were carried out from April 18, 2021 to June 19, 2021. Data was collected through employing online questioner, and then the collected data were coded and analyzed by statistical packages for social sciences 25.0 version statistical software. The statistical significance was set at a P-value ≤0.05.
Findings: The current study revealed that 178 (42.2%) of health care workers intended to receive the COVID-19 vaccines. The results of our study showed that the majority of participants don’t believe that COVID-19 vaccine is effective and safe (n=279.66.1%), and couldn’t save lives (n=228, 54.1%). Factors such as age group >55 (AOR: 2.75; 95% CI: 1.092-5.472; P=0.008), Female(AOR: 1.86; 95% CI: 1.243-2.796; P=0.003), nurses (AOR: 2.17; 95% CI: 0.621-5.087; P=0.0094) and midwives (AOR: 2.521; 95% CI: 2.497-8.24; P=0.0002), married (AOR: 1.74; 95% CI: 0.218-4.530; P=0.006), health care workers who had contact with COVID-19 patient were twice as likely to accept the vaccine (AOR: 1.93; 95% CI: 1.360- 3.784; P=0.0001) and health care workers who indicated that they had more serious medical condition (AOR: 2.61; 95% CI: 0.981-3.618; P=0.007) proved to be significant predictors of the acceptability of the COVID-19 vaccine. Factors such as taking vitamin C (AOR: 1.624; 95% CI: 0.945-2.596; P=0.0003), poor safety of vaccines (AOR: 7.041; 95% CI: 3.692-13.375; P=0.000), those believe effective medicine avail for treating COVID-19 (AOR: 2.16; 95% CI: 1.596-3.485; P=0.0076), no adequate trials about COVID-19 (AOR: 7.041; 95% CI: 3.692-13.375; P=0.000), and unwanted side effects of the vaccines (AOR: 3.422; 95% CI: 1.448-8.096; P=0.005) were identified as indicators why health care workers would decline uptake of COVID-19 vaccines.
Conclusion and Recommendation: Our survey revealed that the eagerness to acceptance of covid-19 vaccine among health care workers in oromia regional state was somewhat meagre. Nurses and Midwives were more likely to accept the COVID-19 vaccines than others health care workers. Oromia health bureau should have to give training about COVID-19 vaccine to all health care workers.
Keywords: Eagerness; COVID-19; Vaccine; Acceptance; Ethiopia
Abbreviations
BEFO: Biiroo Eegumsa Fayyaa Oromiyaa; COVID-19: Coronavirus Disease 2019; ETB: Ethiopian Birr; HCWs: Health Care Workers; H1N1: Swine flu; SARS-CoV-2: Severe Acute Respiratory Syndrome Coronavirus-2; TV: Television; U.S: United States; WHO: World Health Organization
Introduction
The coronavirus disease 2019 (COVID-19) pandemic has spread across the world with millions infected and hundreds of thousands dead [1]. Coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), is believed to have originated from the Huanan Seafood Wholesale Market, Wuhan, Hubei province, China which was declared as a pandemic by the World Health Organization [2]. While most countries impacted have developed successful response strategies and observed significant improvements, the U.S (as of June 28, 2020) leads globally with 2.50 million cases and over 125,000 deaths [3]. The spread of SARS-CoV-2, the causative agent of COVID-19, has resulted in an unprecedented global public health and economic crisis [4]. The outbreak was declared a pandemic by the World Health Organization on March 11, 2020, and development of COVID-19 vaccines has been a major undertaking in fighting the disease. As of December 2020, many candidate vaccines have been shown to be safe and effective at generating an immune response with interim analysis of phase III trials suggesting efficacies as high as 95% [5]. Since the first case was detected in Egypt on the 14th day of February 2020, the number of cases in Africa has been on a steady rise, though has remained lower than the rest of the world [6]. With over 1.3 billion people and a weak health system plagued by lack of healthcare infrastructure and shortages of health manpower, limited access to social protection and low health literacy, the public health measures implemented at the start of the pandemic will not be sufficient to stop further progress of the virus in Africa or end the pandemic. A COVID-19 vaccine may be the most practical and feasible solution for Africa. Several vaccine candidates are currently under different stages of development and some maybe available for phase 3 trials before the end of 2020 [7]. Vaccines are a key strategy to stop the escalation of the COVID19 pandemic [8]. While large-scale vaccine rejection threatens herd immunity goals, large-scale acceptance with local vaccine rejection can also have negative consequences for community (herd) immunity, as clustering of non-vaccinators can disproportionately increase the needed percentage of vaccination coverage to achieve herd immunity in adjacent geographical regions and encourage epidemic spread [9]. There are certain beliefs and barriers regarding vaccination among the general population. Vaccine coverage and its acceptance varies with respect to behaviour of the people, geography, and time [10]. Furthermore, certain key factors such as severity of the disease, previous vaccination history, lack of belief in health care services, route of administration of vaccine, economic and educational status of the individuals, recommendations from doctors, and cost of vaccine also determines the acceptance of vaccines. The first and foremost public concern about the novel vaccines against new emerging pandemics is the safety and effectiveness of candidate vaccines as witnessed in 2009 H1N1 pandemic [11].
Governments, public health officials and advocacy groups must be prepared to address hesitancy and build vaccine literacy so that the public will accept immunization when appropriate. Anti-vaccination activists are already campaigning in multiple countries against the need for a vaccine, with some denying the existence of COVID-19 altogether [12]. Misinformation spread through multiple channels could have a considerable effect on the acceptance of a COVID-19 vaccine. The accelerated pace of vaccine development has further heightened public anxieties and could compromise acceptance [13]. The public’s willingness to accept a vaccine is therefore not static; it is highly responsive to current information and sentiment around a COVID-19 vaccine, as well as the state of the epidemic and perceived risk of contracting the disease. Under these current plausible COVID-19 vaccine acceptance rates, possible levels of existing protective immunity though it is unclear whether postinfection immunity confers long-term immunity and the rapidly evolving nature of misinformation surrounding the pandemic [14], it is unclear whether vaccination will reach the levels required for herd immunity. Vaccine hesitancy is reported as one of the major threats to global health by WHO. High vaccine coverage is needed to flatten the epidemic curve. Vaccine hesitancy affects not only the individual who is hesitant to take the vaccine, but the whole community, making it difficult to reach the threshold to confer herd immunity [15]. There are certain beliefs and barriers regarding vaccination among the general population.
The study were investigate the intention to accept a future COVID-19 vaccine to determine the factors associated with intent to accept or refuse the vaccine, and help the government in identifying the risk health care workers and develop better strategies for mass vaccination against COVID-19.
Methodology
Study design, period and study area
A cross-sectional study design was conducted in 21 zone of Oromia regional state. The Oromia regional state have population of approximately about 55 million people and covers an area of around 286,612km². Oromia regional state have 100 hospitals in which 62 were primary hospitals, 36 were general hospitals and 4 were referral hospitals except Shashemene referral hospitals and Jimma university specialized hospitals. There were 20,541 HCWs with sex composition of 11,422 males and 9,119 females in Oromia regional state hospitals in which 7793 were worked in primary hospitals, 9411 were worked in general hospitals, 1839 were worked in referral hospitals. The study design was carried out for 3 months (from April 18, 2021 to June 19, 2021).
Study participants
All HCWs who were at study area during the study period was study population. Willingness to consent and those capable of using internet on a smart phone or computer, Age above 18 years of age and current place of work in Oromia regional state were included in the study. Younger (aged less than 18 years) HCWs, non-health care employees and those unwilling to participate were excluded.
Sample size determination & sampling technique
The sample size was determined by using the single population proportion formula: Due to absence of data in the country, proportion of population who had eagerness to acceptance of covid-19 vaccine among health care workers was assumed to be 50%. Then, n= ((Za/2)² P(1-P))/d², n= ((1.96)² 0.5(1-0.5))/(0.05)² =384. By adding 10% contingency for non-response rate, a total of 422 study participants were involved. The multi stage sampling techniques were used to approach the participants. Then, the sample size to each selected hospitals was allocated proportionally. Finally, the study participants were selected randomly.
Study variables
Dependent variable was vaccine acceptance, and independent variables were socio demographic factors (age, gender, education status, religion, occupation, marital status, monthly income, employment status, occupation and work place of the respondents), Acceptance rate regarding COVID-19 vaccine, Factors that may hinder COVID-19 vaccine acceptance.
Data collection instruments
Due to limitations in doing face-to-face research during the current active COVID-19 outbreak, this study did an online survey during the period April 18, 2021 to June 19, 2021, were collected from HCW individuals aged greater than 18 years across 21 zone of Oromia regional state. Well-designed online self-administered questionnaire has been used to collect data for assessing to determine the acceptance rate of a COVID-19 vaccine in HCWs. The questionnaire was translated into local languages (Oromiffa). Acceptance rate regarding COVID-19 vaccine in HCWs had five parts. Part I. Sociodemographic parameters. The socio-demographic parameters included (age, gender, education status, religion, occupation, marital status, monthly income, employment status, category of health care workers and work place of the respondents) it also include presence of chronic illness. Part II. Beliefs toward COVID-19 vaccine/vaccination were dichotomized as Yes=1 and 0=No. Part III. COVID-19 vaccine acceptance were 5-point Likert scale (5=Completely agree, 4=Somewhat agree, 3=Neutral/no opinion, 2=Somewhat disagree, 1=Completely disagree) with questions about acceptance and concerns regarding COVID-19 vaccines. Part IV. Factors that can improve COVID-19 vaccine acceptance were dichotomized as Yes=1 and No=0, and in addition, respondents were asked questions on their COVID-19 experience, including previous contact with a COVID-19 patient, whether a member of their household, relatives, friends, or neighbours has been diagnosed with COVID-19. Part V. Factors that may hinder COVID-19 vaccine acceptance were trichotomized as Yes=1, No=0 and none=I don’t know.
Data quality assurance
The questioner translated from English to Oromiffa and back to English to check the consistency. To ensure the quality, the questionnaire checked for completeness, accuracy, clarity and consistency by the principal investigator. HCWs have been informed of detailed information with practice on how to complete and sent the questionnaire. Duplication of responses were controlled by restricting to one response.
Statistical analysis
Data were cleaned and analyzed through employing SPSS 25.0 version statistical Software. Categorical variables were presented as numbers and percentages, while continuous variables were presented as median and standard deviation. Chi-square test for categorical variables as appropriate. Dichotomized responses were presented as proportions. Bivariate analysis was used to examine the association between exposure and outcome variables, and regression analysis to derive the odds ratios (OR) and their 95% confidence intervals (95% CI) for variables significant at bivariate analysis. Multivariate binary logistic regression analysis were used to identify the determinants of intention to vaccinate and the associated factors that perhaps hinder COVID-19 vaccine acceptance. All variables were considered statistically significant at 95% confidence interval (p ≤0.05).
Ethical approval
The study was commenced after approved by health research directorate of Oromia regional health bureau (Ref: BEFO/ HBTFU/146/10239). The study participants were informed about behind the scenes, and oral consent were obtained from each participant. All the HCWs were informed about the objectives of the study, and they agreed and signed a consent form before participation. Behind the scenes were kept and anonymous, and data were accessible only to the researchers.
Operational definitions
Coronavirus disease 2019 (COVID-19) is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), a novel zoonotic coronavirus that emerged from Wuhan, China.
Vaccine: A product that stimulates a person’s immune systems to produce immunity to a specific disease, protecting the person from that disease.
Results
Socio-demographic characteristics of healthcare worker’s
There were a total of 422 health care workers who completed the online survey, of the 422 health care workers, more than half (n=214, 56%) were aged 19-34 years. The majority of the health care workers were males (n=148, 50.5%), Protestant (n=171, 40.5%), living in an urban area (n=384, 91%), and earn monthly income between 5001- 10000 (n=228, 54%). The majority of health care workers were nurses (n=128, 30.3%), and midwives (n=75, 17.8%). In terms of marital status, (n=214, 50.7%) of the health care workers were single. Majority (n=344, 81.5%) of the health care workers reported no chronic disease and had no any addiction (n=365, 86.5%). The source of information for them majorly was TV (n=219, 51.9%). The prevalence of COVID-19 vaccine acceptance among health care workers were (n=178, 42.2%) (Table 1).
Variable
Category
Frequency
Percent
Age
19-34 Years
213
50.5
35-54 Years
181
42.9
>54 Years
28
6.6
Sex
Male
225
53.3
Female
197
46.7
Residence
Urban
384
91
Rural
38
9
Income
<5000
146
34.6
5001-10000
228
54
>10000
48
11.4
Religion
Protestant
171
40.5
Orthodoxy
129
30.6
Muslim
88
20.9
Others
34
8.1
Marital Status
Single
214
50.7
Married
181
42.9
Divorced
19
4.5
Widowed
8
1.9
Profession
Doctors
51
12.1
Nurse
128
30.3
Pharmacy
70
16.6
Psychiatry
45
10.7
Midwives
75
17.8
Clinical Lab
31
7.3
Others
22
5.2
Any Chronic Illness
Yes
78
18.5
NO
344
81.5
Any Addiction
Yes
57
13.5
No
365
86.5
Source of Information
TV
219
51.9
Websites
109
25.8
Telegram/Facebook
67
15.9
Others
27
6.4
Prevalence of COVID -19 Vaccine Acceptance
Yes
178
42.2
No
244
57.8
Table 1: Socio-demographic characteristics of healthcare worker’s in Oromia regional state, Ethiopia (n=422).
Beliefs toward COVID-19 vaccine/vaccination
The results of our study showed that the majority of participants don’t believe that COVID-19 vaccine is effective and safe (n=279, 66.1%), and couldn’t save lives (n=228, 54.1%). In terms of face mask the most of participants were confident to wear face masks, and wash their hands regularly even if they get vaccinated, (n=342, 81%), as well as they believe that vaccine could not stop the transmission of the COVID-19, (n=219, 51.9%) and only protect new infections (n=309, 73.3%). The majority of respondents were believes that COVID-19 vaccine is not available in Ethiopia at that moment, (n=297, 70.4%). Majority (n=405, 95.9%) of the participants were strongly believes that it is important to isolate and treat people who are infected with COVID-19 are effective ways to reduce the spread of the virus, and only few of respondents were take covid-19 vaccine shots and recommend others (n=101, 23.9%) (Table 2).
Statement
Frequency (%)
Yes
No
Do you believe covid-19 vaccine could save lives?
194(45.97)
228(54.03)
Do you believe covid-19 vaccine is effective and safe?
143(33.89)
279(66.11)
If you are vaccinated do you need to wear face mask and wash your hands regularly?
342(81.04)
80(18.96)
Do you believe covid19 vaccine is available in Ethiopia?
41(9.72)
381(90.28)
Could vaccine will stop the transmission of Covid-19?
203(48.11)
219(51.89)
Is Covid-19 vaccine currently avail in Ethiopia?
125(29.6)
297(70.4)
Could Covid-19 vaccine only protect new infections?
309(73.23)
114(26.77)
Would you take covid19 vaccine and recommend others?
101(23.94)
321(76.06)
Is isolation and treatment of people who are infected with COVID19 are effective to reduce the spread of the virus?
405(95.97)
17(4.03)
Table 2: Beliefs toward COVID-19 vaccine among health care workers in Oromia regional state, Ethiopia (n=422).
COVID-19 vaccine acceptance measurement
The results of the study showed that about (n=90, 21.3%) had completely disagree in the information provided by the media is the fight against COVID-19. Also, majority (n=122, 28.9%) of the health care workers had neutral/no opinion to accept COVID-19 vaccine if government recommended it only. Furthermore, more than half (n=245, 58.1%) of health care workers neutral/no opinion that the COVID-19 vaccine will lose its effect with sunshine. Majority (n=178, 42.2%) of respondents were completely agree to take the vaccine if available free and if generally available (n=98, 23.3%) (Table 3).
Statement
Frequency
Percent
Are you accept COVID-19 vaccine if generally available?
Completely Agree
98
23.23
Somewhat Agree
46
10.9
Neutral/No Opinion
132
31.29
Somewhat Disagree
49
11.6
Completely Disagree
97
22.98
Could you accept COVID-19 vaccine if government recommended it only?
Completely Agree
61
14.46
Somewhat Agree
102
24.18
Neutral/No Opinion
122
28.9
Somewhat Disagree
57
13.5
Completely Disagree
80
18.96
Are you trust in the information provided by the media in the fight against COVID-19
Completely Agree
79
18.72
Somewhat Agree
98
23.22
Neutral/No Opinion
102
24.17
Somewhat Disagree
53
12.56
Completely Disagree
90
21.33
Are you think that sunshine will make COVID-19 vaccine lose its effect?
Completely Agree
32
7.58
Somewhat Agree
61
14.45
Neutral/No Opinion
245
58.06
Somewhat Disagree
53
12.56
Completely Disagree
31
7.35
Have taken the vaccine if available free (Without Payment)?
Completely Agree
178
42.18
Somewhat Agree
98
23.22
Neutral/No Opinion
102
24.17
Somewhat Disagree
33
7.82
Completely Disagree
11
2.61
Table 3: COVID-19 vaccine acceptance scale among health care workers in Oromia regional state, Ethiopia (n=422).
Factors that can improve COVID-19 vaccine acceptance
Majority (n=396, 93.8%) of our respondents tested for COVID-19 and being negative (n=417, 98.1%). About (n=215, 50.9%) of the respondents indicated that they had not been in contact with any COVID-19 patient, and (n=250, 59.2%) respondents indicated that no member in their households had been diagnosed with COVID-19. Also (n=373, 64.7%) of the respondents had none of their relatives/ friends been died with COVID-19. Majority (n=282, 66.8%) of the participants were not trained about COVID-19 vaccine. More than half (n=224, 53.1%) of respondents were judge as having more serious medical condition escalate willingness to accept COVID-19 vaccine (Table 4).
Statement
Frequency (%)
Yes
No
Have you trained on COVID 19 vaccine?
140(33.2)
282(66.8)
Are you contact with COVID-19 patient?
207(49.1)
215(50.9)
Are your member of household diagnosed with COVID-19?
172(40.8)
250(59.2)
Would having more serious medical condition escalate willingness to accept COVID 19 vaccine?
224(53.1)
198(46.9)
Is the person you know/your friend/your family member passed away (die) by COVID-19?
149(35.3)
373(64.7)
Have tested for COVID-19?
396(93.8)
26(6.2)
Is your results of COVID test negative?
417(98.1)
5(1.9)
Table 4: Factors that can improve COVID-19 vaccine acceptance among health care workers in Oromia regional state, Ethiopia (n=422).
Factors that may hinder COVID-19 vaccine acceptance
Preponderance (n=143, 33.9%) of health care workers were unwilling to accept the COVID-19 vaccines due to concern about the COVID-19 virus human made, and deliberately released. Also majority (n=234, 55.5%) of HCWs were unwilling to accept the COVID-19 vaccines due to concern about the safety. (n=126, 19.9%) respondents were had misunderstanding about flu vaccine as it protect s/he from COVID-19 virus. Also, taking vitamin C or other vitamins (n=147, 34.8%), eating garlic (n=123, 29.1%), and effective medicine avail for treating COVID-19 virus (n=106, 26.1%) were unwilling to accept due to concern of they protect against COVID-19 respectively. About (n=235, 55.7%) and (n=241, 57.1%) of them were unwilling to accept the COVID-19 vaccines due to concern after side effects of the vaccine, and wear of face mask after s/he vaccinated, respectively (Table 5).
Statement
Frequency (%)
Yes
No
I don’t know
Is ordinary flu vaccine protect you from COVID- 19?
126(29.9)
205(48.6)
91(21.6)
Adequate trials about COVID-19 vaccine/safety
59(14)
234(55.5)
129(30.6)
Will taking vitamin C or other vitamins protect you from COVID-19?
147(34.8)
184(43.6)
91(21.6)
Is there evidence that perhaps eating garlic protect you against COVID-19?
123(29.1)
194(46.0)
105(24.9)
Is there effective medicine avail for treating COV ID-19?
106(26.1)
204(48.3)
112(26.6)
Is COVID-19 virus human made, and deliberately released?
143(33.9)
189(44.8)
90(21.3)
If I vaccinated why I use face mask, so the vaccine had no value against COVID-19 virus?
241(57.1)
148(35.1)
33(7.8)
Is fear of side effects prevent you from taking vaccine for prevention of COVID-19 virus?
235(55.7)
130(30.8)
57(13.5)
Table 5: Factors that perhaps hinder COVID-19 vaccine acceptance among health care workers in Oromia regional state, Ethiopia (n=422).
Logistic regression model for eagerness to accept COVID-19 vaccine among health care workers
Results showed that the acceptance rate for vaccination against COVID-19 was (n=178, 42.2%) as shown in Table 1. Participants in the age group >55 were 3 times as likely to accept the vaccine (AOR: 2.75; 95% CI: 1.092-5.472; P=0.008). Female subject s were twice as likely to accept the vaccine (AOR: 1.86; 95% CI: 1.243-2.796; P=0.003). Nurses (AOR: 2.17; 95% CI: 0.621-5.087; P=0.0094) and Midwives (AOR: 2.521; 95% CI: 2.497-8.24; P=0.0002) were more likely to accept the COVID-19 vaccines than others profession. Participants who were married (AOR: 1.74; 95% CI: 0.218-4.530; P=0.006) were more likely to accept vaccine. Health care workers who had contact with COVID-19 patient were twice as likely to accept the vaccine (AOR: 1.93; 95% CI: 1.360-3.784; P=0.0001) than who hadn’t contact with COVID-19 patients. Health care workers who indicated that they had more serious medical condition were 3 times as likely to accept the vaccine (AOR: 2.61; 95% CI: 0.981-3.618; P=0.007) than who hadn’t (Table 6).
Acceptance of COVID-19 vaccine
n (%)
AOR (95%CI)
P-value
Age
19-34 years
213(50.5)
Ref
35-54 years
181(42.9)
0.75(0.311-1.811)
0.75
>55 years
28(6.6)
2.75(1.092-5.472)
0.008**
Sex
Male
225(53.3)
Ref
Female
197(46.7)
1.86(1.243-2.796)
0.003**
Category of health care workers
Doctor
51(12.1)
Ref
Nurse
128(30.3)
2.17(0.621-5.087)
0.0094**
Pharmacy
70(16.6)
1.092(0.433-2.754)
0.853
Psychiatry
45(10.7)
1.498(0.555-4.041)
0.425
Midwives
75(17.8)
3.521(2.497-8.247)
0.0002**
Clinical lab.
31(7.3)
1.306(0.493-3.461)
0.592
Others
22(5.2)
0.996(0.324-3.060)
0.996
Marital status
Single
214(50.7)
Ref
Married
181(42.9)
1.74(0.218-4.530)
0.006**
Divorced
19(4.5)
1.143(0.248-1.263)
0.864
Widowed
8(1.9)
0.461(0.79-2.682)
0.389
Those who were trained on COVID 19 vaccine
No
282(66.8)
Ref
Yes
140(33.2)
1.421(1.20-1-936)
0.091
Contact with COVID-19 patient
No
215(50.9)
Ref
Yes
207(49.1)
1.93(1.360-3.784)
0.0001**
Member of household diagnosed with COVID-19
No
250(59.2)
Ref
Yes
172(40.8)
1.078(0.715-1.6250
0.075
More serious medical condition escalate willingness to accept COVID 19 vaccine
No
224(53.1)
Ref
Yes
198(46.9)
2.61(0.981-3.618)
0.007**
Person you know/your friend/your family member passed away (die) by COVID-19
No
373(64.7)
Ref
Yes
149(35.3)
1.068(0.709-1.607)
0.754
*P<0.05, **P<0.01.
Table 6: Logistic regression model for eagerness to accept COVID-19 vaccine among health care workers in Oromia regional state, Ethiopia (n=422).
Logistic regression model for factors that perhaps hinder acceptance of COVID-19 vaccine among healthcare workers
Taking vitamin C or other vitamins were 2 times as likely to hinder acceptance of COVID-19 vaccine (AOR: 1.624; 95% CI: 0.945-2.596; P=0.0003) and those believe effective medicine avail for treating COVID-19 were 2 times as likely to hinder acceptance of COVID-19 vaccine (AOR: 2.16; 95% CI: 1.596-3.485; P=0.0076). Fear of side effects (AOR: 3.422; 95% CI: 1.448-8.096; P=0.005) and why wearing face mask after vaccination (AOR: 4.738; 95% CI: 2.272-9.978; P=0.000) were 3 times and 5 times as likely to hinder acceptance of COVID-19 vaccine respectively. No adequate trials about COVID-19 vaccine were 7 times as likely to hinder acceptance of COVID-19 vaccine (AOR: 7.041; 95% CI: 3.692-13.375; P=0.000) (Table 7).
Factors that hinder acceptance of COVID-19 vaccine
n (%)
AOR (95%CI)
P-value
Ordinary flu vaccine protect you from COVID-19
Yes
126(29.9)
Ref
No
205(48.6)
0.566(0.2681.192)
0.134
I don’t know
91(21.6)
0.137(0.298-1.180)
0.598
Taking vitamin C or other vitamins protect you from COVID-19
Yes
147(34.8)
Ref
No
184(43.6)
1.624(0.945-2.596)
0.0003**
I don’t know
91(21.60
1.024(0.524-2.016)
0.808
There evidence that perhaps eating garlic protect you against COVID-19
Yes
123(29.1)
Ref
No
194(46.0)
0.907(0.477-1.726)
0.767
I don’t know
105(24.9)
0.796(0.397-1.5976)
0.52
There effective medicine avail for treating COVID-19
Yes
106(26.1)
Ref
No
204(48.3)
2.16(1.596-3.485)
0.0076**
I don’t know
112(26.6)
0.998(0.488-2.041)
0.097
COVID-19 virus human made, and deliberately released
Yes
143(33.9)
Ref
No
189(44.8)
1.01(0.486-1.548)
0.064
I don’t know
90(21.3)
0.769(0.285-1.428)
0.976
I vaccinated why I use face mask, so the vaccine had no value against COVID-19 virus
Yes
264(62.6)
Ref
No
104(24.6)
4.738(2.272-9.978)
0.000**
I don’t know
54(12.8)
0.523(0.241-1.134)
0.101
Fear of side effects prevent you from taking vaccine for prevention of COVID-19 virus
Yes
235(55.7)
Ref
No
130(30.8)
3.422(1.448-8.096)
0.005**
I don’t know
57(13.5)
0.241(0.098-0.593)
0.001
Adequate trials about COVID-19 vaccine
Yes
59(14)
Ref
No
234(55.5)
7.041(3.692-13.375)
0.000**
I don’t know
129(30.6)
0.418(0.0731-1.008)
0.147
*P<0.05, **P<0.01.
Table 7: Logistic regression model for factors that hinder acceptance of COVID-19 vaccine among health care workers in Oromia regional state, Ethiopia (n=422).
Discussion
Coronavirus disease 2019 (COVID-19) pandemic was first reported in Wuhan city, china on December 31, 2019 and its socioeconomic and public health importance disease that cause a huge of economic losses, more than million death of people and affected a huge number of people in worldwide [16]. In public health, vaccination is one of the most important advances [17]. Scientists have been racing to develop and test new vaccines to protect against SARSFactors CoV-2 and the speed of scientific discovery related to COVID-19 is unprecedented [18].
The current study displayed that the eagerness to acceptance of COVID-19 vaccine among health care workers. The prevalence of vaccine acceptance was 178 (42.2%), which was higher than the study done in Democratic Republic of the Congo (28%), Somalia (36.8%), Ghana 39% [19-21]. In Oromia regional state, government, public health agencies, and private healthcare systems perhaps work together to provide accurate information about the vaccines to HCW. In addition, the prevalence was lower than the study conducted in France (77.6%), chine (72.4%), United States (80%), Russia (55%), Saudi Arabia (64.7%), Egypt (45.9%) [22-27]. This perhaps in Oromia regional state HCWs have been exposed to conspiracy theories such as the claims that novel coronavirus was deliberately created and COVID-19’s lethality for political gain. The acceptability of the COVID-19 vaccines in our study is approximately comparable to that of conducted in Hong Kong (40%) [28] had the intention to accepting the COVID-19 vaccine if available.
In our study, older HCWs were accept COVID-19 vaccines was similar to the study conducted in Democratic Republic of the Congo [19] which showed older HCWs accepted to get vaccinated. In addition older HCWs were accept COVID-19 vaccines was contrary to the study employed in Saudi Arabia [26] which showed younger people were willing to accept a vaccine. Because in our study older HCWs may be take COVID-19 vaccines than younger was due to the notion that older adults and people with serious comorbidities are particularly vulnerable to worse outcomes from COVID-19 can create considerable willing amongst the elderly.
The findings also revealed that female health care workers were more likely to accept the COVID-19 vaccines if available compared to males were same as the study done in Polish [29] study where an affirmative response was more from females. In addition, females were also more likely to accept a vaccine in our survey were, contrary to the study carried out in Nigeria, Ghana, Democratic Republic of the Congo [19,21,30] those showed the higher likelihood for male health care workers to accept COVID-19 vaccination has been attributed to increased risk perception of the disease in men compared to women. According to our survey female is most affected than men because they had more contact with patient than males and also women were more likely to had poor health status and others comorbidities.
The present study revealed that the majority (n=122, 28.9%) of the health care workers had neutral/no opinion to accept COVID-19 vaccine if government recommended it only which were contrary to the study conducted in Ghana [21] found that health care workers who had trust in the accuracy of the measures taken by the government in the fight against COVID-19 were more likely to accept COVID-19 vaccines if available. Also majority (n=178, 42.2%) of respondents take the vaccine if available free and if generally available (n=98, 23.3%). In our study the main source of information were TV which were consistent with the study carried out in Egypt [27] demonstrated that social media and TV media are the main source of knowledge for the participants.
Our study revealed that nurses (AOR: 2.17; 95% CI: 0.621-5.087; P=0.0094) and mid wives (AOR: 2.521; 95% CI: 2.497-8.24; P=0.0002) were more likely to accept the COVID-19 vaccines if available is contrary to the study employed in Ghana [21] which showed medical doctors were more likely to accept the COVID-19 vaccines if available compared to nurses and midwives. In our study nurse and midwives had more contact with patients/they also cleans the bed of patients because of that their willing to accept vaccine were escalated.
Our findings also showed that health care workers who had contact with COVID-19 patient were twice as likely to accept the vaccine (AOR: 1.93; 95% CI: 1.360-3.784; P=0.0001) than who hadn’t contact with COVID-19 patient were contrary in the study conducted in Ghana [21] which revealed that the HCWs whose relatives have not been diagnosed with COVID-19 were less likely to accept the COVID-19 vaccines if available compared to health care workers whose relatives have been diagnosed with COVID-19. In addition our survey showed that the health care workers who indicated that they had more serious medical condition were 3 times as likely to accept the vaccine (AOR: 2.61; 95% CI: 0.981-3.618; P=0.007) than who hadn’t were similar to the study conducted in Egypt [27] which were revealed the presence of comorbidities or chronic diseases were the main factors related to COVID-19 acceptance.
The study also revealed that concerns about the safety of vaccines (AOR: 7.041; 95% CI: 3.692-13.375; P=0.000) and unwanted side effects of the vaccine (AOR: 3.422; 95% CI: 1.448-8.096; P=0.005) were the main reasons why health care workers were unwilling to accept the COVID-19 vaccines were consistent with the study employed in Ghana [21] revealed that the safety of vaccines and unwanted side effects of the vaccine were the main reasons why health care workers were unwilling to accept the COVID-19 vaccines.
Conclusion and Recommendations
It is concluded from this study, eagerness to acceptance of covid-19 vaccine among health care workers in oromia regional state was somewhat low. Nurses and Midwives were more likely to accept the COVID-19 vaccines than others HCWs. Health care workers who had contact with COVID-19 patient were more likely to accept the vaccine than who hadn’t contact with COVID-19 patient. Fear of side effects and wearing face mask after vaccination were more likely to hinder acceptance of COVID-19 vaccine. Oromia regional state should have to take promote vaccination of COVID-19 among health care workers by providing to them adequate training.
Acknowledgement
We would like to express special admiration to our respondents for their response which encouraged us to accomplish our research.
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