Eagerness to Acceptance of Covid-19 Vaccine among Health Care Workers in Oromia Regional State, Ethiopia. An Online Based Cross-Sectional Study, 2021

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: gudisabareda95@gmail.com

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).