Predictors of COVID-19 Vaccine Acceptability Among Health Professions Students in Vietnam

Abstract

Background: The COVID-19 vaccine hesitancy or refusal has actually been a threat to global health. In the current situation, health profession students are at risk for SARS-CoV-2 infection during their internship at healthcare facilities. Furthermore, those future healthcare workers will advise people to accept the COVID-19 vaccination. Therefore, the attitude of students towards vaccine acceptance and the predicting factors needs to be elucidated. This study applied the Health Belief Model to determine predictors of COVID-19 vaccine acceptability among health professions students. Methods: 911 students participated in a cross‐sectional online survey in Vietnam. Multinomial logistic regression model determined predictors of the COVID-19 vaccine acceptability. Results: The overall vaccine acceptance, hesitancy, and refusal rates were 58% (95% CI: 54.7% - 61.3%), 40.4% (95% CI: 37.2% - 43.7%) and 1.5% (95% CI: 0.8% - 2.6%), respectively. Regarding vaccination hesitancy, a predictor such as "Receiving recent flu shots” had a negative correlation, whereas "Vaccines haves little efficacy & serious adverse effects” (Perceived barriers), nationality, and majors were positive correlates. For refusal, "Unvaccinated students feasibly infected COVID-19 during hospital internship” (Perceived susceptibility) was a negative correlate. For both hesitancy and refusal, "Mass media appreciating effectiveness and safety of vaccines" (Cues to action), and " Health professions students get serious complications of COVID-19 if not vaccinated" (Perceived severity) had a negative correlation. In contrast, "Manufacturers do not disclose adverse effects of vaccines" (Cues to action), and "Adverse effect causes death" (Perceived barrier) were positive correlates. Strong Health Belief Model predictors of vaccine refusal were "Manufacturers do not disclose adverse effects of vaccines" (Cues to action) (OR= 5.299, 95% CI: 1.687-16.641, p= 0.004), and "Adverse effect causes death" (Perceived barrier) (OR= 10.255, 95% CI = 3.528-29.814, p= 0.0005). Conclusion: Perceived susceptibility to and severity of COVID-19 might lead to vaccination acceptance among students. However, concerns of vaccine effectiveness and safety may still affect the choice of refusal or hesitancy in vaccination. Health information from mass media and transparency of vaccine effectiveness and safety could improve COVID-19 vaccine acceptance.

Determining the Prevalence and Correlates of COVID-19 Booster Vaccine Hesitancy in the Singapore Population Following the Completion of the Primary Vaccination Series

“…In tandem with reinforcing the benefits of vaccination, it is also important to continue addressing concerns (if any) about the “maleficence” of vaccination to foster favourable risk-benefit evaluations [ 18 , 71 ]. Several studies have shown that vaccine safety is one of the key factors associated with vaccine hesitancy [ 69 , 72 , 73 , 74 , 75 , 76 , 77 , 78 ]. Issues concerning quality control (e.g., rapid development and approval of COVID-19 vaccines) and side effects were among the most commonly cited safety concerns that have contributed towards COVID-19 vaccine hesitancy [ 76 ].…”

The Health Belief Model Applied to COVID-19 Vaccine Hesitancy: A Systematic Review

“…Perceived benefits was inversely associated with COVID-19 vaccine hesitancy in twelve studies [6,[11][12][13][15][16][17][18]20,22,23]. A positive association between perceived barriers and vaccine hesitancy was reported by twelve studies [6,[11][12][13][15][16][17][18][19][20]22,24]. Perceived susceptibility was negatively correlated with COVID-19 vaccine hesitancy in eight studies [10,12,14,[16][17][18]20,23]; however, Chen et al [11] reported a positive correlation between perceived susceptibility and vaccine hesitancy.…”

“…Other HBM components that are inversely related were cues to action in nine studies [6,10,11,16,17,19,21,22,24], perceived severity in six studies [14,16,17,19,23,24], and selfefficacy in one study [11]. Griva et al [13] and Guillon and Kergall [6] found a negative effect of perceived threat (i.e., a combined measure of perceived susceptibility and severity) on vaccine hesitancy.…”

“…Lack of awareness regarding their eligibility for COVID-19 vaccination (+) Lack of trust in government agencies (+) Le et al [19] × (−)…”

“…Other significant modifying variables that directly influenced vaccine hesitancy were knowledge of disease or COVID-19 [10,12,15,17], prior diagnosis of COVID-19, history of flu vaccination [6,14,[19][20]22], religion [15], political leaning [22], and nationality [19]. Individuals who more often were vaccinated when recommended by healthcare workers are less likely to be vaccine-hesitant [6].…”