DOI: https://doi.org/10.21203/rs.3.rs-1838167/v1
Background:
Herd immunity is necessary to contain the coronavirus disease 2019 (COVID-19) pandemic. vaccination is the fastest and safest pandemic exit strategy. Healthcare workers (HCWs) are essential in providing vaccination information and recommendations to patients and the general population. The aim of this study was to assess intent to be vaccinated against COVID-19 among HCWs in Egypt and to determine the factors that may influence their decision to delay or refuse to receive the vaccine.
Methods:
A questionnaire based cross-sectional study was conducted among HCWs who care for patients in several hospitals in Delta region, Egypt. The questionnaire included sociodemographic, clinical, and occupational data, intention to receive COVID-19 vaccine, beliefs and attitudes towards COVID-19 infection and vaccination in addition to status of COVID-19 vaccination.
Results:
The study included 455 HCWs with mean age of 36.55 years (SD=10.31) and 80% were females. The acceptance rate for the COVID-19 vaccine was 70.5%, while hesitancy and resistancy were both 17.6% and 11.9% respectively. About one third (33.4%) of the subjects had previously contracted COVID-19. Most participants believed that they had a higher risk of contracting COVID-19 (71.6 %). More than 64% believed they were at risk for vaccination side effects. Fear of infection, being at high risk of infection, and the desire to resume normal life were the main drivers for COVID-19 vaccination, while the major barriers to the COVID-19 vaccination were waiting for additional experience with these new vaccines and having doubts about the vaccines' efficacy. About 39% of the participants have received the COVID-19 vaccine.
Conclusions:
The acceptance of the COVID-19 vaccination among HCWs is very high. This crucial group needs to be the focus of educational initiatives and campaigns designed to increase public awareness of the safety and effectiveness of COVID-19 vaccinations.
Globally, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused 2019 coronavirus disease (COVID-19) pandemic poses a serious threat [1], instigating a pandemic affecting more than 185 countries [2].The pandemic has crippled global economic activity, overloaded hospital systems, and induced panic among the general population [3].
Vaccination is one of the most important public health measures to stop the spread of certain infectious diseases and to lower their mortality rate [4]. According to the World Health Organization (WHO), vaccines prevented at least 10 million deaths between 2010 and 2015 [5]. To stop the COVID-19 pandemic, high vaccination rates are needed worldwide [6]. Since the emergence of this new corona virus, numerous organizations around the globe have conducted substantial research in an effort to create a vaccine that will protect people from this deadly new virus in a safe and efficient manner [7] .
Globally, worries about vaccine hesitancy are rising, particularly in populous nations with poor literacy rates. The definition of vaccine hesitancy is "delay in accepting or refusing vaccinations notwithstanding the availability of vaccination services"[8].
Healthcare workers (HCWs) play a critical role in offering advice and recommendations to patients and the larger community about vaccination, including accurate information about the risks and advantages of the vaccine [9]. A Values Framework for the Allocation and Prioritization of COVID-19 Vaccination was released in September 2020 and recommends that governments give priority to HCWs, older people, and those with chronic diseases for them to receive the first doses of an approved COVID-19 vaccine [10] .
Among the most trusted sources of information about vaccines and vaccination for the general public are the HCWs [11]. But not all HCWs enthusiastically accept or advocate COVID-19 vaccinations. To enhance vaccination uptake, HCWs must be targeted with supportive communication [11] .However, there is little information about the beliefs and attitudes of Egyptian HCWs towards COVID-19 vaccination.
Thus, the aim of this study was to assess intent to be vaccinated against COVID-19 among health care workers in Egypt and to determine the factors that may influence their decision to delay or refuse to receive the vaccine.
This questionnaire based cross-sectional study was conducted in the duration from August to September 2021. The main population of interest was HCWs who care for patients in several hospitals in Delta region, Egypt. Anyone involved in the delivery of healthcare services, including those who interact directly with patients and those who do not, was generically referred to as a HCW. Thus, a variety of healthcare positions were included by this term such as physicians, pharmacists, radiology, and laboratory technicians ...etc. The study was approved by the institutional review board of Mansoura University (Approval No: R.21.08.1398.R1) and was consistent with declaration of Helsinki 1995. All participants received comprehensive information regarding the study, and their written informed consent was obtained.
Healthcare staff employed by the hospitals were asked to participate in the study. Data were gathered using convenience sampling. The appropriate sample size was determined using the RaoSoft® online sample size calculator. We assumed the population size (current HCWs in Egypt) to be 375 thousand as provided by the most recent report of The Central Agency for Public Mobilization and Statistics (CAPMAS) [12].Based on 50% predicted response, 5% margin of error and 80% degree of precision 95% confidence level, the minimum sample size was 385 participants.
The questionnaire was written in English and a bilingual study author translated it into Arabic. Following editing and review, five medical staff members examined the questionnaire design, content, wording, and simplicity of completion as part of a pilot study that validated the questionnaire. The questions were designed to be as simple and closed-ended as feasible except for the assessment of opinions towards conventional vaccines.
Interviews served as the basis for the study. It was intended to be completed in between five and ten minutes. Early in the day, the interviewer visited the hospitals and spoke with as much HCWs as possible. All healthcare staff who volunteered to participate were interviewed during the interviewer's visits to the hospitals. Face-to-face structured interviews were conducted by a single interviewer with each participant. Participants' anonymity and secrecy were guaranteed by not requesting any personal information.
To adapt the questionnaire to the setting of our study, we included the significant items that were found based on previous literature findings [13–18]. The variables evaluated include:
The data collected included gender, age, marital status, residence, smoking habit, socioeconomic status, and associated comorbidities.
The participants were inquired about their occupation and occupation settings whether offices, laboratories, inpatient wards, intensive care units or others. Information about dealing with patients or interacting with them was also recorded along with the frequency of contact with COVID-19 patients in the workplace.
Information was collected related to history and severity of COVID-19 infection among participants and their household or close friends.
Multiple questions about the perception of COVID-19 infection were also included. To determine the beliefs and attitudes towards conventional vaccination, the participants were asked to score their perception of efficacy, security, usefulness, and estimated knowledge of conventional vaccination in general where 0 was the lowest score and 10 was the highest score ([19].
Additionally, 11 questions about attitudes and convictions regarding the COVID-19 vaccination were included. Eight knowledge-based questions (marked as K for Knowledge, K1-K8: "Yes = 1" vs. "No = 0," score range: 0 to 8), designed to measure participants' knowledge score about the COVID-19 vaccine, were included. The participants' scores indicated how well-versed they were [20]. Also, participants were questioned about their sources of information about COVID-19 vaccine.
Then, the participants were divided into three groups according to the answer to COVID-19 vaccine intention question. The group who answered “Yes, absolutely” or “Yes, probably” was considered as vaccine acceptant group (VA). Those who answered “No, probably not” or “I do not know” were considered as vaccine hesitant group (VH). Participants were considered as vaccine resistant (VR) when their answers were “No, certainly not” or “No, probably not”. Questions about COVID-19 barriers and motivators were also included.
Finally, COVID-19 vaccination status was questioned, and vaccinated participants were asked about the received vaccine type and side effects including allergy, fever, rash, rigors, bone aches, fatigue, headache, GIT upset and chest symptoms.
The responses of participants were documented and conveyed to excel spread sheets. Statistical Package for Social Science (SPSS) version 22 was used to analyze the gathered data. Quantitative data were presented as means with standard deviation (SD) for parametric variables or medians (min-max) for nonparametric variables, and qualitative data were given as numbers and percentages. Shapiro-Wilk test was employed to evaluate the normality of the distribution of variables. One-way ANOVA test was used for parametric variables to compare between the study groups, whereas Kruskal-Wallis test was utilized for non-parametric variables. Comparing qualitative variables was done using the Chi-square test. Significant was defined as a P value of less than 0.05.
This study was conducted on 455 HCWs, their mean age was 36.55 years (SD=10.31). More than 80% of the participants were females. About half of them (50.1%) were from rural origin. Fifty-two were hypertensive (11.4%) and 44 were diabetic (9.7%). Other sociodemographic and clinical data of the participants are illustrated in table 1.
Participants were classified according to intention to receive COVID-19 vaccine into 3 groups: the largest group was VA group (321,70.5%), followed by VH (80,17.6%) then VR group (54,11.9%) (figure 1).
Occupational data are shown in table 2. The participants included nurses (37.8%), physicians (25.9%), administrators (10.1%), workers or security officers (5.3%), radiology or laboratory technicians (4.4%), pharmacists (2.2%) and dentist (1.3%). About one third (31.6%) were working in outpatient, radiology, and hemodialysis units while 27.5% were working in inpatient wards, ambulance, emergency, Operation and delivery rooms. Most of the participants (80%) were working in patient-facing areas. The frequency of contact with COVID-19 patients in the workplace was reported to be daily by 211 participants (46.4%), weekly by 83 (18.2) and monthly by 65 (14.3%).
As shown in table 3, about two thirds (63.3%) of the participants reported COVID-19 infection among their household or close friends. Additionally, 30.8 % and 21.5 % of our cohort, respectively, reported relative hospitalization or mortality due to COVID-19 infection. About one third (33.4%) of the subjects had previously contracted COVID-19, with symptoms lasting an average of six days. In terms of the COVID-19 infection course in previously infected individuals, 32.2% had a mild infection that did not require hospitalization or interfere with daily activities, 63.2% had a more complicated disease in the form of a prolonged disease course that did interfere with daily activities, and 4.6 % had severe symptoms necessitating hospitalization. There was no ICU admission reported by any of the participants.
Most participants believed that they had a higher risk of contracting COVID-19 (71.6 %). More than 64% thought that they were at risk for vaccination side effects, and the percentage of this perception was significantly higher in vaccine resistant group (88.9%). Regarding perceptions of efficacy, security, utility, and estimated knowledge of conventional vaccines, there was a statistically significant difference between the VA, VH, and VR groups. Additionally, the Knowledge score in the VA group was significantly higher than other groups (p=0.001). Other beliefs and attitudes towards COVID-19 vaccination were illustrated in table 4.
The sources of information about the COVID-19 vaccination are displayed in figure 2. Physicians were reported to be primary source of COVID-19 vaccine information in about half of the participants (49%) followed by social media for young participants (<45 years) and television for others (≥45 years).
Fear of infection, being at high risk of infection, and the desire to resume normal life were the main drivers for COVID-19 vaccination in the VA group as shown in figure 3. On the other hand, the major barriers to the COVID-19 vaccination in the VR group were waiting for additional experience with these new vaccines and having doubts about the vaccines' efficacy as illustrated in figure 4. The most significant factors that could influence the decision of the VH group are illustrated in figure 5.
Among participants, 179 (39.3%) had received COVID-19 vaccine. Astrzeneca (53.1%) and Sinopharm (20.7%) were the two most frequently received vaccines. The two most frequently reported vaccination adverse effects were fever (45.3%) and body aches (55.3%). However, as demonstrated in table 5, the least common side effects were rash (3.4%) and anaphylaxis (1.1%)
The COVID-19 vaccination is one of the most crucial strategies for containing the COVID-19 pandemic. HCWs are more likely to contract COVID-19 than the general population, so their attitude toward the vaccination is crucial since it can determine how well the general population responds to it [21].
The aim of this study was to assess Egyptian HCWs' attitudes toward the COVID-19 vaccine. The 455 HCWs who participated in this study were divided into three groups—VA, VH, and VR—based on their attitude toward COVID-19 vaccine. Most of participants were vaccine accepting (70.5%). Of the participants, one-third had previously contracted COVID-19, and the majority of them had prolonged disease course. The majority of participants believed that they were at high risk for both COVID-19 infection and vaccination side effects. There was a statistically significant difference between the VA, VH, and VR groups regarding perception and knowledge of conventional and COVID-19 vaccines. Fear of infection and the desire to resume normal life were the main drivers behind the COVID-19 vaccination. The two major barriers, however, were waiting for additional expertise and having doubts about the effectiveness of the vaccines.
About one third (33.4%) of participants reported having previously contracted COVID-19, a rate that was comparable to that in a prior study also involving Egyptian HCWs [22]. Other studies done in nations with higher incomes found a much lower percentage of COVID-19 infection [23] [24]. In a different study on the general population, the percentage of people with a history of prior COVID-19 infection was around 20%, and there was no difference in this percentage between those in the medical and non-medical fields [25].
Most participants in this study were vaccine accepting (70.5%). This high rate of vaccine acceptance was comparable to the findings of earlier studies conducted on family physicians [26], primary care physicians [27], pediatricians [28], pharmacists [29], dentists [30], medical students [31] and HCWs [32] [33]. Additionally, a recent meta-analysis of ten studies on dental practitioners and students indicated that vaccine acceptability was higher in middle eastern nations [34].
The majority of individuals in other studies, however, were shown to be hesitant to receive COVID-19 vaccine [35] [36]. In a global study that was conducted in 12 countries, the majority of participants were in favor of vaccinations; nevertheless, Egypt and African nations had the lowest vaccination acceptance rates. Higher income countries showed greater vaccine adoption in the same study [37]. In another survey of nurses and midwives, the VR group was found to have the highest percentage (more than 90%), with participants worried about the vaccine's side effects and how rapidly development occurred [38]. Notably, vaccine acceptance in recent surveys was higher than earlier one. This may be ascribed to more recent and available studies, public vaccination campaigns, and political motivations.
Participants from urban areas were more vaccine accepting and these results were consistent with the finding reported by Biswas et al, in which, HCWs working at urban areas, were more vaccine accepting [39]. However, there was no difference as regard age, gender or working with COVID-19 patients in our cohort. In previous studies, it was observed that males and physicians were more accepting of vaccinations than females and nurses [40] [24] [41]. Because of this, physicians play a significant part in increasing public acceptability of the COVID-19 vaccine.
Previous exposure to COVID-19 infection is associated with higher vaccine acceptance (Malik, Malik, and Ishaq 2021) (Elhadi et al. 2021).However , there was no difference between VA, VH, VR groups in this study with relation to prior or family history of COVID-19 infection.
More acceptance of the vaccine was linked to stronger awareness of the COVID-19 vaccine and higher knowledge scores [36]. In the present study, there was a significant difference between the 3 groups as regard perception towards conventional and COVID-19 vaccination and knowledge score. These results were in line with previous studies, which showed a substantial difference between the VR, VH, and VA groups in terms of attitudes toward vaccination and perceptions of the safety of the COVID-19 vaccine [43] [35].
Physicians were reported to be primary source of information in about half of our participants (49%) followed by social media for young participants (<45 years) and television for others (≥45 years). It was found that higher education HCWs rely mainly on institutional sources and scientific literature, however, lower education HCWs rely on internet, mass media and opinions of family and friends [41]. Social and mass media are important sources of information [44].However, using social media as a source of information is associated with more vaccine hesitancy [45], while using national websites is associated with less hesitancy [35].
In this study, fear of infection, being at high risk of infection, and the desire to resume normal life were the main drivers for COVID-19 vaccination in the VA group. Similar causes were reported by previous studies conducted on family physicians and other HCWs [26] [32]
Concerns about safety and efficacy are also important barriers against vaccination [21] [31].In this study, the major barriers to the COVID-19 vaccination in the VR group were waiting for additional experience with these new vaccines and having doubts about the vaccines' efficacy. It was previously reported that the biggest obstacles to vaccination acceptability were the quick creation of the vaccine and a lack of adequate information [46] [44]. Additionally, a lack of clinical trials and concern about side effects are the main reasons why people are hesitant to obtain the vaccination. Providing this group with adequate factual information will boost their acceptance of the vaccine. [22].
Among participants, 179 (39.3%) had received COVID-19 vaccine. In certain studies, a lower vaccination rate was noted [21]. However, some research indicated a far greater rate [47] [48]. Astrzeneca (53.1%) and Sinopharm (20.7%) were the two most frequently received vaccines in our cohort. This was according to which was available for each participant. In general, m RNA vaccines are the most preferred vaccines [48]. Additionally,Pfizer and Astrazeneka vaccines are the most popular vaccination types in Arabic-speaking and African countries [49] [50] .
In conclusion, our results emphasize the value of including HCWs in pandemic vaccination campaigns. HCWs were very accepting of COVID-19 vaccines and played a crucial role in assisting patients in their vaccine decisions despite having expressed vaccine concerns. The community adopts these perceptions because of exposure to false information, which is magnified by the media. Recognizing and addressing issues at all levels is essential for increasing the reach of COVID-19 vaccination campaigns.
This study has many strengths. First, we performed a multicenter study including HCWs with various levels of education and employment experiences. Second, this study sheds essential light on the potential obstacles to and drivers behind vaccination among HCWs who an important source of human resources in vaccination are. Third, this study offers important information regarding the actual conversion of vaccine acceptance into vaccine uptake as well as adverse reactions following vaccination.
However, the study has several limitations. First, because the study was cross-sectional, it was challenging to evaluate the causes and effect relationships. Second, we employed convenience sampling, which could have biased the results. Third, some sites collected data before vaccination began, while others did so after it had begun, which may have an impact on HCWs' attitudes. Hence, as more information about the safety and efficacy of COVID-19 vaccines becomes available, individuals may have different attitudes towards vaccination.
CAPMAS: Central Agency for Public Mobilization and Statistics
COVID-19: coronavirus disease 2019
HCWs: healthcare workers
SARS-CoV-2: severe acute respiratory syndrome coronavirus 2
SPSS: Statistical Package for Social Science
Ethics approval and consent to participate
The work complies with the ethical standards of the 1995 Helsinki declaration and was approved by Institutional review board of Mansoura university (Approval No: R.21.08.1398.R1). All participants received comprehensive information regarding the study, and their written informed consent was obtained.
Consent for publication
Not applicable.
Availability of data and materials
The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.
Competing interests
All authors have no competing interests
Funding
This study did not receive any funding.
Authors' contributions
Conceptualization: ST, DKN, MKN, AMS, FH, Investigation: all authors, Data curation, formal analysis: ST, DKN, writing–original draft: MKN, AMS, FH, writing–review & editing: All authors.
Acknowledgements
The following collaborators are acknowledged by the authors for their contributions to data collection: Shimaa Mohamed Mohamed Saad (Kafr El Sheikh Faculty of Physical Therapy),Noor Abd Elghani Elsaeed Zayed ( Mansoura Faculty of Medicine) and Nada Mohammed Mohammed Abo Musallam ( Mansoura Faculty of Medicine)
Table 1. Sociodemographic and clinical data of the study health care workers according to their intention to get COVID-19 vaccine (n=455)
|
Variable n (%), mean ± SD |
Total (n =455) |
Vaccine Acceptant group (n =321) |
Vaccine Hesitant group (n =80) |
Vaccine Resistsnt group (n =54) |
P |
|
Gender Female Male |
367 (80.7) 88 (19.3) |
254 (79.1) 67 (20.9) |
68 (85) 12 (15) |
45 (83.3) 9 (16.7) |
0.428 |
|
Age, years 18-24 25-35 36-45 46-60 more than 60 |
36.55±10.31 51 (11.2) 182 (40) 132 (29) 86 (18.9) 4 (0.9) |
35.92±10.21 40 (12.5) 134 (41.7) 88 (27.4) 57 (17.8) 2 (0.6) |
37.09±10.19 7 (8.8) 32 (40) 25 (31.3) 15 (18.8) 1 (1.3) |
39.46±10.66 4 (7.4) 16 (29.6) 19 (35.2) 14 (25.9) 1 (1.9) |
0.057 0.539 |
|
Marital status Single/divorced/widowed Married |
128 (28.1) 327 (71.9) |
103 (32.1) 218 (67.9) |
19 (23.8) 61 (76.3) |
6 (11.1) 48 (88.9) |
0.004* |
|
Residence Rural Urban |
228 (50.1) 227 (49.9) |
148 (46.1) 173 (53.9) |
53 (66.3) 27 (33.8) |
27 (50) 27 (50) |
0.006* |
|
Smoking Never Former smoker Current smoker |
421 (92.5) 8 (1.8) 26 (5.7) |
296 (92.2) 5 (1.6) 20 (6.2) |
76 (95) 2 (2.5) 2 (2.5) |
49 (90.7) 1 (1.9) 4 (7.4) |
0.687 |
|
Active lifestyle |
360 (79.1) |
257 (80.1) |
57 (71.3) |
46 (85.2) |
0.112 |
|
Socioeconomic status Low Average High |
44 (9.7) 381 (83.7) 30 (6.6) |
26 (8.1) 274 (85.4) 21 (6.5) |
10 (12.5) 65 (81.3) 5 (6.3) |
8 (14.8) 42 (77.8) 4 (7.4) |
0.490 |
|
Comorbidities Diabetes Hypertension Chronic respiratory disease Psychiatric disorder Ischemic heart disease Autoimmune Disease Chronic renal disease Chronic liver disease Hypersensitivity Obesity Others |
44 (9.7) 52 (11.4) 9 (2) 7 (1.5) 5 (1.1) 4 (0.9) 3 (0.7) 5 (1.1) 67 (14.7) 29 (6.4) 20 (4.4) |
31 (9.7) 38 (11.8) 6 (1.9) 3 (0.9) 3 (0.9) 3 (0.9) 1 (0.3) 2 (0.6) 47 (14.6) 21 (6.5) 12 (3.7) |
8 (10) 7 (8.8) 2 (2.5) 3 (3.8) 0 1 (1.3) 2 (2.5) 2 (2.5) 11 (13.8) 5 (6.3) 3 (3.8) |
5 (9.3) 7 (13) 1 (1.9) 1 (1.9) 2 (3.7) 0 0 1 (1.9) 9 (16.7) 3 (5.6) 5 (9.3) |
0.990 0.689 0.934 0.184 0.114 0.735 0.078 0.302 0.894 0.962 0.178 |
*P<0.05
Table 2. Occupational data of the study health care workers (n=455)
|
Variable
|
Total (n =455) n (%) |
Vaccine Acceptant group (n =321) n (%) |
Vaccine Hesitant group (n =80) n (%) |
Vaccine Resistsnt group (n =54) n (%) |
P |
|
Occupation Physician Nurse Dentist Pharmacist Administrator Radiology or laboratory technician A worker or security officer others |
118 (25.9) 172 (37.8) 6 (1.3) 10 (2.2) 46 (10.1) 20 (4.4) 24 (5.3) 59 (13) |
102 (31.8) 105 (32.7) 6 (1.9) 6 (1.9) 38 (11.8) 16 (5.) 10 (3.1) 38 (11.8) |
13 (16.3) 39 (48.8) 0 3 (3.8) 4 (5) 3 (3.8) 9 (11.3) 9 (11.3) |
3 (5.6) 28 (51.9) 0 1 (1.9) 4 (7.4) 1 (1.9) 5 (9.3) 12 (22.2) |
<0.001* |
|
Occupation settings Offices Labs Patient facing non-clinical (community or hospital pharmacy) Outpatient, radiology, GP, hemodialysis unit Inpatient wards, ambulance, ER, Operation room, delivery room Intensive care Others |
45 (9.9) 29 (6.4) 12 (2.6) 144 (31.6) 125 (27.5) 22 (4.8) 78 (17.1) |
32 (10) 28 (8.7) 7 (2.2) 99 (30.8) 91 (28.3) 16 (5) 48 (15) |
11 (13.8) 0 4 (5) 29 (36.3) 21 (26.3) 3 (3.8) 12 (15) |
2 (3.7) 1 (1.9) 1 (1.9) 16 (29.6) 13 (24.1) 3 (5.6) 18 (33.3) |
0.012* |
|
Contact with patients or working in patient-facing areas |
364 (80) |
258 (80.4) |
63 (78.8) |
43 (79.6) |
0.945 |
|
Frequency of contact with COVID-19 patients in the workplace Never Daily Weekly Monthly |
96 (21.1) 211 (46.4) 83 (18.2) 65 (14.3) |
66 (20.6) 150 (46.7) 62 (19.3) 43 (13.4) |
17 (21.3) 33 (41.3) 12 (15) 18 (22.5) |
13 (24.1) 28 (51.9) 9 (16.7) 4 (7.4) |
0.272 |
*P<0.05
Table 3. Clinical data of COVID-19 infection reported by the study health care workers (n=455)
|
Variable n (%),median (min-max) |
Total (n =455)
|
Vaccine Acceptant group (n =321) |
Vaccine Hesitant group (n =80) |
Vaccine Hesitant group (n =54) |
P |
|
COVID-19 diagnosis among the household or close friends |
288 (63.3) |
208 (64.8) |
45 (56.3) |
35 (64.8) |
0.978 |
|
A relative has been hospitalized because of COVID-19 infection |
140 (30.8) |
105 (32.7) |
23 (28.8) |
12 (22.2) |
0.276 |
|
A relative died from COVID-19 infection |
98 (21.5) |
74 (23.1) |
13 (16.3) |
11 (20.4) |
0.406 |
|
Infected with COVID-19 |
152 (33.4) |
108 (33.6) |
25 (31.3) |
19 (35.2) |
0.751 |
|
Duration of symptoms, from the first day you became ill until symptoms resolved, days |
6 (1-45) |
6 (1-45) |
1 (1-21) |
12 (1-45) |
0.002* |
|
Course of COVID-19 infection Not hospitalized and no difficulties in performing daily activities Not hospitalized but had some difficulties in performing my daily activities Hospitalized and did not require ICU Hospitalized and required ICU care |
49/152(32.2)
96/152 (63.2)
7/152 (4.6) 0 |
39/108 (36.1)
67/108 (62)
2/108(1.9) 0 |
5/25 (20)
16/25 (64)
4/25 (16) 0 |
5/19 (26.3)
13/19 (68.4)
1/19 (5.3) 0 |
0.029* |
*P<0.05
Table 4. Perception, beliefs and attitudes of the study health care workers towards COVID-19 infection, conventional and COVID‐19 vaccination (n=455)
|
Statement n (%), median (min-max) |
Total (n =455) |
Vaccine Acceptant group (n =321) |
Vaccine Hesitant group (n =80) |
Vaccine Hesitant group (n =54) |
P |
|
COVID-19 infection
|
|
|
|
|
|
|
Do you think that you at higher risk of contracting COVID-19? Do you think that you may have more severe COVID-19 due to chronic illness? Do you think that you are at higher risk of COVID-19 vaccine adverse events |
326 (71.6)
261 (57.4)
295 (64.8) |
230 (71.7)
182 (56.7)
193 (60.1) |
54 (67.5)
44 (55)
54 (67.5) |
42 (77.8)
35 (64.8)
48 (88.9) |
0.485
0.469
0.000* |
|
Self-rated knowledge level about COVID-19 Very bad Bad Average Good Very good |
18 (4) 35 (7.7) 220 (48.4) 132 (29) 50 (11) |
11 (3.4) 15 (4.7) 156 (48.6) 100 (31.2) 39 (12.1) |
5 (6.3) 13 (16.3) 40 (50) 15 (18.8) 7 (8.8) |
2 (3.7) 7 (13) 24 (44.4) 17 (31.5) 4 (7.4) |
0.011* |
|
Conventional vaccination (excluding COVID-19 vaccines) |
|
|
|
|
|
|
Efficacy Security Usefulness Estimated knowledge |
6 (0-10) 6 (0-10) 8 (0-10) 7 (0-10) |
6 (0-10) 7 (0-10) 8 (0-10) 7 (0-10) |
5 (0-10) 5 (0-10) 5 (0-10) 5 (0-10) |
5 (0-10) 3 (0-10) 5 (0-10) 5 (0-10) |
0.001* 0.000* 0.000* 0.001* |
|
Knowledge score |
4 (0-8) |
4 (0-8) |
3 (0-6) |
3 (0-8) |
<0.001* |
|
COVID-19 vaccination |
|
|
|
|
|
|
How important do you perceive the COVID‐19 vaccine to be? |
354 (77.8) |
284 (88.5) |
43 (53.8) |
27 (50) |
<0.001* |
|
How important you think that everyone in the community should get the COVID‐19 vaccine once available? |
329 (72.3) |
274 (85.4) |
33 (41.3) |
22 (40.7) |
<0.001* |
|
Vaccination of COVID‐19 should always be compulsory once it is available |
247 (54.3) |
211 (65.7) |
26 (32.5) |
10 (18.5) |
<0.001* |
|
Do you have concerns regarding the COVID‐19 vaccination? |
312 (68.6) |
205 (63.9) |
59 (73.8) |
48 (88.9) |
<0.001* |
|
Vaccination of COVID‐19 should always be compulsory for health care workers once it is available |
311 (68.4) |
256 (79.8) |
37 (46.3) |
18 (33.3) |
<0.001* |
|
I think that approval of the vaccine guarantees its safety |
204 (44.8) |
173 (53.9) |
20 (25) |
11 (20.4) |
<0.001* |
|
Do you have concerns regarding the adverse effects of the vaccine |
316 (69.5) |
211 (65.7) |
60 (75) |
45 (83.3) |
.017* |
|
Do you have concerns about the ineffectiveness of the vaccine |
106 (23.3) |
77 (24) |
18 (22.5) |
11 (20.4) |
.830 |
|
Having a prior bad experience with any vaccines and their adverse reactions |
72 (15.8) |
34 (10.6) |
20 (25) |
18 (33.3) |
<0.001* |
|
Do you have concerns for the acquisition of COVID‐19 from the vaccine |
248 (54.5) |
148 (46.1) |
54 (67.5) |
46 (85.2) |
<0.001* |
|
Do you think that COVID-19 vaccination is the best protective method against COVID-19 infection |
261 (57.4) |
223 (69.5) |
23 (28.8) |
15 (27.8) |
<0.001* |
*P<0.05
Table 5. List of types and adverse effects of COVID-19 vaccines in the study health care workers who have received COVID-19 vaccine (n=179,39.3%)
|
Variables |
Vaccinated HCW (n=179) n (%) |
|
Type of COVID-19 vaccine received Astrazeneca Sinopharm Sinovac Pfizer Sputnik Johnson & Johnson's Janssen Covid-19 Vaccine |
95 (53.1) 37 (20.7) 28 (15.6) 14 (7.8) 4 (2.2) 1 (0.6) |
|
Adverse effects of COVID-19 vaccines Widespread muscle/joint pain Fever or chills Headache Local skin reaction Fatigue or sleepiness Chest pain – palpitations Nausea Poor appetite Vomiting Rash Anaphylaxis |
99 (55.3) 81 (45.3) 77 (43) 66 (36.9) 49 (27.4) 21 (11.7) 14 (7.8) 13 (7.3) 8 (4.5) 6 (3.4) 2 (1.1) |