The purpose of this study was to assess the level of COVID-19 vaccine uptake and its determinant factors in Fitche Town. The authors found that the magnitude of COVID-19 vaccine uptake of at least one dose of any vaccine type among adult Fitche Town residents was 46.3% (95% CI; 42.3–50.2%). This finding is consistent with that of a study conducted in Somalia (48.6%; 95% CI = 46.3–51.7)(17). However, these findings are significantly lower than those of studies of health workers in Ethiopia (62.1%)(4), the USA (57%)(18), Hong Kong (67.8%)(19), France (69%)(20), Saudi Arabia (95%)(21) and the current global vaccinated population (62.1%)(22). This discrepancy could be attributed to differences in knowledge and attitudes across populations, such as the fact that they are not eligible for vaccination, greater access to information, and greater availability of resources in developed countries, as well as the late arrival of the vaccine in Ethiopia; these findings are also higher than those of studies conducted in the South Gondar Zone (18.7%; 95% CI; 15.6% − 21.7%) and Eastern Ethiopia (39.4%; 95% CI; 36-42.6%), even though the timing of these studies has increased when people fear vaccination (12, 23).
According to this study, occupation, ever-tested for COVID-19, friends or family members vaccinated for COVID-19, attitude towards COVID-19, perceived susceptibility, perceived benefit, and cue to action were significantly associated with COVID-19 vaccine uptake. Those ever tested for COVID-19 were tested two times more often for the COVID-19 vaccine than were their counterparts, which was in line with the findings of studies conducted in the Sodo Town Wolaita Zone in which respondents who had tested for COVID-19 were more likely to accept the vaccine than were those who had not tested for COVID-19 (24). However, inconsistent with the findings of a study conducted in Gondar, in which the likelihood of COVID-19 vaccine uptake by individuals who had been tested for COVID-19 was reduced by 31.3% compared to that of individuals who had never been tested for COVID-19 (23).
In this study, the majority of respondents (62.5%) reported that they would encourage their family and friends to get vaccinated for COVID-19, but this percentage was lower than that reported in a study conducted in Saudi Arabia, in which approximately 92% of respondents recommended that their family receive the COVID-19 vaccine(21). In line with these finding, friends or family members vaccinated for COVID-19 consumed the COVID-19 vaccine at least two times more often than did those who were not vaccinated; however, these findings are lower than those of studies conducted in Iran, in which the likelihood of receiving the vaccine among people who encouraged their families to receive the vaccine was seven times greater than that among people who were not vaccinated (25). This may be because they might have seen the suffering of their family members due to COVID-19 infection.
This study revealed that respondents who had a positive attitude were vaccinated at least two times more often than were those who had a negative attitude; this finding is lower than that of a study conducted in the South Gondar Zone, in which respondents who had a positive attitude were vaccinated eight times more often (95% CI = 4.23–15.03%) (23), possibly due to sociodemographic characteristics.
Regarding to the dimensions of the HBM, vaccine uptake may be related to respondents’ perceived susceptibility to COVID-19 which indicate the greater the perceived susceptibility, the higher the individual’s likelihood of getting the vaccine, which would mitigate the COVID-19 exposure, perceived benefits of the vaccine, and cues to action from opinion leader, media, family and friends, health professional and work place but not relate with perceived severity, barrier and self-efficacy which generally show that the perceived likelihood of preventing infection is a more consistent predictor of vaccine uptake than perceived likelihood of a severe infection and finding from this study show that those who were high perceived susceptible to COVID-19 vaccine about five times takes vaccine than who were low perceived susceptibility, which is higher than study conducted women in China (26)and this may be due defence in accessibility of health infrastructure.
Respondents who reported a benefit from the vaccine were five times more likely to be vaccinated than were those not yet vaccinated, which is in line with the findings of a study conducted in Israel, which showed that participants who reported a benefit from vaccines had five more uptakes. These findings showed that individuals who had clues to action had greater odds of taking part, which was consistent with the findings of previous studies (15). Another study in Bangladesh supports the results of this study, which showed that perceived benefits and clues to action were predictors of COVID-19 vaccine uptake(10). This work is supported by the WHO Technical Advisory Group on Behavioral Insights and Sciences for Health, meeting report, 15 October 2020, which stated that vaccination decision-making is influenced by people’s social networks, which include family members, friends, health professionals and others with whom they interact, as well as the sources of information they consult. Encouragement and social pressure from people whose individual respects and trusts have been found to increase vaccine uptake and decrease when a large proportion of people in one’s social network did not recommend vaccination (27).
The perception that COVID-19 infection has spread over is the major reason why participants do not take the COVID-19 vaccine (52.4%) or drop their respective dose (47.6%). Other reasons for dropping a second dose include complaints about side effects from the first dose, and some do not hear about the second dose, while my god protects me (25.6%) and can cause blood clotting (8.2%). However, respondents from other studies mentioned that the reasons for not being vaccinated were doubts about vaccine efficacy (43.1%) and fear of adverse effects (32.9%)(23).
Strengths and limitations of the study
Strength of the Study
The health belief model is a model that explains why people do not utilize certain health services and focuses on the general population. This study involved web-based surveys, which are limited by network service and mobile phone use and include only high-risk groups of people, such as health care workers, old age groups and chronic disease carriers.
Limitations of the study.
The study used a cross-sectional design and captured data at a single point in time, which limits the ability to establish causality or determine the temporal sequence of events.