City University of New York Graduate School of Public Health and Health Policy, New York, New York, United States of America.
CUNY Institute for Implementation Science in Population Health, New York, New York, United States of America.
PLoS One. 2022 Jun 9;17(6):e0269299. doi: 10.1371/journal.pone.0269299. eCollection 2022.
The second wave of the COVID-19 pandemic left the Indian healthcare system overwhelmed. The severity of a third wave will depend on the success of the vaccination drive; however, even with a safe and effective COVID-19 vaccine, hesitancy can be an obstacle to achieving high levels of coverage. Our study aims to estimate the population's acceptance of the COVID-19 vaccine in an Indian district. A pilot community-based cross-sectional study was conducted from March-May 2021. The data was collected from eight primary health centres in Tamil Nadu. The eligible study participants were interviewed using a self-constructed questionnaire. A total of 3,130 individuals responded to the survey. Multinomial logistic regression was performed to assess the factors influencing COVID-19 vaccine hesitancy and refusal. Results of our study showed that 46% percent (n = 1432) of the respondents would accept the COVID-19 vaccine if available. Acceptance for the COVID-19 vaccine was higher among males (54%), individuals aged 18-24years (62%), those with higher education (77%), having the higher income (73%), and employed (51%). Individuals with no education (OR: 2.799, 95% CI = 1.103-7.108), and low income (OR: OR: 10.299, 95% CI: 4.879-21.741), were significant predictors of vaccine hesitancy (p < 0.05). Living in urban residence (OR: 0.699, 95% CI = 0.55-0.888) and age between 18 to 25 years (OR: 0.549, 95% CI = 0.309-0.977) were protective factor of COVID-19 vaccine hesitancy. While individuals in the age group 25-54years (OR = 1.601, 95%CI = 1.086-2.359), fewer education (OR = 4.8, 95% CI = 2.448-9.412,), low income (OR = 2.628, 95% CI = 1.777-3.887) and unemployment (OR = 1.351, 95% CI = 1.06-1.722) had high odds of refusing the COVID-19 vaccine. Concerns and suspicions about the safety of the COVID-19 vaccine (63%) was the major reasons causing hesitancy towards the COVID-19 vaccine The public health authorities and government need to design, develop and implement targeted interventions to enhance awareness about COVID-19 vaccines, and barriers and enablers to vaccine acceptance among individuals across diverse settings. Emphasis on involving local and religious leaders, ASHA workers, community healthcare workers, Anganwadi workers, and auxiliary nurse midwives can help to overcome context-specific barriers in areas of low COVID-19 vaccine acceptance, especially in rural settings.
第二波 COVID-19 疫情使印度医疗体系不堪重负。第三波疫情的严重程度将取决于疫苗接种工作的成功与否；然而，即使 COVID-19 疫苗是安全有效的，犹豫也可能成为实现高覆盖率的障碍。我们的研究旨在评估印度一个地区的人群对 COVID-19 疫苗的接受程度。这是一项基于社区的试点横断面研究，于 2021 年 3 月至 5 月进行。数据来自泰米尔纳德邦的 8 个初级保健中心。符合条件的研究参与者使用自行设计的问卷进行访谈。共有 3130 人对调查做出了回应。使用多项逻辑回归来评估影响 COVID-19 疫苗犹豫和拒绝的因素。研究结果表明，如果疫苗可用，46%（n=1432）的受访者将接受 COVID-19 疫苗。男性（54%）、18-24 岁（62%）、受教育程度较高（77%）、收入较高（73%）和就业（51%）的人更愿意接种 COVID-19 疫苗。没有受过教育的人（OR：2.799，95%CI=1.103-7.108）和低收入者（OR：OR：10.299，95%CI：4.879-21.741）是疫苗犹豫的显著预测因素（p<0.05）。居住在城市（OR：0.699，95%CI=0.55-0.888）和 18-25 岁（OR：0.549，95%CI=0.309-0.977）是 COVID-19 疫苗犹豫的保护因素。而 25-54 岁年龄组的人（OR=1.601，95%CI=1.086-2.359）、受教育程度较低（OR=4.8，95%CI=2.448-9.412）、收入较低（OR=2.628，95%CI=1.777-3.887）和失业（OR=1.351，95%CI=1.06-1.722）的人拒绝 COVID-19 疫苗的几率更高。对 COVID-19 疫苗安全性的担忧和怀疑（63%）是导致对 COVID-19 疫苗犹豫不决的主要原因。公共卫生当局和政府需要设计、制定和实施有针对性的干预措施，以提高公众对 COVID-19 疫苗的认识，以及在不同环境下个人对疫苗的接受程度的障碍和促进因素。强调当地和宗教领袖、ASHA 工作者、社区卫生工作者、安加纳德工作者和辅助护士助产士的参与，可以帮助克服农村地区等 COVID-19 疫苗接受率低的地区的具体障碍。
