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      Perception and attitude towards COVID-19 vaccination: A preliminary online survey from India

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          Abstract

          Context:

          Coronavirus disease 2019 (COVID-19) has rapidly become a global pandemic taking more than 1.7 million lives. While many developed countries are starting their vaccination drive, India is not far behind but still not much is known about the willingness to get a vaccination in India.

          Aims:

          To find out the perception and attitude toward vaccination against COVID-19 among the adult population of India in order to know the proportion of people who are willing to get vaccinated against COVID-19.

          Method:

          A cross-sectional study was conducted between October 26, 2020 and November 10, 2020. Data were collected online using a self-administered and semi-structured questionnaire among adults aged 18 years or more in India via web-based links. The minimum sample size was calculated by considering the proportion of willingness to take the vaccination as 50%, 95% confidence interval, and 5% alpha error—the calculated sample size was 384. However, 467 participants completed the survey during the study period. Data were analyzed using SPSS version 21.

          Results:

          A total of 467 participants responded, out of which 329 (70.44%) showed a willingness to get vaccinated and 138 (29.55%) were hesitant to get vaccinated against COVID-19. Only 49.4% believed that people can be protected by the vaccine; 63.1% of the people were willing to get their children vaccinated; and 59.31% felt the vaccine should be free for all.

          Conclusions:

          The pan India survey conducted online revealed that approximately 3 in 10 adults were not willing to get vaccinated against COVID-19. This can guide policymakers to make multipronged efforts to increase the willingness to get a vaccination against COVID-19.

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          Most cited references16

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          Acceptability of a COVID-19 Vaccine among Adults in the United States: How Many People Would Get Vaccinated?

          Background Coronavirus disease 2019 (COVID-19) was declared a pandemic in March 2020. Several prophylactic vaccines against COVID-19 are currently in development, yet little is known about people’s acceptability of a COVID-19 vaccine. Methods We conducted an online survey of adults ages 18 and older in the United States (n=2,006) in May 2020. Multivariable relative risk regression identified correlates of participants’ willingness to get a COVID-19 vaccine (i.e., vaccine acceptability). Results Overall, 69% of participants were willing to get a COVID-19 vaccine. Participants were more likely to be willing to get vaccinated if they thought their healthcare provider would recommend vaccination (RR=1.73, 95% CI: 1.49–2.02) or if they were moderate (RR=1.09, 95% CI: 1.02–1.16) or liberal (RR=1.14, 95% CI: 1.07–1.22) in their political leaning. Participants were also more likely to be willing to get vaccinated if they reported higher levels of perceived likelihood getting a COVID-19 infection in the future (RR=1.05, 95% CI: 1.01–1.09), perceived severity of COVID-19 infection (RR=1.08, 95% CI: 1.04–1.11), or perceived effectiveness of a COVID-19 vaccine (RR=1.46, 95% CI: 1.40–1.52). Participants were less likely to be willing to get vaccinated if they were non-Latinx black (RR=0.81, 95% CI: 0.74–0.90) or reported a higher level of perceived potential vaccine harms (RR=0.95, 95% CI: 0.92–0.98). Conclusions Many adults are willing to get a COVID-19 vaccine, though acceptability should be monitored as vaccine development continues. Our findings can help guide future efforts to increase COVID-19 vaccine acceptability (and uptake if a vaccine becomes available).
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            Demographic and attitudinal determinants of protective behaviours during a pandemic: A review

            Purpose. A new strain of H1N1 influenza, also known as swine flu was confirmed in the UK in May 2009 and has spread to over 100 countries around the world causing the World Health Organization to declare a global flu pandemic. The primary objectives of this review are to identify the key demographic and attitudinal determinants of three types of protective behaviour during a pandemic: preventive, avoidant, and management of illness behaviours, in order to describe conceptual frameworks in which to better understand these behaviours and to inform future communications and interventions in the current outbreak of swine flu and subsequent influenza pandemics. Methods. Web of Science and PubMed databases were searched for references to papers on severe acute respiratory syndrome, avian influenza/flu, H5N1, swine influenza/flu, H1N1, and pandemics. Forward searching of the identified references was also carried out. In addition, references were gleaned from an expert panel of the Behaviour and Communications sub‐group of the UK Scientific Pandemic Influenza Advisory Group. Papers were included if they reported associations between demographic factors, attitudes, and a behavioural measure (reported, intended, or actual behaviour). Results. Twenty‐six papers were identified that met the study inclusion criteria. The studies were of variable quality and most lacked an explicit theoretical framework. Most were cross‐sectional in design and therefore not predictive over time. The research shows that there are demographic differences in behaviour: being older, female and more educated, or non‐White, is associated with a higher chance of adopting the behaviours. There is evidence that greater levels of perceived susceptibility to and perceived severity of the diseases and greater belief in the effectiveness of recommended behaviours to protect against the disease are important predictors of behaviour. There is also evidence that greater levels of state anxiety and greater trust in authorities are associated with behaviour. Conclusions. The findings from this review can be broadly explained by theories of health behaviour. However, theoretically driven prospective studies are required to further clarify the relationship between demographic factors, attitudes, and behaviour. The findings suggest that intervention studies and communication strategies should focus on particular demographic groups and on raising levels of perceived threat of the pandemic disease and belief in the effectiveness of measures designed to protect against it.
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              A future vaccination campaign against COVID-19 at risk of vaccine hesitancy and politicisation

              Just a few weeks ago, more than half of the world's population was on lockdown to limit the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Scientists are racing against time to provide a proven treatment. Beyond the current outbreak, in the longer term, the development of vaccines against SARS-CoV-2 and their global access are a priority to end the pandemic. 1 However, the success of this strategy relies on people's acceptability of immunisation: what if people do not want the shot? This question is not rhetorical; many experts have warned against a worldwide decline in public trust in immunisation and the rise of vaccine hesitancy during the past decade, especially in whole Europe and in France.2, 3 Early results from a survey done in late March in France suggests that this distrust is likely to become an issue when the vaccine will be made available. We did an online survey in a representative sample of the French population aged 18 years and older 10 days after the nationwide lockdown was introduced (March 27–29). We found that 26% of respondents stated that, if a vaccine against SARS-CoV-2 becomes available, they would not use it. It might come as a surprise given the situation a few weeks ago: the whole population was confined as the outbreak had not yet reached its peak, and media were flooded with daily death tolls and the saturation of intensive care wards. The social profile of reluctant responders is even more worrying: this attitude was more prevalent among low-income people (37%), who are generally more exposed to infectious diseases, 4 among young women (aged 18–35 years; 36%), who play a crucial role regarding childhood vaccination, 5 and among people aged older than 75 years (22%), who are probably at an increased risk for severe illness from COVID-19. Our data also suggest that the political views of respondents play an important part in their attitude. Participants' acceptation of a vaccine against SARS-CoV-2 strongly depended on their vote at the first round of the 2017 presidential election (figure ): those who had voted for a far left or far right candidate were much more likely to state that they would refuse the vaccine, as well as those who abtained from voting. Figure The French public's intention to refuse vaccination against COVID-19 according to their vote at the first round of the 2017 presidential election, March 27–29, COCONEL Survey (n=1012) These early results are not entirely surprising. When this dimension has been studied, researchers have often found a connection between political beliefs and attitudes to vaccines. 6 They highlight a crucial issue for public health interventions: how can we assure the public that recommendations reflect the state of scientific knowledge rather than political interests? This problem is exacerbated in times of crisis, during which there is considerable scientific uncertainty, available measures have a limited effect, and politicians—rather than experts—are the public face of crisis management. This is one of the lessons that can be drawn from the H1N1 influenza pandemic of 2009 in France. As the pandemic unfolded, the apparent national unity of the early phase broke apart. Criticism of the government's strategy was voiced by prominent members of nearly all of the opposition parties. 7 A public debate around the safety of the vaccine arose, with prominent politicians and activists claiming that it had been produced too hastily and not been tested enough. This was crucial in the failure of the vaccination campaign (only 8% of the population was vaccinated). 8 It also ushered in an era of perpetual debate over vaccination in France. 9 One of the crucial mistakes made at the time by French authorities was to refuse to communicate early on the measures taken to ensure the safety of the vaccine for fear that the mere evocation of risk might provoke irrational reactions. 10 This approach let critics set the agenda on this issue, condemning public authorities to a defensive position. Public authorities are setting up fast-track approval processes for a putative vaccine against SARS-CoV-2. 9 It is crucial to communicate early and transparently on these processes to avoid vaccines becoming part of political debates.
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                Author and article information

                Journal
                J Family Med Prim Care
                J Family Med Prim Care
                JFMPC
                Journal of Family Medicine and Primary Care
                Wolters Kluwer - Medknow (India )
                2249-4863
                2278-7135
                August 2021
                27 August 2021
                : 10
                : 8
                : 3116-3121
                Affiliations
                [1 ] Department of Community Medicine, Vardhman Mahavir Medical College (VMMC) and Safdarjung Hospital, New Delhi, India
                [2 ] Additional Medical Superintendent, Vardhman Mahavir Medical College (VMMC) and Safdarjung Hospital, New Delhi, India
                Author notes
                Address for correspondence: Dr. Venkatesh U, Department of Community Medicine, Room No. 429, 4 th Floor, College Building, Vardhman Mahavir Medical College (VMMC) and Safdarjung Hospital, New Delhi, India. E-mail: venkatesh2007mbbs@ 123456gmail.com
                Article
                JFMPC-10-3116
                10.4103/jfmpc.jfmpc_2530_20
                8483144
                eec24a36-b51c-4999-bda8-c2580285b35b
                Copyright: © 2021 Journal of Family Medicine and Primary Care

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 23 December 2020
                : 23 February 2021
                : 26 May 2021
                Categories
                Original Article

                covid-19 vaccination,covid-19,india,sars-cov-2 vaccine,vaccine hesitancy

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