A survey-based study by ICMR was held between July and September 2022 involving 600 adult participants
A small survey-based study held between July and September 2022 involving 600 adult participants from two blocks in Gorakhpur district in Uttar Pradesh has found that COVID-19 vaccine hesitancy among the participants was around 12%. This included those participants who were not vaccinated or had only received only one dose of the COVID-19 vaccine during the period of study; the study did not include those who were fully vaccinated. Of the 600 participants, 524 (87.3%) had taken only one dose of the COVID-19 vaccine, while the remaining 76 respondents (12.7%) did not get vaccinated at the time the survey was conducted. By the end of September 2022, while 900 million people were fully vaccinated with two doses, nearly one-fourth of the total population were not vaccinated with even one dose. The study was conducted by ICMR institutes and published on May 9 this year in the journal PLOS ONE.
The authors used three public health behaviour models — Health belief model (HBM), Theory of planned behaviour (TPB), and 5C Psychological antecedents of vaccination — and employed regression models to assess the level of vaccine hesitancy and predictive health behaviour of the respondents.
The two blocks selected for the study were Charganwa, which represented the highest vaccination coverage area among the five blocks in Gorakhpur district, and Bhathat block, which had the lowest coverage area for the COVID-19 vaccination. This low vaccination coverage was “more prominent” among the rural households, while the urban households reported high vaccination coverage.
While only 9% of the participants who had taken only one dose of the vaccine were hesitant about the COVID-19 vaccines available at the time, vaccine hesitancy was the main reason why nearly 33% of people did not take even one dose and remained completely unvaccinated. The study also found that vaccine hesitancy was comparatively higher among people older than 65 years (27.3%), men (13.2%), people who were married (12.5%), those low levels of education — below primary level (21.2%), and those with no education (18%), and finally those employed in the formal sector (27.2%). Also, people belonging to the general caste (21.2%) and those with older family members (16.1%) exhibited higher vaccine hesitancy. The most surprising finding of the study was that at nearly 16% and 14.2%, participants who regularly consumed alcohol and tobacco in any form, respectively had higher vaccine hesitancy than their counterparts.
The study found that vaccine hesitancy was less when people received information about vaccines from family members, friends, relatives, and health workers, whereas mass media and social media being the source of information led to higher vaccine hesitancy. “The findings confirmed the menace of fake news and misinformation created by social media and mass media,” they write. Being misinformed or taken in by fake news might be one reason why 61% of the participants believed that COVID-19 vaccination could lead to SARS-CoV-2 infection.
Another important finding of the study was that 351 participants (63.5%) were afraid of the side effects of the vaccine, with 300 participants (85.5%) being scared of the primary side effects. If vaccine hesitancy due to fear of “primary side effects” was 6.3%, it was nearly 26% in the case of serious side effects. Vaccine hesitancy was higher among those who did not know about the effectiveness of the vaccine and were either suffering from some chronic ailments. The study also found a link between vaccine hesitancy and the practice of COVID-19 prevention strategies. For instance, vaccine hesitancy was higher among people who did not regularly practice handwashing behaviour (32.1%), did not wear a mask in public or when surrounded by people (28.7%), and avoided crowds (27.9%).
The study found that vaccine hesitancy was almost three-fourths less among those who either agreed or strongly agreed about the perceived benefits of the COVID-19 vaccine. “It shows that awareness of the perceived benefits of the vaccination would reduce the level of vaccine hesitancy. These individuals believed that after getting the vaccine, the risk of getting the COVID-19 infection would be low, with a lesser risk of severity. The results support previous studies that emphasised awareness campaigns among individuals was beneficial,” the authors write.
“From the future policy perspective, this study suggests that addressing the issue of ‘negative attitudes towards the vaccine’ and increasing the trust or confidence for the vaccine through increasing awareness about the benefits of the vaccination in India may reduce vaccine hesitancy,” they write. “It would be beneficial for the government to consider taking proactive measures to launch mass awareness campaigns at various levels, including individuals, locals, and communities, to address vaccine hesitancy.”
