COVID-19 vaccine hesitancy and confidence in the Philippines and Malaysia: A cross-sectional study of sociodemographic factors and digital health literacy

Abstract

With the emergence of the highly transmissible Omicron variant, large-scale vaccination coverage is crucial to the national and global pandemic response, especially in populous Southeast Asian countries such as the Philippines and Malaysia where new information is often received digitally. The main aims of this research were to determine levels of hesitancy and confidence in COVID-19 vaccines among general adults in the Philippines and Malaysia, and to identify individual, behavioural, or environmental predictors significantly associated with these outcomes. Data from an internet-based cross-sectional survey of 2558 participants from the Philippines (N = 1002) and Malaysia (N = 1556) were analysed. Results showed that Filipino (56.6%) participants exhibited higher COVID-19 hesitancy than Malaysians (22.9%; p < 0.001). However, there were no significant differences in ratings of confidence between Filipino (45.9%) and Malaysian (49.2%) participants (p = 0.105). Predictors associated with vaccine hesitancy among Filipino participants included women (OR, 1.50, 95% CI, 1.03–1.83; p = 0.030) and rural dwellers (OR, 1.44, 95% CI, 1.07–1.94; p = 0.016). Among Malaysian participants, vaccine hesitancy was associated with women (OR, 1.50, 95% CI, 1.14–1.99; p = 0.004), social media use (OR, 11.76, 95% CI, 5.71–24.19; p < 0.001), and online information-seeking behaviours (OR, 2.48, 95% CI, 1.72–3.58; p < 0.001). Predictors associated with vaccine confidence among Filipino participants included subjective social status (OR, 1.13, 95% CI, 1.54–1.22; p < 0.001), whereas vaccine confidence among Malaysian participants was associated with higher education (OR, 1.30, 95% CI, 1.03–1.66; p < 0.028) and negatively associated with rural dwellers (OR, 0.64, 95% CI, 0.47–0.87; p = 0.005) and online information-seeking behaviours (OR, 0.42, 95% CI, 0.31–0.57; p < 0.001). Efforts should focus on creating effective interventions to decrease vaccination hesitancy, increase confidence, and bolster the uptake of COVID-19 vaccination, particularly in light of the Dengvaxia crisis in the Philippines.

A psychometric assessment of a novel scale for evaluating vaccination attitudes amidst a major public health crisis

“…However, the sudden and unpredictable nature of such crises can lead to fluctuations in vaccine acceptance. This is attributed to asymmetrical information regarding vaccines, where initial misinformation or incomplete knowledge may foster misunderstandings and resistance towards vaccination, fueling panic and distrust 37 . Yet, as validation of vaccine safety increases, public acceptance gradually improves.…”

Understanding the factors associated with COVID-19 vaccine hesitancy in Venezuela

“…Despite these demographic findings, other studies have reported increased vaccination hesitancy among females, urban populations, and individuals with higher education. Therefore, health promotion efforts should be directed towards the general population to address these concerns [ 12 , 13 ].…”

Identifying Vaccine-hesitant Subgroups in the Western Pacific: A Latent Class Analysis

“…More than one hundred children died in the Philippines as a consequence of the Dengvaxia scandal, resulting from the inappropriate administration of vaccines against Dengue fever. 26, 27 Prior studies found that low-risk perception of COVID-19 and concerns over vaccine safety and side effects are highly in uential barriers for parents in vaccinating their children. [41][42][43] Furthermore, recent studies observed that social media information has a growing impact on the vaccination choices of mothers and women of childbearing age.…”

“…24,25 For example, in the Philippines, where more than a hundred children died from the side effects of a Sano Pasteur vaccine against Dengue fever, Dengvaxia, which was especially dangerous for children who had never been infected with Dengue, 26 vaccine hesitancy is likely to be strongly associated with parents and females. 27 As another example, widespread distrust in the central government exists in the society of Papua New Guinea (PNG), which consists of thousands of tribes commanded by big men or chiefs. 28 Under such circumstances, it is di cult to disseminate reliable information about COVID-19, and compliance with health recommendations from the government may be extremely low.…”