Predictors of COVID-19 Vaccine Confidence: Findings from Slums of Four Major Metro Cities of India

Abstract

There are limited studies on COVID vaccine confidence at the household level in urban slums, which are at high risk of COVID-19 transmission due to overcrowding and poor living conditions. The objective was to understand the reasons influencing COVID-19 vaccine confidence, in terms of barriers and enablers faced by communities in urban slums and informal settlements in four major metro cities in India. A mixed method approach was adopted, where in field studies were conducted during April–May 2021. First, a survey of at least 50 subjects was conducted among residents of informal urban settlements who had not taken any dose of the COVID-19 vaccine in Mumbai, Bengaluru, Kolkata and Delhi; second, a short interview with five subjects who had taken at least one dose of the vaccine in each of the four cities to understand the factors that contributed to positive behaviour and, finally, an in-depth interview of at least 3 key informants in each city to ascertain the vaccination pattern in the communities. The reasons were grouped under contextual, individual/group and vaccine/vaccination specific issues. The most frequent reason (27.7%) was the uncertainty of getting the vaccine. The findings show the need for increasing effectiveness of awareness campaigns, accessibility and the convenience of vaccination, especially among vulnerable groups, to increase the uptake.

Facilitators and barriers to COVID-19 vaccine uptake among women in two regions of Ghana: A qualitative study

“…It, consequently, resulted in long wait times in queues. Consistent with our finding, the uncertainty of not getting vaccinated and the nature of the registration process have been reported among women and older people as barriers against COVID-19 vaccination [54].…”

“…From the narratives, there were misconceptions that COVID-19 vaccines were demonic/satanic, could cause infertility in both men and women and it is meant to kill Africans, including Ghanaians. Tamysetty et al’s [ 54 ] study in India reported similar misconceptions, including the belief that the COVID-19 vaccine could increase the risk of death and decrease a woman’s ability to conceive children. Studies have also documented that some Christians associate the COVID-19 vaccine with the mark of the beast/666 [ 55 , 56 ].…”

Psychological determinants of COVID-19 vaccine acceptance among urban slum dwellers of Bangladesh

“…A similar finding was observed among migrants, another vulnerable population in Shanghai, China, where three in fourth respondents showed higher confidence levels in vaccine safety and effectiveness (48). In contrast, some constraints might be responsible for lessening the vaccine uptake, such as family dynamics and gender, geographical and technological barriers, and socioeconomic reasons (49). The respondents had a high level of calculation of information regarding the effectiveness and more details about the vaccine.…”

COVID-19 pandemic

“…COVID-19 pandemic showed challenges and barriers to vaccinating communities even in urban areas. Role of community-based organizations and groups is invaluable in conveying appropriate messages to the general public 31 .…”