Understanding COVID-19 vaccine hesitancy in Pakistan: The paradigm of Confidence, Convenience, and Complacency; A Cross-sectional study

Abstract

Background and objectives: Vaccine hesitancy is a big obstacle for vaccination programs, as is anticipated for the COVID-19 vaccination program, resulting in low uptake of vaccines thereby hindering the process of reaching herd immunity. Bearing this in mind the current study was aimed to explore the determinants of vaccine hesitancy amongst the Pakistani population. Methodology: A cross-sectional study was carried out from the 23rd-31st January 2021. The conceptual framework of the study was based on the 3Cs (Confidence, Convenience, Complacency) model. Google-forms-based questionnaire was disseminated amongst the general population. Data collected were entered into SPSS version 26 and analyzed. Results: Of the 421 participants, 68.4% were females. Non-healthcare workers were 55.8% of respondents. Vaccine hesitant individuals, 26.13% reported they were very unlikely to get vaccinated. Vaccine was not safe as it came out too fast was agreed upon by 12.6% individuals, 50.6% were worried about experiencing side-effects, 18% believed vaccine will not offer protection and 5.9% believed vaccine would cause death. Low Practice of SOP in non-Healthcare workers was the strongest contributor to vaccine hesitancy (OR: 5.338, p=0.040, 95% CI: 1.082-26.330) followed by High complacency (p=0.026) and Moderate Complacency (OR: 0.212, p=0.007, 95% CI: 0.069-0.654) towards COVID-19 vaccination. In Healthcare workers the strongest contributor to vaccine hesitancy was having a Moderate Confidence (OR: 0.323, p=0.042, 95% CI: 0.109-0.958) in the vaccine followed by Moderate Convenience (OR: 0.304, p=0.049, 95% CI: 0.093-0.993) for vaccination Conclusion: Campaigning and communication strategies to reaffirm confidence in the COVID-19 vaccine and educating the general population about the vaccine could lead to increased perception of vaccine safety and effectiveness thereby restoring confidence in vaccine and decreasing vaccine hesitancy. Likewise, working to increase vaccine convenience and decreasing complacency towards the COVID-19 vaccine would translate into high vaccine uptake.

Factors Influencing Decision Making Regarding the Acceptance of the COVID-19 Vaccination in Egypt: A Cross-Sectional Study in an Urban, Well-Educated Sample

“…However, despite the serious pandemic situation, the willingness of the Egyptian people to receive a vaccine against COVID-19 is still unclear. Vaccine hesitancy is a significant barrier to vaccination campaigns, as it obstructs the process of achieving herd immunity [8]. The initial strategy used by most countries worldwide was reducing disease transmission by mask policies, social distancing, hand sanitization, travel restrictions, and lockdowns [9].…”

COVID-19 Vaccination Hesitancy or Acceptance and Its Associated Factors: Findings from Post-Vaccination Cross-Sectional Survey from Punjab Pakistan

“…The present study reported these factors to be responsible for vaccine hesitancy in Pakistan. Other factors highlighted by the present study that contributes to COVID-19 vaccine hesitancy among people include the perceived side effects of the COVID-19 vaccine [15,24,38,52,53,[60][61][62], concerns of people regarding different types of vaccines developed in a short period of time [58,60], and their alleged side effects including increased chances of death. People also reported some structural barriers, such as time constraint and facility accessibility issues [19,48].…”

“…This study found that people believed in the emergence of Islamophobia in the West, due to which they perceived the COVID-19 infection as well as the vaccination campaign as a genocidal attempt towards Muslims to control their population by causing infertility and considering it a "Western plot" in general, as is perceived about other vaccination campaigns by some communities in Pakistan [9][10][11]. Additionally, the prevalence of other myths and misconceptions included considering COVID-19 to be a man-made virus [18,57], fear of insertion of a secret micro-chip under the guise of vaccination [18], increased chances of death, and a lack of trust in the government [40], health workers [50], and the vaccine [24,39,42,47,51,[58][59][60]. The present study reported these factors to be responsible for vaccine hesitancy in Pakistan.…”

COVID-19 vaccine hesitancy: Pakistan struggles to vaccinate its way out of the pandemic

“…11 Another study conducted to understand the COVID-19 vaccine hesitancy in Pakistan revealed that 50.6% of people are hesitant to take the COVID-19 vaccine, owing to the belief that the vaccine can cause various side effects like autism, infertility, autoimmune disorders, and death. 12 Various conspiracy theories against the COVID-19 vaccine are currently being spread in Pakistan. Fake narratives have been spread that the virus was invented to target Islamic nations so that Jews can rule the world.…”

“…11 Another study conducted to understand the COVID-19 vaccine hesitancy in Pakistan revealed that 50.6% of people are hesitant to take the COVID-19 vaccine, owing to the belief that the vaccine can cause various side effects like autism, infertility, autoimmune disorders, and death. 12…”