key: cord-0685326-tpih5bsz authors: Elgendy, Marwa O.; Abdelrahim, Mohamed E. A. title: Public awareness about coronavirus vaccine, vaccine acceptance, and hesitancy date: 2021-07-20 journal: J Med Virol DOI: 10.1002/jmv.27199 sha: 69f0cf12f455ffec4859d5654f19674af50bacf7 doc_id: 685326 cord_uid: tpih5bsz Measurement of the population's general knowledge of the coronavirus vaccine is very important to improve public acceptance and decrease vaccine hesitancy in confronting the disease. This study aimed to evaluate the knowledge, attitude, and practices of the participants towards the coronavirus vaccine. Data were collected using an online survey, in the form of a structured questionnaire, conducted during April–May 2021 in Egypt, and subjects from all over Egypt participated. The questionnaire was divided into three parts to assess the knowledge and attitude regarding coronavirus. The first part was to assess participants’ experience about coronavirus infection (eight items), the second was to assess the health beliefs about coronavirus and vaccine (16 items) and the third was to assess general knowledge, attitude, and practices of the participants towards vaccine (28 items). A total of 871 (465 females) participants participated, 81% of them were still committed to the precautionary measures for protection. Eighty‐eight percent of them accepted to take the vaccine. Eighty‐three percent of the participants answered that they will encourage family, friends, and colleagues to get the vaccine. Ninety‐four percent knew that the coronavirus vaccine provides immunity against infection for a period of 6–12 months. 91.9% believed that the current infection with coronavirus is one of the main contraindications to vaccination. Eighty‐nine percent believed that both pregnant women and chronic disease patients can get vaccinated and also that there is no specific age for a specific type of vaccination. Ninety‐four percent of them knew that subjects taking immunosuppressive drugs should be prescribed Sinopharm, not AstraZeneca vaccine. The median score of this survey was 20/22 regarding knowledge about the coronavirus vaccine. Overall, the study participants had good knowledge about the coronavirus vaccine and accepted to take the vaccine, which indicates the highly commendable efforts to confront the coronavirus. commitment to hygiene practices, the national and international health organizations are organizing campaigns to increase the public awareness level about the COVID-19 vaccines. 2, 3 The vaccination program campaigns include advertisements on social media and television to increase the population's awareness of vaccines and show the importance of public vaccination to limit the spread of coronavirus infections. 1 At the beginning of the availability of the vaccine doses, there was little vaccination program campaign coverage, providing the opportunity to study the public awareness with COVID-19 vaccines. But now, there is more coverage and an increase in public awareness. 4, 5 This study aimed to evaluate the public awareness, attitudes, and practices regarding the COVID-19 vaccines. 2 | METHODS An online survey was conducted during April-May 2021 in Egypt. An online survey was applied and the participants were included from all over Egypt to take part in the study. Data were collected using an online survey in the form of a structured questionnaire to collect the data from all over Egypt. The time required to fill the questionnaire was 15 min. The questionnaire items were designed according to the information and instructions published by Food and Drug Administration. 6 The questionnaire was divided into four parts: 1. Participants' demographic data: age in year, gender, marital status, educational level, current place of residence (city or country), job. 3. Health beliefs about coronavirus and its vaccine among participants. 4 . General knowledge, attitude, and practices of the participants towards the vaccine. Responses to the last three parts of the survey were mostly written as (Yes), (No), and (I don't know). For the assessment of the total knowledge; the participant was given a score = 1 if he/she answered the question correctly and zero score if he/she could not report the correct answer or did not know the correct answer to end up with a total ranging from 0 to 22. Finally, the participant was classified as having good knowledge about the disease if he/she scored >18 (>80%) points and not having good knowledge if the score was less than this as was suggested previously. 2,3 3 | RESULTS A total of 871 (465 females) participants completed the study. The majority of them were in the age group of 35-45 years (44.8%). 63.8% of them were married and graduated from College; 50% were working in jobs other than the medical field and 74.1% were living in cities. Table 1 shows the participant's demographic data percentages. Eighty-nine percent answered that person can be infected with coronavirus more than one time. Of all participants, 86.5% believed that people who have been vaccinated against the coronavirus may get coronavirus infection again; 62% believed that herd immunity is enough to protect everyone from the coronavirus, and 79% thought that immunity after infection with the virus is better than vaccine immunity. Of all participants, 44.8% answered that the effectiveness of the current vaccines for the coronavirus is high, 48.3% answered that it is moderate and 6.9% answered that it is low. The majority of the participants (82.8%) knew that it is necessary to wear masks after taking the coronavirus vaccine and 81% answered that it is necessary to take the coronavirus vaccine even if the person has already been infected with the coronavirus. Of all participants, 69% believed that the vaccine itself may infect them with coronavirus; 93% believed that the vaccine will eradicate the coronavirus pandemic and 96% answered that the vaccine is the best way to protect against the coronavirus and its complications. Of all participants, 86% have doubts about vaccines in general without specific reasons, 81% were concerned about the effectiveness of the coronavirus vaccine, and concerned that there is not enough clinical data about the vaccine. 84.5% were concerned about the side effects of the coronavirus vaccine. 46.5% of the participants answered that they do not need the vaccine because they take the preventive measures seriously. Table 3 shows the health beliefs about coronavirus and vaccines. The majority of the participants (88%) answered that they will take the vaccine if available. 58.6% of the subjects were sure that they do not have an allergy to vaccines and 53.4% answered that they are 6. Did any of your family members suffer from any complications after recovering from the corona infection? • He did not suffer from any effects 24.3 • Shortness of breath 67.6 • Cough 78.4 • Chest pain 64.9 • Difficulty concentrating or thinking 51.4 • Depression 78.2 • Increase in heart rate 51.2 • Smell problems 45.9 • Taste problems 51.4 • High blood sugar levels 21.6 • Inflammation or redness of the eye 32.4 • not obligated to take the coronavirus vaccine in their workplace. There was a gap difference in the result of the question "Where do you get your information about the coronavirus vaccine?" 50% answered that they got their information from Ministry of Health instructions, 20.7% from the media, 15.5% from social media, 10% from the circle of acquaintances and friends. The majority of the participants (94%) knew that the coronavirus vaccine provides immunity against infection for a period of 6-12 months. Eighty-six percent answered that they will take the vaccine to protect themselves from serious infection with the coronavirus, 88% answered that they will be vaccinated to protect those close to them from contracting the coronavirus and 83% said that they will encourage family, friends, and colleagues to get the vaccine. Knowing the cause is the first step to promote public education. 8 Public knowledge includes disease transmission, preventive considerations, and vaccine information are important to promote vaccine acceptance and decrease the vaccine hesitancy among the population to eradicate the coronavirus infection. 8, 9 Nearly 90% of the respondents were classified as knowledgeable Most of the participants' families who were infected with coronavirus suffered from post-COVID-19 syndrome. Cough and depression are the most common post-COVID-19 syndromes in this study. 12 Depression is the most common neuropsychiatric post-COVID-19 disorder. 13 Previous studies found that about 10% of COVID-19 patients had a persistent cough for 4 months after disease recovery. [14] [15] [16] The majority of the participants were committed to the pre- About two-thirds of their respondents answered "yes" to the question "Is herd immunity enough to protect everyone from the coronavirus?" People become immune if they were infected or get vaccinated. It was reported that to reach herd immunity, 86% of people should be vaccinated. 18 There were differences in people's confidence towards the efficacy of the vaccine, which appeared in the gap difference in answering the question "The effectiveness of the current vaccines for the coronavirus is…" were 44.8% answered "high," 48.3% answered "moderate" and 6.9% answered, "low." That indicates the importance of building trust in COVID-19 vaccines between the populations. This can be achieved by launching advertising campaigns and displaying the available information about the vaccine in all transparency. 9 Communities should listen to problems, find answers to the questions, and clear any misinformation. 19 As public trust in vaccination is relatively low, the COVID-19 vaccination program can succeed if there is a belief that the available vaccines are safe and effective. 20 Most of the participants thought that immunity after infection with the virus is better than immunity after taking the vaccine. Natural immunity and vaccine immunity are likely to play a role in reducing the spread of COVID-19 and its associated mortality. [23] [24] [25] A lot of participants thought that the vaccine may infect them with the virus, were concerned that there is not enough clinical data, and were concerned about the side effects of the coronavirus vaccine. 9 Then, structured awareness campaigns should be organized to offer transparent knowledge about the safety and efficacy of the Nearly half of the participants were obligated to take the coronavirus vaccine in their workplace such as in hospitals and governmental institutions. This heralds the end of the epidemic soon. Half of the participants answered that they get their information about the coronavirus vaccine from Ministry of Health instructions. However, other studies showed that the social media and scientific articles published in the media were the most common sources of information. 10, 26 Most of the participants accepted taking the vaccine and answered that they will encourage family, friends, and colleagues to get the vaccine. That indicates the success of the awareness campaigns. The fear of the infection with coronavirus and considering it a serious disease and the desire for family protection as shown in this study were the motivators for the people to take the vaccine. 9 The study of Natalia et al. reported that memory B-and T-cell responses were maintained at least 6-8 months after infection. 27 Therefore, it is expected that the vaccine immunity may last for a period of 6-12 months. Ninety-four percent of the participants answered "yes" to the question "Coronavirus vaccine provides immunity against infection for a period of 6-12 months." A lot of participants believed that the vaccine should be mandatory for everyone. Like other studies, the vaccine should be mandatory for everyone if the threat to the public is serious and if there is confidence in the safety and efficacy of the vaccine. 28, 29 The majority of participants believed that current pregnancy or planning to become pregnant within 1 year of vaccination is a contraindication to vaccination. Pregnant women who wanted to be vaccinated must discuss with their physician and weigh the potential risks and benefits of and those who work in essentials industries. 31 The participants showed good knowledge about the COVID-19 vaccines information published by Food and Drug Administration and vaccine program campaigns. 6 They knew that there is no specific age for a specific type of vaccination, those recovering from coronavirus infection can receive the vaccine after approximately 3 months, and those who receive the first dose and then becomes infected with the virus must wait until they recover and then receive the second dose. "There is no scientific basis for taking aspirin or anticoagulant drugs with the AstraZeneca vaccination" was answered by a lot of participants. However, a previous study reported that early initiation of coagulation treatment results in a rapid response without thrombotic complications. 32 Similar to a previous study, the participants agreed also that antiallergic or cortisone is used if any allergic symptoms occur within the first 15 min of vaccination. 33 Also, they thought that there is no need to do an IgG test after or before receiving the vaccination. 34 There was an agreement in this study that cases that take immunosuppressive drugs should be prescribed Sinopharm. The inactivated vaccines have been used in cancer and immunosuppressive patients in the past with excellent safety profiles and they are theoretically the safest vaccine for these patients. 35 It was also known by the participants No face-to-face questionnaire was performed. Only an online survey was carried out which was easy as most were of young age compared to old, which is why most of the participants were young. Also, the uneducated or people who cannot deal with the online applications could not participate in the study. The participants in the study had satisfactory knowledge regarding coronavirus and its vaccine. Although the participants were satisfied in terms of acceptance of the vaccine, there are some concerns about it due to insufficient clinical trials and fear of its side effects. The provision of sufficient information about the vaccines is important. Continuous training and education are needed to improve public vaccine acceptance and reduce its hesitancy. Concept, Experiment, data entry, writing: Marwa O. Elgendy. Concept, planning of study design, and reviewing the manuscript: Mohamed E.A. Abdelrahim. Threat of COVID-19 vaccine hesitancy in Pakistan: the need for measures to neutralize misleading narratives Public awareness in Egypt about COVID-19 spread in the early phase of the pandemic COVID-19 patients and contacted person awareness about home quarantine instructions Policy response, social media and science journalism for the sustainability of the public health system amid the COVID-19 outbreak Repurposing of some anti-infective drugs for COVID-19 treatment: a surveillance study supported by an in silico investigation Commentary: the new coronavirus COVID-19 Knowledge, attitude and acceptance of a COVID-19 vaccine: a global cross-sectional study Knowledge of Middle East respiratory syndrome coronavirus (MERS-CoV) and its management: a survey among Saudi people in Taif; Kingdom of Saudi Arabia Vaccine hesitancy: beliefs and barriers associated with COVID-19 vaccination among Egyptian medical students COVID-19 vaccination perception and attitude among healthcare workers in Egypt Fearing the disease or the vaccine: the case of COVID-19 Assessment and characterisation of post-COVID-19 manifestations Post-COVID syndrome and suicide risk Persistent symptoms 1.5-6 months after COVID-19 in non-hospitalised subjects: a population-based cohort study Long COVID in the Faroe Islands-a longitudinal study among non-hospitalized patients Confronting COVID-19-associated cough and the post-COVID syndrome: role of viral neurotropism, neuroinflammation, and neuroimmune responses COVID-19 Vaccines vs variants-determining how much immunity is enough How to understand herd immunity in the context of COVID-19 Social Science Support for COVID-19: Lessons Learned Brief 3: Humanitarian Programme Recommendations for COVID-19 Based on Social Sciences Evidence from the DRC Ebola Outbreak Response. UNICEF CAPMAS Central Authority for Public Mobilization and Statistics (Egypt) CFAD Tunisian Center for Training and Support CAOA Central Agency for Organization and Administration COVID-19 vaccine hesitancy among medical students Vaccines are not yet a silver bullet: The imperative of continued communication about the importance of COVID-19 safety measures The interaction of natural and vaccine-induced immunity with social distancing predicts the evolution of the COVID-19 pandemic A study of the possible factors affecting COVID-19 spread, severity and mortality and the effect of social distancing on these factors: machine learning forecasting model Bacillus Calmette-Guérin vaccine, antimalarial, age and gender relation to COVID-19 spread and mortality Intention to participate in a COVID-19 vaccine clinical trial and to get vaccinated against COVID-19 in France during the pandemic Persistence of SARS-CoV-2-specific B and T cell responses in convalescent COVID-19 patients 6-8 months after the infection Good reasons to vaccinate: mandatory or payment for risk? Attitudes on voluntary and mandatory vaccination against COVID-19: evidence from Germany Pregnancy, postpartum care, and COVID-19 vaccination in 2021 COVID-19 vaccine: a comprehensive status report Successful treatment of vaccineinduced prothrombotic immune thrombocytopenia (VIPIT) Serving as trusted messengers about COVID-19 vaccines and therapeutics Impact of age, ethnicity, sex and prior infection status on immunogenicity following a single dose of the BNT162b2 mRNA COVID-19 vaccine: real-world evidence from healthcare workers, Israel COVID-19 vaccination for cancer patients, what oncologists and cancer patients need to know? https://orcid.org/0000-0003-0227-8404