Awareness, Perception and Willingness to Receive Covid-19 Vaccines by Medical Trainees in the University College Hospital, Ibadan, Nigeria.pptx

Awareness, Perception and
Willingness to Receive Covid-19
Vaccines by Medical Trainees in the
University College Hospital, Ibadan,
Nigeria
Authors: Esther Ejiroghene Ajari and the COMUI MBBS 2017
Set (Group B)
Affiliation: (1) Department of Medicine and Surgery, University
of Ibadan, Ibadan, Oyo State, Nigeria
(2) Global Research Initiative, The Trihealthon, Ibadan, Oyo
State, Nigeria
1

INTRODUCTION
Monday, May 2, 2022 2

OVERVIEW
• Coronavirus disease 2019 (COVID-19) is caused
by severe acute respiratory syndrome corona
virus-2 (SARS-CoV-2).
• It was declared as a public health emergency of
international concern by the World Health
Organization in late January 2020, due to it's
widespread occurrence and global health
challenge (Euro surveill, 2020).

ORIGIN
• The first known infections from Sars-CoV-2 were
discovered in Wuhan, China.
• The original source of viral transmission to
humans remains unclear, also whether the virus
became pathogenic before or after the spillover
event (Andersen et al, 2020).

EPIDEMIOLOGY
• By the first week in march 2020, the number of
cases had risen to over 100,000 globally,
affecting multiple continents
• WHO subsequently declared COVID-19 a global
pandemic on March 11, 2020 (Shigemura et al,
2020).
• As of February 25, 2021, there were over 112
million cases of COVID-19 across the globe and
more than 2.4 million deaths

EPIDEMIOLOGY IN NIGERIA
• Nigeria reported its index case on February 27,
2020, from an Italian citizen who tested positive
in Lagos state (NCDC, 2020).
• In Nigeria, data showed over 152,000 cases with
about 1839 deaths (ECDC, 2021)

MODE OF TRANSMISSION
COVID 19 can be transmitted through various
means:
• Contact
• Droplet
• Airborne
• Fomite
• Fecal-oral
• Bloodborne
• Mother-to-child

MECHANISMS OF INFECTION
• The new coronavirus latches its spiky surface proteins
to receptors on healthy cells, especially those in your
lungs.
• Specifically, the viral proteins burst into cells through
Ace2 receptors. Once inside, the coronavirus hijacks
healthy cells and takes command. Eventually, it kills
some of the healthy cells.
• The “vector” is the spike proteins found on the
surface of the coronavirus. Once the body’s cells are
“infected”, the cells are instructed to produce a large
amount of antigens, which in turn trigger an immune

SARS-COV-2 STRUCTURE
Visualization of the outer shell of the COVID-19 Virus (Eckert & Higgins, 20

MANAGEMENT
• There has not been any proven treatment against
the SARS-CoV-2.
• The recommendations of the disease control
bodies are focused on disease prevention and
control measures.
• The development of vaccines is hoped to help in
addressing this disease outbreak. (Olomofe et
al, 2021) Monday, May 2, 2022 10

PREVENTION
The preventive methods against covid 19 includes:
• Wear a nose mask properly
• Clean your hands always either with soap and
water or alcohol based hand sanitizers
• Keep a safe distance

ROLE OF HEALTH WORKERS
• However, in the face of anti-vaccines uprise, it is
important to understand the factors that may
influence the uptake of COVID-19 vaccines
among medical trainees, as they are at the
frontline, and their response will greatly
influence how successful the fight against
COVID-19 will be in the long term.

ROLE HEALTH WORKERS AND
MEDICAL TRAINEES
• Health workers are at
the frontline of the
COVID-19 pandemic
response, and in turn
medical trainees as well,
and this puts them at an
increased risk of
infection (WHO, 2020),
despite the judicious
usage of Personal
Protective Equipment
Frontline Health Care Workers are
at greater risk of infection (2020)

Apart from pathogen exposure, they are subject to
various risks which include:
• long working hours
• psychological distress
• fatigue
• Occupational burnout
• stigma,etc (WHO, 2020)

• With this in mind, the urgency to keep them
healthy is essential.
• An effective means would be through
administration of safe and efficacious vaccines
(Jackson et al, 2020).
• Notably, even with vaccine availability, there are
some personal reasons and barriers that would
lead to hesitancy to undergo vaccination among
health workers.

Some of which include;
• Concerns regarding quality control,
• Side effects,
• Efficacy
• Religion
• Perception of the disease as mild (Dror et al,
2020).

CONSPIRACY ABOUT COVID VACCINE
About a third of people who are not intending to be
vaccinated against COVID-19 often believe in
conspiracy theories (Newhagen et al, 2020).
Some of the common misconceptions about the vaccine
are:
• It is unsafe because it was developed so quickly,
• It alters dna,

CONSPIRACY ABOUT COVID VACCINE
About a third of people who are not intending to be
vaccinated against COVID-19 often believe in
conspiracy theories (Newhagen et al, 2020).
Some of the common misconceptions about the vaccine
are:
• It is unsafe because it was developed so quickly,
• It alters DNA,

CONSPIRACY ABOUT COVID
VACCINE
• It includes a tracking device,
• It has severe side effects,
• It causes infertility in women,
• It can transmit COVID-19 (The COVID-19 Vaccine:
Myths Vs. Facts 2020).

• Fortunately, vaccine hesitancy does not
necessarily lead to rejection of a vaccine, as
many individuals who are skeptical about a
vaccine nonetheless take it (Dubé et al, 2013).

LITERATURE REVIEW
21
Monday, May 2, 2022

HEALTH WORKERS ARE PARTICULARLY
VULNERABLE TO COVID-19
• WHO announced in July, 2020, that the COVID-19 prevalence
among health workers was at least 10% of the global prevalence
• The prevalence as at March 7, 2021:
• Global: 116 million cases and 2.58 million deaths
• Nigeria: 158,535 cases and 1,969 deaths
• Oyo state: 6,766 cases and 114 deaths
22
Monday, May 2, 2022

THE DISEASE BURDEN IN THE
UNIVERSITY COLLEGE HOSPITAL,
IBADAN, OYO STATE, NIGERIA
• 45% of 133 asymptomatic health workers, who participated
in a 2021 study by Olayanju et al., were seropositive for
SARS-COV-2
23
Monday, May 2, 2022

VACCINATION IS A PRIMARY
COVID-19 PREVENTION AND
CONTROL STRATEGY
• As at December 28, 2020, the WHO had listed 222 vaccine
candidates in development
• By 18th February 2021, at least seven different vaccines
across three platforms have been rolled out in countries
• These vaccines have been subjected to accelerated clinical
trials (without compromising methodological integrity)
• Growing global concerns over their potential side-effects 24
Monday, May 2, 2022

TYPES OF VACCINE
• Based on their mechanism of action, there are
four types of COVID-19 vaccine (Rachel
MacArthur 2021):
1. Whole (inactivated) virus vaccine
2. Non-replicating viral vector
3. Protein subunit
4. RNA (Mrna) vaccine
• All vaccines are intra-muscular injection. 25
Monday, May 2, 2022

WHOLE VIRUS VACCINE
• It uses a weakened or deactivated form of the pathogen that
causes COVID-19 to trigger protective immunity to it
• E.G. SINOVAC, SINOPHARM, AND BHARAT BIOTECH.
27
Monday, May 2, 2022

NON REPLICATING VIRAL VECTOR
• Introduces a safe, modified version of the virus (known as
“the vector”) to deliver genetic code for the antigen
• E.G. University of Oxford/AstraZeneca, Cansino Biological
Inc./Beijing Institute of Biotechnology, sputnik V/Gamaleya
Research Institute, Janssen Pharmaceutical Companies.
28
Monday, May 2, 2022

PROTEIN SUBUNIT
• The protein subunit vaccine contains purified “pieces” of a
pathogen rather than the whole pathogen to trigger an
immune response.
• E.G. Novavax, Anhui Zhifei Longcom Biopharma/Institute of
Microbiology/Chinese Academy of Sciences.
29
Monday, May 2, 2022

RNA (MRNA) VACCINE
• The nucleic acid coding for the viral MRNA protein antigen
is injected.
• Once injected into the body, the mrna instructs the cells to
produce antigens
• E.G. Moderna/NIAID, BioNTech/Fosun Pharma/Pfizer.
30
Monday, May 2, 2022

31
Pfizer COVID-19
Vaccine (Cancemi,
2021)
AstraZeneca COVID-
19 Vaccine (n.d.)
Johnson & Johnson
COVID-19 Vaccine
(n.d.)
Monday, May 2, 2022

NOTABLE VACCINES : BIONTECH-
PFIZER, MODERNA, ASTRAZENECA,
JOHNSON & JOHNSON, SINOPHARM,
AND SINOVAC
• They have been authorized for emergency use in USA, UK,
Germany, France, and other influential nations globally.
• In Nigeria, the AstraZeneca vaccine, donated by Covax, is
being distributed to citizens, especially front-line health
workers.
• Transient mild to moderate side effects (e.g. headaches,
fatigue, joint pain, pain/redness at injection site etc.) Have
been consistently reported.
32
Monday, May 2, 2022

RARE CASES OF SEVERE VACCINE-
RELATED SIDE EFFECTS RECORDED
DURING PHASE-3 CLINICAL TRIALS
• Pfizer - bell’s palsy and anaphylactoid reaction in people with or
without a known allergy history
• Moderna - Facioparesis, in participants with concurrent medical
conditions
• AstraZeneca - Transverse myelitis (dismissed as being unrelated to
the vaccine)
• Nb: severe allergic reactions are likely to occur with vector
vaccines (AstraZeneca and Johnson & Johnson vaccines)
33
Monday, May 2, 2022

MAINSTREAM ACCEPTANCE OF COVID-
19 VACCINES
• In a 2020 study conducted in 19 countries among 13,426
participants:
• 71.5% would take the vaccine if it were proven safe and effective
• 48% would take the vaccine if their employer recommended it
• In a 2021 study of 499 Nigerians:
• 51.1% were willing to take the vaccine
• 52% disagreed with a making vaccination mandatory
34
Monday, May 2, 2022

COVID-19 VACCINE ACCEPTANCE
AMONG HEALTH WORKERS
• In a 2021 study conducted in Italy, among 1723 health care workers:
• 67% were willing to get vaccinated
• 26% were undecided
• 17% were not willing to get vaccinated
• Acceptance promotion factors = younger age, close contact with high risk
groups, and previous administration of vaccines
• Acceptance inhibiting factor = using Facebook as main source of covid-19
related information
35
Monday, May 2, 2022

36
• In a 2020 study of 613 Congolese health workers, only 27% were
willing to receive the vaccine
Due to the spread of misinformation, particularly on social media
• But in a 2021 study of 821 Nigerians healthcare workers, 50.2% were
willing to receive the vaccine
Acceptability increased with advancing age
Monday, May 2, 2022

RATIONALE ,
JUSTIFICATION,
PROBLEM STATEMENT
& OBJECTIVES

RATIONALE
• Studies have shown that vaccination is one of the most effective
ways to reduce or eliminate the burden of infectious diseases,
but vaccine hesitancy - the delay of acceptance or refusal of
vaccines despite availability of vaccine services—remains a
barrier to providing effective herd immunity against highly
transmissible infectious diseases (manning et al 2020).
• In a study by olomofe et al (2020) only a simple majority
(58.2%) were willing to take a COVID 19 vaccine when available
in nigeria and about one-fifth of the respondents were
unwilling to receive a potential vaccine which appears to stem
from skepticism about the safety of the potential vaccine.

• In another study, majority, were unsure if the potential
vaccine is 'a mark of the beast' or if the motive is to 'reduce
the world population’(olomofe et al 2020).
• The attitude and perception of healthcare workers’ (hwcs) as
well as their recommendations play an influential role in the
patients’ vaccination behavior. HCW serve as an important
source of information for the general public and the
counseling given by health care providers during consultation
may be a key factor in patients’ decision to be vaccinated or
not.

• In a recent study, only 28% of the hcws interviewed said
they would get a COVID-19 vaccine if available(kabamba et
al 2020).
• In another study, hcws in beijing have a little more above
moderate willingness to get the future covid-19 vaccination
before the completion of phase iii vaccine clinical trials, and
the willingness were strongly associated with the perception
of whether the vaccine is free and safe( suo luodan et al
2020)

• Uptake of vaccines amongst hcws can be influenced by several
factors such as personal risk perception, fear of side effects,
access to media, information sources, religious/cultural beliefs,
the convenience of getting to a health facility, level of trust for
the healthcare system, household wealth, residence, ethnicity,
and other demographic variables, as well as other social
influences( olomofe et al 2020)
• Although there are various studies about the perception and
readiness to receive covid19 vaccines amongst hcws in many
countries, there is paucity of data about the perception and
willingness to receive covid-19 vaccine amongst medical
trainees especially in a country with weaker health care system
like nigeria. Monday, May 2, 2022 41

• Healthcare trainees are the future healthcare workers and
dream of a better health care in nigeria, the most populous
nation in africa and are involved directly or indirectly in the
care of COVID-19 patients as well as counseling and
recommendation of the vaccine to the populace.
• There is a concern as to the likely picture of perception of
covid-19 vaccine amongst medical trainees in nigeria. This
study is aimed to investigate the perception and
willingness to receive the COVID-19 vaccine amongst
medical trainees in south-west nigeria.

• This study will helps to identify the perception and fears of
healthcare trainees towards receiving the vaccine including
the myths.
• The refusal of covid-19 vaccine by healthcare trainees
sends a negative signal which may have a negative
influence on the patients they come in contact with and the
society at large. Vaccine refusal will also result in vaccine
wastage and loss of resources invested in the manufacture
and procurement of the vaccines.

PROBLEM STATEMENT
• Worldwide, scientists have been working tirelessly in order to
stop the spread of sar-cov-2 infection and COVID-19 disease.
• One of the strategies to curtail the spread of the infection is
helping the population achieve herd immunity through
vaccination.
• Vaccination helps the population to develop immunity,
prevent spread of infection and protects the vulnerable or
high risk groups that may not be eligible for vaccination.
• Unwillingness to receive vaccine or vaccine decline is a
concept which may pose a challenge to achieving herd
immunity and prevent disease spread. Monday, May 2, 2022 44

• This may be due to lack of awareness, poor perception,
wrong information disseminated by the media, fear of
potential side effects, doubts regarding the efficacy, issues
with the transportation and storage of vaccines.
• The university college hospital, ibadan, is a tertiary
institution and centre of reference in southwestern part of
nigeria. It is a major referral hospital and it has played an
active role in the management of COVID-19 and therefore
constitutes a moderate to high-risk environment for the
medical staff and trainees.

• Furthermore, some medical staff and trainees involved in the
care of high-risk patients with conditions such as dental,
maternal/child health, unbooked obstetric patients, medical
comorbidities may be at increased risk of contracting the
disease.
• The perception of medical trainees on their level risk of
exposure to sars-cov-2 in addition to other individual beliefs
and factors may affect willingness and vaccine uptake among
healthcare trainees.
• It is therefore important to understand the perception and
vaccine interest among this population in order to better
protect and care for them.

• This study aims to assess the awareness, perception and
willingness of medical trainees( medicine and surgery,
dentistry, medical laboratory science,physiotherapy and
nursing students) of the university college hospital ,ibadan
to receiving the covid-19 vaccine.

OBJECTIVES
GENERAL OBJECTIVES:
• To assess the awareness, perception and willingness of
healthcare trainees of the university college hospital,
ibadan about covid-19 vaccine.

SPECIFIC OBJECTIVES:
• To assess the awareness and perception of healthcare
trainees of the university college hospital, ibadan about
covid-19 vaccine.
• To assess the willingness of healthcare trainees of the
university college hospital, ibadan to get the covid-19
vaccine.
• To assess the reason for the unwillingness and the
barriers/factors against uptake of the vaccine.

METHODOLOGY

STUDY SETTING/AREA
• The departments of medicine and surgery, dentistry, physiotherapy,
and biomedical laboratory science of the university of ibadan, and the
school of nursing of the university college hospital, both in ibadan-
north local government area of oyo state, in southwestern nigeria.

STUDY DESIGN
• This is a prospective online cross-sectional study that was carried out among
trainees of medical and paramedical subspecialties to assess the perceptions
and willingness to receive COVID-19 vaccine.
• Data were collected via an anonymous questionnaire on a google form from
3rd of march 2021 to 3rd of april, 2021.

STUDY POPULATION
• The participants included medical trainees from school of nursing,
medicine and surgery, dentistry, physiotherapy and biomedical laboratory
science departments of the university of ibadan in university college
hospital, ibadan, oyo state.

SAMPLE SIZE DETERMINATION
• This is a survey with the study population < 10,000.
• Hence, sample size (nf) will be calculated using the formula:
𝑛𝑓 =
N
(1 + (
N
N
))
WHERE; NF = Desired sample size when study population < 10,000
N = Desired sample size when study population > 10,000
N = Estimate of the population size.

• USING 𝑛 = 𝑍2
PQ/𝑑2
• WITH Z = 1.96, P = 0.5, Q = 0.5, AND D = 0.05 YIELDS N =
384.16
• IF N IS 384.16 And the population size, N is estimated at 200;
then
• 𝑛𝑓 =
384.16
1+
384.16
200
= 131.5256
• NF = 132

DATA COLLECTION PROCEDURE
• Data were collected using a google form in order to comply with COVID-19
protocols, ensure the safety of investigators and study participants, and
maintain the anonymity of participants. : Socio-demographics (six
questions); awareness (four questions); perception (two questions); and
willingness to take the COVID-19 vaccine (five questions).
• A systematic random sampling technique was used to select study
participants by convenience to ensure that the target departments, being
high-risk groups, were adequately represented. The period of data
collection was from 3rd march 2021 to 3rd april 2021

RESEARCH INSTRUMENT
The google form contained a pre-tested structured questionnaire
made up of four sections namely:
• Section A: socio-demographics (six questions)
• Section B: awareness of COVID-19 vaccines (four questions)
• Section C: perception of COVID-19 vaccines (two questions)
• Section D: willingness to receive COVID-19 vaccines (five questions)

INCLUSION CRITERIA
Individuals who:
• Were trainees in the university college hospital, ibadan;
• Able to read and fill the online questionnaire;
• Voluntarily agreed to participate in the survey.

EXCLUSION CRITERION
• Individuals not in any of the target departments.

DATA ANALYSIS
• Data collected were automatically saved in a google sheet and exported to
SPSS 23.0 for analysis. Bivariate analysis was done to explore associations
followed by multiple logistic regressions.
• Frequency and proportion were calculated for categorical variables while
mean and standard deviation were calculated for continuous variables as
appropriate.
• Fischer students t-test and chi square test was used to calculate the
differences between the responses from different classes in the study
population. A p value < 0.05 was considered statistically significant

ETHICAL APPROVAL
• Participants were well informed about the purpose of this study and
informed consent was obtained informed consent from voluntary
participants.
• We explained that their participation is completely voluntary, and they may
withdraw from the research at any time and for any reason.
• We informed participants that their data will be treated with full
confidentiality and if published, all identifying information will be
excluded from the reports and published documents.
• Ethical approval for this study was obtained from the university of
ibadan/university college hospital ethical committee.

RESULTS AND
ANALYSIS

SOCIODEMOGRAPHIC
CHARACTERISTICS
VARIABLES FREQUENCY (%)
AGE (years)
<20
20-24
≥25
MEAN Age (X ±SD)
4 (2.5)
126 (77.3)
33 (20.2)
GENDER
Female
Male
93 (57.1)
70 (42.9)
RELIGION
Christianity
Islam
Others
139 (85.3)
19 (11.7)
5 (3.1) Monday, May 2, 2022 63
163 respondents were able to access and fill the questionnaire.

SOCIODEMOGRAPHIC
CHARACTERISTICS CONT’D
MARITAL STATUS
Married
Single
4 (2.5)
159 (97.5)
SPECIALTY OF TRAINING
Biomedical Laboratory Science
Dentistry
Medicine and Surgery
Nursing
Physiotherapy
29 (17.8)
10 (6.1)
80 (49.1)
32 (19.6)
12 (7.4)

SOCIODEMOGRAPHIC
CHARACTERISTICS CONT’D
NUMBER OF YEARS IN CLINICAL
TRAINING
≤ 2
3
4
26 (16.0)
92 (56.4)
45 (27.6)

KNOWLEDGE AND AWARENESS OF
COVID-19 VACCINE
Knowledge of types of COVID
vaccines
respondents who were aware of at
least a type of vaccine
Awareness of the route of
administration of the vaccine
Intramuscular
Subcutaneous
Oral
Don’t know
150 (92)
102 (62.6)
15 (9.2)
1 (0.6)
45 (27.6)

KNOWLEDGE OF CONSTITUENTS OF
COVID-19 VACCINE
mRNA vaccine
Live attenuated vaccine
Viral Vector vaccine
Protein Subunit vaccine
DNA vaccine
72 (44.2)
47 (28.8)
32 (19.6)
45 (27.6)
21 (12.9)

KNOWLEDGE OF SIDE EFFECTS OF
COVID-19 VACCINE*
Pain in the arm
fatigue
fever
Swelling
Headache
Malaise
Not aware of any possible side
effect
100 (61.3)
67 (41.1)
64 (39.3)
64 ((39.3)
58 (36.6)
40 (24.5)
55 (33.7)
Others: Sore throat 17 (10.4%), difficulty with breathing 12 (7.4), Death
13 (8.0)
*: multiple responses

89
6
41
6
DO YOU THINK YOU ARE AT RISK OF COVID-19?
HAVE YOU EVER TESTED POSITIVE FOR COVID-19?
HAVE YOU COME IN CONTACT WITH SOMEONE WHO
TESTED POSITIVE WITH COVID-19?
HAVE YOU BEEN INVOLVED IN THE MANAGEMENT OF
COVID-19 POSITIVE PATIENT?
PREVIOUS EXPOSURE AND PERCEIVED RISK OF COVID-
19

PERCEPTION AND ATTITUDE TOWARDS
COVID-19 VACCINE
The vaccines can prevent COVID-19 infection
The vaccines are safe
There may be laboratory errors while manufacturing
the vaccines, as a result of the speed with of they
were manufactured.
There may be unknown long term adverse effects of
the vaccine
I think that the vaccines brought to Nigeria different
from that for other parts of the world
154 (94.5)
131 (80.4)
58 (35.6)
92 (56.4)
19 (11.7)

PERCEPTION AND ATTITUDE TOWARDS
COVID-19 VACCINE
Willingness to be tested for COVID-19 at regular
intervals
Willingness to pay for the COVID-19 vaccine
Willingness to receive the COVID-19 vaccine if made
available for free
Recommend the vaccine to a friend or colleague.
Dose preference
Single dose
Double dose
90 (55.2)
42 (24.8)
94 (57.7)
105 (64.4)
130 (80)
33 (20)

SOME TESTS OF ASSOCIATION
Willingness to uptake COVID-19
Vaccine if it is free
Chi-
squared
(χ2)
p-value
Safety of
the Vaccine
No Undecided Yes
NO
YES
12 (37.5)
5 (3.8)
19 (59.4)
33 (25.2)
1 (3.1)
93 (71.0)
57.938 < 0.001

Statistically significant factors affecting the willingness to
receive the COVID-19 vaccine for free include;
• Perception about risk of having COVID-19 at a p-value of
0.007
• Perception about safety and efficacy of the vaccine at a p-
value of 0.000
Statistically significant factor affecting willingness to pay for
the vaccines is the perception about safety at a p-value of
0.001

77
146
34
39
2
1
TV/RADIO
SOCIAL MEDIA
FRIENDS AND RELATIVES
JOURNALS
ONLINE
SCHOOL
SOURCES OF INFORMATION
ABOUT COVID-19 VACCINE
147
131
123
136
142
110
115
120
125
130
135
140
145
150
FREQUENCY
PERCEIVED CHALLENGES TO VACCINATION
Challenges to vaccinating health
workers/general population

DISCUSSION

OVERVIEW
• Since the commencement of the global search for a COVID-19
vaccine in 2020, till date, several studies (fisher et al., 2020;
pogue et al., 2020; kourlaba et al., 2021; lazarus et al., 2021)
have assessed the level of perception and awareness of the
general public in different countries, as well as measure the level
of acceptance of the vaccine in these populations.

• One of the first sub-groups to receive the vaccine, are
healthcare workers or trainees (HCW/ts), due to their
heightened risk of contracting the virus in the course of
offering care to COVID-19 patients, it is important that the
factors influencing their acceptance of the vaccine be
investigated.
• This importance is further underpinned by the fact that hcw/ts
can be a crucial source of information about the vaccine to the
general population.

• While a few similar studies have been carried out in saudi
arabia (qattan et al., 2021), DR congo (kabamba nzaji et al.,
2020) and the USA (shekhar et al., 2021), to the best of our
knowledge, this is the first of such studies, investigating the
perception and knowledge of HCW/ts and their willingness to
take the COVID-19 vaccines in nigeria.

ON KNOWLEDGE AND AWARENESS
• Respondents demonstrated sufficient knowledge level of
knowledge about COVID-19 vaccine across most of the
domains investigated, including: appropriate knowledge
about viral cause of COVID-19 (100%), awareness about
the several COVID-19 vaccine options, and knowledge
about the appropriate route of administration of the
vaccine (where over two-thirds or 62.6% of respondents
knew it was intramuscular).

ON KNOWLEDGE AND AWARENESS
• While on the knowledge about the vaccine constituents, all
respondents were aware of the constituents of at least one of
the many COVID-19 vaccines that have been approved, when
asked about the efficacy of the vaccine, less than one-half of
respondents reported correct efficacy values, with another
1.2% reporting incorrect values and about 50.3% being
unaware.
• This high level of knowledge and awareness about the vaccine
was anticipated among hcts as compared with other members
of the general population.

ON PERCEPTION
• On vaccine efficacy close to two-thirds (n = 95, 58.3%)
hcts surveyed agreed that the vaccine was effective in
preventing COVID-19. This proportion is considerably
lower than figures obtained from a similar study from
australia (seale et al., 2021), where more than 80% of
respondents agreed with the effectiveness of the vaccine in
preventing COVID-19.

ON PERCEPTION
• On safety, over 80% agreed that the vaccines are safe, but
close two-thirds (n = 92; 56.4%) of respondents agreed that
the vaccines could have some unknown long-term adverse
effects, not detected in the clinical trials. This is possible due
to the fact that most of the vaccines remain in the phase III
clinical trials, and there is a possibility that some other side
effects could be detected by the end of this trial phase.

ON PERCEPTION
• Interestingly, over one-half of hcts were either undecided or
agree (n = 91; 55.9%) that the vaccine sent to nigeria had a
different constituent from that used in developed countries.
This could be an indication of improper information
dissemination to these hcts.
• To confirm this, we found that close to 90% of the surveyed
hcts selected social media as their primary source of
information about the covid-19 vaccines (n = 146; 89.6%),
while less than one-third of them (n = 39; 22.75%), utilised
academic journals and findings from clinical trials.

ON PERCEPTION
• This underpins the need to utilise unconventional sources of
information such as social media, radio and TV to disseminate
information about the COVID-19 vaccine, as they are fast
becoming an important channel of information access for
many hcts.
• Concerning potential challenges militating against vaccination
of healthcare providers and the general population, some
responses of the hcts surveyed include: challenges with
vaccine supply (n = 147; 90.2%), vaccine storage (n = 142;
87.1%) and vaccine hesitancy (n = 136; 83.4%).

ON WILLINGNESS
• In our study, close to two-thirds (n = 94; 57.7%) of
respondents were willing to take the COVID-19 vaccine, if
available for free. This value however reduced drastically to
less than one-third (n = 42; 25.8%) of respondents, when
asked if they were willing to receive the vaccine, should it be
up for sale.
• This result is in keeping with findings from a similar study
from egypt, by (qattan et al., 2021), in which about 50.2% of
surveyed hcws were willing to take the COVID-19 vaccine
when available. Monday, May 2, 2022 85

ON WILLINGNESS
• When compared with data from a similar study by (tobin et
al., 2021), investigating the acceptance of the COVID-19
vaccine by the general population in nigeria, we see that
the results are similar (50.2% vs. 57.7%), confirming the
opinion of the authors that the willingness to accept the
vaccine was not significantly different between HCW/ts and
non-hcw/ts in nigeria.

STUDY STRENGTH
• A major strength of our study is that our survey population
is diverse, representing hcts with different genders, age
groups, religions, marital status, clinical specialties and a
range of years of clinical training.
• Furthermore, because we employed systematic random
sampling, we were able to eliminate selection bias amongst
study respondents.

STUDY LIMITATIONS
• However, we recognise the limitations of our study. Because
the study population was restricted to the university college
hospital (UCH), ibadan we are unable to sufficiently generalise
the results of our study to be representative of hcts in nigeria.
• In addition, because of the online mode of delivery of the
survey questionnaire, there may have been selection bias
favouring hcts with internet access.
• Finally, because the study was conducted at a time when
vaccinations campaigns for hcts were just kicking off, the
results may evolve over time.

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