research

1. KNOWLEDGE, ATTITUDE AND UPTAKE OF COVID-19 VACCINES
AMONG UNDERGRADUATE STUDENTS AT MERU UNIVERSITY OF
SCIENCE AND TECHNOLOGY
MUTISO MBINDYO NS202/101448/19
MUMBE DORCAS NS202/101451/19
VICTORIA KYALO NS202/101579/19
THIS PROPOSAL IS SUBMITTED FOR PARTIAL FULFILLMENT FOR THE REQUIREMENTS
FOR AWARD OF DEGREE OF BACHELOR OF SCIENCE HEALTH SYSYTEMS
MANAGEMENT OF MERU UNIVERISTY OF SCIENCE AND TECHNOLOGY
MAY 2022

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DECLARATION
We hereby declare that this proposal is our original work and has not been presented for academic award or
qualification in any institution of higher learning. Appropriate referencing has been made where citation of
other people’s work has been done.
RESEARCHERS
MUMBE DORCAS NS202/101451/19 Signature ………………. DATE ………………..
MUTISO JOHN NS202/101448/19 Signature ……………….. DATE ……………….
VICTORIA KYALO NS202/101579/19 Signature ………………..DATE ……………….
This proposal has been submitted for examination and review with our approval as university supervisors
Supervisor's Name: ELIZABETH KAMOLO
Signature ………………………... Date ………………………

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DEDICATION
We dedicate this project to our families for the support they have shown us both financially and emotionally.
To our colleague, we extend our gratitude for accepting to be part of this work by allowing us to interview
you. Our lecturers especially our supervisor, we thank you for guiding us throughout the research process.

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ACKNOWLEDGEMENT
Special thanks to God for the good health He has accorded us and the grace to carry out the research study.
We also wish to thank our family members during the research study period for their unlimited support and
encouragement throughout the study. We wish to acknowledge with sincere gratitude and appreciation to
Ms. Elizabeth Kamolo our research supervisor for her tireless efforts and assistance she accorded us
spending her valuable time in her tight schedule to guide us through the study. To our friends and to all
those in one way or another assisted us during the process we also register our appreciation to all of you.

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Table of Contents
DECLARATION .......................................................................................................................................... ii
DEDICATION .............................................................................................................................................iii
ACKNOWLEDGEMENT ........................................................................................................................... iv
ACRONYMS AND ABBREVIATIONS ..................................................................................................viii
DEFINITION OF TERMS........................................................................................................................... ix
ABSTRACT.................................................................................................................................................. x
CHAPTER ONE ............................................................................................................................................... 1
INTRODUCTION............................................................................................................................................. 1
1.1 Background ............................................................................................................................................. 1
1.2 Statement of the problem ........................................................................................................................ 3
1.3 Justification ............................................................................................................................................. 3
1.4 Significance of the study......................................................................................................................... 3
1.5 Research questions.................................................................................................................................. 3
1.6 Objectives................................................................................................................................................ 4
1.6.1 General objective.................................................................................................................................. 4
1.6.2 Specific objectives............................................................................................................................ 4
CHAPTER TWO............................................................................................................................................... 5
LITERATURE REVIEW.................................................................................................................................. 5
2.0 Introduction............................................................................................................................................. 5
2.1 Theoretical literature review ................................................................................................................... 5
2.1.1 COVID 19 meaning ......................................................................................................................... 5
2.1.2 Symptoms of COVID 19 ................................................................................................................ 5
2.1.3 Transmission .................................................................................................................................... 5
2.1.4 Prevention......................................................................................................................................... 6
2.1.5 COVID 19 vaccination..................................................................................................................... 6
2.2 Empirical literature review...................................................................................................................... 6
2.2.1 Knowledge about COVID 19 vaccines ......................................................................................... 7
2.2.2 Attitude............................................................................................................................................. 8
2.2.3 Uptake of COVID 19 vaccine .......................................................................................................... 9
CHAPTER THREE......................................................................................................................................... 11
RESEARCH METHODOLOGY.................................................................................................................... 11
3.1 Introduction........................................................................................................................................... 11
3.2 Study design......................................................................................................................................... 11
3.3Study area............................................................................................................................................... 11
3.4 Study population ................................................................................................................................... 11
3.4.1 Inclusion criteria............................................................................................................................. 11
3.4.2 Exclusion criteria............................................................................................................................ 12

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3.5 Sample size determination .................................................................................................................... 12
3.6 Sampling techniques and procedures .................................................................................................... 12
3.7 Data collection tools and procedures .................................................................................................... 13
3.8 Data analysis and presentation .............................................................................................................. 13
3.9 Ethical consideration............................................................................................................................. 13
CHAPTER FOUR........................................................................................................................................... 15
DATA PRESENTATION, ANALYSIS, AND INTERPRETATION OF RESULTS ................................... 15
4.0 Introduction........................................................................................................................................... 15
4.1 Socio-demographic characteristics of the respondents. ........................................................................ 15
4.2 Knowledge on COVID 19 vaccine among undergraduate student. ...................................................... 16
4.3Attitude of COVID 19 vaccine among undergraduate students at MUST............................................. 19
4.4 Uptake of COVID 19 vaccine among undergraduate students at MUST ............................................. 22
CHAPTER FIVE:............................................................................................................................................ 25
CONCLUSION, INTERPRETATION AND DISCUSSION......................................................................... 25
Introduction................................................................................................................................................. 25
5.1 Discussion ............................................................................................................................................. 25
5.1.1 Socio-demographic characteristics of the respondents. ................................................................. 25
5.1.2 Knowledge on COVID 19 vaccine among undergraduate student ................................................ 25
5.1.3 Attitude of COVID 19 vaccine among undergraduate students at MUST..................................... 26
5.1.4 Uptake of COVID 19 vaccine among undergraduate students at MUST ...................................... 26
5.2 conclusion.............................................................................................................................................. 27
5.3 Recommendation................................................................................................................................... 27
5.4 limitation of the study ........................................................................................................................... 27
REFERENCES................................................................................................................................................ 28
APPENDICES................................................................................................................................................. 31
Appendix I: CONSENT FORM.................................................................................................................. 31
Questionnaire .............................................................................................................................................. 32
Section A: Personal information ............................................................................................................ 32
Section B: knowledge on COVID 19 vaccine......................................................................................... 32
Section C; attitude towards COVID 19 vaccine...................................................................................... 35
Section C; Uptake of COVID 19 Vaccine .............................................................................................. 35
CONSENT LETTER................................................................................................................................... 37
To: Vice Chancellor, ................................................................................................................................... 37
Budget ......................................................................................................................................................... 38

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ACRONYMS AND ABBREVIATIONS
COVID –Corona Virus disease
EUL- Emergency Use Listing Procedure
KAP- Knowledge, attitude, practice
MUST- Meru University of Science and Technology
SAFS- School of Agriculture and Food Science
SBE- School of Business Education
SCI- School of Computing and Informatics
SEA- School of Engineering and Architecture
SED- School of Education
SHS- School of Health Sciences
SON- School of Nursing
SPAS- School of Pure and Applied Sciences
SPAS-Statistical Package for Social Sciences
SPSS- Statistical Package for Social Science
WHO- World Health Organization

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DEFINITION OF TERMS
Utilization: The action of making practical and effective use of health services.
Health services: A public service providing curative and preventive care
Access to healthcare refers to having timely use of personal health services to achieve the best possible
outcomes
Student: A member of Meru University pursuing undergraduate degree who has been in session for at least
one month.
Accessibility: The quality of been able to reach, obtain or use health facility.
Attitude: a settled way of thinking or feeling about health care being provided.
Effectiveness: The degree to which health services is successful in producing a desired result/success
Barriers: circumstances or obstacles that keep people from using health services.
Factors: things that help produce or influence health services results

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ABSTRACT
Corona-viruses are a family of respiratory viruses that cause common cold and severe acute respiratory
syndrome (SARS). Preventive measures include, maintaining a social distance, wearing a mask in public,
especially indoors or when physical distancing is not possible, choose open, well-ventilated spaces over
closed ones, open a window if indoors.
The main aim of the study was to evaluate the level of knowledge, attitude and prevalence of COVID 19
vaccination among undergraduate students at MUST main campus. Descriptive cross-sectional study design
was used. The target population was undergraduate students of MUST main campus with a total population
of approximately 11, 000 students. Proportionate sampling technique was used and sample of 350 students
was used. The population was divided into 8 strata, based on the school of study. Data was analyzed using
the Statistical Package for Social Science (SPSS) Version 26, and was summarized using descriptive
statistics which include frequency distribution tables, percentages and cross tabulation. The findings were
tthe overall level of knowledge of the participants concerning COVID 19 vaccines was good. Regarding
attitude, the students depicted poor attitude towards COVID 19 vaccine. Concerning uptake, a low turnout
was recorded which was in relation to attitude. The results of the study were presented to the MUST
administration to aid in vaccine program implementation.

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CHAPTER ONE
INTRODUCTION
1.1 Background
The Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome
Coronavirus 2 (SARS-CoV-2). SARS-CoV-2 first appeared in late 2019 in Wuhan, China, and has
since spread to over 220 nations. The COVID-19 pandemic has resulted in more than 76.2 million
illnesses and 1.6 million deaths worldwide as of December 22, 2022. The pandemic has a
devastating global impact, necessitating the implementation of mitigating programs to curb the
outbreak. The most common ground tactic used by most countries around the world was to decrease
the disease's transmission. According to studies conducted, it is found that an adequate level of
knowledge, attitude, and acceptance regarding COVID-19 vaccinations. Approximately, 62% of the
study population were willing to receive the COVID-19 vaccine with an efficacy of 69% or more
and 79% with an efficacy of 91% (Arregocés et.al 2022)
Vaccine reluctance and skepticism among the general public are thought to be a major impediment to
achieving such a goal. The World Health Organization (WHO) Strategic Advisory Group of Experts
(SAGE) described vaccine hesitancy as "delay in uptake or refusing immunization notwithstanding
the availability of vaccination services." Three elements influence vaccine uptake; confidence,
convenience, and complacency (González et.al 2021)
Confidence is described as trust in the vaccine's safety and effectiveness, trust in the healthcare
system's delivery system, and trust in policymakers. Many people are skeptical about vaccination
safety, is a key barrier for health care providers, politicians, community leaders, and governments to
overcome in order to promote vaccine uptake. Vaccination convenience also refers to the relative
ease with which a vaccine can be obtained, including its physical availability, price, and accessibility
(Tamam et. al2021). Vaccine complacency is linked to a low perceived risk of a vaccine-preventable
disease and, as a result, to more negative attitudes regarding vaccines. In a separate survey of adult
Americans, 58% said they planned to get vaccinated, 32% said they weren't sure, and 11% said they
didn't plan to get vaccinated (Mazor, K. M.et al (2020). However, according to another study, 67%
of Americans would accept the COVID-19 vaccination if it were prescribed to them, despite major
demographic variances in vaccine uptake (Kaplan & Milstein 2021).

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Kenya's government intends to vaccinate 50% of all adult populations in a phased way by the end of
June 2022, while retaining a prioritizing matrix. As a result, in March 2021, Kenya began rolling out
COVID-19 immunization obtained through the COVID-19 Vaccines Global Access Facility
(COVAX). All COVID-19 vaccines with WHO EUL (Emergency Use Listing Procedure) are safe
for most people 18 years and older, including those with pre-existing conditions of any kind,
including auto-immune disorders. These conditions include: hypertension, diabetes, asthma,
pulmonary, liver and kidney disease, as well as chronic infections that are stable and controlled
(Wang, P. H et.al 2021)
As of 1st May 2022, there were 12,507,476 people who received at least one dose of the vaccine
which is 24% of the population, 9,079,472 people who are fully vaccinated 17% and 296,768, 0.7
have received the booster vaccine doses administered in Kenya. Given the emergence of new
variants that are highly transmissible and reduce vaccine effectiveness, and the inequitable
availability of vaccines, there is growing concern that vaccination may not lead to herd immunity.
However, vaccines have been shown to reduce the risk of severe disease and death, there is
consensus that countries will need high levels of vaccine coverage to facilitate a near normal
resumption of socio-economic activities, and protect the health system from case surges (Hibbs et al.,
2018). One major barrier to achieving high levels of vaccine coverage is vaccine hesitancy, defined
as the refusal or delay in acceptance of vaccines, despite their availability (Dhama 2021). It lies
across a spectrum between total acceptance and total refusal.
A growing body of evidence shows that people who are up to date with their vaccines are at
substantially reduced risk of severe illness and death from COVID-19 compared with those not
vaccinated (Tanne, 2021). Cognitive barriers to vaccination among people may be explained through
misconceptions of virus treatment, vaccines, and misappraisal of infection threat. The
misconceptions included that the vaccine has ingredients that harm or even kill people, it is
dangerous and has severe side effects that are long-lasting in the body, and that the COVID-19
vaccine can give you corona-virus (Milovanovic & Dumic, 2021). Others believe that natural
immunity is better than vaccine immunity and that they are strong enough to handle the illness
because they eat natural foods. Beliefs that the vaccine was developed too quickly without proper
research compounded the misconception of its safety (Turner, K. et.al (2021)

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1.2 Statement of the problem
As of 1st May 2022, there were 12,507,476 people had received at least one dose of Covid 19
vaccine which is 24% of the population, 9,079,472 people who are fully vaccinated 17% and
296,768, 0.7 have received the booster vaccine doses administered in Kenya, the total population in
Kenya is 55,944,116, therefore three quarters of the population is not vaccinated (Wise, 2021). The
lack of knowledge has created a gap for people to get vaccinated which has contributed to a negative
attitude towards the uptake of the vaccine. Getting vaccinated against COVID-19 can lower risk of
getting and spreading the virus that causes COVID-19. Vaccines can also help prevent serious illness
and death. The hesitancy in getting vaccinated has led to an increased spread of the COVID 19 also
hesitation and delay may result in vaccination refusal (Abebe et al., 2021).
This could lead to devastating effects in public health and hinder the healthcare system’s ability to
accommodate the challenges of the pandemic. Meru university students were targeted because of
their reachability.
1.3 Justification
The existing literature cites concern about COVID-19 vaccine safety, including the rapid pace of
vaccine development, as a primary reason for hesitancy (Caussy, 2020). There is limited evidence
and understanding of the public willingness to accept, and the confidence they place on the COVID-
19 vaccine in Kenya, which mainly targets the adult population. This study is suitable for Meru
University students since majority of population is aged 18 to 29 years and they were on a physical
session and registered for the semester. Report from the university dispensary confirmed that a low
uptake of COVID 19 vaccine was recorded so this attracted our interest in the study.
1.4 Significance of the study
Vaccines are effective interventions that reduce the high burden of diseases globally. The research
will help in bridging the gaps in awareness, uptake and accessibility of COVID 19 vaccine at MUST.
More so, findings of this study will help in understanding drawbacks for not accessing the vaccine
and strategies to be implemented like media awareness, which helps to pass more knowledge on
COVID 19 vaccine to increase its uptake and curb the Covid 19 spread.
1.5 Research questions
1. What is the level of knowledge of COVID 19 vaccine among undergraduate students of Meru
University of science and technology?

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2. What is attitude towards COVID 19 vaccine among undergraduate students of Meru
University of Science and technology?
3. What is the prevalence of COVID 19 vaccine uptake among undergraduate students of Meru
University of Science and technology?
1.6 Objectives
1.6.1 General objective
To assess knowledge, attitude and uptake of COVID 19 vaccine among students at Meru university
of science and technology
1.6.2 Specific objectives
1. To evaluate level of knowledge of COVID 19 vaccine among undergraduate students of
Meru University of science and technology
2. To determine attitude towards COVID 19 vaccine among undergraduate students of Meru
University of science and technology
3. To determine the prevalence of COVID 19 vaccine uptake among undergraduate students of
Meru university of science and technology

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CHAPTER TWO
LITERATURE REVIEW
2.0 Introduction
The purpose of the study is to determine the knowledge, attitude and uptake of COVID 19 vaccine
among undergraduate students at Meru University of science and technology. This literature review
explores various theories of COVID 19 vaccine and the empirical literature review based on or study
objectives. The theories and past research findings have been accurately cited.
2.1 Theoretical literature review
2.1.1 COVID 19
COVID-19 is a serious global infectious disease outbreak. It is part of a family of viruses called
coronaviruses that infect both animals and people. This particular one originated in China at the end
of 2019, in the city of Wuhan, which has 11 million residents. In the past two decades coronavirus
outbreaks have caused global concern, including one in 2003 with the severe acute respiratory
syndrome (SARS) and more recently in 2012 with the Middle East Respiratory Syndrome (MERS)
(Roe, 2021).
2.1.2 Symptoms of COVID 19
COVID-19 can cause symptoms very similar to the flu fever and a dry cough (most common),
fatigue, aches and pains, and nasal congestion. As the pandemic spread around the world, other
symptoms such as a loss of sense of smell or taste have emerged – these are not yet conclusive
evidence of infection with the new coronavirus, and the World Health Organization is investigating
this. Severe cases can lead to serious respiratory disease, and even pneumonia (Roe, 2021). Those
most at risk are the elderly, or people with underlying medical issues, such as heart problems or
diabetes.
2.1.3 Transmission
The evidence so far indicates that the virus is spread from person to person through small respiratory
droplets. When a person coughs or sneezes, these droplets can also land on nearby surfaces. There is

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also evidence that the COVID-19 virus can last on surfaces – especially plastic or metal – for up to 3
days. This is why advice to avoid catching COVID-19 has focused on hand washing with soap, the
use of alcohol-based hand sanitizing gels and keeping a distance from people who are symptomatic.
2.1.4 Prevention
Infection prevention and control (IPC) is a practical, evidence-based approach which prevents
patients and health workers from being harmed by avoidable infection and as a result of
antimicrobial resistance.
To prevent the spread of COVID-19:
Maintain a safe distance from others (at least 1 metre), even if they don’t appear to be sick, wear a
mask in public, especially indoors or when physical distancing is not possible, choose open, well-
ventilated spaces over closed ones, open a window if indoors, clean your hands often, use soap and
water, or an alcohol-based hand rub, get vaccinated when it’s your turn, follow local guidance about
vaccination, cover your nose and mouth with your bent elbow or a tissue when you cough or sneeze,
stay home if you feel unwell.
2.1.5 COVID 19 vaccination
Safe and effective vaccines are available that provide strong protection against serious illness,
hospitalization and death from COVID-19. Billions of people have been vaccinated against COVID-
19. Getting vaccinated is one of the most important things you can do to protect yourself against
COVID-19, help end the pandemic and stop new variants emerging (WHO). It is still possible to get
COVID-19 and spread it to others after being vaccinated, so continue to do everything you can to
keep yourself and others healthy. As of 8 April 2022, WHO has evaluated that the following
vaccines against COVID-19 have met the necessary criteria for safety and efficacy:
AstraZeneca/Oxford vaccine, Johnson and Johnson,Moderna, Pfizer/BionTech, Sinopharm, Sinovac,
COVAXIN, Covovax, Nuvaxovid
2.2 Empirical literature review
This section comprises of data of past research finding on the knowledge, attitude and uptake of
COVID 19 vaccine.

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2.2.1 Knowledge about COVID 19 vaccines
Lunsford et al., 2019 mentioned that providing knowledge about diseases to educate the public is
considered as a strategy to help people adopt preventive health behaviors. Therefore, the knowledge
of disease and health is regarded as the key to whether an individual adopts healthy behaviors, and it
is also believed that the more health knowledge an individual has, the better healthy behaviors they
will adopt. From the perspective of health literacy, the acquisition and the understanding of health or
disease knowledge are essential for effective self-management of health or disease (Aljamili, 2020).
In addition, people’s health literacy plays an important role in understanding specific health
knowledge. That is, if they are able to understand the facts of COVID-19, they will convert the
acquired knowledge into practical health-promoting behaviors to improve or maintain their health
conditions. However, knowledge does not necessarily elicit behavioral responses; Allegrante, Auld,
and Natarajan pointed out a huge gap between respondents’ knowledge and behaviors about COVID-
19, whereby respondents did not take preventive health behaviors against COVID-19 not because of
an insufficient knowledge of COVID-19 but due to other factors (Allegrante et al., 2020).
One recent review reported that lack of knowledge and understanding of the benefits of vaccination,
inconsistent recommendations by providers, and uncertainties about cost benefits might be some
critical causes of low adult vaccination coverage (Colizza et.al (2022). Similarly, education about
herd immunity and local vaccination coverage could be a useful tool for increasing willingness to
vaccinate, generating benefits both to individuals and communities (Lazarus et.al (2022). It is safe
and effective for you to receive a second or a third dose of a different COVID-19 vaccine. If you’re
offered a different type of vaccine, you can go ahead and get vaccinated. WHO considers two doses
of any WHO EUL vaccine to be a complete primary series.
WHO Strategic Advisory Group of Experts on Immunization (SAGE) stated that Pfizer or AstraZeneca can
also be used for the third dose, if the original vaccine is not available ("WHO Strategic Advisory Group of
Experts (SAGE) on immunization: Request for nominations", 2018). There is some evidence that being
fully vaccinated can prevent infection with the COVID-19 virus. Even once you are fully vaccinated, continue
to practice the same prevention measures to protect other people. Stay at least 1 metre away from other
people, wear a properly fitted mask over your nose and mouth when you can’t keep this distance, avoid poorly
ventilated places and settings, clean your hands frequently, stay home if unwell and get tested, and stay
informed about how much virus is circulating in the areas where you travel, live and work. Even after getting
vaccinated, keep taking precautions to protect yourself, family and friends if there is still COVID-19 in your

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area. The maximum level of protection is not reached until several weeks after full vaccination
(Allegrante et al., 2020). If you have a two-dose vaccine, this means that you don’t get full immunity
until 2–4 weeks after the second dose.
2.2.2 Attitude
Willingness to accept a vaccine against COVID-19 is recognized as a key issue in determining the
success of a vaccination program. Compared to other sub-populations, college students are better
educated, more open-minded, and respond more quickly to public health issues, therefore, their
attitudes toward COVID-19 vaccines are probably high. A study conducted among medical students
in the Kenya found that concerns about vaccine safety/efficacy were associated with vaccine
acceptability (Yusuf et.al (2022)
Studies conducted reveal that students living in urban and those with health-related course were
positively associated with acceptance of future COVID-19 vaccination .In addition, college students
who worried about being infected with COVID-19, who heard about the COVID-19 vaccines
previously, who thought that vaccines are safe, who thought that vaccines could protect people from
being infected with COVID-19, and who encouraged their family and friends to have the vaccine
were more likely to accept future COVID-19 vaccination (Mathew, T. A. et.al (2022)
Attitude also guides individuals’ behaviors and becomes the motivation for behavior, which
prompts individuals’ intention to take a certain action. Attitude is an individual’s general and
persistent assessment of an object, and this assessment is multidimensional, which is usually divided
into two aspects: cognitive and affective. Cognitive attitude (i.e., instrumental attitude) refers to the
values and beliefs related to objects or beliefs about the costs and benefits on actions, while affective
attitude refers to the emotional experience related to objects, which is an emotion-based perception
(Brandt & Kubin, 2021). Emotions include moods and feelings, embracing both positive and
negative emotions. When an individual feels good, the emotional state is positive; otherwise, it is
negative.
Many studies on attitude and behavior focused on the cognitive aspect of attitude, but less on the
aspects of emotion. For example, Alahdal, Basingab, and Alotaibi indicated that there was significant
positive correlation between participants’ cognitive attitudes and COVID-19 preventive behaviors
(i.e., beliefs that taking certain preventive actions can help to curb the spread of the disease). In KAP
studies on COVID-19, the attitude assessments mainly focused on beliefs of anti-pandemic
behaviors, for example, beliefs that “the pandemic will eventually be controlled” and “handwashing

19. 9
is essential for protecting yourself from infection”. Moreover, prior studies integrally used cognitive
and affective attitudes without distinguishing them for discussion. Pal et al. researched the aspect of
COVID-19 attitude; they not only evaluated individuals’ cognitive beliefs about anti-pandemic
behaviors, but also included emotional evaluations such as COVID-19 anxiety (Stodolinska, 2021).
2.2.3 Uptake of COVID 19 vaccine
Vaccine uptake is the number of people vaccinated with a certain dose of the vaccine in a certain time period,
which can be expressed as an absolute number or as the proportion of a target population. Studies conducted
in Kenya shows that higher COVID-19 vaccine acceptance observed among the rural population in
our study is attributed to the relatively older population who has a higher risk perception due to the
association between old age and severe forms of COVID-19(Yusuf, K. et.al (2022)
It could also be the result of the inaccessibility of online media sources relaying negative COVID-
19 vaccine information. Other studies have also found higher vaccine acceptance rates among the
rural populations as compared to the urban ones. These higher rates of vaccine acceptance in the
rural populations were thought to be due to low knowledge about vaccine side effects, a greater
proportion of older adults and people with comorbidities are at higher risks of severe COVID-19.
However, other studies found that rural populations were more likely to be hesitant about receiving
the COVID-19 vaccine. A study carried out in Kenya just before the roll-out of the vaccine found
that rural counties were 2.5 times more likely to report COVID-19 vaccine hesitancy compared to
urban counties. In this phone-based Kenyan study, the vaccine acceptance level was 53.8% in the
rural counties and 75.9% in the urban counties. The vaccine hesitancy in these rural populations has
been associated with the inconvenience of travel involved in accessing the vaccine and the lack of
confidence in the vaccine.
A study based on a sample from 19 countries involving 13,426 participants showed that the global
uptake of COVID-19 vaccines ranges between as low as 54.8% from Russia to as high as 88.6%
from China (Holt, 2021). Moreover, most western countries report relatively higher public uptake
(59–75%). Similarly, Saudi Arabia, a country with similar demographic distributions as Jordan,
reported a higher acceptance level (64.7%). The acceptability level of vaccinations in Jordan was
often lower than global averages, including seasonal influenza vaccines in 2016–2018 (Aljamili,
2020).
Younger participants were more likely to accept COVID-19 vaccines in the Covid 19 study, contrary
to studies reporting higher acceptance among older age groups (Kwek et al., 2021). This can be

20. 10
explained by the different age distribution among countries, given Jordan as a country with mostly a
young population and high literacy levels. Moreover, there are contrasting reports of gender effects
in the literature, wherein some males were more likely to accept the vaccine, compared to others
reporting higher acceptance among females. Studies conducted in, Jordanian males were more likely
to take the vaccine, in agreement with other researched conducted by other researchers. Interestingly,
Jordanian males were more likely to participate in COVID-19 vaccine clinical trials compared to
females in 2020 (Kwek et al., 2021). Moreover, employed participants were less likely to accept
taking the COVID-19 vaccines, in a contrasting result to available studies in the literature suggesting
that employed individuals were more likely to accept COVID-19 vaccines. The Covid 19 study
confirmed that, the employed participants were older than the unemployed ones, which were found
to be less acceptable to get COVID-19 vaccines (Kwek et al., 2021).

21. 11
CHAPTER THREE
RESEARCH METHODOLOGY
3.1 Introduction
This chapter presents the contains research design, study area, target population, sampling procedure
sample size, data collection instruments, pretesting, data collection and data analysis and ethical
consideration.
3.2 Study design
Cross sectional descriptive study design was used.. The method entails a rigorous and controlled
research or phenomena that can be precisely measured and characterized and it allows collection of
data from a large number of respondents in relatively short period of time.
3.3Study area
Our research was conducted in MUST main campus. MUST is a public university in Kenya located
inMeru county, Tigania west subcounty at NCHIRU market 15 km from Meru town along Meru
Maua highway (MUST website). MUST main campus is also the largest campus with the greatest
number of students from various coursed hence all students got represented.
3.4 Study population
The study population was Meru university students both male and female aged 18 to 29 years
undertaking various programs. The population is estimated to be 11,000 students. The university has
8 schools, including: SAFS (school of agriculture and food science), SBE (school of business
studies), SON (school of nursing), SED (school of education), SCI school of computing and
informatics, SPAS (school of pure and applied sciences), SHS (school of health sciences) and SEA
(school of engineering and architecture). Undergraduate students from each of the schools was
chosen to represent the others in the study population. The undergraduate students were chosen
because they are the largest number in the school, comprising around 89% of the total population of
the students (MUST website)
3.4.1 Inclusion criteria
1. Undergraduate students at Meru University of Science and Technology.
2. Aged between 18 to 29 years
3. Student registered for the semester at the point of data collection

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3.4.2 Exclusion criteria
1. Upgrading undergraduate students.
2. Those attached in their practice areas.
3.5 Sample size determination
Sample size determination is the mathematical estimation of the number of subjects to be
included in a study. Optimum size determination was used as it provides the required or desired
level of accuracy, it also allows for appropriate analysis and valid of significance test.
Sample size was calculated by use of formulae by
n= (Z^2) (p q) ÷d^2 where;
N is the desired sample size,
Z is the standard normal deviate, usually set at 1.96, which corresponds to 95% confidence level.
p is the proportion in the target population estimated to have a particular characteristic.
q =1-p, proportion in the target population not having the particular characteristic
d is the degree of accuracy required, usually set at 0.05 level.
Thus, for this study the desired sample size of population
1.96^2×0.65×0.35÷0.05^2 =349.5856
=350 students.
3.6 Sampling techniques and procedures
Proportionate sampling was used because takes each stratum in the sample as proportionate to the
population size of the stratum.
Schools Number of students in each
school
Sample size of each school
School of Nursing 400 13
School of Education 3900 124
School of Business and
Economics
3500 111
School of Pure and Applied
Sciences
1000 31
School of Computing and
Informatics
500 16

23. 13
3.7 Data collection tools and procedures
Self-administered questionnaire was used without the intervention of the researcher collecting the
data. A structured questionnaire was designed to include 22 questions divided into 4 parts. The first
part comprised questions regarding personal demographic information place. The second parts
covered the respondent’s knowledge, attitude, and uptake of COVID-19 vaccine. Scores for
knowledge regarding the COVID-19 vaccine and new sources were coded as No, Yes and don’t
know. For attitude, a five point Likert scale was used as follows, agree (1), strongly agree (2),
disagree (3), strongly disagree (4) and unsure (5). Uptake was also graded either as vaccinated of not
vaccinated (YES or NO). The questionnaire handed out physically and randomly to the student
within the school and only those who are on session.
3.8 Data analysis and presentation
Results were analysed using descriptive analysis. Statistical Package for Social Science (SPSS)
version 26, was used to analyse the data collected. The frequency and the obtained percentages
helped in determining the uptake, knowledge and accessibility of COVID 19 vaccine.
Attitude was analyzed using a Likert scale (strongly agree, Agree, neutral, disagree, strongly
disagree). Uptake was categorised as either vaccinated or not vaccinated. The analysed data was
presented in pie charts as frequencies and percentages.
3.9 Ethical consideration
Approval to collect data was sought from Vice chancellor, Meru University of Science &
Technology and the Dean, School of Nursing and it was also presented before the ethical committee
for approval. Consent was obtained from participants before data collection. Confidentiality was
maintained by ensuring that the questionnaires collected should not entail the names of the
participants. No unauthorized person was allowed to access the questionnaire. Physical data
collected from participants was shredded and burnt after analysis.
School of Agriculture and
Food sciences
300 10
School of Health Sciences 800 26
School of Education and
Arts
600 19
TOTAL 11000 350

24. 14

25. 15
CHAPTER FOUR
DATA PRESENTATION, ANALYSIS, AND INTERPRETATION OF
RESULTS
4.0 Introduction
This section focuses on data analysis, interpretation, and also the presentation of the results. The
general objective of the study was to assess the knowledge, attitude, and uptake of COVID19
vaccine among undergraduate students of MUST, who were evaluated in a sample of 350
participants. The response rate was 89% (n=310) as shown in the Figure 1 below
Fig.1 shows a pie chart representing questionnaire participant rate.
4.1 Socio-demographic characteristics of the respondents.
Table 1: Distribution of respondents by their Socio-demographic characteristics (n=310).
Variable category Frequency
N=310
Percentage %
Gender Male 100 32.3

26. 16
female 210 67.7
Age 18-20yrs
21-24yrs
25-29years
12
248
50
3.9
80
16.1
School SON
SED
SBE
SPAS
SCI
SAF
SHS
SEA
13
120
82
29
14
10
24
18
4.2
38.7
26.5
9.4
4.5
3.2
7.7
5.8
Year of study Year 1
Year2
Year3
Year4
120
79
59
52
38.7
25.5
19.0
16.8
Table 1. shows distribution of respondents and their characteristics.
The findings in table 1. above reveal that most of the respondents were female 67.7 % (n=210) since
they were easily approachable. The majority of respondents were aged (21-24 years) 80% (n=248).
The respondents were chosen from each school within the university whereby most were from the
School of Education 38.7% (n= 120) while the least were from the School of Agriculture and food
Sciences (n=10). The majority of participants were the first years 38.7% (n=120) since they were the
most willing and easily available within campus hostels while the least were the fourth years 16%
(n=52).
4.2 Knowledge on COVID 19 vaccine among undergraduate student.

27. 17
In figure 2 below it represents participant’s distribution about knowledge.
Figure 2 shows the distribution of knowledge among respondents
Regarding the level of knowledge on COVID 19 vaccine, 71% (n =220) of the respondents had
correct scores on questions assessing knowledge indicating good knowledge on COVID 19 vaccine
whilst almost a quarter of the respondents lacked good knowledge.
Table 2: Univariate analysis of knowledge of COVID 19 vaccine among undergraduate
students at MUST.
VARIABLE ATTRIBUTE FREQUENCY PERCENTAGE
Those who have ever
received a COVID 19
vaccine
AstraZeneca/Oxford
vaccine
Johnson and
Johnson
YES
NO
YES
YES
140
170
110
30
45.2
54.8
78.6
21.4
71
29
knowledge about COVID 19 vaccine
good
poor

28. 18
Those who received a
booster vaccine
YES
NO
80
230
25.8
74.2
Being vaccinated against
infectious diseases reduces
the morbidity and mortality
rates of individuals
YES
NO
290
20
93.5
6.5
Usually, vaccination
against infectious diseases
is protective and improving
the quality of life,
especially for people with
low immunity and those
who suffer from chronic
diseases
YES
NO
305
5
98.4
1.6
awareness of the ongoing
COVID 19 vaccination
through;
social media platforms
fliers
bill boards
YES
NO
310
0
200
40
70
100
0.0
64.5
12.9
22.6
Those who think awareness
has been created about
COVID- 19 vaccine?
YES
NO
180
130
58.1
41.9
Is COVID-19 vaccine safe? YES
NO
150
160
48.4
51.6
Does vaccination affect

29. 19
your body immunity? YES
NO
200
110
64.5
35.5
Are there side effects of
COVID 19 vaccine
YES
NO
210
100
67.7
32.3
Table 2. shows Univariate analysis of knowledge of COVID 19 vaccine.
In figure 2. above majority of participants 93% (n=290) are aware and have the knowledge about
COVID 19 vaccine and the importance of being vaccinated. Almost all the students are aware of the
benefits of getting the vaccine and how it helps boost immunity for people with chronic diseases.
Less than half of participants had received the vaccine. Slightly more than half of the participants
indicated that the vaccines was unsafe for use while 48.4% n = (150) agreed that the vaccine is safe
for use. 67.7% (n=210) of the participants believe that there are side effects of COVID19
vaccination.
4.3Attitude of COVID 19 vaccine among undergraduate students at MUST
Figure 3 shows a representation of attitude among the respondents.
55
45
attitude towards COVID 19 vaccine
poor
good

30. 20
In figure 3 above, it represents that 55% of the participants had poor attitude towards COVID 19
vaccine while less than half had good attitude towards getting vaccinated.
Category Frequency n=310 Percentage %
I believe vaccines are
effective at
preventing diseases.
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
0
0
17
83
210
0
0
5.5
26.8
67.7
There is no need for
vaccine once
recovered from
COVID 19
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
20
29
35
46
180
6.5
9.4
11.3
14.8
58.1
I trust scientists have
developed safe
COVID 19 vaccines
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
144
70
56
19
21
46.5
22.6
18.1
6.1
6.8
I trust the
government to ensure
that COVID 19

31. 21
vaccines are safe.
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
0
0
120
70
100
0
0
38.7
22.6
32.3
The short period of
COVID 19 vaccine
development is
worrisome
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
41
21
38
69
141
13.2
6.8
12.6
22.3
45.5
I don’t believe in the
existence of COVID
19
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
0
0
67
160
83
0
0
21.6
51.6
26.8
I am afraid of side
effects of COVID 19
Vaccine.
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
0
0
0
6
56
100
148
0
0
1.3
18.1
32.3
47.7

32. 22
Table 3 shows the number of respondents and their percentages in terms of attitudes
In figure 3. Respondents were asked different questions concerning attitude towards COVID 19,
67.7% (n=210) strongly believe that vaccines can effectively prevents diseases. 58.1% (n=180)
agreed that there was no need to receive vaccines after recovery while 6.5% (n=20) strongly agreed
that there was need to get vaccinated. 46.5% (n=144) disagreed that scientist have developed safe
COVID 19 vaccines while 6.8% (n=21) believed that the scientist have developed safe COVID 19
vaccine. More than half of the participants agreed that the government should ensure safety of
COVID 19 vaccines while 38.7% (n=120) were not sure of government ensuring vaccines safety.
67.8% (n=210) agree that the vaccines were developed within a short period of time which is
worrisome while 20% (n=62) disagree that vaccines were developed within a short period of time.
Three quarters of the respondents agreed that there was the existence of COVID 19 vaccine. 80%
(n=248) of the participants agree that the COVID 19 vaccine have side effects.
4.4 Uptake of COVID 19 vaccine among undergraduate students at MUST
Figure 4. shows the illustration of uptake of COVID 19 vaccines in form of percentage.
Less than half of the participants have received their vaccination.
45.2
55%
uptake of covid 19 vaccine
VACCINATED
NOT VACCINATED

33. 23
The table below shows distribution of participants uptake of COVID 19 vaccines and booster
vaccines.
variable attribute frequency percentage
If a COVID-19 vaccine is
available with an efficacy
of 95%, would you be a
candidate for receiving all
shots?
YES
NO
247
63
79.7
20.3
If a COVID-19 vaccine is
available with an efficacy of
70%, would you be a candidate
for receiving the vaccine?
YES
NO
49
261
15.8
84.2
Those who have ever
received a COVID 19
vaccine
AstraZeneca/Oxford
vaccine
Johnson and
Johnson
YES
NO
YES
YES
140
170
110
30
45.2
54.8
78.6
21.4
Table 4. shows uptake of COVID 19 vaccines and their frequencies.

34. 24
Regarding the efficacy of COVID 19 vaccine 79.7% (n=247) were willing to get vaccinated. If the
efficacy of COVID 19 vaccine was 70 only 15.8 % (n=49) were not willing to get vaccinated while
84.2 % n=261 were willing to get vaccinated if the efficacy was 90%. Almost all the participants
were will to get the vaccines if the desired efficacy was achieved.

35. 25
CHAPTER FIVE:
CONCLUSION, INTERPRETATION AND DISCUSSION
Introduction
This chapter concludes this report. A summary of the research is presented, and findings of the study
are discussed and interpreted. The significance of this research findings in the context of knowledge,
attitude and uptake of COVID 19 vaccine is examined. Recommendations are also given at end of
the chapter.
5.1 Discussion
5.1.1 Socio-demographic characteristics of the respondents.
Majority of the participants were female students with a percentage of 67.7% (n=??) as they were
easily approachable and willing to participate in the study. Most of the participants were aged
between 18 to 24 years with 83.9% (n=?) and mostly comprised of first year students who were
readily available in the campus hostels.
5.1.2 Knowledge on COVID 19 vaccine among undergraduate student
According to our findings majority of the participants 71% (n=?) had good knowledge, about the
questions concerning COVID 19 vaccines compared to 29% of the participants who had poor
knowledge. According to Aljamili, (2020), from the perspective of health literacy, the acquisition
and the understanding of health or disease knowledge are essential for effective self-management of
health or disease therefore if they are able to understand the facts of COVID-19, they will convert
the acquired knowledge into practical health-promoting behaviors to improve or maintain their
health conditions, which explains our findings on knowledge.
Nearly all the participants agreed that being vaccinated against infectious diseases reduces the
morbidity and mortality rates of individuals. 98.4% of the participants agreed that vaccination
against infectious diseases is protective and improving the quality of life, especially for people with
low immunity and those who suffer from chronic diseases. More than half of the participants believe
that COVID 19 vaccines awareness has been created. Additionally, 64.5% (n=310) were in
agreement that vaccination affects your body immunity. According to Colizza et.al (2022) recent
review reported that lack of knowledge and understanding of the benefits of vaccination, inconsistent

36. 26
recommendations by providers, and uncertainties about cost benefits might be some critical causes of
low adult vaccination coverage which was in in line with our findings.
5.1.3 Attitude of COVID 19 vaccine among undergraduate students at MUST
Regarding attitude 55% (n=310) of the participants had a poor attitude towards the COVID 19
vaccine. Additionally, 58.1% (n=310) of the participants agree that there was no need to receive
vaccines after recovery. 67.8% (n=310) agreed that the vaccines were developed within a short
period of time which was worrisome. According to Yusuf et.al (2022), willingness to accept a
vaccine against COVID-19 is recognized as a key issue in determining the success of a vaccination
program. Compared to other sub-populations, college students are better educated, more open-
minded, and respond more quickly to public health issues, therefore, their attitudes toward COVID-
19 vaccines are high according to our literature review which contradicts with our findings. In
addition, studies conducted in a college in northwest Ethiopia, students had a positive attitude
towards COVID-19 vaccination. Having comorbidity and being male were significantly associated
with good attitude. In addition, being married, being a health science student, being exposed to mass
media, having a good knowledge of COVID-19 vaccination, and having paternal primary education
were significantly associated with a positive attitude towards COVID-19 vaccination which
contradicts our study.
5.1.4 Uptake of COVID 19 vaccine among undergraduate students at MUST
Regarding uptake of COVID 19 vaccine 54.8 % (n=310) of the participants had not received the
vaccine. For instance, 67.7%(n=??? believe that COVID 19 vaccine has side effects which could
affect their health. Only 45.2% have ever received a COVID 19 vaccine with 25.8% receiving
booster vaccine. According to Kwek et al., (2021) Japanese study, younger participants were more
likely to accept COVID-19 vaccines. This is in contradiction to our findings in which there was a
low vaccine uptake among the students. In a research done at Pwani university, 65%N?? of the study
participants had received a COVID-19 vaccine. Furthermore, the vaccinated students seemed to
agree more that COVID-19 vaccines are safe and effective to prevent disease. They also have greater
trust in recommendations and information about COVID-19 given by the healthcare sector which
contradicted our findings.

37. 27
5.2 Conclusion
In conclusion, the knowledge that people possess toward COVID 19 vaccines determine their
attitude which in turn affect their uptake. The study shows that the overall level of knowledge of the
participants concerning COVID 19 vaccines was good. Regarding attitude, the students depicted
poor attitude towards COVID 19 vaccine, this was evident from our finding where majority of the
participants agreed that COVID 19 vaccine was not safe and had side effects. Concerning uptake, a
low turnout was recorded which was in relation to attitude.
5.3 Recommendation
There is a need to establish increased and in-depth mass awareness about COVID 19 vaccines to
ensure sensitization among the campus students to increase knowledge levels which in turn leads to
improved attitude thus increased uptake. Adopting reliable source of information from sources like
WHO which is a more reliable and authorized information source. Encouraging the mass on the
importance of COVID 19 vaccination and the need to get vaccinated. More research regarding
COVID 19 vaccines, knowledge, attitude and uptake should be done to ensure readiness in future
outbreaks.
5.4 limitation of the study
Time constraint due to tight schedule of the school and work overload. In addition, there was lack of
financial resources to facilitate the whole process of data collection and other resources like laptops
which were inadequate among the group members. Some students were harsh and unapproachable
hence it led to a low response rate.

38. 28
REFERENCES
Aljamili, A. (2020). Knowledge and practice toward seasonal influenza vaccine and its barriers at the
community level in Riyadh, Saudi Arabia. Journal Of Family Medicine And Primary
Care, 9(3), 1331. https://doi.org/10.4103/jfmpc.jfmpc_1011_19
Allegrante, J., Auld, M., & Natarajan, S. (2020). Preventing COVID-19 and Its Sequela: “There Is
No Magic Bullet... It's Just Behaviors”. American Journal Of Preventive Medicine, 59(2),
288-292. https://doi.org/10.1016/j.amepre.2020.05.004
Arregocés-Castillo, Rojas-Botero, M. L., Fernández-Niño, J. A, L., & Ruiz-Gómez, F. (2022).
Estimated number of deaths directly avoided because of COVID-19 vaccination among older
adults in Colombia in 2021: an ecological, longitudinal observational
study. F1000Research, 11(198), 198.
Brandt, M., & Kubin, E. (2021). Ratings of Reasons for Disagreement about 95 Attitude Object Pairs
and 190 Attitude Objects. Journal Of Open Psychology Data, 9(1), 4.
https://doi.org/10.5334/jopd.53
Colossi, E., Bassignana, G., Contreras, D. A., Poirier, C., Boëlle, P. Y., Cauchemez, S., ... & Colizza,
V. (2022). Screening and vaccination against COVID-19 to minimise school closure: a
modelling study. The Lancet Infectious Diseases.
Dhama, K., Sharun, K., Tiwari, R., Dhawan, M., Emran, T. B., Rabaan, A. A., & Alhumaid, S.
(2021). COVID-19 vaccine hesitancy–reasons and solutions to achieve a successful global
vaccination campaign to tackle the ongoing pandemic. Human Vaccines &
Immunotherapeutics, 17(10), 3495-3499.
El-Elimat, Tamam, et al. "Acceptance and attitudes toward COVID-19 vaccines: a cross-sectional
study from Jordan." Plos one 16.4 (2021): e0250555.
Fisher, K. A., Bloomstone, S. J., Walder, J., Crawford, S., Fouayzi, H., & Mazor, K. M. (2020).
Attitudes toward a potential SARS-CoV-2 vaccine: a survey of US adults. Annals of internal
medicine, 173(12), 964-973.
González-Block, M. Á., Arroyo-Laguna, J., Rodríguez-Zea, B., Pelcastre-Villafuerte, B. E.,
Gutiérrez-Calderón, E., Díaz-Portillo, S. P., ... & Sarti, E. (2021). The importance of

39. 29
confidence, complacency, and convenience for influenza vaccination among key risk groups
in large urban areas of Peru. Human vaccines & immunotherapeutics, 17(2), 465-474.
Hibbs, B., Miller, E., Shi, J., Smith, K., Lewis, P. and Shimabukuro, T., 2018. Safety of vaccines that
have been kept outside of recommended temperatures: Reports to the Vaccine Adverse Event
Reporting System (VAERS), 2008–2012. Vaccine, 36(4), pp.553-558.
Holt, E. (2021). Countries split from EU on COVID-19 vaccines. The Lancet, 397(10278), 958.
https://doi.org/10.1016/s0140-6736(21)00620-6
Kanagavelu, A., 2021. Knowledge, attitude and practice towards COVID-19 among the general
public in Tamil Nadu, India. International Journal of Community Medicine and Public
Health, 8(4), p.1935.
Kaplan, R. M., & Milstein, A. (2021). Influence of a COVID-19 vaccine’s effectiveness and safety
profile on vaccination acceptance. Proceedings of the National Academy of
Sciences, 118(10).
Kricorian, K., & Turner, K. (2021). COVID-19 vaccine acceptance and beliefs among black and
Hispanic Americans. PloS one, 16(8), e0256122.
Kwek, B., Tan, M., Yu, L., Zhou, W., Chang, C., & Li, D. (2021). Aggressive males are more
attractive to females and more likely to win contests in jumping spiders. Animal
Behaviour, 179, 51-63. https://doi.org/10.1016/j.anbehav.2021.06.030
Navin, M. C., Oberleitner, L. M. S., Lucia, V. C., Ozdych, M., Afonso, N., Kennedy, R. H., ... &
Mathew, T. A. (2022). COVID-19 Vaccine Hesitancy Among Healthcare Personnel Who
Generally Accept Vaccines. Journal of Community Health, 1-11.
Oliu-Barton, M., Pradelski, B. S., Algan, Y., Baker, M. G., Binagwaho, A., Dore, G. J., ... &
Lazarus, J. V. (2022). Elimination versus mitigation of SARS-CoV-2 in the presence of
effective vaccines. The Lancet Global Health, 10(1), e142-e147.
Raja, S. M., Osman, M. E., Musa, A. O., Hussien, A. A., & Yusuf, K. (2022). COVID-19 vaccine
acceptance, hesitancy, and associated factors among medical students in Sudan. Plos
one, 17(4), e0266670.
Rodrigues, F., Block, S., & Sood, S. (2022). What Determines Vaccine Hesitancy:
Recommendations from Childhood Vaccine Hesitancy to Address COVID-19 Vaccine
Hesitancy. Vaccines, 10(1), 80.
Soares, P., Rocha, J. V., Moniz, M., Gama, A., Laires, P. A., Pedro, A. R., ... & Nunes, C. (2021).
Factors associated with COVID-19 vaccine hesitancy. Vaccines, 9(3), 300.

40. 30
Spoulou, V., Alain, S., Gabutti, G., Giaquinto, C., Liese, J., Martinon-Torres, F., & Vesikari, T.
(2019). Implementing universal varicella vaccination in Europe: the path forward. The
Pediatric infectious disease journal, 38(2), 181-188.
Stodolinska, Y. (2021). American University Discourse in the COVID-19 Pandemic: Multimodal
Aspect. Cognitive Studies | Études Cognitives, (21). https://doi.org/10.11649/c.2488
Sturgis, P., Brunton-Smith, I., & Jackson, J. (2021). Trust in science, social consensus and vaccine
confidence. Nature human behaviour, 5(11), 1528-1534.
Suwannapusit, U., & Chayomchai, A. (2018). Innovations and Their Effects on One Tambon One
Product (OTOP) Enterprises’ Performance in Thailand. University of the Thai Chamber of
Commerce Journal Humanities and Social Sciences, 38(1), 18-35.
Tanne, J., 2021. Covid-19: Biden renews vaccines push as cases and deaths rise among unvaccinated
people. BMJ, p.n1742.
Teng, E., Anthony, V., Helen, W., & Shona, C. (2020). Is Knowledge Enough? The Relationship
Between Mental Health Knowledge and Stigmatising Attitudes Among Australian
Adolescents. Adolescent Psychiatry, 9(3), 206-219.
https://doi.org/10.2174/2210676609666181204145835
Wang, P. H., Lee, W. L., Yang, S. T., Tsui, K. H., Chang, C. C., & Lee, F. K. (2021). The impact of
COVID-19 in pregnancy: Part II. Vaccination to pregnant women. Journal of the Chinese
Medical Association, 84(10), 903-910.
Wheelock, A., & Ives, J. (2022). Vaccine confidence, public understanding and probity: time for a
shift in focus? Journal of medical ethics, 48(4), 250-255.
WHO Strategic Advisory Group of Experts (SAGE) on immunization: Request for nominations.
(2018), 36(24), 3567. https://doi.org/10.1016/j.vaccine.2018.05.055
Wise, J. (2021). Covid-19: People who have had infection might only need one dose of mRNA
vaccine. BMJ, n308. https://doi.org/10.1136/bmj.n308
Wise, J., 2021. Covid-19: People who have had infection might only need one dose of mRNA
vaccine. BMJ, p.n308.

41. 31
APPENDICES
Appendix I: CONSENT FORM
Please sign below if you agree to participate in the study;
I hereby give my permission to take part in this research. The nature of the study that will be
conducted has been explained to me. I also understand that my participation in the study is entirely
voluntary, and that I have the right to withdraw anytime without reason or consequence. I have also
been told that my personal information and details will be kept confidential. I affirm that the
investigator has sufficient addressed all of my concerns about my involvement in the study and that
the investigator has asked me questions to ensure that I understand the information provided.
Interviewee……………. Date…………….
I confirm that I have fully explained the study’s purpose and the contents of this consent form to the
participant, and that the person has chosen to participate voluntarily and without compulsion or
undue pressure.
Investigators signature …………... date ……………
Investigators signature …………... date ……………
Investigators signature …………... date ……………

42. 32
Questionnaire
The participant will be required to fill this questionnaire by ticking appropriately.
Section A: Personal information
1 Gender
a. Male [ ]
b. Female [ ]
c. Rather not say [ ]
2. Age [ ]
3. Religion
a. Christianity [ ]
b. Islamic [ ]
c. Traditional [ ]
d. Unaffiliated [ ]
4 School/ department
a. SEA [ ]
b. SCI [ ]
c. SPAS [ ]
d. SBE [ ]
e. SHS [ ]
f. SOE [ ]
g. SAFS [ ]
h. SON [ ]
5 Year of study [ ]
Section B: knowledge on COVID 19 vaccine
6. Being vaccinated against infectious diseases reduces the morbidity and mortality rates of
individuals?
YES [ ]

43. 33
NO [ ]
7. Usually, vaccination against infectious diseases is protective and improving the quality of life,
especially for people with low immunity and those who suffer from chronic diseases?
YES [ ]
NO [ ]
8 Are you aware of the ongoing COVID 19 vaccination?
YES [ ]
NO [ ]
9 Have you ever received a COVID 19 vaccine?
YES [ ]
NO [ ]
If yes which one
a. [ ] AstraZeneca/Oxford vaccine
b. [ ] Johnson and Johnson
c. [ ] Moderna
d. [ ] Pfizer/BioNTech
e. [ ] Sinopharm
f. [ ] Sinovac
g. [ ] COVAXIN
h. [ ] Covovax
i. [ ] Nuvaxovid
10. Have your received a booster vaccine
YES [ ]
NO [ ]
If yes which one
a. [ ] AstraZeneca/Oxford vaccine
b. [ ] Johnson and Johnson
c. [ ] Moderna
d. [ ] Pfizer/BionTech
e. [ ] Sinopharm
f. [ ] Sinovac

44. 34
g. [ ] COVAXIN
h. [ ] Covovax
i. [ ] Nuvaxovid
j. [ ] I don’t remember
11 What was your source of information about vaccines
a. Health workers [ ]
b. Media (television, radio) [ ]
c. Social media platforms [ ]
d. Family/ friends [ ]
12 Do you think enough awareness has been created about COVID- 19 vaccine?
YES [ ]
NO [ ]
If no state how you think awareness can be created;
a. [ ]Through media
b. [ ]Through social media platforms
c. [ ]Through fliers
d. [ ]Through bill boards
13 Do you think COVID-19 vaccine is safe?
YES [ ]
NO [ ]
Explain reason for your answer above………….
14 Will you be willing to get COVID 19 vaccine?
YES [ ]
NO [ ]
If no state why? [ ]
15 Does vaccination affect your body immunity.
YES [ ]
NO [ ]
If YES how
[ ] strengthens
[ ] weakens
16. Are there side effects of COVID 19 vaccine

45. 35
YES [ ]
NO [ ]
If YES which ones
[ ] Impairments
[ ] Death
Section C; attitude towards COVID 19 vaccine
agree Strongly
agree
neutral disagree Strongly
disagree
I believe vaccines are effective at
preventing diseases
There is no need for vaccine once
recovered from COVID 19
I trust scientists have developed safe
COVID 19 vaccines
I trust the government to ensure that
COVID 19 vaccines are safe
The short period of COVID 19
vaccine development is worrisome
I don’t believe in the existence of
COVID 19
I an afraid of side effects of COVID
19 Vaccine
Section C; Uptake of COVID 19 Vaccine

46. 36
18 If a COVID-19 vaccine is available with an efficacy of 95%, would you be a candidate for
receiving all shots?
YES [ ]
NO [ ]
19. If a COVID-19 vaccine is available with an efficacy of 70%, would you be a candidate for receiving the
vaccine?
YES [ ]
NO [ ]
if NO state one reason …………………………
20. If a COVID-19 vaccine was available with the desired efficacy, would you encourage your
fellow students to get the vaccine?
YES [ ]
NO [ ]
22. Are you planning to receive a COVID vaccine in the this year?
YES [ ]
NO [ ]

47. 37
CONSENT LETTER
To: Vice Chancellor,
MERU UNIVERSITY OF SCIENCE AND TECHNOLOGY
TECHNOLOGY,
P.O BOX, 792-60200.
MERU, KENYA
RE: REQUEST FOR PERMISSION TO CONDUCT RESEARCH IN THE UNIVERSITY
DEAR SIR,
Our names are Mutiso John, Dorcas Mumbe, Vicktoria Kyalo, fourth year students perusing bachelor
of health systems management at Meru University of science and Technology. We are currently
undertaking our final research project and we are seeking to assess knowledge, attitude and uptake of
covid-19 vaccines among undergraduate students at MUST. This project will be conducted under
supervision of our lecturer Ms Elizabeth Kamolo.
We are hereby seeking your approval to carry out the study. We have provided you with a copy of
approval letter from the school of nursing. Thank you in advice for your time and consideration.
Student Name Registration Number Signature
Mutiso John NS202/101448/19
Dorcas Mumbe NS202/101451/9
Victoria Kyalo NS202/101479/19

48. 38
Budget
Expenses Units Cost per unit Total cost Rationale
Laptop 1 30000 30000 For googling
research work
Notebook 1 300 300 For writing notes
during data
collection
Rim papers 1 600 600 For printing
questioners
Airtime 1 500 500 For calling
during inquiry
and clarification
Data bundles 3gb 200 600 For searching
information
from the internet
Pens 3 25 75 For
documentation
when collecting
data
Total 3275