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      The community acceptance of COVID-19 vaccines in Rakhine State: A cross-sectional study in Myanmar

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          Abstract

          The global pandemic situation of SARS-CoV-2 (COVID-19) has been ongoing for more than 2 years with the emergence of different variants. With the rapid development of vaccines, countries including Myanmar rolled out vaccination programs to reduce the morbidity and mortality due to COVID-19 with the ultimate goal to end the pandemic. This study seeks to explore the acceptance of the general adult population towards the COVID-19 vaccines administered by the Ministry of Health, and barriers to vaccine acceptance. A quantitative cross-sectional study was conducted by adopting valid and reliable questionnaires from similar studies around the world. Simple random sampling was used to select 288 participants from 12 townships of Rakhine State, Myanmar. The interview was performed using standardized paper-based documents. While the data entry and manipulation were performed using Microsoft Excel, the data analysis process was performed using the Statistical Package for Social Science (SPSS) software. As descriptive statistics, the level of vaccine acceptance, and barriers to vaccine acceptance were calculated. Chi-square analysis and bivariate logistics regression was performed to explore the associated socio-demographic characteristics, COVID-19 and vaccine-related experience, and perceptions of participants on the health belief model (HBM) domains related to vaccine acceptance. A total of 276 participants entered the study and revealed an overall vaccine acceptance level of 91.3%. Higher level of education, working in skilled manual and sales services, monthly income of more than 200,000 MMK (111 USD), history of previous vaccination, not experiencing side effects of vaccine after previous immunization, and elements of the health belief model (HBM) were associated with higher vaccine acceptance. The barriers to vaccine acceptance were mistrust of the efficacy of vaccines and potential major adverse events of COVID-19 vaccines. The high level of vaccine acceptance among the general population in Rakhine state provides an opportunity for health authorities to achieve high vaccination coverage within the community. Nevertheless, the vaccine-related education campaigns should be targeted and conveyed frequently to the sub-groups of the population with vaccine hesitancy to obtain the highest achievable level of vaccine coverage within the community for the ultimate goal to end the pandemic.

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          Most cited references30

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          Vaccine hesitancy: Definition, scope and determinants.

          The SAGE Working Group on Vaccine Hesitancy concluded that vaccine hesitancy refers to delay in acceptance or refusal of vaccination despite availability of vaccination services. Vaccine hesitancy is complex and context specific, varying across time, place and vaccines. It is influenced by factors such as complacency, convenience and confidence. The Working Group retained the term 'vaccine' rather than 'vaccination' hesitancy, although the latter more correctly implies the broader range of immunization concerns, as vaccine hesitancy is the more commonly used term. While high levels of hesitancy lead to low vaccine demand, low levels of hesitancy do not necessarily mean high vaccine demand. The Vaccine Hesitancy Determinants Matrix displays the factors influencing the behavioral decision to accept, delay or reject some or all vaccines under three categories: contextual, individual and group, and vaccine/vaccination-specific influences.
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            A global survey of potential acceptance of a COVID-19 vaccine

            Several coronavirus disease 2019 (COVID-19) vaccines are currently in human trials. In June 2020, we surveyed 13,426 people in 19 countries to determine potential acceptance rates and factors influencing acceptance of a COVID-19 vaccine. Of these, 71.5% of participants reported that they would be very or somewhat likely to take a COVID-19 vaccine, and 61.4% reported that they would accept their employer’s recommendation to do so. Differences in acceptance rates ranged from almost 90% (in China) to less than 55% (in Russia). Respondents reporting higher levels of trust in information from government sources were more likely to accept a vaccine and take their employer’s advice to do so.
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              Vaccine hesitancy: the next challenge in the fight against COVID-19

              Vaccine hesitancy remains a barrier to full population inoculation against highly infectious diseases. Coincident with the rapid developments of COVID-19 vaccines globally, concerns about the safety of such a vaccine could contribute to vaccine hesitancy. We analyzed 1941 anonymous questionnaires completed by healthcare workers and members of the general Israeli population, regarding acceptance of a potential COVID-19 vaccine. Our results indicate that healthcare staff involved in the care of COVID-19 positive patients, and individuals considering themselves at risk of disease, were more likely to self-report acquiescence to COVID-19 vaccination if and when available. In contrast, parents, nurses, and medical workers not caring for SARS-CoV-2 positive patients expressed higher levels of vaccine hesitancy. Interventional educational campaigns targeted towards populations at risk of vaccine hesitancy are therefore urgently needed to combat misinformation and avoid low inoculation rates.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: MethodologyRole: Project administrationRole: SoftwareRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: Data curationRole: Supervision
                Role: Data curationRole: SupervisionRole: Validation
                Role: Data curationRole: SupervisionRole: Validation
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Project administrationRole: SoftwareRole: SupervisionRole: Writing – review & editing
                Role: Editor
                Journal
                PLOS Glob Public Health
                PLOS Glob Public Health
                plos
                PLOS Global Public Health
                Public Library of Science (San Francisco, CA USA )
                2767-3375
                3 August 2023
                2023
                : 3
                : 8
                : e0002162
                Affiliations
                [1 ] Faculty of Health and Social Sciences, University of Bedfordshire, Luton, United Kingdom
                [2 ] University Research Co., LLC (URC), Eliminate Malaria Burma Project, Yangon, Myanmar
                [3 ] Myanmar Health Assistant Association, Yangon, Myanmar
                [4 ] Myanmar Nurse and Midwife Association, Yangon, Myanmar
                [5 ] Department of Health and Social Sciences, STI Myanmar University, Yangon, Myanmar
                Fundacao Oswaldo Cruz, BRAZIL
                Author notes

                The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0003-0480-4922
                Article
                PGPH-D-22-01528
                10.1371/journal.pgph.0002162
                10399871
                80f90baf-bfb7-4096-a9d1-a62a8f5036b1
                © 2023 Simon et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 21 September 2022
                : 19 June 2023
                Page count
                Figures: 3, Tables: 8, Pages: 20
                Funding
                The authors received no specific funding for this work.
                Categories
                Research Article
                Medicine and Health Sciences
                Medical Conditions
                Infectious Diseases
                Infectious Disease Control
                Vaccines
                Medicine and Health Sciences
                Medical Conditions
                Infectious Diseases
                Viral Diseases
                Covid 19
                Biology and Life Sciences
                Immunology
                Vaccination and Immunization
                Medicine and Health Sciences
                Immunology
                Vaccination and Immunization
                Medicine and Health Sciences
                Public and Occupational Health
                Preventive Medicine
                Vaccination and Immunization
                People and Places
                Geographical Locations
                Asia
                Myanmar
                Biology and Life Sciences
                Immunology
                Vaccination and Immunization
                Vaccine Development
                Medicine and Health Sciences
                Immunology
                Vaccination and Immunization
                Vaccine Development
                Medicine and Health Sciences
                Public and Occupational Health
                Preventive Medicine
                Vaccination and Immunization
                Vaccine Development
                Social Sciences
                Sociology
                Education
                Schools
                Medicine and Health Sciences
                Medical Conditions
                Infectious Diseases
                Infectious Disease Control
                Vaccines
                Viral Vaccines
                Biology and Life Sciences
                Microbiology
                Virology
                Viral Vaccines
                Social Sciences
                Anthropology
                Cultural Anthropology
                Religion
                Social Sciences
                Sociology
                Religion
                Custom metadata
                The datasets mentioned in this research are available in online repositories, and the repository names as well as the corresponding accession numbers are provided below: https://figshare.com/s/61577bcefb92002f87cc.
                COVID-19

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