What are the COVID-19 vaccine willingness rates among the health care workers (HCWs) in 3 Southeast Asian jurisdictions in the context of pandemic severity and vaccination policies?
In this survey study including responses from 3396 doctors and nurses , willingness to take the COVID-19 vaccine was highest in Nepal, followed by Vietnam, and lowest in Hong Kong, which may be associated with the pandemic severity and vaccination policy in the 3 jurisdictions. Type of HCW (doctor), older age, male gender, higher educational level, and having seasonal influenza vaccination history were found to be factors associated with vaccination willingness.
The findings of this study may have utility in informing future public health policies and strategies to promote vaccine acceptance during pandemics.
COVID-19 vaccine hesitancy is widespread and may lead to refusal or delay of vaccination, eventually reducing the overall vaccination coverage rate and vaccine effectiveness. Willingness to receive COVID-19 vaccination among health care workers (HCWs) is diverse across different jurisdictions.
To assess the COVID-19 vaccine willingness among HCWs in 3 Southeast Asian jurisdictions in the context of pandemic severity and vaccination policy.
Design, Setting, and Participants
A cross-sectional online survey was conducted among frontline HCWs in Hong Kong, Nepal, and Vietnam from May to November 2021. Eligible participants were nurses and doctors aged 18 and older, working in public or private health care settings on a full-time or part-time basis.
The COVID-19 pandemic and vaccination policy.
Main Outcomes and Measures
COVID-19 vaccination willingness was defined as HCW willingness toward receiving the COVID-19 vaccine in full course or the first dose of the vaccine, and willingness to take the second dose. Information on sociodemographic characteristics, the history of seasonal influenza vaccination, attitudes toward vaccination, and opinions on strategies associated with vaccination uptake from the study participants.
Among the 3396 eligible doctors and nurses who participated in the survey, 2834 (83.4%) were from Hong Kong, 328 (9.7%) were from Nepal, and 234 (6.9%) were from Vietnam. Most respondents were female (76.2% [2589 ]), aged 30 to 39 years (31.2% ), and nurse HCWs (77.6% ); the response rates were 11% (2834 of 25 000) in Hong Kong, 36% (328 of 900) in Nepal, and 13% (234 of 1800) in Vietnam. Overall, the prevalence rate of willingness to take the COVID-19 vaccine was highest in Nepal (95.4% [313 of 328]), followed by Vietnam (90.6% [212 of 234]), and lowest in Hong Kong (54.4% [1542 of 2834]), relating to their different attitudes and opinions toward the COVID-19 vaccination, and the pandemic severity and vaccination policy in the 3 jurisdictions. Doctors were more willing to take COVID-19 vaccination than nurses (odds ratio, 5.28; 95% CI, 3.96-7.04). Older age (odds ratios, 1.39-3.70), male gender (odds ratio, 1.41; 95% CI, 1.11-1.75), higher educational level (odds ratio, 1.48; 95% CI, 1.17-1.87), and having seasonal influenza vaccination uptake history (odds ratio, 2.15; 95% CI, 1.82-2.54) were found to be associated with increased willingness. Choice of vaccination brand with adequate information, immunity passport, time off from work for vaccination and subsidy for travel to inconvenient vaccination centers were considered as strategies to enhance vaccine willingness.
Conclusions and Relevance
In this survey study, vaccination unwillingness existed among HCWs in Southeast Asian regions, especially in Hong Kong. The findings of this study may have utility in the formulation of vaccination promotion strategies such as vaccination incentives. Attitudes toward vaccination in HCWs might be examples for the general population; however, changes over time should be further investigated.
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Accepted for Publication: July 7, 2022.
Published: August 22, 2022. doi:10.1001/jamanetworkopen.2022.28061
Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2022 Wong ELY et al. JAMA Network Open.
Corresponding Author: Eliza Lai-yi Wong, PhD, Professor, Prince of Wales Hospital, School of Public Health Building, Room 418, Shatin, NT, Hong Kong (email@example.com).
Author Contributions: Ms E. LY Wong and Dr Qiu had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: E. Wong, Chien, C. Wong, Chan, M. Wong, Yeoh.
Acquisition, analysis, or interpretation of data: E. Wong, Qiu, Chalise, Hoang, Trang Nguyen, Cheung.
Drafting of the manuscript: E. Wong, Qiu.
Critical revision of the manuscript for important intellectual content: E. Wong, Chien, C. Wong, Chalise, Hoang, Trang Nguyen, Chan, M. Wong, Cheung, Yeoh.
Statistical analysis: Qiu.
Administrative, technical, or material support: Chien, C. Wong, Cheung.
Supervision: E. Wong, Chan, M. Wong, Yeoh.
Conflict of Interest Disclosures: None reported.
Additional Contributions: We thank Ms Zoe Pui Yee Tam (BSc) and Mr Jonathan Chun Hei Ma (BSc) from the Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, HKSAR, China for their support on monitoring the survey collection platform. No compensation was received.
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