Coronavirus disease 2019 (COVID-19) is a contagious disease caused by SARS-CoV-2 and the first known case was identified in Wuhan China in December 2019 (World Health Organization, 2020). In an attempt to control the pandemic, restrictive measures have been done. The Philippines implemented strict lockdowns in response to the pandemic, this also includes a prohibition of movements within the national territory. In March 2020, schools and universities were suspended as precautionary measures to control the rapid spread of COVID-19 infections (CNN, 2020). Since then, the pandemic spread rapidly across the globe and has infected 243 million people, and caused 4.9 million deaths as of October 26, 2021 (World Health Organization, 2021). Philippines’ nationwide COVID-19 cases as of October 26, 2021, reached 2.7 million and 42 thousand deaths. Whereas in Region VII, the total cases as of October 26, 2021, is 151,552 and 4,379 deaths (DOH, 2021). On the same date, Cebu City’s total confirmed cases reached 40,980 and 1,476 deaths (Mancelita, 2021). However, with the advent of the COVID-19 pandemic, vaccination has been considered the best method for controlling the rapid spreading of infectious diseases.
On March 1, 2021, Philippine General Hospital Director Dr. Gerardo Legaspi was the first to receive the first shot of the Sinovac vaccine in front of the media to increase the public’s confidence to get vaccinated (Venzon, 2021). Since then, the country has continuously rolled out vaccines to reach 77 million vaccinated Filipinos by the end of the year 2021 (Jalea, 2021). Furthermore, efficacy rates of the available vaccines according to DOH (2021) are as follows: AstraZeneca 70.4%; Sinovac CoronaVac 65 to 91%; Gamaleya Sputnik V: 91.6%; Janssen: 66.9%; Bharat BioTech: 80.6%; Pfizer-BioNTech: 95%; Moderna: 94.1%.
Given that COVID-19 vaccinations are already implemented, President Rodrigo Duterte with Commission on Higher Education (CHED) approved the limited face-to-face classes for medicine and health allied courses. On September 21, 2021, other programs were also been approved by President Duterte for limited face-to-face classes. CHED encourages students to get vaccinated to ensure safe learning amidst the pandemic. With the plan of expanding the face-to-face classes to other programs, urging college students to get vaccinated is vital. Although vaccination is currently nonmandatory for students undergoing face-to-face classes, CHED Chair Prospero de Vera said they’re still discussing this matter to provide extra protection (Montemayor, 2021). Globally, 2.8 billion individuals are fully vaccinated as of October 26, 2021, according to WHO (2021). In the Philippines, the RESBAKUNA program of DOH campaigns to encourage citizens to get vaccinated. Fully vaccinated individuals in the country have reached 26 million and 56 million total doses administered (DOH, 2021). Additionally, Cebu City reached the 39.3% coverage rate wherein 282,806 individuals received 2nd dose (DOH, 2021). As COVID-19 vaccination programs are being implemented widely, it is still vital to examine the factors that may correlate to college students’ acceptance and uptake towards the COVID-19 vaccine.
People’s knowledge of the COVID-19 vaccine is a critical aspect that the government, policymakers, or even the school administrators must take into account to address needs for health education and enhance vaccine uptake. In the study conducted by Islam et al. (2021), they found out that the higher educational background individuals have, will most likely have higher knowledge about the COVID-19 vaccine. Furthermore, Mohamed et al. (2021) conducted a web-based study among the Malaysian population and it was determined that high knowledge scores regarding the COVID-19 vaccine are associated with higher education background, higher-income category, and living with who is at higher risk of getting severe COVID-19. The study also pointed out the lower age group tends to be willing to get vaccinated. In contrast to the study of Mohamed et al. (2021), a study of Abebe et al. (2021) found out that the adult population from Ethiopia (with age > 46) has higher vaccine acceptance in comparison to the adult population with age in between 18 and 25 years old. Significant factors identified that influenced COVID-19 vaccine acceptance, including having chronic diseases, attending secondary and higher education, and good knowledge about the vaccine.
The vaccination program is the key strategy to halt the escalation of COVID-19 cases (Pogue et al., 2020). A study performed in Slovenia, Poland, and Serbia among nursing students declared that attitudes in higher adherence to preventive health protocols are associated with trust in institutions, profound belief in benefits/effectiveness of the vaccine, social environments influences, and perceived health care professionals’ duty. However, the main reason for the refusal of vaccines is the fear of side effects (Kregar Velikonja et al., 2021). To promote vaccine acceptance among the population, it is important to also determine how people perceive and make sense of the developed COVID-19 vaccines (Roldan de Jong, 2021). University students as the target sample, it is essential to understand their perceptions of public health planning.
A study conducted by Mant et al. (2021) showed that students from Canadian public universities are willing to get vaccinated which can be associated with a higher perception of the individual to the severity of the COVID-19 pandemic. It was stated that some respondents would be more encouraged if medical professionals are the ones that will give them advice. In a further study conducted on college students in South Carolina, information sources about COVID-19 vaccines play a critical role in vaccine acceptance. Social media sources have negative impacts on vaccine acceptance while health agencies, scientists, and healthcare providers who garnered the trust of the participants were associated with higher vaccine acceptance (Qiao et al., 2020).
Based on thorough observation on various reviews of related literature, it has allowed the researchers to identify the following gaps to the research study: it failed to highlight how vaccine efficacy can proportionally affect vaccination acceptance. Most of their research highlighted how income level, age, educational background, and geographical location impact vaccination acceptance. However, the impact of vaccine benefits outweighing risks has not been given an emphasis. Furthermore, the studies made were all done internationally which paved an interest for the researchers to conduct here in the locality. COVID 19 vaccine hesitancy has been frequently studied among health care workers and most especially medical students, putting more emphasis on specific municipalities/barangays/community’s demographic basis but is least likely conducted towards educational institutions/universities. Nevertheless, putting into consideration the rapidly evolving situation, there is only limited data available. Knowledge, Attitude, Perception as the aforementioned reasons can be applied to further show a strong correlation towards COVID 19 vaccine hesitancy.
In this paper, researchers will utilize an online survey questionnaire to investigate the knowledge, attitude, and perception towards acceptance of the COVID-19 vaccine and to fill in the gaps of previous studies. Taking into consideration, the impact of vaccine efficacy levels on vaccine acceptance among Josenian college students. Furthermore, this study aims to explore the significance of the three factors knowledge, attitude, and perceptions on COVID-19 vaccine acceptance. As well as it will serve as a basis for information dissemination and health education for safety of all the students as well as the teachers in preparation for limited face-to-face classes of different programs at the University of San Jose-Recoletos. To also contribute to more knowledge regarding this topic.
II. CONCEPTUAL FRAMEWORK
The researchers have identified three variables namely, Knowledge, Attitude, and Perception. The three variables have different specifications, as shown in the framework below. The first variable Knowledge specifies the benefits of the vaccine, safety of the vaccine, long-term protection, side effects, and availability. The second variable, Attitude, specifies protection, safety and effectiveness, and prevention. Lastly, the third variable Perception includes compliance with a government mandate, safe and prevention, information dissemination, and perception of the pandemic.
The study of Islam et al. (2019) emphasizes how one should take steps to ensure adequate knowledge, positive attitudes, and perceptions towards COVID-19 vaccinations to reduce the vaccine hesitancy facilitated and encouraged by misinformation in the media.
Figure 1. Conceptual Framework of the Study
Based on the conceptual framework shown above, it shows three variables: Knowledge, Attitude, and Perception depict how they are related towards the acceptance of the COVID-19 vaccine of the Josenian college students.
Knowledge is understanding of or information about a subject that you get by experience or study, either known by one person or by people generally (Cambridge Dictionary, 2021). With the continuing rollout of the COVID-19 vaccines in our country, the decision to vaccinate or not is influenced by one of the factors, such as an individual’s level of knowledge. In this study, one of our goals is to evaluate the Josenian College Students’ level of knowledge and awareness of the virus and the available vaccines using the provided standardized questionnaire. Misinformation or a lack of awareness due to no information can pose an increased level of vaccine hesitancy. However, accurate knowledge alone is not enough to ensure vaccine acceptance but can still yield a high probability for an individual to get vaccinated.
Attitude is a mental disposition regarding a fact or state that affects a person’s behavior (Merriam-Webster Dictionary, 2021). It pertains to what the Josenian College students feel about COVID-19 vaccination. With the distribution of vaccines underway, it is very important to investigate public attitudes of the students towards COVID-19 vaccinations to implement the most effective vaccination strategy.
Perception, on the other hand, is the “mode of apprehending reality and experience through the senses” (Given, 2008). Thus, it plays a critical role in college students’ acceptance of the COVID-19 vaccine. This study defines Perception as college students’ discernment and judgment towards the legitimacy of the pandemic and the COVID-19 vaccines. The conceptual framework also mentions how the students perceive if the pandemic is real. Pandemic in the context of the study is defined as the global outbreak of Coronavirus disease (COVID-19) that significantly affected a large proportion of the world’s population (Rogers, 2020).
According to Lindholt et al. (2021), effective management of the COVID-19 pandemic should not only limit the approval of safe and effective vaccines but also improve vaccine acceptance among people. Acceptance is defined as “the act of accepting something” (Merriam-Webster Dictionary, 2021). Acceptance can be spoken or assumed, and it might be conditional. Reluctance, resistance, or even opposition may be due to different variables present. Furthermore, this study intends to determine the significant relationship for the three variables as the predictors of COVID-19 acceptance among the Josenian college students to help for future efforts to increase vaccine uptake that may eventually lead to herd immunity against COVID-19.