CHAPTER ONE
1.0 BACKGROUND
1.1 INTRODUCTION
Coronavirus disease 2019 (COVID-19) is defined as an illness caused by a novel coronavirus called Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2; formerly called 2019-nCoV). It was first identified amid an outbreak of respiratory illness cases in Wuhan City, Hubei Province, China (WHO, 2020). It was initially reported to the World Health Organization (WHO) on December 31, 2019. On January 30, 2020, the WHO declared the COVID-19 outbreak a global health emergency. On March 11, 2020, the WHO declared COVID-19 a global pandemic, its first such designation since declaring H1N1 influenza a pandemic in 2009 (Cennimo, 2020).
According to CDC (2020b), COVID-19 spreads when an infected person coughs, sneezes, or breathes out droplets and very small particles that contain the virus. These droplets and particles can be breathed in by other people or land on their eyes, noses, or mouth which acts as a source of entry for the virus. People who are closer than 6 feet from the infected person are most likely to get infected. In several instances, the droplets or the infected person may contaminate surfaces they touch and an uninfected individual will pick it up later on and transfer it into the body through exposed mucosa surfaces (eyes, nose, and mouth).
Due to the easy spread of the virus, governments globally have imposed several measures and protocols to help halt the spread of COVID-19 such as travel bans, wearing of nose masks, national lockdowns, social distancing, frequent handwashing with soap and water, among others. To further halt the spread and deaths associated with COVID-19, researchers and pharmaceutical companies are collaborating to develop safe and effective vaccines for the general public to lessen the trouble brought by the instilled measures. Currently, the FDA-approved COVID-19 vaccines are the only effective way of curbing the pandemic (CDC, 2020a).
A vaccine is a substance used to stimulate the production of antibodies and provide immunity against one or several diseases, prepared from the causative agent of a disease, its products, or a synthetic substitute, treated to act as an antigen without inducing the disease. Hence when an individual is vaccinated, the person’s immune system is stimulated to form defenses against the disease (Uzochukwu et al., 2021). Vaccines are well-acknowledged for their effectiveness in controlling and, in certain occurrences, eliminating some diseases of humanity such as smallpox. Smallpox was eradicated in May 1980 following inoculation while wild-type poliomyelitis was just beaten in Nigeria in August 2020.
1.2 PROBLEM STATEMENT
In Ghana, from 3rd January 2020 to 4:48 pm CET, 10th December 2021, there have been 131,246 confirmed cases of COVID-19 with 1,228 deaths, reported to WHO [Ghana: WHO Coronavirus Disease (COVID-19) Dashboard, 2021]. The MOH, Ghana has started a mass vaccination of the general public seeking to reach herd immunity. Herd immunity (or community immunity) occurs when a high percentage of the community is immune to a disease (through vaccination and/or prior illness), making the spread of this disease from person to person unlikely. Even individuals not vaccinated (such as newborns and the immunocompromised) are offered some protection because the disease has little opportunity to spread within the community (APIC, 2015). However, such immunity requires a sufficient proportion of the population to be vaccinated. While vaccination is effectively recognized as an effective way to reduce and eliminate the burden of COVID-19, its effectiveness depends on the population’s willingness to be vaccinated. Immunization programs are only successful when there is a high acceptance rate of the vaccine.
As of 24th November 2021, 2,651,463 which is 8.5% of the entire population have taken at least 1 dose out of the 2 doses. 842,225 which is 2.7% of the entire population is fully vaccinated (Ritchie et al., 2020). This is due to various reasons by individuals. These include risk perception of the disease, perception of vaccine safety and efficacy, general vaccination attitudes, past vaccination history, doctors’ recommendation, vaccination costs, vaccination convenience, and sociodemographic characteristics. Reports indicate that even some HCW have refused the COVID-19 vaccine and are even propagating false messages against the vaccination. HCW are important people in educating and influencing the general public in taking the vaccine and if they are rather not taking it, then there is a call for alarm.
1.3 JUSTIFICATION
The FDA of Ghana on 26th July 2021, publicly pronounced the availability of the Oxford/AstraZeneca, Sputnik V, CovishieldTM, Johnson & Johnson’s Janssen, Moderna Spikevax, Pfizer BioNTech COVID-19 vaccines for use in the country. HCW has been recognized as the first receiver of the vaccine. Since the announcement was made for the availability of the COVID-19 vaccines in Ghana, there has been a varied response as to whether or not to receive or refuse the vaccination by quite a lot of people in the country, including university students. There are no studies in Ghana to assess the extent to which university students have accepted vaccination.
Preferably, people rely on HCW including health professionals under training for information to influence their decision. For example, studies have indicated that HCW counseling on exclusive breastfeeding and complementary feeding influenced the practice of exclusive breastfeeding among mothers (Aidam et al., 2005). For this reason, this study seeks to assess and identify the determinants of COVID-19 vaccination attitudes among UHAS undergraduate students who are yet to be professional HCW. Scrutinizing the knowledge, perception, and attitudes of undergraduate university students towards COVID-19 vaccination will help researchers and policymakers to strategize suitable interventions to decrease the negative attitude towards the vaccination among HCW and more importantly but subsequently, the general population.
1.4 AIM
To assess the knowledge, perception, attitude, and factors that influence the acceptance of COVID-19 vaccination among undergraduate students of UHAS, Ho.
1.5 SPECIFIC OBJECTIVES
1. To assess the knowledge and perception of UHAS undergraduate students on COVID-19 vaccination.
2. To determine the attitude of UHAS undergraduate students towards COVID-19 vaccination.
3. To identify the factors that influence the acceptance or rejection of COVID-19 vaccination among UHAS undergraduate students.