Understanding COVID-19 vaccine hesitancy in Malaysia: Public perception, knowledge, and acceptance.

BACKGROUND: Vaccine hesitancy has been around since the introduction of smallpox vaccine. Vaccine hesitancy has become more intense due to the rise of vaccine information in social media and mass adult vaccination during COVID-19 pandemic. This study investigated knowledge, perception, and reasons for rejection of the COVID-19 vaccine among Malaysian adults who refused to get free COVID-19 vaccination. METHODS: An online cross-sectional survey using an embedded mixed-method study [QUAN(quali)] was conducted among Malaysian adults. The quantitative section consisted of a 49-item questionnaire, whereas the qualitative sections consisted of two open-ended questions (1) "Please state your reason why you have not registered or have no intention to register at all for COVID-19 vaccines?" and (2) "Please tell us if you have any suggestions for improvement about COVID-19 vaccine delivery". Data from respondents who were not willing to get vaccination were extracted from the overall data and further analyzed in this paper. RESULT: Sixty-one adults completed the online open-ended survey with a mean age of 34.28 years (SD = 10.30). Among factors that influenced them to get vaccinated was information on vaccine effectiveness (39.3%), death due to COVID-19 (37.7%), and recommendations from the Ministry of Health (36.1%). Most of the respondents (77.0%) were knowledgeable about vaccines, with half having high-perceived risks (52.5%) to COVID-19. While 55.7% and 52.5% had, high perceived barriers and benefits to COVID-19 vaccines respectively. The reasons for vaccine rejections included vaccine safety, indecisiveness, underlying medical conditions, herd immunity, non-transparent data, and use of traditional or complementary medicine. CONCLUSION: The study explored the multitude factors that drive perception, acceptance, and rejection. The qualitative approach with a small sample size provided more data point for interpretations and allowed participants to express themselves. This is important to develop strategies to create public awareness on vaccines not just for COVID-19 but any infectious diseases that can be curbed through vaccination.

Assessment of acceptability of the COVID-19 vaccine based on the health belief model among Malaysians-A qualitative approach.

INTRODUCTION: Several countries have started mass vaccination programs to halt the spread of the COVID-19 pandemic. With an R naught value of 2 to 3, about 70% of the population needs to be immunized to achieve herd immunity. This study aimed to investigate the reasons for acceptance or refusal of COVID-19 vaccines among the Malaysian population. METHODOLOGY: An exploratory, descriptive qualitative design was performed. The cross-sectional survey used a non-probability convenient sampling technique to recruit the respondents, who were required to answer an open-ended question: Either "If you are willing to get the vaccine, please state your reason" or "If you are not willing to get vaccinated, please state your reason." The survey also included questions on demography such as age, gender, and place of residence. According to the Health Belief Model, the data was transcribed, translated, and analyzed: perceived susceptibility, perceived severity, perceived barrier, and cues for action. RESULTS: A total of 1091 respondents who completed the online survey comprised 685 (62.8%) females, 406 (37.2%) males, with a mean age of 38.16 (SD = 16.44). The majority (81.1%) were willing to get vaccinated. Thematic analysis showed that most respondents perceived that the vaccine is safe, effective, protective and will provide herd immunity. Barriers to vaccination include unknown long-term side effects, rapid vaccine production, inadequate information and concerns regarding halal status. Cues to vaccination included individual desire, social responsibility, economic concerns and wait-and-see behavior. CONCLUSIONS: The public should be well informed about the vaccine, its efficacy, side effects, and halal status to increase vaccine acceptability and achieve herd immunity.

The effectiveness of various gargle formulations and salt water against SARS-CoV-2.

The COVID-19 is difficult to contain due to its high transmissibility rate and a long incubation period of 5 to 14 days. Moreover, more than half of the infected patients were young and asymptomatic. Virus transmission through asymptomatic patients is a major challenge to disease containment. Due to limited treatment options, preventive measures play major role in controlling the disease spread. Gargling with antiseptic formulation may have potential role in eliminating the virus in the throat. Four commercially available mouthwash/gargle formulations were tested for virucidal activity against SARS-CoV-2 in both clean (0.3 g/l BSA) and dirty (0.3 g/l BSA + 3 mL/L human erythrocytes) conditions at time points 30 and 60 s. The virus was isolated and propagated in Vero E6 cells. The cytotoxicity of the products to the Vero E6 was evaluated by kill time assay based on the European Standard EN14476:2013/FprA1:2015 protocol. Virus titres were calculated as 50% tissue culture infectious dose (TCID50/mL) using the Spearman-Karber method. A reduction in virus titer of 4 log10 corresponds to an inactivation of ≥ 99.99%. Formulations with cetylperidinium chloride, chlorhexidine and hexitidine achieved > 4 log10 reduction in viral titres when exposed within 30 s under both clean and dirty conditions. Thymol formulations achieved only 0.5 log10 reduction in viral titres. In addition, salt water was not proven effective. Gargle formulations with cetylperidinium chloride, chlorhexidine and hexetidine have great potential in reducing SAR-CoV-2 at the source of entry into the body, thus minimizing risk of transmission of COVID-19.

Knowledge, acceptance and perception on COVID-19 vaccine among Malaysians: A web-based survey.

BACKGROUND: Coronavirus disease 2019 or COVID-19 is caused by a newly discovered coronavirus, SARS-CoV-2. The Malaysian government has planned to procure COVID-19 vaccine through multiple agencies and companies in order to vaccinate at least 70% of the population. This study aimed to determine the knowledge, acceptance and perception of Malaysian adults regarding the COVID-19 vaccine. METHODOLOGY: An online survey was conducted for two weeks in December 2020. A bilingual, semi-structured questionnaire was set up using Google Forms and the generated link was shared on social media (i.e., Facebook and WhatsApp). The questionnaire consisted of questions on knowledge, acceptance and perception of COVID-19 vaccine. The association between demographic factors with scores on knowledge about COVID-19 vaccine were analysed using the Mann-Whitney test for two categorical variables, and the Kruskal-Wallis test used for more than two categorical variables. RESULTS: A total of 1406 respondents participated, with the mean age of 37.07 years (SD = 16.05) years, and among them 926 (65.9%) were female. Sixty two percent of respondents had poor knowledge about COVID-19 vaccine (mean knowledge score 4.65; SD = 2.32) and 64.5% were willing to get a COVID-19 vaccine. High knowledge scores associated with higher education background, higher-income category and living with who is at higher risk of getting severe COVID-19. They were more likely to be willing to get vaccinated if they were in a lower age group, have higher education levels and were female. CONCLUSION: Even though knowledge about vaccine COVID-19 is inadequate, the majority of the respondents were willing to get vaccinated. This finding can help the Ministry of Health plan for future efforts to increase vaccine uptake that may eventually lead to herd immunity against COVID-19.

In vitro virucidal activity of povidone iodine gargle and mouthwash against SARS-CoV-2: implications for dental practice.

Introduction Virus particles in respiratory droplets and aerosols generated during medical/dental procedures are a potential source of SARS-CoV-2 cross infection. In the dental setting, oral decontamination could be an important adjunct to personal protective equipment and is recommended by a number of national COVID-19 guidance documents for dental settings.Aim To assess the in vitrovirucidal activity of an oral povidone iodine (PVP-I) product against SARS-CoV-2.Material and methods BETADINE gargle and mouthwash (1% PVP-I) was tested against SARS-CoV-2 virus under both clean and dirty conditions using a suspension assay based on EN14476 methodology. Virucidal activity of the product, undiluted and at 1:2 dilution, was tested at contact times of 15, 30 and 60 seconds. Viral titres were calculated using the Spearman-Kärber method and reported as median tissue culture infectious dose (TCID50/ml).Results The undiluted product achieved >5 log10 reduction in viral titres compared to the control at 15, 30 and 60 seconds under both clean and dirty conditions. At a twofold dilution (0.5% PVP-I), the test product demonstrated >4 log10 kill at 15 seconds and >5 log10 kill at 30 and 60 seconds in both clean and dirty conditions.Conclusion PVP-I gargle and mouthwash product, undiluted and at 1:2 dilution, demonstrated potent and rapid virucidal activity (≥4 log10 reduction of viral titre) in 15 seconds against SARS-CoV-2 in vitro. The PVP-I gargle and mouthwash product is widely available and could be readily integrated into infection control measures during dental treatment including pre-procedural oral decontamination.