COVID-19 VACCINE PERCEPTION AND HESITANCY AMONG PATIENTS WITH AUTOIMMUNE RHEUMATIC DISEASE (AIRD) IN MALAYSIA

BackgroundPatients with autoimmune rheumatic disease (AIRD) are at risk of severe COVID-19 infection and vaccine has been demonstrated to be able to reduce the severity of infection. Malaysia has a low flu vaccination coverage rate (approximately 3%) and hence it is important to assess the perception and hesitancy of COVID-19 vaccine especially among the vulnerable group.ObjectivesTo study the perception of COVID-19 vaccine and to determine the prevalence of vaccine hesitancy among AIRD patients in Malaysia.MethodsThis was a cross-sectional survey using online Google Forms® that was conducted among adult AIRD patients (18 years and older) from August 2021 until February 2022. Patients were recruited from the outpatient clinics as well as distribution of the survey through social medias. The survey was in English and Malay language. The survey collected data on the socio-demographic background, prior history of other vaccination after the age of 18 and COVID-19 vaccination with reasons of hesitancy, defined as being unsure or unwilling to be vaccinated. The survey also assessed the patients' perception by specifying the level of agreement to COVID-19 vaccine statements using the Likert response scale: 1-Strongly disagree;2- Disagree;3-Neither agree nor disagree;4-Agree;5-Strongly agree.ResultsA total of 162 patients participated in the survey and majority of them were females (87.7%). Our multi-racial cohort consisted of Malay (n=103, 63.5%), followed by Chinese (n=38, 23.5%), Sabahan Bumiputra (n=12, 7.4%) and Indian (n=7, 4.3%). More than half (n=107,66.6%) have not had any history of other vaccination after the age of 18. Only 16.7% (n=27) agreed/strongly agreed that COVID-19 vaccine can be given to patients with co-morbidities and 24.1 (n=39) agreed/strongly agreed that COVID-19 vaccine can be given to patients who have history of allergy to other drugs or food. At the time of the survey, vast majority of the respondents have received at least the 1st dose of Covid-19 vaccine (n=148, 91.4%). A total of 9 (5.6%) patients were hesitant to be vaccinated (6 were unsure and 3 patients were not willing to be vaccinated). The commonest reasons of being unsure or not willing to be vaccinated was worried of the vaccine's adverse effects (66.7%), worried of the blood clot complication (33,3%), worried of disease flare post-vaccine (33,3%), worried of allergic reaction (22.2%), lack of information on the safety of the vaccine in patients with AIRD from government and media (22.2%), face mask and social distancing measures were adequate (22.2%). Statistical analysis revealed that more patients who had vaccine hesitancy were from the lower socioeconomic status (income <1066 Euro/month), 88.9% vs 11.1%, p=0.03 but no association with ethnicity, education status, marital status or place of residence (urban vs rural).ConclusionCOVID-19 vaccine hesitancy is low in Malaysian patients with AIRD but patients with a low socioeconomic status are prone to have vaccine hesitancy. More education on the vaccine's efficacy and safety especially among patients with co-morbidities are warranted.Reference[1]Knowledge, acceptance and perception on COVID-19 vaccine among Malaysians: A web-based survey. Mohamed NA, Solehan HM, Mohd Rani MD, Ithnin M, Che Isahak CI (2021) Knowledge, acceptance and perception on COVID-19 vaccine among Malaysians: A web-based survey. PLOS ONE 16(8): e0256110.Acknowledgements:NIL.Disclosure of InterestsSyahrul Sazliyana Shaharir Speakers bureau: Pfizer,Novartis, Lydia Kamaruzaman: None declared, Theepa Nesam Mariamutu: None declared, Mohd Shahrir Mohamed Said: None declared, Azmawati Mohammed Nawi: None declared, Wan Syamimee Wan Ghazali: None declared, Malehah Mohd Noh: None declared.

Moving seaweed farms from shallow to deep seawater to cope with warming and diseases in Zanzibar. Current socio-economic and cultural barriers

This study aimed at identifying the climate and non-climate stressors affecting the seaweed farming practices. It also examines the deep water seaweed farming as a viable adaptation measure to these stressors and barriers that could constrained female seaweed farmers who are the majority. The study was carried out in six selected groups, two groups were from South District, Unguja Main Island (Furahiya Wanawake-Paje and Flower Group-Muungoni). And four groups were selected from Pemba Island (Tuwe Imara and Umoja Kazi- East Msuka and Ipo sababu and Umoja ni Nguvu - East Tumbe) from Micheweni District. These groups were selected because they participated in previous project implemented by Milele Zanzibar Foundation (MZF) and The Panje Project (TPP). Questionnaire interview collected various information related to the study from 111 seaweed farmers who are members of these groups. Information such as baseline seaweed production, climate change and diseases that affect seaweed production, farmer's awareness on moving seaweed farms to deep water to cope with increasing warming and diseases and their capacity to swim as prerequisite for the adoption of this coping strategy. The focal group discussions were conducted in all six groups to collect various information to triangulate the findings collected from the questionnaire interview. The data obtained from three methods analyzed using descriptive statistics. The findings show that seaweed farming production has declined at least over the last seven years. Climate change and its variability, diseases, over utilization of shallow water space for farming seaweed, COVID 19 and price has contributed a lot in the observed decline. Deep water (0.5 meter during low tide and 3-5 meters during high tide) seaweed farming seen as viable option to cope and adapt to increasing warming and diseases but its adoption especially amongst female seaweed farmers constrained by their limited capacity to swim and their limited ownership of the vessels. The study also identified other barriers such as age, gender and cultural factors that could constrained female seaweed farmers from participation in swimming and sea safety training. To facilitate adoption of the deep-water seaweed farming method amongst the seaweed farmers, concerted effort should be made to overcome the barriers that are likely to limit the massive adoption of this method.