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Objective: The purpose of this study was to assess willingness to receive COVID-19 vaccine in Pakistan and to understand the reasons causing hesitation towards vaccine administration. Study Design: A cross-sectional study was done through an online survey that was created using google forms. Place and Duration of Study: The study was conducted online from Mar to Aug 2021 in different cities of Pakistan employing nonprobability convenience sampling technique. The link to the questionnaire was shared on different social media platforms such as WhatsApp and Facebook. Methodology: Any individual over the age of 16 and willing to fill the questionnaire was enrolled. Questionnaire used were standardized Oxford COVID-19 vaccine hesitancy scale to assess intent and Oxford general vaccine hesitancy scale to assess attitude towards vaccinations in general. SPSS v25 was used for data analysis. Results: A total of 589 valid responses were finally analyzed. Among the respondents, 24%(141) showed at least some hesitancy regarding COIVD-19 vaccination and 9%(53) of the respondents showed extreme hesitancy. The Pearson correlation coefficient indicated a significant positive correlation (p<0.000) between hesitancy to childhood vaccines and COVID vaccine hesitancy. There was also a significant correlation (p<0.000) between belief in conspiracy's related to COVID-19 virus and refusal to get vaccinated. Conclusion: Vaccine hesitancy is present in roughly 1/4th of the study population. Conspiracy theories and low vaccine acceptance among the general public pose a severe danger to COVID-19 vaccination success. Public vaccine education programs should be started to educate the public regarding their fear of vaccination. © 2022, Army Medical College. All rights reserved.
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Objective: To determine public acceptance of COVID-19 booster dose, to know about perceptions and possible barriers regarding the vaccine. Study Design: Analytical cross-sectional study. Place and Duration of Study: Conducted regarding the acceptance and perception of the vaccine booster dose among the residents of Rawalpindi Pakistan, from Jun till Aug 2022 Methodology: The sample size was 320 and collected using convenient sampling technique. The study included residents of Rawalpindi between ages 18 and 65. Google forms based on Health Belief Model were used for data collection. Data analysis was done using SPSS version 28 and summary statistics were produced using frequencies, percentages and mean. Chi-square test was also used to determine associations between categorical variables. Results: The results revealed that 74% of the participants' primary reason for getting booster dose was their own safety while major barrier to booster dose vaccination was side effects related to vaccine-62%. 81.3% people were willing to get the booster dose and 87.9% people agreed to receive booster dose for free. Chi-square test indicated a significant association between acceptance and perceived susceptibility, benefits and severity. Conclusion: In conclusion, our findings reveal that majority of people were willing to get booster dose primarily for own safety. However, counselling is required to decrease the perceived barriers to vaccination regarding side effects of the vaccine. © 2022, Army Medical College. All rights reserved.
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Objective: To find out the side effects of vaccines of COVID-19 and its association with sociodemographic factors among students of medical colleges of Rawalpindi. Study Design: Cross sectional analytic study. Place and Duration of Study: A cross-sectional analytical study was carried out from May to Aug 2022 among medical students of three Medical Colleges (AMC, FUMC, RMC) in Rawalpindi Pakistan. Methodology: There were 200 participants that were conveniently selected with the Rao soft sample size calculator. A validated questionnaire was used to collect data. SPSS (v:26) was used to analyze the data. Chi square analysis was used to assess the relationship between side effects and demographic characteristics and a p-value of 0.05 was taken as significant. Results: Majority of the participants were male 126(63%) and unmarried 182(94%). The mean age of the participants was 20 years (SD=1.4). Almost all were vaccinated 197(98.5%) with two doses 195(97.5%). The side effects after the first dose were more profound as compared to the second dose, like normal pain 133(66.5%), tenderness at injection site 69(34.5%), fever 65(32.5%) and fatigue 80(40%). Muscular pains were also documented to be pronounced after the administration of first dose 58(29%). Association analysis showed significant association between first dose side effects, normal pain(p=0.001), tenderness (p=0.004), redness (p=0.02) and fatigue (p=0.02) with gender variable. Whereas age and degree socio demographic variables reported significant association with first dose side effects, normal pain (p=0.04) and muscle pain (p=0.01), respectively. Conclusion: It was conclusive that adverse effects were more common and more severe after the first dose than after the second. The most frequent side effect was normal pain at the injection site, found more frequently in men, with muscular pain being noticeably worse after the first dosage and surprisingly minimal following the second dose of the COVID-19 vaccination. © 2022, Army Medical College. All rights reserved.
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Objective: To determine the prevalence of PTSD symptoms and its severity among HCWs, amid the COVID pandemic in a tertiary care setting. Study Design: Cross sectional analytic study. Place and Duration of Study: Pakistan Emirates Military Hospital, Rawalpindi Pakistan, from May to Aug 22. Methodology: The study was conducted on 173 healthcare workers of a tertiary care hospital. The sample size was calculated using the Rao-soft calculator. Validated questionnaires such as the Impact of Event Scale-Revised (IES-R) and PTSD Checklist Civilian Version (PCL-C) were used to collect the data. Data was entered and analyzed by using Statistical Package for Social Sciences (SPSS) version 26. Results: Out of 173 participants, majority of participants 90(52%) were male and single 103(63%). Mean age of the participating HCWs was 27(SD= 2.3). HCWs performing duties the in COVID-19 ward for one year were 66(38.2%) and majority were from Emergency medicine 61(35.3). Almost 150(86.71%) of HCWs did not experiencing any PTSD symptoms and those exhibiting a higher severity of symptoms were only 5(2.9%). There was no statistically significant difference in total and sub scales mean scores of IES-R among males and females (p=0.28). Conclusions: Our study concluded that prevalence of symptoms of PTSD was significantly low in Health Care Workers despite of the fact, majority of doctor participants were working in COVID-19 ward for one year. The symptoms were evident among healthcare professionals, however there was modest severity. © 2022, Army Medical College. All rights reserved.
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Objectives: To find the effect of information channels on Covid-19 acceptance among university students of Rawalpindi/ Islamabad. Study Design: Cross sectional analytic study. Place and Duration of Study: Study was conducted in four imminent Universities in Rawalpindi/Islamabad, Air University, Rawalpindi Medical University, Riphah University and Quaid-e-Azam University, Rawalpindi, from May to Aug 2022. Methodology: Participants from four universities in Rawalpindi/Islamabad Pakistan, were recruited for this current research from May to August 2022. A sample size of 377±14 was computed using the Rao soft sample size calculator, maintaining a 5% margin of error and a 95% confidence interval a population proportion (50%). Non-probability convenient sampling was used. Data was analysed using SPSS version 26. Results: There were 377 students recruited, out of which majority 207(55%) were female. Most of the students were in the Medicine and allied fields 227(60.2%). Almost, half of the respondents (44.56%) received information about the COVID-19 vaccine from mobile networks. The level of trust in vaccine information was also highest for Mobile Networks (31.30%). Participants' perceptions of the covid 19 risk, 156(41%) revealed high concerns for infecting family and friends with the virus. There was a significant association of female gender (p<0.05) and being from the Medicine and allied fields (p=p<0.05) with vaccine acceptance. Conclusion: In our study the mobile and traditional media were reported as the main sources of information about the COVID-19 vaccination however they were not significantly associated with vaccine acceptance. Female gender, education level and being from the Medicine and allied fields was associated with intention to be vaccinated. © 2022, Army Medical College. All rights reserved.
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Objectives: This study aimed to determine the prevalence of hesitancy towards COVID-19 vaccination among the adult population of Quetta and the likelihood predictors of hesitancy towards COVID-19 vaccination. Study Design: Analytical cross-sectional study. Place and Duration of Study: Study was conducted at Quetta, from Nov 2021 to May 2022. Methodology: A total of 396 individuals participated in the study. Along with socio-demographic details, participants responded to the COVID-VAX scale and questions from WHO determinants of vaccine-hesitancy. A relationship was modelled between WHO determinants of vaccine-hesitancy, socio-demographic characteristics and vaccine-hesitancy using logistic regression. Results: Results showed that majority of individuals were vaccine-hesitant (67.2%). The final model obtained significant predictors among contextual influences as demonstrated past bad experiences on vaccination, non-belief in risking their own and family's health for being non-vaccinated and negative influences by an influential person. Among individual influences, knowledge about someone having bad experiences to vaccines, confusion about scheduling of vaccines, lack of trust in the healthcare system and provider, disbelieving in immunization as a social norm and concerns regarding vaccine. Among factors directly related to vaccine/vaccination, difficult vaccination schedule, fear of pain/needles, and non-willingness to pay for vaccination were found as significant predictors of the COVID-19 vaccine-hesitancy (p-value <0.05). Conclusions: More than half of the participants showed hesitancy towards COVID-19 vaccine. Factors contributing to vaccine-hesitancy must be addressed to build confidence regarding COVID-19 vaccines among the people to attain the goal of herd immunization against COVID-19. © 2022, Army Medical College. All rights reserved.
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Objective: To assess the impact of COVID-19 confinement on different aspects of physical activity and sedentary time of medical students with special emphasis on gender. Study Design: This was a longitudinal study in which two samples were taken, one during the confinement period and one after it, to assess the differences between the time spent on physical activity and sedentary time. Place and During of Study: This study was conducted on a total of 300 medical students from two medical colleges of Rawalpindi. The study extended from Apr till Jun 2021 over a period of two months. Methodology: Modified International Physical Activity Questionnaire (IPAQ) was used as a data collection tool. The respondents filled the questionnaire twice. First during COVID-19 confinement and the second, after the confinement ended. Results: A total of 300 individuals were selected to fill in the questionnaire, 200 of them filled in the first questionnaire. The second questionnaire was, however, filled by only 146 individuals and the rest were lost to follow-up. The 146 participants in our study were all students in medical schools in Rawalpindi/Islamabad Pakistan. Out of the total 43.2%(63) were male, while 56.8%(83) were female. The mean age was 20.18±1.72. Post confinement, the amount of time spent on moderate and vigorous activities by all the individuals increased by 26.7% and 82.5%, respectively. In addition, walking time was increased by 82%, sedentary time was also reduced by 36.4%. Conclusion: Physical activity of both men and women was found to be reduced during COVID-19 confinement along with increased sedentary time as compared to their normal routine. © 2022, Army Medical College. All rights reserved.
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Objective: To determine prevalence of online fatigue among academicians and to analyse factors associated with online fatigue. Study Design: Analytical, cross-sectional study. Place and During of Study: The study was conducted online from Nov 2021 to Apr 2022 on academicians belonging to educational institutions and teaching hospitals of Rawalpindi Pakistan. Methodology: One hundred fifty academicians, aged 20-75 years, belonging to Rawalpindi were enrolled through snowball sampling. Data was collected online by using google forms. A validated questionnaire having an online fatigue scale was used. Partial responses were excluded. Qualitative variables were expressed as frequency and percentage while quantitative variables were expressed as mean and S.D. Chi-square test was applied. Results: Out of 150 academics, 72(48%) were males and 78(52%) were females. Mean age of participants was 32±9.4 years. Amongst the study participants 27(18%), 67(44.7%), 50(33.3%) and 6(4%) suffered from mild, moderate, severe and extreme online fatigue respectively. The degree of online fatigue was found to be significantly associated with female gender (p=0.000), older age (p=0.005) and higher level of education (p=0.002). Association of online fatigue with factors such as workplace (p=0.054), residence (p=0.129) and amount of technology usage (p=0.995) was found to be statistically insignificant. Conclusions: Our study showed that online fatigue was prevalent among the academic community of Rawalpindi, especially females. Online fatigue can be reduced by training the academicians about work-life balance and updating their knowledge on practical technology. © 2022, Army Medical College. All rights reserved.
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Objectives: To assess perceptions of parents regarding vaccinating their children against COVID-19 and to assess the prevalence of COVID-19 vaccine hesitancy as compared to routine childhood vaccinations. Study Design: Analytical, cross-sectional, quantitative study Place and Duration of Study: Study was conducted in Rawalpindi/Islamabad Pakistan, from Nov 2021 to Apr 2022. Methodology: Parents having children of either gender, 12 to 18 years of age, residents of Rawalpindi/Islamabad Pakistan were included in the study. Study was conducted online using Google forms. Sample size of 303 was taken and participants were enrolled through non probability convenience sampling. Modified Vaccine Hesitancy Scale (VHS) was used. Parental attitudes towards routine childhood vaccinations versus COVID-19 vaccines were compared using paired sample T test. Results: Among 303 parents, 196(64.5%) were willing to vaccinate their child with COVID-19 vaccine. Reasons for COVID-19 vaccine hesitancy included insufficient vaccine safety information (16.8%), avoidance of vaccines/ medications in general (8.9%), inconvenient / painful vaccine administration (7.9%), perceiving child as not at high risk of developing complications of he gets infected by COVID-19(6.3%) and concerns of getting COVID-19 through the vaccine (4.6%). An encouraging attitude was seen among parents for routine childhood vaccination as compared to COVID-19 vaccination with higher mean VHS 2.68±0.44 vs. 2.52±0.43 respectively (p<0.001). Conclusions: A large proportion of parents were hesitant regarding the COVID-19 vaccine as compared to routine childhood vaccines. Relying on the national authorities regarding the immunization information is a much better option to l imit hesitancy. © 2022, Army Medical College. All rights reserved.
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Objective: To assess the risk of COVID-19 to healthcare workers (HCWs) in Tertiary care hospitals and its association with demographic factors. Study Design: Cross-sectional analytical study. Place and Duration of Study: Tertiary Care Hospital, Rawalpindi Pakistan, from May to Dec 2020. Methodology: Healthcare workers working in a designated COVID-19 Tertiary care hospital were included in the study. A modified "Risk assessment and management of exposure of HCWs in the context of COVID-19 tool" was distributed. HCWs were categorized as "high risk" and "low risk" of COVID-19 infection. Frequency and percentages were computed for demographic variables. Results: A total of 182 healthcare workers were included, and 167(91.7%) returned the study questionnaire. Most of them were nurses (n=65, 40.1%) working in the medical unit (n=99, 61.1%). Low risk HCWs were 73.5%( n=119) and only 26.5%( n=43) were high risk. Gender (p-value: .02) and type of HCWs (p-value: .01) were significantly associated with the risk of COVID-19. Conclusion: One-fourth of HCWs were at high risk of COVID-19 virus infection. Female gender and nurses were more likely to acquire COVID-19 infection. © 2023, Army Medical College. All rights reserved.