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.

A cross-sectional study on the impact of the COVID-19 pandemic on psychological outcomes: Multiple indicators and multiple causes modeling.

Although the psychological impact of coronavirus disease 2019 (COVID-19) has been evaluated in the literature, further research is needed, particularly on post-traumatic stress disorder (PTSD) and psychological outcomes, is needed. This study aims to investigate the effect of the COVID-19 pandemic on psychological outcomes (depression, anxiety, and insomnia). A cross-sectional study using an online survey was conducted using the following instruments: Impact of Event Scale-Revised (IES-R), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder (GAD-7), and Insomnia Severity Index (ISI). Confirmatory factor analysis (CFA), structural equation model (SEM), multiple indicators and multiple causes (MIMIC) modeling, and differential item functioning (DIF) were performed to analyze the collected data. According to the results, participants with PTSD (n = 360) showed a higher level of depression, anxiety, and insomnia than those without PTSD (n = 639). Among the participants, 36.5% experienced moderate to severe symptoms of depression, and 32.6% had mild depressive symptoms. Moreover, 23.7% of participants experienced moderate to severe anxiety symptoms, and 33.1% had mild anxiety symptoms. In addition, 51.5% of participants experienced symptoms of insomnia. In conclusion, the PTSD caused by COVID-19 is significantly associated with depression, anxiety, and insomnia at the level of latent constructs and observed variables.

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.