Abstract

Corona virus: is an acute respiratory illness caused by Severe Acute Respiratory Syndrome-corona virus-2(SARS-CoV-2), capable of producing severe symptoms and in some cases death. As a consequence of molecular mimicry (probably with spike protein), infection with SARS-CoV-2 results in the production of a broad spectrum of auto-antibodies which contributes to the pathophysiology of COVID-19 infection.

Most people ars scared of taking the vaccine for one reason or the other. Some because they do not trust the system, others because the feel taking the vaccine will in turn give them the disease. More clarifications will be made in this study

Aim: The aim of this study was to identify the factors that hinder adults from taking the vaccine and their perceptions as well.

Method: This study was a community based cross sectional study carried out in the Molyko Health Area in the  Buea Health District of the South West Region of Cameroon. A total of 32 participants from 21 years and above were recruited for this study using a simple stratified random sampling technique to select the community and a simple random sampling technique to select participants. Data was collected using an interview guide and analyze using a thematic collaizi.

Results: Majority of the participants had good knowledge about COVID-19 vaccine, many had poor perception and were not willing to take the vaccine due to fear of side effects,fear access.

Conclusion: Participants had good knowledge on COVID-19 vaccine, poor perception and factors hindering COVID-19 vaccine uptake included fear, access, causing more harm than good.

CHAPTER ONE

INTRODUCTION

1.1. Background to the Study

Coronavirus virus is an acute respiratory illness caused by Severe Acute Respiratory Syndrome-corona virus-2(SARS-CoV-2), capable of producing severe symptoms and in some cases death. The disease spread to 18 countries within 2months which prompted the World Health Organization to declare it as Public Health of International Concern on January 30, 2020.

The number of cases persistently increased, which resulted in the WHO declaring it as a pandemic on March 11 2020. As of April 17, 2021, the total number of people who have been infected with COVID-19 was 140,598,841 while 3,014240 people have died of the disease, [1]

Many countries have implemented various safety measures to control COVID-19 including restrictions on the mass gathering, enforcing stay-at-home orders, wearing of masks, sanitary measures and promoting the use of personal protective equipment (PPE).

Vaccines remain the most important public health measure and most effective strategy to protect the population from COVID-19, since SARS-CoV-2 is a highly contagious virus and affects population globally. John Hopkins Medicine views all authorized vaccines as highly effective at preventing serious disease, hospitalization and death from COVID-19.

The competition for the COVID-19 vaccine invention and development against the spread and catastrophic effect of the disease is ongoing and new more effective vaccines are likely to be developed [1].Equitable access to safe and effective vaccine is critical to ending the COVID-19 pandemic.

The COVAX program, backed by the WHO and other multilateral bodies aim to supply 600million doses to Africa enough to vaccinate at least 20% of the population. COVAX, the vaccines pillar of the access to COVID-19 vaccines states that “no one is safe, unless everyone is safe”. To prevent a widespread and continues spread of the covid-19 virus among adults population, growing attention and emphasis have been laid on vaccinating high risk population. [2]

As of 23 January 2022, over 827 million vaccine doses have been administered in the European Union, 317 million people have completed the primary vaccination course and over 198 million individuals have already received a vaccine dose in addition to the primary course (all 30 countries reporting).Since the start of COVID-19 vaccine deployment in December 2020, the cumulative vaccine uptake in the total population in the European union has reached 70% for the complete primary course and 42.6% for an additional dose while among adults (aged 18 years and older) the cumulative vaccine uptake reached 81.4% for the complete primary course and 51.8% for an additional dose (pooled data from 30 reporting countries).

However, progress differs across countries, with 3 countries (Bulgaria, Romania and Slovakia) still reporting less than 50% of the total population having the primary vaccination course. The median uptake of full vaccination with a complete primary course among older adults aged 60 years and above has reached 90%. However, uptake is still slowly increasing among young adults (90.8% in those aged 60+ years, 73.3% in 18-24 years-olds, 78% in 25-49 year-olds, 85.1% in 50-59 year-olds; 28 countries reporting).[3]

A global survey of potential COVID-19 vaccine acceptance shows that 48% of their study population were confused about the COVID-19 vaccination and remained unsure about whether they would have the vaccine. Willingness to receive a COVID-19 vaccine is a challenge to many countries; China, Vietnam, India, South Korea etc [4] adult’s reluctance to accept COVID-19 vaccination may not only increase the risk of virus transmission to new born, pregnant and breastfeeding women but also reduce likelihood that they will encourage others to be vaccinated. Major concerns of adults are on vaccine safety, efficacy and potential side effects.

A strong advocate for vaccine equality, the UN organization is concerned about the slow deployment of jabs on the African continent, where only 11.3% of the population is fully vaccinated-despite a considerable increase in doses in recent months [5]

Despite the scarcity of COVID-19 vaccines in Africa, several countries including Sierra Leone and Malawi have discarded large numbers of vaccines doses that expired before they were used due to low demand in the population, a situation also anticipated in Uganda.

In addition to the low accessibility of COVID-19 vaccines and hesitancy to be vaccinated for COVID-19, a preference for traditional medicines may constitute another barrier to vaccine acceptance in African countries. The COVID-19 vaccination rate in Africa needs to increase six-folds for the continent to meet the 70% target set for the middle of 2022.[6]

As of 17thFebruary 2023, Cameroon had registered 18,599 cases of COVID-19 with 16,540 recoveries and 406 deaths. This gives a recovery rate of 88.9% and with an overall death rate of 2.1%[6] However, recent trends show that new cases of infection continue to emerge despite the control measures put in place by the WHO and the ministry of Public Health in Cameroon. It became evident that an efficacious vaccine is required to put COVID-19 under control and eventually eradicate it.

According to last updates of the 21st January 2022, 4 vaccines are approved for use in Cameroon which are the; Janssen (J&J) Ad26.CoV2.S, AstraZeneca Vaxzevria, Sinopharm Beijing Covilo and Gamaleya. Only about 7.9% of the elderly and 6.2%of people with pre-existing conditions have received at least one dose. On average, the vaccination rate among vulnerable groups is even lower than that of the general population (7.8%) this low vaccination rate is based on a simple logic: the less risk people perceive, the less they feel the need to get vaccinated.

According to Cameroon tribune, of the 16thApril 2021, the Minister of Public Health, Manaouda Malachie, stood as witness to the inoculation of the medical and administrative authorities of the Buea Regional Hospital. Despite this, there is still a great controversy as to the COVID-19 vaccines among the general population and a proportion of the adults are still hesitating to take the vaccine lest they should be infected.

In order to attain the presumed vaccination coverage of 70% targeted by the World Health Organization by mid-2022, general community knowledge and perceptions on the COVID-19 vaccines should be properly assessed and understood. And since there was a limited study in the country and no scientific evidence of such study in the area, I saw it necessary to determine the level of knowledge and various perceptions on the COVID-19 vaccines among adults in the Molyko Health Area.

1.2. Statement of the Problem

It is becoming evident that an efficacious vaccine would be required to put COVID-19 under control and eventually eradicate it. Despite the scientific breakthroughs to the vaccine, the journey from vaccine discovery to global herd immunity against COVID-19 continues to present significant policy challenges that require a collaborative, response.

It appears that during my research work in the Molyko Health Area, a majority of adults avoided the COVID-19 vaccine ranging from health workers to students and to pastors with diverse reasons. Many factors come into play for the vaccine hesitancy. The vaccination strategies do not seem to be followed by the population of Cameroon and those in the MHA. This is taken from the statistics that only about 2.5% of the population has been fully vaccinated.

This is in contrast to the targeted percentage stated by COVAX which is 20% of each country’s population while matching forward to attaining 70% vaccination coverage by mid-2022 as targeted by the WHO. The difference is wide given the time the vaccines have been approved and inoculated in many hospitals and this calls for concern. Hence, in order to be able to use these vaccines to eradicate the disease, the knowledge and perceptions about the vaccine by the population has to be assessed together with the barriers to vaccination.

1.3. Research Questions

1.3.1. General Research Questions

What is the knowledge level on the belief and perception about the COVID-19 vaccine and what factors affect adult vaccination in the MHA

1.3.2. Specific Research Questions

1. What do adults in the MHA know about the COVID-19 vaccines?
2. What do the adult in MHA think about the COVID-19 vaccine?
3. What adults in the MHA belief affects vaccination against Covid-19?

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