Social and Emotional Determinants of COVID-19 Vaccination Attitudes among the Elderly at Health Center Manatuto, Timor-Leste

Abstract

This study aimed to identify the key factors influencing COVID-19 vaccine acceptance among the elderly at Manatuto Villa Health Center, Kota Manatuto, Timor-Leste, with a focus on knowledge, social influence, personal experiences, emotional factors, and access to health information. A cross-sectional design was used, involving 278 respondents aged 60 years and above who completed the structured questionnaires. Data analysis was conducted using univariate, bivariate, and logistic regression to identify the main determinants of vaccine acceptance. The results revealed that 72% of respondents lacked sufficient knowledge about the benefits of COVID-19 vaccination, which was attributed to low education levels and limited access to information (p < 0.05). Additionally, 12% of the respondents reported negative experiences related to vaccine side effects, such as dizziness and nausea, which increased their hesitancy to receive subsequent doses. Social and family influences were also significant, with 71% of respondents following the advice of religious and community leaders in making vaccination decisions. Emotional factors, such as anxiety and fear of declining health due to old age, affected 67% of the respondents, becoming a barrier to vaccine acceptance. This study concludes that improving knowledge through community-based outreach programs, addressing anxiety, and involving trusted local leaders are essential strategies for enhancing vaccine acceptance among the elderly. The practical implications of these findings highlight the need for policies that focus on community education and outreach approaches to increase vaccination coverage in areas with limited access to healthcare.

References

1. Abba-Aji, M., Stuckler, D., Galea, S., & McKee, M. (2022). Ethnic/racial minorities’ and migrants’ access to COVID-19 vaccines: A systematic review of barriers and facilitators. Journal of Migration and Health, 5, 100086. https://doi.org/10.1016/j.jmh.2022.100086
2. Abuhashesh, M. Y., Al-Dmour, H., Masa’deh, R., Salman, A., Al-Dmour, R., Boguszewicz-Kreft, M., & AlAmaireh, Q. N. (2021). The Role of Social Media in Raising Public Health Awareness during the Pandemic COVID-19: An International Comparative Study. Informatics, 8(4), 80. https://doi.org/10.3390/informatics8040080
3. Ajzen, I. (2020). The theory of planned behavior: Frequently asked questions. Human Behavior and Emerging Technologies, 2(4), 314–324. https://doi.org/10.1002/hbe2.195
4. Alarcón-Braga, E. A., Hernandez-Bustamante, E. A., Salazar-Valdivia, F. E., Valdez-Cornejo, V. A., Mosquera-Rojas, M. D., Ulloque-Badaracco, J. R., Rondon-Saldaña, J. C., & Zafra-Tanaka, J. H. (2022). Acceptance towards COVID-19 vaccination in Latin America and the Caribbean: A systematic review and meta-analysis. Travel Medicine and Infectious Disease, 49, 102369. https://doi.org/10.1016/j.tmaid.2022.102369
5. Alimul Hidayat, A. (2011). Metode Penelitian Kebidanan dan Teknik Analisis Data. Jakarta: Salemba Medika.
6. Ariestia, M. (2021). Faktor-Faktor Yang Mempengaruhi Partisipasi Lansia Dalam Mengikuti Program Vaksinasi Covid-19 di Puskesmas Andalas. Jurnal Ilmiah Cerebral Medika, 3(2), 8–8.
7. Betsch, C., Böhm, R., & Chapman, G. B. (2015). Using Behavioral Insights to Increase Vaccination Policy Effectiveness. Policy Insights from the Behavioral and Brain Sciences, 2(1), 61–73. https://doi.org/10.1177/2372732215600716
8. Betsch, C., Schmid, P., Heinemeier, D., Korn, L., Holtmann, C., & Böhm, R. (2018). Beyond confidence: Development of a measure assessing the 5C psychological antecedents of vaccination. PLOS ONE, 13(12), e0208601. https://doi.org/10.1371/journal.pone.0208601
9. Chan, N. N., Ong, K. W., Siau, C. S., Lee, K. W., Peh, S. C., Yacob, S., Chia, Y. C., Seow, V. K., & Ooi, P. B. (2022). The lived experiences of a COVID-19 immunization programme: Vaccine hesitancy and vaccine refusal. BMC Public Health, 22(1), 296. https://doi.org/10.1186/s12889-022-12632-z
10. Davila, F., Bourke, R. M., McWilliam, A., Crimp, S., Robins, L., Van Wensveen, M., Alders, R. G., & Butler, J. R. A. (2021). COVID-19 and food systems in Pacific Island Countries, Papua New Guinea, and Timor-Leste: Opportunities for actions towards the sustainable development goals. Agricultural Systems, 191, 103137. https://doi.org/10.1016/j.agsy.2021.103137
11. Ernawati, E., Naziyah, N., & Rifiana, A. J. (2022). Hubungan Pengetahuan dan Sikap Terhadap Kecemasan Lansia Comorbid dengan Pemberian Vaksinasi Covid-19. Malahayati Nursing Journal, 4(3), 634–642. https://doi.org/10.33024/mnj.v4i3.6033
12. Fitri Mailani. (2022). PERSEPSI LANSIA TERHADAP VAKSINASI COVID-19 DI KELURAHAN PASIE NAN TIGO KECAMATAN KOTO TANGAH KOTA PADANG. Jurnal Endurance, 7(2), 343–355. https://doi.org/10.22216/jen.v7i2.887
13. Galagali, P. M., Kinikar, A. A., & Kumar, V. S. (2022). Vaccine Hesitancy: Obstacles and Challenges. Current Pediatrics Reports, 10(4), 241–248. https://doi.org/10.1007/s40124-022-00278-9
14. Glanz, K., Rimer, B. K., & Viswanath, K. (2015). Health Behavior: Theory, Research, and Practice. John Wiley & Sons.
15. Gunter, B. (2022). Psychological Insights on the Role and Impact of the Media during the Pandemic: Lessons from COVID-19 (1st ed.). Routledge. https://doi.org/10.4324/9781003274629
16. Hosmer Jr, D. W., Lemeshow, S., & Sturdivant, R. X. (2013). Applied logistic regression. John Wiley & Sons.
17. Karafillakis, E., Dinca, I., Apfel, F., Cecconi, S., Wűrz, A., Takacs, J., Suk, J., Celentano, L. P., Kramarz, P., & Larson, H. J. (2016). Vaccine hesitancy among healthcare workers in Europe: A qualitative study. Vaccine, 34(41), 5013–5020. https://doi.org/10.1016/j.vaccine.2016.08.029
18. Kellyvan Dellen. (2024). Timor-leste launches the COVID-19 vaccination campaign for children age 12 to 17—P4H Network. https://p4h.world/en/news/timor-leste-launches-the-covid-19-vaccination-campaign-for-children-age-12-to-17/
19. Kirscht, J. P. (1974). The Health Belief Model and Illness Behavior. Health Education Monographs, 2(4), 387–408. https://doi.org/10.1177/109019817400200406
20. Kyprianidou, M., Konstantinou, P., Alvarez-Galvez, J., Ceccarelli, L., Gruszczyńska, E., Mierzejewska-Floreani, D., Loumba, N., Montagni, I., Tavoschi, L., Karekla, M., & Kassianos, A. P. (2023). Profiling Hesitancy to COVID-19 Vaccinations in Six European Countries: Behavioral, Attitudinal and Demographic Determinants. Behavioral Medicine, 49(4), 362–373. https://doi.org/10.1080/08964289.2022.2071198
21. Larson, H. J., Clarke, R. M., Jarrett, C., Eckersberger, E., Levine, Z., Schulz, W. S., & Paterson, P. (2018). Measuring trust in vaccination: A systematic review. Human Vaccines & Immunotherapeutics, 14(7), 1599–1609. https://doi.org/10.1080/21645515.2018.1459252
22. Larson, H. J., Cooper, L. Z., Eskola, J., Katz, S. L., & Ratzan, S. (2011). Addressing the vaccine confidence gap. The Lancet, 378(9790), 526–535.
23. Locke, E. A. (1987). Social Foundations of Thought and Action: A Social-Cognitive ViewSocial Foundations of Thought and Action: A Social-Cognitive View, by Bandura Albert. Englewood Cliffs, NJ: Prentice-Hall, 1986, 617 pp., cloth. Academy of Management Review, 12(1), 169–171. https://doi.org/10.5465/amr.1987.4306538
24. Ma, S., Lavelle, T. A., Ollendorf, D. A., & Lin, P.-J. (2022). Herd Immunity Effects in Cost-Effectiveness Analyses among Low- and Middle-Income Countries. Applied Health Economics and Health Policy, 20(3), 395–404. https://doi.org/10.1007/s40258-021-00711-y
25. Moritzky, S. A., Richards, K. A., Glover, M. A., Krammer, F., Chaves, F. A., Topham, D. J., Branche, A., Nayak, J. L., & Sant, A. J. (2023). The Negative Effect of Preexisting Immunity on Influenza Vaccine Responses Transcends the Impact of Vaccine Formulation Type and Vaccination History. The Journal of Infectious Diseases, 227(3), 381–390. https://doi.org/10.1093/infdis/jiac068
26. Nicholls, L. A. B., Gallant, A. J., Cogan, N., Rasmussen, S., Young, D., & Williams, L. (2021). Older adults’ vaccine hesitancy: Psychosocial factors associated with influenza, pneumococcal, and shingles vaccine uptake. Vaccine, 39(26), 3520–3527. https://doi.org/10.1016/j.vaccine.2021.04.062
27. Niu, L., Miraj, M., Chuntian, L., ur Rehman, R., & Shereen, S. (2024). Global coronavirus vaccination campaign: The role of religious workers in vaccine distribution, public mobilization and the eradication of nationalism. WORK, 77(1), 3–21. https://doi.org/10.3233/WOR-230092
28. Notoatmodjo, S. (2003). Pendidikan dan perilaku kesehatan.
29. Polack, F. P., Thomas, S. J., Kitchin, N., Absalon, J., Gurtman, A., Lockhart, S., Perez, J. L., Pérez Marc, G., Moreira, E. D., Zerbini, C., Bailey, R., Swanson, K. A., Roychoudhury, S., Koury, K., Li, P., Kalina, W. V., Cooper, D., Frenck, R. W., Hammitt, L. L., … Gruber, W. C. (2020). Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine. New England Journal of Medicine, 383(27), 2603–2615. https://doi.org/10.1056/NEJMoa2034577
30. Pratiwi, D. R., Ningrum, D. M., Natali, O., Maryam, S., Jupriadi, L., & Alfandi, Z. (2022). Determinan Kepatuhan Terhadap Vaksin Covid-19 Pada Lansia di Wilayah Kerja Puskesmas Suela Kabupaten Lombok Timur. Lumbung Farmasi: Jurnal Ilmu Kefarmasian, 3(2), 165–170. https://doi.org/10.31764/lf.v3i2.8341
31. Rogers, E. M., Singhal, A., & Quinlan, M. M. (2014). Diffusion of innovations. In An integrated approach to communication theory and research (pp. 432–448). Routledge.
32. Schuman, H., & Johnson, M. P. (1976). Attitudes and Behavior. Annual Review of Sociology, 2, 161–207.
33. Soares, P., Rocha, J. V., Moniz, M., Gama, A., Laires, P. A., Pedro, A. R., Dias, S., Leite, A., & Nunes, C. (2021). Factors Associated with COVID-19 Vaccine Hesitancy. Vaccines, 9(3), 300. https://doi.org/10.3390/vaccines9030300
34. Stasiuk, K., Maciuszek, J., Polak, M., & Doliński, D. (2021). Profiles of vaccine hesitancy: The relation between personal experience with vaccines, attitude towards mandatory vaccination, and support for anti-vaccine arguments among vaccine hesitant individuals. Social Psychological Bulletin, 16(2), e6525. https://doi.org/10.32872/spb.6525
35. UNICEF. (2021). Timor-Leste situation reports | UNICEF. https://www.unicef.org/appeals/timor-leste/situation-reports
36. Utami, A., Margawati, A., Pramono, D., Nugraheni, A., & Pramudo, S. G. (2022). Determinant Factors of COVID-19 Vaccine Hesitancy Among Adult and Elderly Population in Central Java, Indonesia. Patient Preference and Adherence, 16, 1559–1570. https://doi.org/10.2147/PPA.S365663
37. WHO. (2021). COVID-19 cases | WHO COVID-19 dashboard. https://data.who.int/dashboards/covid19/cases
38. Yanto, T. A., Lugito, N. P. H., Hwei, L. R. Y., Virliani, C., & Octavius, G. S. (2022). Prevalence and Determinants of COVID-19 Vaccine Acceptance in South East Asia: A Systematic Review and Meta-Analysis of 1,166,275 Respondents. Tropical Medicine and Infectious Disease, 7(11), 361. https://doi.org/10.3390/tropicalmed7110361
39. Zhu, N., Zhang, D., Wang, W., Li, X., Yang, B., Song, J., Zhao, X., Huang, B., Shi, W., Lu, R., Niu, P., Zhan, F., Ma, X., Wang, D., Xu, W., Wu, G., Gao, G. F., & Tan, W. (2020). A Novel Coronavirus from Patients with Pneumonia in China, 2019. New England Journal of Medicine, 382(8), 727–733. https://doi.org/10.1056/NEJMoa2001017

License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 Aurita Dos Santos Chorry Santana, Anderias Umbu Ronga, Pius Weraman

Indexing & Citations