The impact of health status on attitudes toward COVID-19 vaccination

The COVID-19 outbreak has had an overwhelming effect on societies' access to essential services. Human-to-human transmission facilitates the spread of the disease, as do other conditions, such as temperature. Individuals with underlying health conditions are at increased risk of acquiring and suffering the devastating effects of COVID-19. Consequently, vaccine manufacturing was envisaged as a milestone toward "normalizing" the world. While scholarly attention has focused on attitudes toward vaccination, the relationship between health status and attitudes toward vaccination is understudied. This study attempted to fill this knowledge gap by assessing the impact of health status on attitudes toward the COVID-19 vaccine.

We developed a 26-item questionnaire titled "Attitudes toward COVID-19 Vaccination Scale" for data collection. A total of 1047 school or university staff members from 22 countries completed the questionnaire. The data were initially validated using exploratory factor analysis to determine its structure and subsequently analyzed using SPSS version 28. Two-way factorial analysis of variance and multiple regression analysis were performed to understand the influence of health status on attitudes toward vaccination.

The results showed a direct effect of health status on attitudes toward COVID-19 vaccination, (Step 1; β = 0.11, p = 0.001; Step 2: β = 0.10, p = 0.001). In Step 2 also, vaccination status (β = 0.22, p = 0.001) and place of residence (β = -0.08, p = 0.04) also influenced attitudes towards vaccination. Health status also moderated the relation between attitude and education level (F[3, 1038] = 3.04) of participants.

Results show possible fear and hesitancy toward COVID-19 vaccination among those with underlying health conditions. Therefore, expeditious sensitization programs may be needed to promote the importance of vaccination for developing resistance against COVID-19 and vaccine acceptance. However, such initiatives should target vulnerable groups in society. Policymakers could focus on improving sensitization toward COVID-19 vaccination among those living with underlying health conditions.