The Barriers, Challenges, and Strategies of COVID-19 (SARS-CoV-2) Vaccine Acceptance: A Concurrent Mixed-Method Study in Tehran City, Iran

Acceptance and willingness to receive the vaccine are among the main factors in the success or failure of a health system in implementing the vaccination program. The present study was conducted in Tehran, the political and economic capital of Iran, to determine the acceptance of the COVID-19 vaccin...

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Main Authors: Hamid Reza Khankeh, Mehrdad Farrokhi, Mohammad Saeed Khanjani, Yadollah Abolfathi Momtaz, Ameneh Setareh Forouzan, Mehdi Norouzi, Shokoufeh Ahmadi, Gholamreza Ghaedamini Harouni, Juliet Roudini, Elham Ghanaatpisheh, Arya Hamedanchi, Mohammad Pourebrahimi, Fardin Alipour, Maryam Ranjbar, Mehrdad Naghikhani, Mohammad Saatchi
Format: Article
Language:English
Published: MDPI AG 2021-10-01
Series:Vaccines
Subjects:
Online Access:https://www.mdpi.com/2076-393X/9/11/1248
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author Hamid Reza Khankeh
Mehrdad Farrokhi
Mohammad Saeed Khanjani
Yadollah Abolfathi Momtaz
Ameneh Setareh Forouzan
Mehdi Norouzi
Shokoufeh Ahmadi
Gholamreza Ghaedamini Harouni
Juliet Roudini
Elham Ghanaatpisheh
Arya Hamedanchi
Mohammad Pourebrahimi
Fardin Alipour
Maryam Ranjbar
Mehrdad Naghikhani
Mohammad Saatchi
author_facet Hamid Reza Khankeh
Mehrdad Farrokhi
Mohammad Saeed Khanjani
Yadollah Abolfathi Momtaz
Ameneh Setareh Forouzan
Mehdi Norouzi
Shokoufeh Ahmadi
Gholamreza Ghaedamini Harouni
Juliet Roudini
Elham Ghanaatpisheh
Arya Hamedanchi
Mohammad Pourebrahimi
Fardin Alipour
Maryam Ranjbar
Mehrdad Naghikhani
Mohammad Saatchi
author_sort Hamid Reza Khankeh
collection DOAJ
description Acceptance and willingness to receive the vaccine are among the main factors in the success or failure of a health system in implementing the vaccination program. The present study was conducted in Tehran, the political and economic capital of Iran, to determine the acceptance of the COVID-19 vaccine and identify its associated factors, and explain the most important barriers and acceptance strategies for vaccination. This research was a concurrent quantitative and qualitative mixed-method study. In the quantitative part, 1200 individuals aged more than 18 years were selected from the households in 22 districts of Tehran City, with a multistage stratified cluster sampling method. Two questionnaires were used to evaluate the acceptance of the COVID-19 vaccine and vaccine acceptance determinants. The qualitative content analysis method addressed the influencing factors, as well as challenges and strategies related to the acceptance of the COVID-19 vaccine in four groups of Tehran inhabitants: the elderly, people with underlying diseases, healthcare workers, and the general population. The related data were simultaneously collected by applying in-depth semi-structural interviews and a data analysis process. Furthermore, we used the Graneheim and Lundman method for data analysis. We analyzed the data of 1200 people with a mean (SD) age of 46.4 (11.1) years, and approximately 58% of them were men. The vaccine acceptance was 83.6% (95% CI: 81.3–85.9). Among those who welcomed vaccination, 58% preferred the imported vaccines, 25% the Iranian ones, and 17% both. There was a significant association between the variables of age (adjusted odds ratio [AOR] = 1.72, 95% CI: 1.01–2.93), being single (AOR = 0.54, 95% CI: 0.41–0.91), moderate pharmacotherapy adherence (AOR = 0.58, 95% CI: 0.4–0.85), and the willingness to receive COVID-19 vaccine. Qualitative study after interviewing 45 people from four study groups showed an insufficient social trust in healthcare system officials, pharmaceutical and vaccine production companies; distrust in the effectiveness of the vaccines, concerns about the vaccine adverse effects, being tracked by microchips after vaccination, traditional anti-vaccination movements, the feeling the inessentiality of vaccination, and uncertainty about the fair distribution of the vaccine. These concerns were the main challenges addressed by the study groups. A good proportion of Tehran residents reported their willingness to receive the COVID-19 vaccine. Additionally, they expressed their critical concerns, such as insufficient trust in the healthcare system, vaccine safeties, and adverse effects that were the significant barriers to vaccine acceptance. It seems that conflicts raised by the shortage of vaccines and their import due to the sanctions have led to intense desire and demand in the general population, and especially the elderly, for vaccination. Besides, vaccination phobia in some individuals requires further investigations.
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spelling doaj.art-c2f536b3c867458597e80cdb8e08c8f52023-11-23T01:51:41ZengMDPI AGVaccines2076-393X2021-10-01911124810.3390/vaccines9111248The Barriers, Challenges, and Strategies of COVID-19 (SARS-CoV-2) Vaccine Acceptance: A Concurrent Mixed-Method Study in Tehran City, IranHamid Reza Khankeh0Mehrdad Farrokhi1Mohammad Saeed Khanjani2Yadollah Abolfathi Momtaz3Ameneh Setareh Forouzan4Mehdi Norouzi5Shokoufeh Ahmadi6Gholamreza Ghaedamini Harouni7Juliet Roudini8Elham Ghanaatpisheh9Arya Hamedanchi10Mohammad Pourebrahimi11Fardin Alipour12Maryam Ranjbar13Mehrdad Naghikhani14Mohammad Saatchi15Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran 1985713871, IranHealth in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran 1985713871, IranDepartment of Counseling, University of Social Welfare and Rehabilitation Sciences, Tehran 1985713871, IranIranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran 1985713871, IranSocial Welfare Management Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran 1985713871, IranSocial Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran 1985713871, IranHealth in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran 1985713871, IranSocial Welfare Management Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran 1985713871, IranHealth in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran 1985713871, IranHealth in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran 1985713871, IranIranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran 1985713871, IranNursing Faculty, Baqiyatallah University of Medical Sciences, Tehran 1435916471, IranResearch Center of Social Welfare Management, Department of Social Work, University of Social Welfare and Rehabilitation Sciences, Tehran 1985713871, IranHealth in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran 1985713871, IranDepartment of Basic Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran 1985713871, IranHealth in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran 1985713871, IranAcceptance and willingness to receive the vaccine are among the main factors in the success or failure of a health system in implementing the vaccination program. The present study was conducted in Tehran, the political and economic capital of Iran, to determine the acceptance of the COVID-19 vaccine and identify its associated factors, and explain the most important barriers and acceptance strategies for vaccination. This research was a concurrent quantitative and qualitative mixed-method study. In the quantitative part, 1200 individuals aged more than 18 years were selected from the households in 22 districts of Tehran City, with a multistage stratified cluster sampling method. Two questionnaires were used to evaluate the acceptance of the COVID-19 vaccine and vaccine acceptance determinants. The qualitative content analysis method addressed the influencing factors, as well as challenges and strategies related to the acceptance of the COVID-19 vaccine in four groups of Tehran inhabitants: the elderly, people with underlying diseases, healthcare workers, and the general population. The related data were simultaneously collected by applying in-depth semi-structural interviews and a data analysis process. Furthermore, we used the Graneheim and Lundman method for data analysis. We analyzed the data of 1200 people with a mean (SD) age of 46.4 (11.1) years, and approximately 58% of them were men. The vaccine acceptance was 83.6% (95% CI: 81.3–85.9). Among those who welcomed vaccination, 58% preferred the imported vaccines, 25% the Iranian ones, and 17% both. There was a significant association between the variables of age (adjusted odds ratio [AOR] = 1.72, 95% CI: 1.01–2.93), being single (AOR = 0.54, 95% CI: 0.41–0.91), moderate pharmacotherapy adherence (AOR = 0.58, 95% CI: 0.4–0.85), and the willingness to receive COVID-19 vaccine. Qualitative study after interviewing 45 people from four study groups showed an insufficient social trust in healthcare system officials, pharmaceutical and vaccine production companies; distrust in the effectiveness of the vaccines, concerns about the vaccine adverse effects, being tracked by microchips after vaccination, traditional anti-vaccination movements, the feeling the inessentiality of vaccination, and uncertainty about the fair distribution of the vaccine. These concerns were the main challenges addressed by the study groups. A good proportion of Tehran residents reported their willingness to receive the COVID-19 vaccine. Additionally, they expressed their critical concerns, such as insufficient trust in the healthcare system, vaccine safeties, and adverse effects that were the significant barriers to vaccine acceptance. It seems that conflicts raised by the shortage of vaccines and their import due to the sanctions have led to intense desire and demand in the general population, and especially the elderly, for vaccination. Besides, vaccination phobia in some individuals requires further investigations.https://www.mdpi.com/2076-393X/9/11/1248coronavirus disease 2019 (COVID-19) vaccinevaccine hesitancyvaccination acceptancevaccine efficacychallengestrust
spellingShingle Hamid Reza Khankeh
Mehrdad Farrokhi
Mohammad Saeed Khanjani
Yadollah Abolfathi Momtaz
Ameneh Setareh Forouzan
Mehdi Norouzi
Shokoufeh Ahmadi
Gholamreza Ghaedamini Harouni
Juliet Roudini
Elham Ghanaatpisheh
Arya Hamedanchi
Mohammad Pourebrahimi
Fardin Alipour
Maryam Ranjbar
Mehrdad Naghikhani
Mohammad Saatchi
The Barriers, Challenges, and Strategies of COVID-19 (SARS-CoV-2) Vaccine Acceptance: A Concurrent Mixed-Method Study in Tehran City, Iran
Vaccines
coronavirus disease 2019 (COVID-19) vaccine
vaccine hesitancy
vaccination acceptance
vaccine efficacy
challenges
trust
title The Barriers, Challenges, and Strategies of COVID-19 (SARS-CoV-2) Vaccine Acceptance: A Concurrent Mixed-Method Study in Tehran City, Iran
title_full The Barriers, Challenges, and Strategies of COVID-19 (SARS-CoV-2) Vaccine Acceptance: A Concurrent Mixed-Method Study in Tehran City, Iran
title_fullStr The Barriers, Challenges, and Strategies of COVID-19 (SARS-CoV-2) Vaccine Acceptance: A Concurrent Mixed-Method Study in Tehran City, Iran
title_full_unstemmed The Barriers, Challenges, and Strategies of COVID-19 (SARS-CoV-2) Vaccine Acceptance: A Concurrent Mixed-Method Study in Tehran City, Iran
title_short The Barriers, Challenges, and Strategies of COVID-19 (SARS-CoV-2) Vaccine Acceptance: A Concurrent Mixed-Method Study in Tehran City, Iran
title_sort barriers challenges and strategies of covid 19 sars cov 2 vaccine acceptance a concurrent mixed method study in tehran city iran
topic coronavirus disease 2019 (COVID-19) vaccine
vaccine hesitancy
vaccination acceptance
vaccine efficacy
challenges
trust
url https://www.mdpi.com/2076-393X/9/11/1248
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