Prevalence and determinants of COVID-19 vaccine acceptance among vulnerable populations in Thailand: An application of the health belief model

Navarat Rukchart; Kanit Hnuploy; Sameh Eltaybani; Kittipong Sonlom; Nirachon Chutipattana; Cua Ngoc Le; Patthanasak Khammaneechan; Wajinee Jongjit; Suttakarn Supaviboolas

doi:10.1016/j.heliyon.2024.e26043

Prevalence and determinants of COVID-19 vaccine acceptance among vulnerable populations in Thailand: An application of the health belief model

Heliyon. 2024 Feb 12;10(4):e26043. doi: 10.1016/j.heliyon.2024.e26043. eCollection 2024 Feb 29.

Authors

Affiliations

¹ School of Nursing, Walailak University, Nakhon Si Thammarat, 80161, Thailand.
² Suratthani Rajabhat University, Suratthani, 84100, Thailand.
³ Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-0033, Japan.
⁴ Khon Kaen University, Khon Kean, 40002, Thailand.
⁵ Department of Community Public Health, School of Public Health, Walailak University, Nakhon Si Thammarat, 80161, Thailand.
⁶ Excellent Centre for Dengue and Community Public Health (E.C. for DACH), School of Public Health, Walailak University, Nakhon Si Thammarat, 80161, Thailand.
⁷ Department of Public Health Strategy Development, Nakhon Si Thammarat Provincial Public Health Office, Nakhon Si Thammarat, 80000, Thailand.
⁸ Southern Border Regional Center for Primary Health Care Development, Nakhon Si Thammarat, 80000, Thailand.

Abstract

Background: Assessing the acceptance of vaccinations among vulnerable populations is essential to ensure proper coronavirus disease 2019 (COVID-19) control. This study used the Health Belief Model to examine the intention to vaccinate against COVID-19 among vulnerable populations in Thailand.

Methods: This analytical cross-sectional study was conducted in Thailand between October and November 2021. Using multistage random sampling, 945 individuals from vulnerable populations (i.e., older adults, pregnant women, market or street vendors, and individuals with chronic diseases) were selected and invited to complete a self-reported questionnaire. The questionnaire assessed participants' socioeconomic characteristics, COVID-19 preventive measures, knowledge, preventative health beliefs, and vaccine intention. A generalized linear mixed model was used to identify factors associated with the intention to receive the vaccine.

Results: The prevalence of intent to accept the COVID-19 vaccine was 75.03% (95% confidence interval [CI]: 72.16-77.68). The Health Belief Model factors associated with vaccine acceptance were cue to action (adjusted odds ratio [AOR] = 3.13; 95% CI: 2.07-4.71), perceived benefits (AOR = 2.04; 95% CI: 1.38-3.01), and perceived severity (AOR = 1.77; 95% CI: 1.18-2.65). Significant other covariates were wearing a face mask in the previous month (AOR = 2.62; 95% CI: 1.59-4.31), being 1-2 m away from other people (AOR = 1.58; 95% CI: 1.11-2.24), trust in government (AOR = 1.44; 95% CI: 1.03-2.02). Additionally, women were more likely to accept the COVID-19 vaccine compared to men (AOR = 1.43; 95% CI: 1.02-2.01).

Conclusions: Approximately one quarter of vulnerable individuals do not intend to be vaccinated. Health Belief Models can explain vaccine acceptance, and aid the Ministry of Public Health in planning future efforts to increase vaccine uptake. Healthcare professionals' advice, village health volunteers' information, and partnership collaborations are critical. Facilitating mobile community units, launching educational campaigns, maintaining a distance of 1-2 m from others, and wearing masks may increase COVID-19 vaccine acceptability. This research can help prepare for future pandemics.

Keywords: COVID-19; Health belief model; Prevalence; Vaccine hesitancy; Vulnerable population.