Abstract |
Introduction: The Covid-19 pandemic outbreak brought back to light the vaccine hesitancy
issue. Scientific community is consistently examining the factors that lead to this phenomenon.
Evidence from international studies indicate that low socioeconomic level is associated with
higher levels of vaccination hesitancy and/or refusal. The aim of this study was to investigate
the vaccination hesitancy of vulnerable socioeconomic populations in Crete. Side goals were
the illustration of the necessity of interventions regarding the increase of notification, the
vaccination coverage and the adoption of positive behaviours of the population under
investigation.
Methods: A qualitative research was conducted which included people registered in Fund for
European Aid to the Most Deprived (FEAD), since bibliography suggests that low
socioeconomic level increases the risk of the virus’ spread and disease, while vaccine hesitancy
is expected to be higher within this population. Specifically, two focus groups were conducted
in a rural area in Heraklion and in an urban area in Rethymno, in the Region of Crete.
Participants were selected in such a way to have representation of gender and age. Sample was
purposely and conveniently selected. Conversations were guided by a specific interview
structure that was conducted according to the international bibliography. Theoretical
framework utilised for the development of the interview structure and that guided the
methodology of the research was the Health Belief Model (HBM), considering also elements
and parameters of the Theory of Planned Behavior (TPB) and the Vaccine Hesitancy
Determinants Model. The data collected included; knowledge about COVID-19 disease and the
ways of its spread and protection, reasons for vaccination hesitancy, information resources
about the disease, the vaccines and the progress of both, the family’s and friends’ influence and
the trust towards the doctor and health system. Thematic analysis was utilized to analyze the
verbatim transcripts.
Results: 11 people participated in this research, aged between 21 to 68 years, from which 9
were women and 2 were men. Thematic analysis released 6 themes. The first one was about the
beliefs about the virus and the vaccine, within which many participants seemed to have
formulated mistaken beliefs. The second theme was about the influence of family and friends
in the decision about the vaccine uptake. The third theme was about the mass media effect,
where the large number of affairs and the preference to specific sources found to be related to
the vaccine uptake. The fourth theme was about the relationship between people and health
system and the health professionals, where people expressing negative opinions about the
abovementioned to be found with greater vaccine hesitancy. The fifth theme was about the trust
in authorities, with those expressing mistrust to illustrate hesitancy and refusal about the
vaccination. The last theme was about the cultural norms, where religiosity and popularised
way of thinking were associated with increased vaccine hesitancy.
Conclusion: This research affirms that vaccine hesitancy is a multidimensional issue and
underlines the necessity of interventions within the vulnerable populations to increase the
vaccination coverage and to improve the attitudes within the health sector. Further research,
which should include quantitative methodology, is required to confirm the findings.
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