Preety Gupta¹, Rajesh Kumar Gupta²*, Shivani Gupta³ and Sumit Garg⁴

¹Reader, Department of Public Health Dentistry, Swami Devi Dyal Hospital and Dental College, Barwala, Haryana, India
²Reader, Department of Oral Medicine and Radiology, Swami Devi Dyal Hospital and Dental College, Barwala, Haryana, India
³Senior Lecturer, Department of Pedodontics, Guru Nanak Dev Dental College and Research Institute, Sunam, Punjab, India
⁴Senior Lecturer, Department of Periodontics, Guru Nanak Dev Dental College and Research Institute, Sunam, Punjab, India

*Corresponding Author: Rajesh Kumar Gupta, Reader, Department of Oral Medicine and Radiology, Swami Devi Dyal Hospital and Dental College, Barwala, Haryana, India.

Received: March 15, 2021; Published: : March 24, 2021

Citation: Rajesh Kumar Gupta., et al. “Metagenomics: Rejuvenating Oral Medicine: Concepts Recultured- A Meta-Analysis Research”. Acta Scientific Dental Sciences 5.4 (2021): 200-205.

Abstract

Background: Coronavirus (SARS-CoV-2) made the headlines after its initial breakout in Wuhan, China in December 2019. Virus by genome, lethal naturally, strongly contagious by character succeeded in making a brand new chapter in everyone’s life during a very short span making it a deadly disease. Its widespread has raised many concerns for global health particularly healthcare providers. Vaccines are effective interventions which will reduce the high burden of diseases globally. However, public health authorities face problem of hesitancy of individuals for vaccine. With the supply of COVID-19 vaccines, little information is offered on the general public acceptability and attitudes towards the COVID-19 vaccines. This study is aimed to analyze the acceptability of COVID-19 vaccines and its predictors additionally to the attitudes towards these vaccines among public in tricity.

Methods: A self-structured, closed ended questionnaire was administered to every participant to record the acceptability of COVID-19 vaccine. Statistical analysis was performed using SPSS Version.

Results: A total of 476 participants completed the survey. Within the present study, 27.4% of the participants were acceptable, 46.3% weren't acceptable and 26.3% were neutral to receive COVID-19 vaccines. Furthermore, participants who believed that the COVID-19 pandemic may be a conspiracy and people who failed to trust any information (p < .001) were less acceptable for the vaccine. Moreover, participants who expressed their willingness to procure COVID-19 vaccines were 20 times more likely to simply accept taking them compared to those that didn't show their willingness to pay (p < .001).

Conclusion: To scale back the amount of vaccines’ hesitancy and improve their acceptance public health authorities require systematic interventions. These includes structured awareness campaigns, reviving the trust in national health authorities which offer transparent information about the security and efficacy of the vaccines.

Keywords: COVID-19; Attitudes; Vaccines; Acceptance

Introduction

  Virus by genome, lethal naturally, strongly contagious by character succeeded in making a replacement chapter in everyone’s life during a very short span making it a virulent disease. Nobody could have imagined that the top of the year 2019 will witness the historic birth of 1 of the foremost deadly, an abstruse virus, and the severe acute respiratory syndrome coronavirus (SARS-CoV-2). COVID-19 which is able to strangulate the globe by spreading its tentacles altogether spheres of life within no time, initiated as a pneumonia outbreak in Wuhan, China. Before anyone could have understood the virus WHO declared it as pandemic emergency on 11^th March 2020 involving quite 216 countries within the world [1]. Lethality of this virus is often envisioned as statistical figures which are strongly petrifying. Till mid-January 2021, this pandemic had affected over 95 million people and 52 million confirmed deaths worldwide amongst which India still holds a second position with over 10 million confirmed cases and 2274 confirmed deaths which is increasing everyday with average 0.12% [2].

  Dental health care providers must ensure stringent infection prevention. The SARS-Cov-2, previously named 2019-novel coronavirus by the World Health Organization (WHO), could be a beta-coronavirus containing an enveloped, non-segmented, positive-sense RNA genome with high rates of mutation and recombination [3]. Initially, it started as a zoonotic infection, followed by human-to-human transmission. SARS-CoV-2 uses angiotensin-converting enzyme (ACE-2) which is found within the lower tract as its entry receptor. It is transmitted through both micro droplets; thanks to direct proximity (at distance of 2 meters and exposure duration greater than 15 minutes) and core droplets that remain suspended in aerosol. Its transmission has been mainly described through inhalation/ingestion/direct mucous contact with saliva droplets with the time period starting from 5 to 14 days [4].

  Though, there's no definite cure for this disease; however, recently national and international pharmaceutical companies have claimed to manufacture vaccines to combat this deadly disease with some currently undergoing preclinical trials while a few already in use. Vaccines are one in all the foremost reliable and cost-effective public health interventions ever implemented that are saving voluminous lives annually [5-7]. Following the deciphering of the genome sequence of SARS-CoV-2 in early 2020 and therefore the declaration of the pandemic by WHO in March 2020, scientists and pharmaceutical companies are racing against the clock in efforts to develop vaccines [8,9]. At least 85 vaccines are in preclinical development in animals and 63 are in clinical development in humans, of which 43 in phase I clinical trial, 20 in phase II, 18 in clinical test, 6 are approved for early or limited use, 2 are approved for full use, and one vaccine has been abandoned. Pfizer-Biotech’s (BNT162b2) and Modern (mRNA-1273) mRNA vaccines are approved for emergency use. With the uplifting news about SARS-CoV-2 vaccines approval, optimism is raising to determine an end to the pandemic through herd immunity [10,11]. The whole number of individuals inoculated in India has reached 12,165,598 - that's 110.30% of its total caseload, and 0.876% of population.

  One major obstacle facing the achievement of such a goal is believed to be vaccine hesitancy and skepticism among the population worldwide [12,13]. Vaccine hesitancy was defined by the WHO Strategic Advisory Group of Experts (SAGE) as “delay in acceptance or refusal of vaccination despite availability of vaccination services” [14]. Vaccine acceptability is set by three factors: confidence, convenience, and complacency. Confidence is defined because the trust within the safety and effectiveness of the vaccine, trust within the delivery system, and also the trust within the policymakers [15]. To extend the widespread acceptance of the vaccines, doubts about vaccine safety goes to be a serious challenge which needs to be resolved by healthcare providers, policymakers, community leaders, and governments.

  Hence, it's crucial to explore the acceptance of COVID-19 vaccines and its predictors likewise because of the attitudes towards COVID-19 vaccines amongst the population. The results of current study could assist the policymakers to spotlight the importance of vaccination to the community and inspiring vaccine uptake and acceptance, especially by vulnerable patients to prevent further deaths and to confine the spread of the pandemic by undertaking proactive campaigns.

Materials and Methods

  A cross sectional study was conducted among healthcare practitioners in Tricity (Chandigarh, Panchkula and Mohali) area from June 2020 to January 2021. A complete of 500 healthcare practitioners were randomly selected and only those that agreed to participate were included within the survey. The protocol of the study was approved by the concerned Ethical authorities. Written consent was obtained on the topic ‘COVID-19 Pandemic Related Information’. Participants were asked to point if they were infected with COVID-19 or knew anyone who was infected with confirmation of diagnosis using standard laboratory testing protocols. Another questionnaire was dedicated to surveying participants who believed that they might have contracted the virus but without a confirming test.

  Participants were asked to point their most trusted sources when seeking knowledge of COVID-19 vaccines. Besides, participants were asked about their concerns during the COVID19 pandemic.

  Participants were asked whether or not they accept to receive COVID-19 vaccines after they are approved and available in tricity with 3 response levels (non-acceptance, neutral, acceptance). Variables that were investigated as potential predictors of COVID-19 vaccines acceptance were: age, gender, legal status, having children, academic area, employment, smoking status, whether the person received a seasonal flu vaccine this year, stating that vaccines are safe, concerned that there's a conspiracy behind COVID-19 pandemic, not having any trust in any source of data on vaccines, and willingness to obtain COVID-19 vaccines (Table 1).

  The attitudes towards COVID-19 vaccines’ section consists of 6 statements with a 5-point Likert scale (5 = strongly agree, 4 = agree, 3 = neutral, 2 = disagree, 1 = strongly disagree), with questions on hesitancy and concerns regarding COVID-19 vaccines (Table 2).

  Statistical analysis was performed using SPSS version 20. The results were expressed in percentages and to assess the association of participants’ demographics multivariable regression toward the mean analysis was administrated. Cronbach’s alpha (a˛) of the questionnaire was found to be good (0.82).

Result

  Of the 500 healthcare practitioners contacted to participate within the study, a whole of 476 (95.71%) practitioners responded. The demographic variables are described in table 1. The sample consisted of 395 (82.9%) male and 81 (16.3%) female practitioners. Majority of the practitioners belonged to the people of 25 - 40 years (84.5%). 60.8% of the respondents were married and 36.1% had kids. About 65% had an undergraduate degree and 46.4% of the participants were employed. Only 13.4% had chronic diseases but 10% of the participants received the influenza vaccine this year. About 12% of the respondents reported that they had tested positive for COVID-19. However, about one-third of the participants (47.1%) stated that they might have been infected with COVID-19, but they didn’t confirm it by any laboratory testing. The participants were concerned about different issues during the COVID-19 pandemic (Table 2). The most-reported concern by participants was a fear of members of the family being infected with COVID-19 (80%), which is above a priority about them being infected (20%). Almost one-fourth of the participants (25%) were concerned about death and 5.5% about the unavailability of vaccines.

Table 1

Table 2

  Within the present study, 27.4% of the participants were acceptable, 46.3% weren't acceptable and 26.3% were neutral to receive COVID-19 vaccines. As shown in table 2, the results of statistical method identified the independent factors that predicted the extent of acceptance. The result indicated that the older age groups (> 35 years old) were less likely to accept the COVID-19 vaccines compared to younger age groups (p < .001). Additionally, employed participants (p < .001) were less likely to just accept COVID 19 vaccines compared to unemployed participants. Furthermore, participants who believed that the COVID-19 pandemic may be a conspiracy and people who failed to trust any information (p < .001) were less acceptable for the vaccine. On the other hand, males were more likely to own acceptance for COVID-19 vaccines compared to females. Additionally, participants who took the influenza vaccine this year were more likely to simply accept COVID-19 vaccines compared to people who didn't take the influenza vaccine Furthermore, participants who stated that vaccines are safe generally were 9 times more likely to just accept taking COVID-19 vaccines compared to people who stated that vaccines don't seem to be safe (p < .001).

  Moreover, participants who expressed their willingness to procure COVID-19 vaccines were 20 times more likely to simply accept taking them compared to those that didn't show their willingness to pay (p < .001) Similarly, ‘neutral’ group, suggested that the predictors that make participants more likely to be within the acceptance group compared to the neutral group were being male (p < .0001) and among the cohort of 18-25 years (p = .015). Additionally, people that didn't believe that there's a conspiracy behind COVID-19 were also 2 times more likely to be within the acceptance group (p = .02)

Discussion

  Corona virus, a recently declared global public health concern, has been spreading at an alarming pace. Most of the dental treatments generate significant amounts of aerosols and droplets which may result in rapid transmission of tract infections within the dental office [16]. As, SARS-CoV-2 has been shown to survive in aerosols for hours and on some surfaces for days, the Occupational Safety and Health Administration (OSHA) has placed Dental health professionals within the very high exposure risk category [17,18] because of less distance between the dentist and also the working field and certain dental treatments can require lengthy procedures, which puts the dentist at the next risk of contracting COVID-19 [19,20]. Several reports are emerging concerning the infection and deaths of health care professionals thanks to COIVD-19. Therefore, it becomes important for the complete healthcare personnel to constantly update their knowledge in order that they're ready to potentially screen such patients for prevention of possible spread of the disease. Our study revealed that almost all of the participants were found to be postgraduates (65%) with > 2 years of labor experience (50%) which is comparable to a study done by Kamate., et al [10]. Our study revealed that only 33.3% of the clinicians had high knowledge regarding Corona virus. Therefore, it is often assumed that lack of data may end up in possible transmission of the disease, and it becomes important that doctors should be accustomed to recent medical happenings from time to time regarding these recent outbreaks [21].

  This study sought to look at, for the primary time, the tricity healthcare practitioners’ acceptance of COVID- 19 vaccines. Vaccine hesitancy could threaten the efficiency of COVID-19 vaccines once they become commercially available worldwide [22]. Data shows that till date only. 08 blood type populations has been fully vaccinated while only 0.75 blood type population has taken single and also the first dose of vaccine in India while 1.58% population has been fully vaccinated while only 0.5 population has taken single and therefore the first dose of vaccine worldwide.

  Of the targeted 1,500 physicians, 1,133 were inoculated, helping the Panchkula health department record 71.5% target achievement. In Mohali, of 1,054 expected to induce the jab during the day, only 505 came forward, resulting in 48.3% achievement rate. as the bottom target was kept in Chandigarh, it lagged behind with 47.3% achievement. Only 426 of 900 doctors turned up at various vaccination sites. In terms of overall achievement rate, too, Panchkula leads with 61.6%, while Chandigarh and Mohali have achieved almost 50% target on a mean daily basis.

  A study supported a sample from 19 countries involving 13,426 participants showed that the world acceptance of COVID-19 vaccines ranges between as low as 54.8% from Russia to as high as 88.6% from China. Moreover, most western countries report relatively higher public acceptance (59 - 75%). The acceptability level of vaccinations in India was often under global averages, including seasonal influenza vaccines [23,24].

  In the current study, younger participants were more likely to simply accept COVID-19 vaccines contrary to studies reporting higher acceptance among older people. In our study, males were more likely to participate in COVID-19 vaccine clinical trials compared to females in 2020. Moreover, employed participants were less likely to simply accept taking the COVID-19 vaccines, in a very contrasting result to available studies within the literature suggesting that employed individuals were more likely to simply accept COVID-19 vaccines. In our study, the employed participants were older than the unemployed ones, which were found to be less acceptable to urge COVID-19 vaccines.

  The low acceptance level of COVID-19 vaccines amongst the Jordanians is often attributed to multiple factors, a number of which are shared with the wide global community. There’s a visible uncertainty clouding the COVID-19 vaccines. Firstly, the new mRNA-based vaccines as a completely unique technology might be received with some skepticism since no prior experience or successes with such approach are reported within the past. Also, the speed of vaccine development and registration in a year may have mediated a task in lowering the acceptance level. Our study revealed that 1/2 the participants had safety concerns about the vaccine once it being available as indicated by their concerns about related side effects. Our results supported such perceived viewpoints, where those that didn't believe a conspiracy behind COVID-19 were more likely to just accept COVID-19 vaccines.

  Some people expressed their frustration as many selections were unwelcomed, disproportional with the pandemic status, not justified or backed with science. However, the source of the vaccine affects the perceived safety, as only one-third of the participants within the current study perceived that COVID-19 vaccines that were manufactured in Europe or America were safer than those made in other countries. Study reveals the shortage in approach from government authorities or morally and scientifically boosting even the healthcare professionals which can further deteriorate the aspect with general public.

Conclusion

  The health authorities via healthcare providers, who were identified by the people because the most trust source of knowledge regarding information about COVID- 19 vaccines, should design interventions in terms of awareness campaigns via every type of multimedia to spread more transparent information about the security and efficacy of the vaccines. The attention campaigns should also shed the sunshine over the new technology that was utilized for the production of a few of them so as to spice up COVID-19 vaccines acceptance. Making the vaccine available free or at subsidized prices by the government could yet enhance vaccines acceptance among the population. This study thus provides an insight in shaping future guidelines, stratagem, and policies to be implemented.

Declaration of Competing Interest

The authors declare no conflicts of interest relevant to this work.

Acknowledgement

We would like to thank all the professionals of Tricity who have contributed towards this survey and have given their valuable opinion.

Bibliography

1. Adhikari S., et al. “Epidemiology, causes, clinical manifestations and diagnosis, prevention and control of coronavirus disease (COVID19) during the early outbreak period: A scoping review”. Infectious Diseases of Poverty 9 (2020): 1-12.
2. Huang C., et al. “Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China”. Lancet 395 (2020): 497-506.
3. Ming WK., et al. “Breaking down of healthcare system: Mathematical modelling for controlling the novel coronavirus (2019-nCoV) outbreak in Wuhan, China”. Bio Rxiv (2020).
4. G Spagnuolo., et al. “COVID- 19 outbreak: an overview on dentistry”. International Journal for Environmental Research and Public Health 9 (2020): 2094.
5. Hajj Hussein I., et al. “Vaccines Through Centuries: Major Cornerstones of Global Health”. Front Public Health 3 (2015): 269.
6. Rodrigues CMC and Plotkin SA. “Impact of Vaccines; Health, Economic and Social Perspectives”. Frontiers in Microbiology 11 (2020): 1526.
7. Ehreth J. “The value of vaccination: a global perspective”. Vaccine27 (2003): 4105-4117.
8. Zimmer C., et al. “Coronavirus vaccine tracker US: The New York Times (2020).
9. Coustasse A., et al. “COVID-19 and Vaccine Hesitancy: A Challenge the United States Must Overcome”. The Journal of Ambulatory Care Management 1 (2021): 71-75.
10. Omer SB., et al. “Herd Immunity and Implications for SARS-CoV-2 Control”. The Journal of the American Medical Association 20 (2020): 2095-2096.
11. Fine P., et al. “Herd Immunity”: A Rough Guide”. Clinical Infectious Diseases 7 (2011): 911-916.
12. Schoch-Spana M., et al. “The public’s role in COVID-19 vaccination: Human-centered recommendations to enhance pandemic vaccine awareness, access, and acceptance in the United States”. Vaccine (2020).
13. MacDonald NE. “Vaccine hesitancy: Definition, scope and determinants”. Vaccine 34 (2015): 4161-4164.
14. MacDonald NE. “Vaccine hesitancy: Definition, scope and determinants”. Vaccine 34 (2015): 4161-4164.
15. Lazarus JV., et al. “A global survey of potential acceptance of a COVID-19 vaccine”. Nature Medicine (2020): 1-4.
16. Harrel SK and Molinari J. “Aerosols and splatter in dentistry: A brief review of the literature and infection control implications”. Journal of the American Dental Association 4 (2004): 429-437.
17. Guidance for Dental Settings. CDC (2020).
18. Guidance on Preparing Workplaces for COVID-19 (2020).
19. The Dentist’s Operating Posture - Ergonomic Aspects - Pub Med (2020).
20. Meng L., et al. “Coronavirus Disease 2019 (COVID-19): Emerging and Future Challenges for Dental and Oral Medicine”. Journal of Dental Research 5 (2020): 481-487.
21. Assessing Knowledge, Attitudes and Practices of dental practitioners regarding the COVID-19 pandemic: A multinational study (2020).
22. French J., et al. “Key Guidelines in Developing a Pre-Emptive COVID-19 Vaccination Uptake Promotion Strategy”. International Journal of Environmental Research and Public Health 16 (2020): 5893.
23. Ababneh M., et al. “Seasonal influenza vaccination among older adults in Jordan: prevalence, knowledge, and attitudes”. Human Vaccines and Immunotherapeutics 9 (2020):2252-2256.
24. Abu-rish EY., et al. “Knowledge, awareness and practices towards seasonal influenza and its vaccine: implications for future vaccination campaigns in Jordan”. Family Practice 6 (2016): 690-697.

Copyright: © 2021 Rajesh Kumar Gupta., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.