RESEARCH COLLOQUIUM FORM

Name of Student:
Institution: Position: Staff Nurse
Proposal Title: Apprehension to COVID-19 Vaccine among Elderly in Zamboanga City: A Phenomenological Study

Background of the Study and Research Gap (limit to 3 to 5 sentences):

There have been misconceptions about the COVID-19 immunization that greatly caused the people
to doubt its efficacy and question its mandate. Misleading information has profusely captured social
media, adding more confusion to the already doubtful populations. One argument used to rebut the
authenticity of trial studies is why people get ‘sick’ or acquire some COVID-like symptoms after
receiving the dose. Although we know that this is a normal response of the body because of the
pathogen response, this does not seem to produce a positive attitude among some members of the
community. Vaccines do not cause the diseases they are meant to prevent. The fact that a number
of the vulnerable population still refuses to get vaccinated is a problem that needs to be further
investigated and acted upon.

Research Gap: Despite the proliferation of false information in social media which may have direct
or indirect effects on the community’s perception (particularly the elderly’s) towards getting a
COVID-19 vaccination, there is no study in Zamboanga City that highlights the causation of such
apprehensions, and its perceived effects to the individual or community.

Statement of the Problem:

Elders of the community possess negative feelings regarding COVID-19 immunizations mainly due
to perceived effects extracted from false information presented to them. Hence, the researcher
would like to explore the apprehensions among the elderly to COVID 19 vaccine.

1. How do the participants feel about COVID 19 mass vaccination especially among elderly?
2. What are the apprehensions of the participants to COVID 19 vaccine?
3. What are the alternative strategies of the participants to be protected against COVID-19?
4. What output can be drawn based from the findings of this study?

Research Design: Qualitative Research

Research Methodology Matrix:

Research Question: Locale and Research Method: Research Data Data Analysis
Sampling: Instrument: Gathering Procedure:
Procedure:
1. 60–90 minutes LOCALE: Descriptive Semi- In-depth Interpretative
2. What are the Barangay Phenomenological structured interviews with Phenomenological
factors that lead to Mampang, Approach interviews participants Analysis
apprehension to Zamboanga City,
COVID-19 Philippines
vaccination among
the elderly?
3. What perceived SAMPLING:
effects do the Convenience
participants believe Sampling
would occur due to 60-year-old (and
COVID-19 above) residents
vaccination? of Barangay
4. What are the Mampang
participants’ beliefs
on the effects of
non-COVID-19
immunization to the
following:

a. Their health
b. Their family
c. The community
5. What are the
alternative methods
of protection
against COVID-19
do the participants
practice?

Comment from the Panel of Examiner:

 COVID-19 Vaccine Apprehension

RESEARCH PROSPECTUS
Apprehension to COVID-19 Vaccine among Elderly
in Zamboanga City

DECEMBER 2021
FOREWORD

` Numerous significant studies have been conducted in recent years to better understand the
nature of the disease caused by the COVID-19 virus. These studies have aided various government
and health agencies in developing a comprehensive and sustainable plan to address the increasing
rate of mortality and morbidity associated with the COVID-19 pandemic. This resulted in the
establishment of a free vaccination campaign by the local government and agency with the goal of
lowering the risk of infection among Filipino citizens. Despite the presence of such programs and
interventions within the community, misunderstandings regarding the COVID-19 vaccination have
spread throughout the country, prompting a large number of individuals to dispute its efficacy and
mandate. With such extensive false information, the country's case and mortality rates have
continued to rise, particularly among the country's large susceptible population.

Anti-vaccine sentiment and fear, and the growing number of COVID-19 cases is the focus of
this study. This Research Prospectus introduces a novel and fascinating research endeavor during
the COVID-19 epidemic, with the goal of producing new insights and techniques for tackling the
numerous issues confronting the Zamboanguenos. The study was divided into four research domains
— (1) Psychological factors affecting apprehensions about COVID-19 vaccination, (2) social
dynamics and associated factors that contribute to apprehension about COVID-19 vaccination, (3)
environmental dynamics and the implications of vaccine hesitancy toward COVID-19 vaccination on
an individual's health, family, and community, and (4) Preventive practice, such as alternative
methods used to combat COVID-19 virus.– this research effort will be delivered through partnerships
that are grounded in science.

The Prospectus establishes future research directions for the next three to five years and
serves as a framework for government and health organizations to collaborate on efficient planning
that will connect various research and governmental groups, as well as health practitioners, in order
to develop an efficient strategy that will assist the general public in achieving protection against the
COVID-19 pandemic, focusing on health and wealth. Additionally, the study seeks to take the lead in
collaborating with similar global research activities in order to further expand and develop the global
study of Vaccine Hesitancy.
COVID-19 Vaccine Apprehension Research Prospectus
● FOREWORD
● 1.0 INTRODUCTION
● 2.0 APPROACH AND GUIDING QUESTIONS
● 3.0 THEMES FOR RESEARCH AND INNOVATION
● 4.0 PROPOSED STRUCTURE AND DELIVERY
● 5.0 RESEARCH OUTPUTS AND OUTCOME
● 6.0 BENEFITS OF PARTNERING
● 7.0 LITERATURE CITED
1.0 INTRODUCTION
Worldwide, health providers and several national governments have prioritized encouraging
individuals to receive coronavirus vaccinations-2019 (COVID-19). However, several studies
conducted over the last few years have revealed a range of vaccination attitudes and differences that
significantly impact people's willingness to be vaccinated (Cordina, 2021). According to a research
done in the year 2021, information of the disease is likely to impact acceptance of vaccination.
Individuals with enough awareness of COVID-19 had a greater willingness to get vaccinated than
those with insufficient knowledge of the illness. This indicates that those who do not want to be
vaccinated are more likely to have a poor level of education and social isolation. Furthermore, a
substantial inverse link between vaccination intentions and anti-vaccine conspiracy beliefs has been
discovered (Javier & Ramón, 2021). In addition, MacDonald (2015) defines vaccine hesitancy as a
term that refers to a delay in accepting or refusing immunization despite the presence of vaccination
services. Vaccine reluctance is a complicated and context-dependent phenomenon that varies
according to time, place, and vaccine. It is impacted by a variety of elements, including complacency,
convenience, and confidence (SAGE Working Group on Vaccine Hesitancy, 2015). Additionally,
several studies and research have shown and proven that a large number of recent outbreaks of
vaccine-preventable illnesses have been connected to under vaccinated or unvaccinated
communities. Additionally, they say that with the Internet, anti-vaccine groups are more strong than
ever and have the ability to reach and influence a large number of parents (Mascaro, 2019).
Community fear and mistrust of the state and health institutions also contributed to vaccination
hesitation. However, given the recurrent nature of health and vaccination conflicts, it has been
determined that such dilemmas may be resolved by strengthened communications and a people-
centered health paradigm among people (David, 2021).
Nonetheless, the Research Prospectus responds to this opportunity for determining various
factors, events, and determinants of vaccine hesitancy by highlighting an exciting new research effort
within the healthcare delivery system and government that will result in a more integrated and
therapeutic intervention and strategy by various organizations that are linked in the COVID-19
response team in order to formulate positive strategies. The following four fundamental ideas guide
this research: What this focus provides is a multi-level understanding of the resilience of urban
systems which recognizes the role of (1) Psychological factors such as fear, acceptance, and anxiety
when accepting the COVID-19 vaccination, towards well-being and quality of life; (2) social dynamics
and cultural factors that its ability shape one's perception towards the COVID-19 vaccine adapt or
resistance; and (3) environmental dynamics of people as citizens, members of communities, and their
relationship with the built environment; (4) preventive practice and pattern used as a alternative to
combat the COVID-19 pandemic.
The Research Prospectus establishes areas for future research for the next three to five years
and serve as a foundation for government and health organizations to collaborate on efficient
planning that will connect various research and governmental groups, as well as health practitioners,
in order to develop an efficient strategy that will assist the general public in protecting themselves
against the COVID-19 pandemic, with a focus on health and wealth. Additionally, it serves to
represent the broad population of Zamboaguenos in order to develop important concepts, shared
ideologies, and held beliefs on the COVID-19 epidemic, as well as to act as a guide for health
education in the community.
2.0 The Problem and the Opportunity

Vaccine apprehension or hesitancy continues to be a social and health issue, particularly

among the elderly. The threat is heightened by the possibility of a COVID-19 outbreak. Vaccination
coverage has been reduced in remote areas of the country, such as the Zamboanga Peninsula.
Between August and September 2021, infections caused primarily by the Delta type increased by
approximately 37% in Zamboanga City. The city government's vaccination campaign against
coronavirus disease 2019 (Covid-19) has shifted its focus to barangays with high infection rates. The
public's fear of being vaccinated against COVID has contributed to the low vaccination rates. This is
primarily due to misinformation that circulates in the form of rumors and conspiracy theories.
According to some, vaccinations can actually cause disease to develop and can even be toxic,
resulting in death. Despite the proliferation of false information on social media, which may have a
direct or indirect effect on the community's attitude toward getting a COVID-19 vaccination
(particularly among the elderly).
The Prospectus is organized around four research priorities – psychological factors, social
dynamics, environmental dynamics, and various preventive practices – which we intend to investigate
through the lens of people's concerns about COVID-19 vaccination. In accordance with the
approach , the nature of the research will be demonstrated and aims to produce the most relevant
studies and results, various programs, and trends in COVID-19 vaccine development that are
descriptive in nature. Thus, the findings enable the establishment of future research directions for the
next three to five years and serves as a framework for government and health organizations to
collaborate on efficient planning that connects various research and governmental groups, as well as
health practitioners, in order to develop an efficient strategy that assists the general public in
achieving protection against the COVID-19 pandemic, with a particular emphasis on health and
wealth.
This paper will conduct a phenomenological study to define various ideologies, mindsets, and
apprehension barriers associated with the COVID-19 vaccine. The study will be led and conducted by
established local government and non-government units in Zamboanga City, as well as throughout
the Philippines.
Numerous integrated and holistic questions will be used to investigate the elderly's fear of the
COVID 19 vaccine:
1. How do the participants feel about COVID 19 mass vaccination especially among elderly?
2. What are the apprehensions of the participants in the COVID 19 vaccine?
3. What are the alternative strategies of the participants to be protected against COVID-19?
4. What output can be drawn based on the findings of this study?
3.0 THEMES FOR RESEARCH AND INNOVATION

False information has taken over social media in droves, further confusing already doubtful
populations. Vaccines do not cause the diseases for which they are intended. The fact that a portion
of the vulnerable population continues to refuse vaccination is a problem that must be investigated
and addressed.

Figure 1: Associated Themes Affecting the Apprehension of Elderly towards to COVID-19

Vaccine in Zamboanga City

Figure 1 depicts these interconnected themes. The purpose of this study is to ascertain the
cause-and-effect relationships between Misinformation about COVID-19 and Vaccination and the
Elderly's Refusal of Vaccination and Alternative Health Practices against COVID-19, as well as the
Elderly's Apprehensions and Beliefs about the Effects of Refusing Vaccination, as well as the factors
that influence the elderly's behavior and beliefs, as well as the preventive practices they follow.
The focus of the study will aim to provide a multi-level understanding of the various factors that
affect the apprehension of elderly towards the COVID-19 pandemic. It acknowledges the role of
psychological factors such as fear, acceptance, and anxiety in determining one's well-being and
quality of life when accepting the COVID-19 vaccination; social dynamics and cultural factors that
can influence one's perception of the COVID-19 vaccine's adaptability or resistance; and the
environmental dynamics of people as citizens, members of communities, and consumers;
preventive practice and pattern used as a alternative to combat the COVID-19 pandemic.
3.1 PSYCHOLOGICAL FACTORS
Fear, Acceptance, and Anxiety
Vaccination is widely regarded as a critical role in resolving the COVID-19 epidemic in a
sanitary manner. However, vaccination hesitancy can jeopardize its spread, having a devastating
impact on world health. Simione (2021) indicated that confidence in conspiracy theories, mistrust of
medical knowledge, and skepticism of medicine and science all contribute to an increased death rate,
while anxiety was found to decrease vaccination rates.
Vaccine hesitancy is a major public health concern that jeopardizes human safety, particularly
throughout this pandemic. As a result, it is essential to comprehend the psychological factors that
contribute to vaccine refusal. Wheelock (2013) explains that the major psychological factors
influencing society's social acceptance or fear of vaccination were their broad sense perceptions
forward into wellbeing and immunisations, their motivators, and their altruism. Nazl (2021) explained
that the majority of participants had a negative attitude toward vaccines as a result of the perceived
side effects associated with vaccination. This was discovered to be largely due to their belief in
conspiracy theories, misleading claims made on social media by anti-vaccine advocates, and well-
known conservative political beliefs. Additionally, individuals who tend to underestimate pandemics
had a negative view of vaccines. Additionally, their study discovered that vaccine hesitancy is
associated with conspiracy theories, paranoia, and religious beliefs. That, in aggregate, results in
distrust of authorized individuals was evaluated in relation to vaccine rejection. Additionally, Bock et
al. (2017) explain that, in addition to fear and conspiracy, other general psychological factors such as
self-efficacy, enthusiasm, and subjective health may help explain why some people vaccinate and
others do not. Dutta (2020) also explains that the majority of anti-vaxxers exhibited mistrust,
particularly conspiracy mentality but also general paranoia, which resulted in the development of
various negative behavioral responses to vaccines. Lo et al. (2021) also discovered that people's
understanding of the virus's origin played a role in postponing immunization recognition. Individuals
who believed the virus was produced synthetically felt helpless and were more concerned about the
possible vaccine side effects, which has been significantly negatively correlated with their
immunization intention. Murphy (2021) explained that persons who have been resistant to a COVID-
19 vaccine have been likely to get information about the pandemic from conventional and religious
authoritative figures that have a similar degree of mistrust in these sources.
In general, vaccination hesitancy poses a risk to global public health. Understanding the
psychological elements that influence the community's influence, preferences, and desires for a future
vaccine may aid in developing methods for global vaccination program improvement.
Research questions
● What perceived effects do the participants believe would occur due to COVID-19 vaccination?
○ What were their thoughts with the vaccination program runned by the government?
○ Were there any known concerns that ones have with regards to the Vaccine?
○ What are the associated emotions that one has with regards to vaccines?
○ What are their beliefs with vaccines?

3.2 – SOCIAL DYNAMICS AND CULTURAL FACTORS

Demographics, Social Media, Information, cultural beliefs, and inequity
Vaccine reluctance is distinct in Asia compared to Western countries due to the complex
social-cultural norms that impact vaccination opinions. Wong and Zimet (2020) indicated that in their
study, parents with more fervent religious convictions were frequently more likely to resist the vaccine
than parents with weaker religious beliefs. Additionally, it has been discovered that individuals with a
strong religious affiliation frequently require collaboration with religious figures or cultural
organizations to gain approval for vaccine acceptability, despite the vaccine's demonstrated efficacy.
Additionally, despite the lack of compelling evidence for its efficacy, tradition and indigenous beliefs
influence how people undertake conventional medical care.
Religion may play a role, as conventional religious teachings are likely to conflict with the
unique magical/spiritual health ideas that frequently underpin anti-vaccination emotions. Eriksson &
Vartanova (2021) also discovered a high correlation between religiosity and vaccine reluctance. Thus,
even when religions do not address vaccines explicitly, spirituality might serve to overshadow the
intellectual basis of anti-vaccine beliefs. However, Troiano (2021) explained that the most frequently
cited reasons for vaccine refusal were a perception of vaccines as dangerous and ineffective as a
result of a lack of trust, doubts about the vaccine's efficacy, belief that one was already immunized,
and doubt about the vaccine's provenience. Pugliese-Garcia (2018) also discusses vaccine hesitancy
in detail; her study demonstrates that a variety of factors, including personal experiences with
vaccinations, alternative belief models, limited knowledge, a profound misunderstanding of how
vaccines work, and barriers to access all contributed to vaccine hesitancy. In general, her research
found that traditional remedies, alcohol usage, and religious beliefs emerged as factors contributing to
vaccine hesitation, which was likely exacerbated by a priori skepticism of western medicine.
Additionally, Keshet & Popper-Giveon (2021) explain the significant influence religious leaders play in
parents' vaccine decision-making. They discovered that religious views frequently played a role in
vaccine reluctance. Additionally, they assert that the rabbi's recommendation to vaccinate is outside
the scope of rabbinical knowledge. Additionally, Keshet & Popper-Giveon (2021) explain the
significant influence religious leaders play in parents' vaccine decision-making. They discovered that
religious views frequently played a role in vaccine reluctance. Additionally, they assert that the
religious leader’s recommendation to vaccinate is outside the scope of rabbinical knowledge.
Research questions
● What is your attitude toward vaccination? Has it changed over the years?
● Whom do you consult with on this matter?
● What sources of information do you rely on?

3.3 ENVIRONMENTAL DYNAMICS

Institutional structures and organisations
The increasing use of "alternative" medicine in children has coincided with an increase in the
incidence of certain vaccine-preventable diseases. According to Gowda (2013), this was mostly
related to parents' attitudes and views about vaccines. Certain parents are concerned that
administering an excessive number of immunizations, particularly in a short period of time, could be
hazardous to their child's health. There are worries regarding the cumulative pain and suffering that
children who receive many doses at the same time may endure. Vaccine skepticism among VHPs is
exacerbated by the disparity between falling levels of perceived illness susceptibility and increasing
levels of actual disease susceptibility. In aggregate, this has resulted in an increase in preference for
natural immunity, indicating a lack of awareness regarding vaccination principles, indicating a
possible focus area for future educational initiatives. Giambi & Martinelli (2018) go on to clarify that
the prime concern expressed by parents when rejecting or halting immunization was security.
Additionally, numerous parents believe that school vaccination causes particular emotional reactions
in health care personnel who are exposed to it. It has been observed that the school and education
departments have been negligent in alerting parents that if their child is not vaccinated, their child's
risk of catching the disease is increased (Chandra, 2016). Additionally, Charron et al. (2020) clarify
that the three primary sources of vaccine information were medical practitioners, the Web, and
families. It has been demonstrated that immunization habits and acceptability were improved when
parents received the information from HCPs rather than the Internet or relatives. Thus, it is proposed
that excellent information concerning vaccination be made available on the Internet.

Research questions
● What are the participants’ beliefs on the effects of non-COVID-19 immunization to the
following:
○ Their health
○ Their family
○ The community
● What sources of information do you rely on?
 ● Do you have access to primary health care?
● Do you work/schools offer vaccination services to you and your family?

3.4 PREVENTIVE PRACTICES AND PATTERN

Disease Prevention and Practices
Trogen & Pirofski (2021) also emphasized that vaccine refusal frequently has strong political,
cultural, and emotional implications that can be challenging to overcome. This was mostly due to
disinformation disseminated by these groups, which has its origins in more than a century-old anti-
vaccine propaganda. This results in the use of specific cultural interventions in an attempt to mitigate
the growing threat and concerns associated with an ongoing illness threat. Additionally, Eskola &
Duclos (2015) emphasize that vaccine skeptics were primarily concerned with the need to strengthen
protection against a specific vaccination-related disease through other cultural disease prevention
measures. Additionally, Wong & Wong (2020) stated that anti-vaccine misinformation, religious
restriction, and a confidence in the safety of conventional alternative medicine (TCAM) use were
highlighted as factors for vaccine hesitation. Numerous characteristics such as ethnic origin,
employment status, faith, politics, gender, age, education, and income all influenced acceptance or
refusal.

Research questions
● What are the alternative methods of protection against COVID-19 do the participants practice?
○ What were the various practices that ones perform to prevent the contraction of the
disease?
○ Even with several known disease prevention practices? Would they still vaccinate one
4.0 PROPOSED STRUCTURE AND DELIVERY

A qualitative study will be done among residents of Barangay Mampang who are 60 years old
(or older) and live in Barangay Mampang, Zamboanga City, Philippines. A practical sample approach
will be extensively used in studies addressing sensitive issues, such as the elderly's fear of the
COVID-19 vaccine). Researchers will select which participants to contact on a personal level, utilizing
our existing social, professional, and familial networks, while developing rapport and trust with
members of the older population in barangay Mampang, while maintaining their identity and right to
privacy. Scholars that employ this simple method of sampling first pick a few participants and then
ask them to propose others who fulfill the study's criteria and might be willing to participate. The data
collection method will be in-depth interviews with participants lasting 60–90 minutes, using a
language in which all participants are conversant. The participants will be asked a series of open-
ended questions about their perspective and apprehension over their vaccination decision-making
process and the impact of various factors. The researcher will conduct semi-structured interviews
using a questionnaire customized for this topic. After obtaining oral consent from participants,
interviews shall be recorded and subsequently verbatim transcribed and evaluated.
5.0 RESEARCH OUTPUTS AND OUTCOMES
The Prospectus establishes future research directions for the next three to five years and
serves as a framework for government and health organizations to collaborate on efficient planning
that will connect various research and government organizations, as well as health practitioners, in
order to develop an efficient strategy that will assist the general public in achieving protection against
the COVID-19 pandemic, with an emphasis on health and wealth. Additionally, the project aspires to
lead collaborations with similar global research efforts in order to broaden and develop the global
study of Vaccine Hesitancy.
● Comparative analysis framework for vaccination hesitancy research – Comparing
and contrasting vaccine hesitancy studies is critical for developing a robust
understanding of the associated factors for establishing appropriate action against such
resistance. This action will establish standard approaches, protocols, and frameworks
for individuals and groups who are vaccination reluctant.

6.0 BENEFITS OF PARTNERING

This area of research has gotten scant or fragmented attention to date, despite the fact that it
contains critical information on the causes linked with vaccine hesitancy, which can be used to guide
their cities' transition toward a reduction in vaccine resistant populations in the future. Furthermore,
Through a coordinated worldwide approach, innovations developed in a specific case study or by a
specific organization will be shared and made available to all partners, thereby increasing the
production and use of research knowledge. Additionally, with this knowledge in hand, risk reduction
will be accomplished as a result of governmental issues and strategies resulting from this research.
 CHAPTER I

Introduction

In the Philippines, vaccine hesitancy or apprehension remains a social and health issue, particularly

among the elderly population. As of September 23, 2021, Kabagani reports that data revealed by the National

Task Force (NTF) against COVID-19 compares the number of fully vaccinated individuals across priority

groups nationwide. The numbers per priority group are as follows: healthcare workers (A1): 2,242,931, seniors

(A2): 433,396, adults with comorbidities (A3): 6,282,480, essential front-liners (A4): 5,307,222, and indigents

(A5): 1,770,301. According to the World Health Organization Philippines (2021), A2 vaccination rates remain

low, despite improvements in other priority groups. Only around 25 percent of the A2 population has been fully

vaccinated, and only approximately 35 percent has received their first dose. Local government units (LGUs)

have been alerted to make more efforts to vaccinate all the elderly population. Moreover, the threat is

heightened by the possibility of an increase in COVID-19 cases following confirmation of the more

transmissible Delta variant's emergence.

There has been a lower rollout of vaccinations in distant regions of the country, such as Zamboanga

Peninsula. As of September 27, 2020, the city of Zamboanga had provided a first dose to 179,578 individuals

and a second dose to 107,290 individuals who were qualified for the vaccination. However, the number of

individuals who have been fully vaccinated in Zamboanga City totals to only 11 percent of the entire population

(Iellamo, 2021).

On October 21, 2021, Tomacruz published an article on “Why are COVID-19 vaccinations in the

Philippines slowing down?” She emphasizes that the supply of vaccines has been a hurdle for the country.

However, after acquiring a stockpile of vaccines for the country, the next primary challenge is the ‘throughput.’

There are logistical challenges in transport of the vaccines to distant regions, shortage of staff to administer the

doses, and residents that had no access at all to a vaccination site. Moreover, the biggest challenge regarding

this vaccine rollout was the safety concerns on vaccines. Local officials were dealing with a problem in their

communities: vaccination apprehension.

 In an investigative research study entitled, “COVID-19 vaccine rumors and conspiracy theories: The

need for cognitive inoculation against misinformation to improve vaccine adherence,” Islam & et al (2021) has

uncovered numerous rumors and conspiracy theories that have the potential to undermine confidence in the

COVID-19 vaccination. Without fact-based information, the dissemination of these rumors across many social

media platforms risks being misunderstood as genuine information. The most widely circulated rumor claimed

that the COVID-19 vaccine composed of a messenger RNA (mRNA) is capable of altering people's

deoxyribonucleic acid (DNA), thereby transforming them into genetically modified humans. According to one

claim, the WHO admitted that the COVID-19 vaccine would not be effective; another claim is that the vaccine

would have 80% adverse effects.

In Zamboanga City, infections caused primarily by the Delta type increased by about 37% between

August and September 2021. Barangay Mampang has been ranked in the top 20 of the communities with the

greatest number of active cases. The city government's coronavirus disease 2019 (Covid-19) vaccination

campaign has been shifting its focus on barangays with high infection rates as it continues the conduct of

mobile inoculation activities (Garcia, 2021). Considering these presenting issues, this research is aimed at

increasing the vaccination rates among the elderly population in Zamboanga City. Concerning the vulnerability

of the elderly, this research will serve as essential to the local government unit and Department of Health

Region 9 to improve strategic measures to protect the health of the elderly communities within the city.

Background of the Problem

An identified contributing factor to the sluggish vaccination rates in the country is the public’s

apprehension on getting inoculated by COVID vaccines. This primarily has been caused by misinformation that

circulates as rumors and conspiracy theories throughout the media and even across countries. Dr. Romeo

Quijano, a retired UP College of Medicine professor, was turned down for spreading false information about the

vaccine, stating that they are unsafe and more dangerous than the virus itself (as cited in Philippine News

Agency, 2021). There are some claims that the vaccination can cause the disease to develop and even be toxic
and cause death among the elderly. However, the World Health Organization (2021) concludes in a report that

there is no indication in the present records of an unexpected increase in mortality among frail, old people, or

any peculiar characteristics of adverse events after inoculation. Deaths were only linked to pre-existing

comorbidities. There have also been arguments in the religious context. A Davao-based preacher, Rod Cubos

(2021, as cited in Gomez, 2021), warned his followers to not get jabbed as it would not only endanger one’s

body but also their relationship with God. Cubos taught that anyone who received COVID-19 vaccinations will

die within two years due to the vaccines allegedly containing metal components. However, he added that the

vaccinated may begin to morph into zombies and begin biting the uninfected. The preacher's outlandish beliefs

quickly circulated as a popular joke on social media. With all these circulating misinformation, increasing the

vaccination rates of communities have been a struggle. This leaves the vulnerable groups, particularly the

elderly, at most risk of morbidity and mortality.

Significance for this Study in Zamboanga City

Identifying the apprehensions of the elderly population against COVID-19 vaccination would assist the

local government unit, Department of Health Region 9, and health institutions to responsibly address the issues

of misinformation and the public’s mistrust. It would aid community health care workers to assess the

knowledge, attitudes, and practices of the elderly population. With such assessment, collaborative strategic

planning can be done to correct the misinformation and convince the population to willingly get vaccinated.

Despite the proliferation of false information in social media which may have direct or indirect effects

on the community’s perception (particularly the elderly’s) towards getting a COVID-19 vaccination, there is no

study in Zamboanga City that highlights the causation of such apprehensions, and its perceived effects to the

individual or community. The findings and conclusions of this research may be beneficial in conducting

programs for effective information dissemination and persuasion to get vaccinated and promote healthy

lifestyles amid the pandemic.

Conceptual Framework

This phenomenological study will examine the cause-and-effect relationships between the following

variables: “Misinformation regarding COVID-19 and Vaccination” as the independent variable and “Refusal of

Vaccination and Alternative Health Practices of the Elderly against COVID-19” as the end-dependent variable.

The mediating variables of “Apprehensions of the Elderly on Vaccination” and “Beliefs of the Elderly on

Effects of Refusing Vaccination” are influenced by the by the ‘false information,’ which further influences the

elderly’s decision to refuse vaccination and pursue alternative health practices. In general, the researchers

expect that dissemination of misleading information has a direct effect on people’s health attitudes and beliefs.

Additionally, these will be mirrored in their health choices and behaviors.

Literature Review

Definition of Terms
In this study, vaccination is the process of administering a vaccine to the body in order to provide protection

against a specific disease (CDC, 2021). It is often used interchangeably with the term inoculation and

immunization. Immunization is the “process by which a person becomes protected against a disease through

vaccination,” (CDC, 2021). Vaccine hesitancy and ‘apprehension’ are also used interchangeably, referring to

the “reluctance or refusal of vaccines despite availability of vaccines” and is influenced by factors such as

complacency, inconvenience in accessing vaccines, and lack of confidence (World Health Organization, n.d.).

The elderly population refers to individuals aged 60 years old and above, classified under the A2 priority group

in the national vaccination campaign. Misinformation is defined as false information that is spread, regardless

of whether there is intent to mislead (Dictionary.com, n.d.). Social media platforms have risen in importance as

a source of health-related information. These platforms include but may not be limited to Facebook, YouTube,

and Google. During a pandemic, people can use social media to learn more about the disease, how it spreads,

and how to prevent it (Islam & et al, 2021).

 CHAPTER II
REVIEW OF RELATED LITERATURE

FOREIGN LITERATURE

Vaccination Hesitancy and Refusal

Vaccine hesitancy refers to delay in acceptance or refusal of vaccination despite the

availability of vaccination services (WHO, 2020). MacDonald (2015) further explained that vaccine
reluctance varies according to time, place, and vaccine. Additionally, he emphasizes that it is
impacted by a variety of elements, including complacency, convenience, and confidence. Mathur
(2016) explained that various social factors, such as cultural issues and strong religious beliefs, have
a significant impact on parents' decision-making when it comes to vaccinating their children. These
factors have the potential to undermine the conventional trust in natural and artificial medicines.

Socioeconomic factors of vaccine hesitancy

The perceived convenience of a vaccine, which refers to the degree of comfort associated with
the time, place, and quality of a vaccine, influences the uptake of a vaccine. Together with the
perceived risk of disease is also assumed to contribute to the overall total acceptance or complete
refusal of vaccines, according to Walker (2021). Another worldwide phenomenon, as noted by
Almomani et al. (2021), that had a detrimental impact on individuals from lower socioeconomic
classes was the different anti-vaccination efforts launched by anti-vaccinationists, which were driven
by new technology and the short period for vaccine development. Because of numerous conspiracy
ideas held by certain people, some information is created, inaccurate, and frequently misleading. As a
result, many people expressed their growing dissatisfaction with the situation. There is much debate
over the relative efficiency of vaccine-induced immunity vs immunity gained via the normal course of
events, with some parents favoring immunity acquired naturally over immunity acquired by
vaccination. Furthermore, some parents are particularly concerned about the cumulative pain and
suffering experienced by their children as a result of many doses administered at the same time. This
is why vaccine apprehension of parents is important with regards to vaccine effectiveness which can
play an important role in their choice to vaccinate their children (Spier, 2001). Parental acceptability of
vaccination appears to be influenced by a variety of socioeconomic circumstances, according to
Bertoncello and Cocchio (2020). This suggests that individuals' knowledge, information, and
understanding of when, where, and who should be vaccinated had a significant role in the
development of vaccine reluctance. As a result, individuals who come from lower-income families are
more likely to misinterpret the vaccination information needed to raise the awareness of parents,
which will significantly hinder efforts to reduce vaccine reluctance in the community. This study, which
was conducted in the year 2021, was able to identify the role of biomedical and complementary, and
alternative medicine (CAM) providers in the decision-making process for vaccination. It is further
explained that individuals who have fewer patient-provider interactions frequently use and receive
relief from complementary and alternative medicine (CAM) and biomedical medicine and that people
across the life span perceive the increased efficacy brought about by CAM and biomedical medicine
rather than the vaccines themselves. This socioeconomic factor has a significant role in mediating the
effects of vaccination hesitancy on underimmunization in the general population (Deml et al., 2019).

Communication and media factor of vaccine hesitancy

Over the last two decades, vaccination faith has been eroded by controversy and incorrect
information. It was shown that the majority of information errors were spread by religious leaders, who
should be taught and included as key partners in speaking about vaccination since they may have a
significant influence when supporting it (Bruyneel, 2019). Wilson and Wiysonge (2020) also
discovered that the usage of social media platforms capable of organizing offline action is strongly
predictive of the view that vaccines are harmful, with such attitudes increasing as more organizations
happen on social media. Additionally, the presence of foreign misinformation is significantly predictive
of a decline in mean vaccination coverage over time, both statistically and substantively. Additionally,
it has been discovered that supporting foreign misinformation with negative social media activity
against vaccination has a meaningful effect, increasing the frequency of unfavorable vaccine tweets
by 15%. Goldstein & MacDonald (2015) also cited a lack of communication as a factor in the
immunization program's problematic pragmatic implementation. With this situation, individuals and
groups with vested anti-vaccine interests or religious views can allocate free space for discussion. In
the country, vaccine reluctance is not considered a concern. Rather than that, there is vaccination
rejection, which is related to religious groups and affluence. Certain bad rumors about vaccination
have proliferated in certain locations and groups of individuals, and this, along with worries about
vaccine safety and the negative effect of "Internet tales," was also a contributing factor (Dubé et al.,
2014). The issue of vaccine hesitancy is one of postponing or refusing vaccinations. This is partly due
to the media's rising worries nowadays. Due to the existence of a virtual community, it is easier for
misleading information regarding vaccinations to proliferate, which generates conflict with facts and
misunderstanding among the general public (Jung, 2018). Kricorian et al. (2021) supplied facts that
made it clear how disinformation was communicated. They observed that the majority of those who
were uninformed and believed inaccurate information about the vaccination lived in non-metropolitan
or rural regions and were thus more likely to die from COVID-19 than those who lived in urban areas.
In general, their study's findings indicate that unfavorable opinions against the COVID-19
immunization are connected with lesser health literacy and ignorance.

Religious factor of vaccine hesitancy

Vaccine reluctance is usually related to mass immunization programs, notably against the
COVID-19 vaccine. It is noticed predominantly in major cities and connected with certain religious
groups. This is partly due to the known bad myths regarding immunization that have propagated in
certain locations and sections of the population, along with the inaccessibility of vaccination services
for women and nomadic groups of people (Dubé et al., 2014). Keshet & Popper-Giveon (2021)
explained that oftentimes people constantly refer their health choices to their religious figure and this
is often connected to the hope of salvation that faiths offer to meet various mental and sociological
requirements. As a result, individuals prefer to look to organized religion, and church figures, in
particular, to advise them when dealing with health concerns. This in turn induces different
misconceptions and community distrust within the community. Furthermore, it has been found that
religiosity, coupled with the necessary information about the efficiency and effectiveness of COVID-19
immunizations, tends to provide an effect in the determination to be vaccinated with the vaccines.
This has led a vast number of participants to believe that religious ideas value prayers over medicine,
therefore resulting in vaccine hesitation among devotees. Thus making believers embrace alternate
treatments such as usage of holy water and prayer to alleviate diseases, fearing vaccination may lead
to the death of their children. Whitehead (2020) also said that with regards to the COVID-19 actions
amongst religious sections most of them thought that they no longer need the protection that they get
from vaccinations since heavenly protection is present for them. This finally led to a complete mistrust
towards the government and health care professionals.

Psychological Factor
Vaccination is widely regarded as a critical role in resolving the COVID-19 epidemic in a
sanitary manner. However, vaccination hesitancy can jeopardize its spread, having a devastating
impact on world health. Simione (2021) indicated that confidence in conspiracy theories, mistrust of
medical knowledge, and skepticism of medicine and science all contribute to an increased death rate,
while anxiety was found to decrease vaccination rates.
Vaccine hesitancy is a major public health concern that jeopardizes human safety, particularly
throughout this pandemic. As a result, it is essential to comprehend the psychological factors that
contribute to vaccine refusal. Wheelock (2013) explains that the major psychological factors
influencing society's social acceptance or fear of vaccination were their broad sense perceptions
forward into wellbeing and immunizations, their motivators, and their altruism. Nazl (2021) explained
that the majority of participants had a negative attitude toward vaccines as a result of the perceived
side effects associated with vaccination. This was discovered to be largely due to their belief in
conspiracy theories, misleading claims made on social media by anti-vaccine advocates, and well-
known conservative political beliefs. Additionally, individuals who tend to underestimate pandemics
had a negative view of vaccines. Additionally, their study discovered that vaccine hesitancy is
associated with conspiracy theories, paranoia, and religious beliefs. That, in aggregate, results in
distrust of authorized individuals was evaluated concerning vaccine rejection. Additionally, Bock et al.
(2017) explain that, in addition to fear and conspiracy, other general psychological factors such as
self-efficacy, enthusiasm, and subjective health may help explain why some people vaccinate and
others do not. Dutta (2020) also explains that the majority of anti-vaxxers exhibited mistrust,
particularly conspiracy mentality but also general paranoia, which resulted in the development of
various negative behavioral responses to vaccines. Lo, et al. (2021) also discovered that people's
understanding of the virus's origin played a role in postponing immunization recognition. Individuals
who believed the virus was produced synthetically felt helpless and were more concerned about the
possible vaccine side effects, which has been significantly negatively correlated with their
immunization intention. Murphy (2021) explained that persons who have been resistant to a COVID-
19 vaccine have been likely to get information about the pandemic from conventional and religious
authoritative figures that have a similar degree of mistrust in these sources.

Common apprehensions against COVID-19 immunization

Alkokhardi (2021) describes that even though understanding about what happens post-
vaccination among some of the overall population remains limited, a comprehensive description
about what to anticipate during the first and second dose of vaccination will help decrease
apprehension about the type of vaccine that shall be injected, that will increase the trust of citizens in
the safety of vaccines, and speed up the immunization process against COVID-19. Huynh (2021)
further clarified that at instances where people that have not fully realized all elements of the virus,
often lack sufficient understanding about the adverse effects, safety, and efficacy, and would not be
understood the goal of the COVID-19 vaccine. In addition, it is mentioned that there is still a quantity
of unregulated material circulating regarding COVID-19, which leads to clear falsehoods that may
impact people’s trust and intents in connection to prospective vaccination would substantially fall.

Perceived effects do the participants believe would occur due to COVID-19 vaccination
Vaccine reluctance is connected with a lack of supposed advantage of immunization due to the
low frequency of vaccine-preventable illness in the country. There are also worries over vaccination
safety and the detrimental effect of “Clickbait articles” that has resulted in dread and anxiety (Dubé et
al., 2014). People that are hesitant to be vaccinated were mostly the general population concerned by
adverse events following vaccination. This generally arises from the different media accounts of
infrequent adverse occurrences making parents afraid to vaccinate their children, resulting in lower
uptake. This was particularly evident in isolated communities, with an inadequate education level is
noticeable, which generates negative views based on misconceptions such as immunization of
women leading to infertility (Dubé et al., 2014). Freeman (2020) notes that vaccine public
communication emphasizing prosocial benefits may be especially successful. This means that
variables such as conspiracy ideas typically generate mistrust and destroy societal cohesion will limit
vaccine uptake. Nayar (2019) also further emphasized that prior unfortunate experiences regarding
immunization, such as suffering side effects, only foster vaccine resistance. Additionally, it has also
been observed that the latest available side-effects include paralysis, allergies, weariness, and
weakness were all bad experiences that have been disseminated by social media. This predisposes a
big number of moms who do not trust the doctors or the immunizations, which they deem harmful.
Banerjee (2020) also ultimately determined that the higher awareness of the COVID-19 viral infection
implies that an individual would more likely acknowledge the benefits of vaccination, which ultimately
means that recognizing global epidemic dangers is a key component of preventing disease, hence
individuals must be updated with latest data regarding COVID-19 thru the popular means of
communications including media such as television, which is likely to have the capacity to deliver
quicker updating of information to the community.

Anti-vaccine movement
Keshet & Popper-Giveon (2021) indicates that the anti-science movement may erode public
faith in the information that science creates. Anti-science emotions may impair public and individual
support for science and may foster negative views about science and scientific medicine, which in
turn cause a reduction in the vaccination uptake of the population. Despite the expanding academic
and scientifically based knowledge, there is still a rising number of anti-vaccine movements. In turn,
this has led to substantial interruptions in immunization programs, with the outcome of an increasing
rate of the cause of death and disability (Poland, 2001). Pro movements have indeed been linked to
decreasing vaccination uptake rates and in the growth of vaccine-preventable illness outbreaks and
epidemics. Anti-vaccination is as ancient as immunization itself not likely to fade. With both the World
wide web, the pro groups are more strong than ever and have the ability to reach and influence many
parents. This implies the necessity for an approach to improve the unique issues in a certain
environment, time, and vaccination (Dubé et al., 2014). Burki (2020) explained that many of the anti-
vaccine movements were primarily shifting online that work overtime to promote suspicion in
vaccinations. In addition, businesses have also been part of such anti-vaccine movements, seizing
opportunities by taking advantage of people's fear and worry about advertisements for items claiming
to have health advantages. While the last type falls among the conspiracy theorists. However, for
Ransing (2021) COVID-19 vaccines inaccessibility, unacceptance, and inability to afford, especially
those in poor and middle-income nations were the known group that has a lack of necessary
resources, and safety concerns. And this generally originates from the creation of an anti-vaccine
movement. In addition, owing to the prevalence of incorrect beliefs, a loss of confidence among
stakeholders, and a projected lack of openness in the vaccine clearance process, the majority of
persons were also led to accept refutable allegations emanating from the anti-vaccine movement.

LOCAL LITERATURE

Vaccination Hesitancy and Refusal

Additionally, the Department of Health (DOH) notes that vaccination reluctance was a factor in
the outbreak. The organization explained that one of the primary reasons for such anti-vaccine
behavior was the fear associated with reported deaths following vaccination, such as the situation of
Dengvaxia, and an insufficient time for families to attend local health facilities and hospitals
(Department of Health, 2018). Mercado et al. (2020) stated that much of the news and information
over the world wide web news sites, publications, and social networking sites were primarily
containing reported adverse events during and after the vaccination program, which would include
public announcements on mortalities and rising suspiciousness of the immunization over the
Philippines. This has mostly produced vaccination hesitation and refusal, and the resultant drop in
immunization coverage. The fear, bewilderment, and outrage felt by the community over the dengue
vaccination debate have destroyed trust in the government’s health department and its initiatives. The
year after the dengue vaccination controversy, vaccine confidence in the Philippines drastically fell
from 2015 when 93 percent "strongly agreed" that vaccines were vital to only 32 percent in 2018
(Dayrit et al., 2020).

The Implication of Social Media to Vaccination Hesitancy

Mercado et al. (2020) stated that much of the news and information over the world wide web
news sites, publications, and social networking sites were primarily containing reported adverse
events during and after the vaccination program, which would include public announcements on
mortalities and rising suspiciousness of the immunization over the Philippines. This has mostly
produced vaccination hesitation and refusal, and the resultant drop in immunization coverage.
Landicho-Guevarra & McMahon (2021) further even further noted that among the reasons for delay or
rejection of childhood immunizations, includes the fear of side effects appearing as the most
prominent worry, worsened by past unpleasant experiences from a dengue vaccine in the Philippines.
With such enormous dread and controversy and increase in resistance rate about any new
vaccinations and distrust towards school-based immunization, the distribution channels were judged.
Reñosa (2021) even further discussed the relevance of familial heads of households in decision-
making concerning the adoption of immunizations. This essentially indicates that their opinions of
vaccinations are vital, and this may be further impacted by many social variables such as religion and
organization, as well as conventional media or neighbors.

The effects of Poverty (Social Class) to Vaccination Hesitancy

The number of impoverished Filipinos grew by 5.5 million (San Juan, 2020). Parents that
mostly belong to the disadvantaged neighborhoods have an increased desire for precise information
about vaccination safety. However, data from community health clinics as well as from the
department of health has been regarded to be poor and non-reassuring. Thus, this means that
communication techniques must be taken into consideration in resolving growing concerns and can
be custom fit and focused. The absence of sufficient and adequate communication led to lower
confidence in providers and subsequently led to bad experiences (Valido, 2018).
Giambi & Martinelli (2018) go on to clarify that the prime concern expressed by parents when
rejecting or halting immunization was security. Additionally, numerous parents believe that school
vaccination causes particular emotional reactions in health care personnel who are exposed to it. It
has been observed that the school and education departments have been negligent in alerting
parents that if their child is not vaccinated, their child's risk of catching the disease is increased
(Chandra, 2016). Additionally, Charron et al. (2020) clarify that the three primary sources of vaccine
information were medical practitioners, the Web, and families. It has been demonstrated that
immunization habits and acceptability were improved when parents received the information from
HCPs rather than the Internet or relatives. Thus, it is proposed that excellent information concerning
vaccination be made available on the Internet.

FOREIGN STUDIES

Common alternative methods of protection against COVID-19

Older people during the COVID-19 pandemic were those who are the most vulnerable persons
during this coronavirus illness 2019 (COVID-19) pandemic. Interestingly, this worry and the
associated emotional distress are known to increase vulnerability to infection, which may impact their
immune function coupled with their decreasing performance of numerous organs owing to age. In
addition, Koenig (2020) also genuinely feels that religious views and activities are known to assist
individuals to manage times of stress, and in several studies are related to decreased anxiety and
increased hope, especially in older adult populations. Bekele (2021) indicated from his study that
following the announcement of the COVID-19 pandemic most people recognized many scientific
measures to protect themselves from the novel coronavirus (COVID-19), and these involve the
preservation of social distance and regular handwashing. Religious or conservative and religious
were more likely to oppose academic and public resources which led to the breach of social distance,
wear masks, or another form of advised preventive measures, to minimize the propagation of the
COVID-19 virus. In turn, this has mostly resulted in the worsening of heightened illness and death
rate prolonging it through time (Perry, 2020). (Perry, 2020). Whitehead (2020) also said that with
regards to the COVID-19 actions amongst religious sections most of them thought that they no longer
need the protection that they get from vaccinations since heavenly protection is present for them. This
finally led to a complete mistrust towards the government and health care professionals. Faith and
practices primarily play a big role in assisting persons to keep free from contamination by the
coronavirus and in helping to mitigate the effects of infection if it should occur (Koenig, 2020a).
 Trogen & Pirofski (2021) also emphasized that vaccine refusal frequently has strong political,
cultural, and emotional implications that can be challenging to overcome. This was mostly due to
disinformation disseminated by these groups, which has its origins in more than century-old anti-
vaccine propaganda. This results in the use of specific cultural interventions in an attempt to mitigate
the growing threat and concerns associated with an ongoing illness threat. Additionally, Eskola &
Duclos (2015) emphasize that vaccine skeptics were primarily concerned with the need to strengthen
protection against a specific vaccination-related disease through other cultural disease prevention
measures. Additionally, Wong & Wong (2020) stated that anti-vaccine misinformation, religious
restriction, and confidence in the safety of conventional alternative medicine (TCAM) use were
highlighted as factors for vaccine hesitation. Numerous characteristics such as ethnic origin,
employment status, faith, politics, gender, age, education, and income all influenced acceptance or
refusal.
The increasing use of "alternative" medicine in children has coincided with an increase in the
incidence of certain vaccine-preventable diseases. According to Gowda (2013), this was mostly
related to parents' attitudes and views about vaccines. Certain parents are concerned that
administering an excessive number of immunizations, particularly in a short period, could be
hazardous to their child's health. There are worries regarding the cumulative pain and suffering that
children who receive many doses at the same time may endure. Vaccine skepticism among VHPs is
exacerbated by the disparity between falling levels of perceived illness susceptibility and increasing
levels of actual disease susceptibility. In aggregate, this has increased preference for natural
immunity, indicating a lack of awareness regarding vaccination principles, indicating a possible focus
area for future educational initiatives.

LOCAL STUDIES

Vaccination Hesitancy and Refusal

The Philippines is launching a massive COVID-19 vaccination with an ambitious objective of

up to 70 million Filipino adults being immunized by 202. However, according to many governmental
agencies that are assisting with the program, a growing prevalence of vaccination hesitancy among
Filipinos is deemed to be a danger to the program's aim and objectives, and as a result, the
program's target and goals are at risk of being derailed (Rappler, 2021). Even though vaccination
hesitancy has decreased over time in the Philippines, it should not be dismissed at this time. Although
around 45 percent of Filipinos were eager to be vaccinated, during the course of May, the number of
vaccinations increased. Anti-vax organizations such as Gising Maharlika are still active in
disseminating false information about the government's coronavirus vaccination program. This has
been a major contributor to the widespread mistrust and fear that exists in communities toward both
the state and healthcare institutions (Lacsamana, 2021). As previously stated, according to Landicho-
Guevarra (2021), the most common reason for vaccination rejection was a fear of adverse effects.
The second most common reason was a poor experience in the past, such as trauma from a dengue
vaccine debate. With this knowledge in hand, Landicho-Guevarra advised that a variety of
interventions be conducted to reestablish trust and boost confidence in vaccinations throughout the
country (Landicho-Guevarra, 2021). Moreover, Caple (2021) went on to emphasize that individuals
are far more likely to engage in disease preventive practices if they are provided with adequate
incentives and cues to take immediate action. As a result, Filipinos are significantly more ready to get
vaccinated against COVID-19 if they perceive that the disease is very contagious, severe, and offers
large advantages; all of these factors might improve the predictors of vaccination intent among
Filipinos.
The research was done in 2021 that highlighted that despite the government's continuous
immunization effort, many Filipinos were still triggered by the societal traumas that they had
experienced as a result of the prior deaths as a result of Dengvaxia vaccine. In addition, Vergara
(2021) also emphasizes that Filipinos' poor net trust toward China was also a major factor why such
vaccine hesitancy is still prevalent in the country despite the government's defense of certain
Chinese-origin vaccinations. This was largely due to the growing concerns relating to the West
Philippine Sea and the CO VID-19 virus among the contributing causes to this perception (Vergara,
2021). To ensure the success of a vaccination program, the government must first earn the public's
trust. It was recently discovered that a more 'localized' public education and role-modeling program
from public officials and health authorities can aid in the development of public trust and that this can
be delivered through various technology over the virtual world and internet, which has a significant
impact on the online environment (Cordero, 2021). Lau & Wei (2020) was able to identify in their
study the COVID-19 perspective of households facing severe poverty in the Philippines. It has been
discovered that there is a need for integrative health education as a responsible approach to COVID-
19 in low-income settings. In addition, irrespective of the known limited knowledge it has been
determined that participants were able to determine the relevance of handwashing as a preventive
step against the infection. However, social separation and avoiding crowds were only noted by a
small number of respondents. Pastor (2020) was also able to assess the consequences of worry and
terror towards Filipinos amid this COVID-19 epidemic. Oftentimes Filipinos get health concerns to
improve the immune mechanism to protect themselves from becoming infected. It is done by
concurrently assessing their health state such as core temperature and often taking vitamin C. In
addition, a large number of people also started to eat nutritious foods to restore their immune
function. Furthermore, for preventive steps, Filipino also frequently use masks, and face shields as
well as utilize alcohol.
 Chapter 3

METHODOLOGY

In this chapter, the principal author will describe the approach and techniques used to conduct

the research and the rationale for the choice of the methods. These will be explained in five sections:

(1) research design; (2) sampling design; (3) research instruments; (4) research locale; (5)

participants; and (6) data gathering procedure.

Research Design

This study utilized a qualitative approach, and in particular, a phenomenological research

design. Based on the corresponding answers that the Zamboanguenos’ Elderly will provide according

to its corresponding question, the researchers analyzed the relationship between the psychological

factors such as fear, acceptance, and anxiety; social dynamics and cultural factors; environmental

dynamics; and preventive practice and pattern and its influence to their apprehension of the COVID-

19 vaccine.

Sampling Design

For this study, convenience sampling was performed for gathering of respondents and data.

The sample size of approximately 5-10 participants ages 60 years old and above from Barangay

Mampang, Zamboanga City Philippines was chosen.

Research Instruments

The research tool for data gathering was semi-structured interviews containing a series of in-

depth questions on the various apprehension of Zamboanguenos elderly, its contributing factors such

as psychological, social, cultural, and environmental, and which sociocultural factor and preventive

measures were most likely be used as an alternative choice of preventive practice for COVID-19
pandemic. This In-depth interview with participants was delivered in a face to face setup.. Electronic

gadgets such as mobile phones and laptops were tapped to record and document the verbatim

language and answers of participants during the data gathering.

Research Locale

With the ongoing quarantine, a strict protocol was followed during the data gathering process

such as wearing of face shield, face mask, and maintaining social distancing. The collection of data

was obtained through the performance of home visiting of Zamboanguenos elderly at the Barangay

Mampang, Zamboanga City, Philippines.

Ethical Consideration

This study observed the principle of voluntary participation. The respondents who participated

did so based on their own free will and decision. Respect was given to students who refused to take

part in this study. Moreover, withdrawal of responses was permitted. This study highly observed

confidentiality and anonymity of the respondents.

Participants

The target respondents for this study were the 60-year-old (and above) residents of Barangay

Mampang. Typically, elderlies around this range have developed the independence or autonomy of

making simple health care habits and practices.

Data Gathering Procedure

Prior to conducting the study, the researchers provided a letter of consent given to the

participants of the study to endure the principle of autonomy being held in place. Through this, the

researchers were able to present the focus and purpose of the study and the rights of the elderlies

before they opt to participate. It was emphasized that the interview was only applicable to 60-year-old
(and above) residents of Barangay Mampang. Queries and clarifications regarding the study were

encouraged and answered. The verbatim languages of the respondent’s answer were then presented

and interpreted.

Data Analysis

The responses of the survey were processed through utilizing phenomenological research

design. For data concerning the elderlies’ apprehension of the COVID-19 vaccine, a Semi-structured

interview was conducted that examines the different scope of influence that affects their

apprehension.This is an open-ended question that expects the respondents to freely explain their

question that was significantly applied to them.

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