Community Medicine Project

KNOWLEDGE, ATTITUDE AND PRACTICE OF COVID-19 VACCINATION AMONG
MEDICAL STUDENTS OF BINGHAM UNIVERSITY TEACHING HOSPITAL
BY
LUKA, NEHEMIAH
TENEBE, MARY-CLARA ADESUA
KOLAJO, BOLUWATIWI JOHN
FEBRUARY 2022
TITLE PAGE
MEDICAL STUDENTS OF BINGHAM UNIVERSITY TEACHING HOSPITAL
BY
LUKA, NEHEMIAH BHU/13/01/01/0098
TENEBE, MARY-CLARA ADESUA BHU/14/01/01/0094
KOLAJO, BOLUWATIWI JOHN BHU/14/01/03/0003
“SUBMITTED TO THE DEPARTMENT OF COMMUNITY MEDICINE, AND
PRIMARY HEALTH CARE, COLLEGE OF MEDICINE AND HEALTH
SCIENCES,
BINGHAM UNIVERSITY, NEW KARU, NASARAWA STATE, IN PARTIAL
FULFILMENT OF THE AWARD OF BACHELOR OF MEDICINE, BACHELOR
OF SURGERY (MBBS) OF BINGHAM UNIVERSITY”
FEBRUARY 2022
i
CERTIFICATION
This is to certify that this study was initiated, conducted, and submitted to the Department of
Community Medicine and Primary Health Care, College of Medicine and Health Sciences, in
partial fulfilment of the award of Bachelor of Medicine and Bachelor of Surgery Degree, Bingham
University, New Karu, Nasarawa State, Nigeria.
31st January 2022
…………………………………. ………………………………….
Dr. Sunday Asuke Date
(Project Supervisor)
…………………………………. ………………………………….
Dr Oguntunde O. Olugbenga. Date
(Head of Department)
ii
DECLARATION
We hereby declare that this research was solely and independently conducted by us, Kolajo
Boluwatiwi John, Luka Nehemiah, and Tenebe Mary-Clara Adesua, under the supervision of Dr.
Sunday Asuke, Department of Community Medicine and Primary Health Care, College of Health
Sciences, in partial fulfilment of the award of Bachelor Of Medicine and Bachelor of Surgery
Degree, Bingham University, New Karu, Nasarawa State, Nigeria.
…………………………………. ………………………………….
KOLAJO BOLUWATIWI JOHN DATE
…………………………………. ………………………………….
LUKA NEHEMIAH DATE
…………………………………. ………………………………….
TENEBE MARY-CLARA ADESUA DATE
iii
DEDICATION
To the Almighty God who has been our solid and dependable rock and our parents who made sure
everything was in place for us to actualize our dreams and achieve our highest potentials, we
dedicate this work to them for the chance given to us to fly.
iv
ACKNOWLEDGEMENT
We express our heartfelt gratitude to God Almighty, who has brought us so far, and has seen us
through our academic pursuit.
Enormous appreciation is also extended to our project supervisor, Dr. Sunday Asuke, for his
continuous supervision, support and mentoring. His dedication to us and our progress during this
exercise, and constant guidance and constructive criticism has enabled us bring out the best in
ourselves.
We are also grateful to the staff and the department of Community Medicine and Primary Health
Care, for ensuring we had a fruitful experience.
We appreciate the Provost of the College of Medicine and Health Sciences, Professor Musa
Dankyau, and all the staff of the college of Medicine and Health Sciences of Bingham
University, for their contributions towards our medical training.
We are grateful to the Vice Chancellor, Professor William B. Qurix, the management and staff of
the University, for providing an enabling environment of study.
We specially appreciate our parents, Dr. Kolajo I.R and Mrs. Kolajo Elizabeth; Mr. Luka Zakka
Ngoshe and Mrs. Evelyn Ngoshe; and Dr. Tenebe Christian Y. and Mrs. Tenebe Janet O., for
their endless support, love, patience, care and sacrifice, and for giving us an unfair advantage in
life. A big thank you goes to our siblings, we love you.
We are grateful to our friends and well-wishers for their encouragement and support, worthy of
mention are Tanko Hayyatudeen and Ifedigbo Stella-Maris. May God bless and reward the entire
students of Bingham University Teaching Hospital who were gracious enough to participate in
our study.
v
God bless you all.
vi
CONTENTS
TITLE PAGE ..................................................................................................................................................... i
CERTIFICATION .............................................................................................................................................. ii
DECLARATION .............................................................................................................................................. iii
DEDICATION ................................................................................................................................................. iv
ACKNOWLEDGEMENT ................................................................................................................................... v
LIST OF TABLES ............................................................................................................................................. ix
LIST OF FIGURES ............................................................................................................................................ x
ABSTRACT..................................................................................................................................................... xi
INTRODUCTION ............................................................................................................................................. 1
1.0 BACKGROUND ..................................................................................................................................... 1
1.2 PROBLEM STATEMENT ........................................................................................................................ 4
1.3 JUSTIFICATION .................................................................................................................................... 7
1.4 AIM AND SPECIFIC OBJECTIVES ........................................................................................................... 9
1.5 SCOPE OF STUDY ................................................................................................................................. 9
LITERATURE REVIEW ................................................................................................................................... 10
2.1 INTRODUCTION ................................................................................................................................. 10
2.2 KNOWLEDGE OF COVID-19 VACCINATION ....................................................................................... 11
2.3 ATTITUDE TOWARDS COVID-19 VACCINATION ................................................................................ 12
2.4 FACTORS THAT FACILITATE OR HINDER UPTAKE OF COVID-19 VACCINATION ................................ 13
2.5 ACCEPTANCE OF COVID-19 VACCINATION ....................................................................................... 14
2.6 RELATIONSHIP BETWEEN SOCIODEMOGRAPHICS AND ACCEPTANCE OF COVID-19 VACCINATION 15
2.7 SOCIAL MEDIA AND ITS EFFECTS ON COVID-19 VACCINATION UPTAKE .......................................... 16
METHODOLOGY .......................................................................................................................................... 18
3.1 BACKGROUND TO THE STUDY AREA ................................................................................................. 18
3.2 STUDY DESIGN................................................................................................................................... 19
3.3 STUDY POPULATION ......................................................................................................................... 19
3.3.1 INCLUSION CRITERIA ........................................................................................................ 19
3.3.2 EXCLUSION CRITERIA ....................................................................................................... 19
3.4 SAMPLE SIZE DETERMINATION ......................................................................................................... 19
3.5 SAMPLING TECHNIQUE ..................................................................................................................... 20
3.6 DATA COLLECTION TECHNIQUE ........................................................................................................ 21
3.7 DATA ANALYSIS ................................................................................................................................. 21
vii
3.8 ETHICAL CLEARANCE ......................................................................................................................... 22
3.9 LIMITATIONS ..................................................................................................................................... 22
RESULTS ...................................................................................................................................................... 23
DISCUSSION................................................................................................................................................. 62
5.1 SOCIO-DEMOGRAPHIC CHARACTERISTICS ........................................................................................ 62
5.2 KNOWLEDGE OF COVID-19 AND COVID-19 VACCINATION .............................................................. 62
5.3 ATTITUDE OF RESPONDENTS TOWARDS THE COVID-19 VACCINE ................................................... 66
5.4 ACCEPTANCE OF COVID-19 VACCINE BY PARTICIPANTS................................................................... 67
5.5 FACILITATORS OF COVID-19 VACCINE ACCEPTANCE AMONG PARTICIPANTS.................................. 68
5.6 HINDERERS OF COVID-19 VACCINE ACCEPTANCE AMONG PARTICIPANTS. ..................................... 69
5.7 PREVENTIVE PRACTICES TO COVID-19 VACCINATION AMONG RESPONDENTS ............................... 70
5.8 CONCLUSION ..................................................................................................................................... 73
5.9 RECOMMENDATION ......................................................................................................................... 73
INDEX .......................................................................................................................................................... 75
6.1 REFERENCES ...................................................................................................................................... 75
6.2 INFORMED CONSENT ........................................................................................................................ 90
6.3 QUESTIONNAIRE ............................................................................................................................... 91
6.4 ETHICAL CLEARANCE REQUEST LETTER .......................................................................................... 106
6.5 ETHICS COMMITTEE CLEARANCE LETTER ....................................................................................... 107
viii
LIST OF TABLES
TABLE 1: Socio-demographic characteristics of respondents .................................................... 23
TABLE 2A: Knowledge of COVID-19 vaccine by the participants ............................................ 25
TABLE 2B: Knowledge of COVID-19 vaccine by the participants……………………………26
TABLE 2C: Knowledge of COVID-19 vaccine by the participants……………...……….…….30

TABLE 3A: Attitude of participants towards the COVID-19 vaccine…………………………..38
TABLE 3B: Attitude of participants towards the COVID-19 vaccine…………………………..40
TABLE 4: Acceptance of COVID-19 vaccine by participants………………………………….42
TABLE 5: Facilitators of COVID-19 vaccine acceptance among participants…………………43
TABLE 6: Hinderers of COVID-19 vaccine acceptance among participants…………………..46
TABLE 7A: Preventive Practices to COVID 19 among participants…………………………..48
TABLE 7B: Preventive Practices to COVID 19 among participants…………………………..50
TABLE 8: Respondents’ knowledge, attitude and practice of COVID-19 vaccine……………52
TABLE 9: Cross-tabulation between knowledge and attitude to COVID-19 vaccine…………54
TABLE 10: Cross-tabulation between Socio-demographics and knowledge of the COVID-19
vaccine………………………………………………………………………………………….55
TABLE 11: Cross-tabulation between Socio-demographics and attitude towards COVID-19
vaccine………………………………………………………………………………………….57
TABLE 12: Cross tabulation between doses of vaccines taken and attitude of participants to
COVID-19……………………………………………………………………………………...59
TABLE 13: Cross-tabulation between Socio-demographic factor and the level COVID-19
vaccine
acceptance……………………………………………………………………………………..60
ix
LIST OF FIGURES
Figure 1: Sources of information regarding COVID-19 Virus amongst the respondents in Bingham
University Teaching Hospital. .................................................................................................................... 33
Figure 1: Symptoms of COVID-19 infection as reported by the respondents in Bingham

University Teaching Hospital……………………………………………………………………33
Figure 3: Types of COVID-19 vaccines known amongst the respondents in Bingham University Teaching
Hospital ....................................................................................................................................................... 35
Figure 2: How COVID-19 vaccines are administered as reported by the respondents in Bingham
University Teaching Hospital……………………………………………………………………35
Figure 5: Adverse effects of COVID-19 vaccination as reported by the respondents in Bingham
University Teaching Hospital. .................................................................................................................... 37
x
ABSTRACT
Coronaviruses are a large family of viruses known to cause respiratory diseases ranging from the
Common Cold to more severe diseases like the MERS/SARS Coronavirus. There are several
known coronaviruses circulating in animals that have not yet infected humans (however, possible
in spillover events). This study was done to assess knowledge, attitude and practice of COVID-19
vaccination among medical students of Bingham University Teaching Hospital, Jos North Local
Government Area, Plateau State, Nigeria.
Stratified Random Sampling Technique was used to recruit 299 participants between the ages of
19 and 29. SPSS Version 20 was used to analyse after the findings from a self-administered
pretested Google Forms questionnaire were cleaned. Independent variables were cross tabulated
against dependent variables using a chi-square test at p less than 0.05.
Majority of the participants were females 167 (55.9%), almost all were Christians 295(98.7%),
most belonged the age group 21-25 with 245 (81.9%), majority of the participants were single
(98%), relatively high responses came from Batch K of the 5 Batches (31.1%), and majority of the
participants came from minority tribes (47.8%)
Majority of the respondents (100%) were aware of the Covid-19 virus and the vaccine, with 54.5%
knowing at least 3 vaccine types.
About two-thirds of the respondents (64.2%) had not taken the COVID-19 vaccine, 11.2% had
only one dose and 24.1% had 2 doses. 64.5% believed the vaccine was safe. 61.2% believed there
were immediate adverse effects associated with COVID-19 vaccines.
xi
Majority of the respondents (57.2%) had good knowledge of the COVID-19 vaccine. Most
(59.5%) of respondents had good attitude towards the vaccine. Most of the respondents (54.2%)
had a poor COVID-19 preventive practices.
In conclusion, our participants were noted to have good knowledge, good attitude, and poor
COVID-19 preventive practices.
Keywords: COVID-19, Vaccination, Knowledge, Attitude, Practice
xii
CHAPTER ONE
INTRODUCTION
1.0 BACKGROUND
Many viruses have emerged over several decades and this has posed great challenges to public
health. Some of these viruses include Severe Acute Respiratory Syndrome (SARS) Coronavirus
which emerged in China in 2002, H1N1 Influenza virus (2009), 2012 Middle Eastern
Respiratory Syndrome (MERS) Coronavirus which emerged in Saudi Arabia and the 2019 Novel
Coronavirus which emerged in China I 2019. [1]
About 75% of emerging infectious diseases that have affected people over the past three decades
have originated from animals. [2]
Coronaviruses are a large family of viruses known to cause respiratory diseases ranging from the
Common Cold to more severe diseases like the MERS/SARS Coronavirus. SARS Coronavirus
was transmitted from Simian cats to humans in China in 2002 while MERS Coronavirus was
from dromedary camels to humans in Saudi Arabia in 2012. There are several known
coronaviruses circulating in animals that have not yet infected humans (however, possible in
spillover events). [3]
Coronavirus Disease (COVID-19) is a deadly disease ravaging the world, caused by the new
strain of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-Cov-2). [4] The World
Health Organization (WHO) declared the COVID-19 outbreak as a pandemic on 11 March 2020.
The first COVID-19 case in Nigeria was reported on 27th of February 2020, it was the first case
to be reported in Nigeria since the beginning of the outbreak in China in January 2020. Since
1
then, the numbers of new cases have been rising rapidly in the country. As of 24th May 2020, the
global cumulative incidence was over 5 million reported cases with over 337,000 deaths in 213
countries/ territories and two international conveyances, giving an estimated global case fatality
rate (CFR) of 6.5%2. As at 15th August 2020 the global cumulative incidence was over
21million reported cases with over 750,000 associated deaths, and a CFR of 3.6%5.
In Nigeria, the number of cases as seen to be rising rapidly, and as of 3rd June, 2021, the country
recorded 166,560 positive cases of COVID-19 and 2099 deaths.[6]
People at risk of Novel Coronavirus include those exposed to the animal source (workers in the
animal market) as well as family members and healthcare workers caring for a patient infected
with the Novel Coronavirus. [7]
Early symptoms may be non-specific, hence can be missed by healthcare workers unless
additional precautions are put in place necessitating standard universal precaution. They include
fever, cough, difficulty breathing and may progress to pneumonia which could be severe.
Respiratory Distress Syndrome (RDS) can also be fatal. Personal protective equipment and safe
injection practices, environmental cleaning, waste management and care of patient equipment are
also emphasized. Early recognition of patients with Novel Coronavirus is important because a
high index of suspicion is advised. For a patient with suspected novel coronavirus, a medical
mask should be given. The patient is then put in a separate area because studies show that adults
with mild to moderate COVID-19 remain infectious no longer than 10 days after symptom onset.
Those with severe to critical illness or severe cases can be infectious for as long as 20 days after
onset of symptoms and no more. [8] At triage, an organized and well-ventilated space is needed
with screening questionnaires according to novel coronavirus case definition. About 1-2m should
be kept from a suspected patient. Symptomatic patients are also advised to contacts Healthcare
2
Workers (HCWs). On admission to the ward, only confirmed patients should be kept with
confirmed cases of the novel coronavirus. HCWs caring for these patients should employ droplet
and contact precautions to avoid the spread. Single rooms and wards should be well-ventilated. A
medical mask, face shield or goggles and a gown should be used when coming in contact with
these patients. Proper disposal of the PPE and hand hygiene should be observed after. Disposable
or dedicated equipment should be used. Surfaces shouldn’t be touched. Eyes, nose and mouth
must not be touched with potentially contaminated gloved or ungloved hands. Aerosol-
generating procedures must be done with adequate protection and precautions.
The following increase chances of survival in these patients: Antimicrobials (for pneumonia and
sepsis); Oxygen (People with respiratory distress syndrome, reduced oxygen levels and shortness
of breath, benefit from supplementary oxygen therapy); and Specific therapies for underlying
conditions such as diabetes and kidney failure. [9]
People with asymptomatic infection, should be isolated, followed up daily for symptoms and
tested at least weekly or earlier if symptoms manifest. Isolation should continue until two
consecutive upper respiratory samples such as nasopharyngeal and/or pharyngeal swabs taken at
least 24 hours apart test negative on Polymerase Chain Reaction (PCR). [10]
To protect oneself from the Novel Coronavirus, it is advisable to avoid overcrowded places,
leave a distance of at least 1m, washing one’s hands with soap and water or an alcohol-based rub
and practicing good respiratory hygiene such as covering one’s mouth and nose with a face mask
if sick, use of tissue or sleeve or a flexed elbow when sneezing as well as avoiding unprotected
close contact with someone with respiratory symptoms. It is also advisable to seek medical care
as soon as one notices symptoms like fever, cough and difficulty in breathing. Direct unprotected
contact with animals and surfaces in an animal market should be avoided. Soap and water must
3
be used to wash hands thoroughly after leaving said market. Food should be cooked thoroughly
as well.
The most important public health measure and most effective strategy to protect the population
from COVID-19, is vaccination since SARS-CoV-2 is a highly contagious virus. Evaluating the
community acceptance of COVID-19 vaccination is important with the worldwide distribution of
vaccines underway. A proportion of the Bangladeshi population is found to be hesitant about
taking the vaccines, lest they should be infected. [11] A global survey of potential COVID-19
vaccine acceptance shows that 48% of their study population were confused about the COVID-
19 vaccinations and remained unsure about whether they would have the vaccination [11].
Similarly, a Chinese study found that only just over half of their participants (54%) said that they
intended to have the vaccination. [11] These relatively low proportions of people willing to have
the vaccine are potentially worrying, since although the most effective measure of controlling the
spread of the virus is to protect oneself from being exposed to COVID-19, it is also necessary to
vaccinate the vulnerable group of people as soon as possible. [11]
1.2 PROBLEM STATEMENT

What had initial been thought as an emerging pneumonia-like illness in Wuhan, China in
December 2019 had now been declared as a global pandemic by the World Health Organization
(WHO) on March 11, 2020. Since the first patient admission was reported on December 12, 2019,
and the first death of a Chinese national in early January 2020, travel-related cases began emerging
in Thailand, Japan, South Korea, France, and the United States of America (USA) by mid-January
[12]
.
4
By the end of January, the novel coronavirus had spread through the Western Pacific,
South-East Asia, USA, Canada, Europe, and Eastern Mediterranean countries [13].
There had been over 172million confirmed cases and over 3million deaths and a case
fatality ratio of 3.6% to 6.5% between 24th of May 2020 and 4th of June 2021 from over 220
countries and territories around the globe [14]. (Case Fatality Rate is the ratio or proportion of deaths
from a certain disease compared to the total number of people diagnosed with the disease for a
particular period15.)
Apart from the impact of Covid19 on mortality, it also has affected the livelihood of many due to
the restriction that had to be put in place by Government of various countries, these measures
had a collateral impact on the situation of the poor and poorest households, which depend on the
informal economy for their already fragile livelihoods and day-to-day survival. The situation
seems to be worse especially amongst the west Africa countries, because of poor hygiene and
sanitation[16], overcrowding in urban slums and displaced people’s camps, fragile health systems,
the poor health of some of the population and also the impacts of COVID-19 on the supply and
demand of food. For instance the impact of COVID-19 on food supply and demand directly and
indirectly affected the four pillars of food security and nutrition: availability, access, utilization
and stability. The instability in supply chains impacted greatly the market supply and thus food
availability. The closure of markets reduced the access of the poorest populations to necessities,
especially in rural and peri-urban areas. In the cities, poor and poorest households couldn’t afford
to buy their supplies in the supermarkets that remained open, with processed food products
becoming more expensive. In addition, restrictions resulted in the loss of jobs and income for
millions of people working in the informal sector, including workers in the agric-food chain, who
ended up with products they couldn’t sell in markets. The restriction on movements and
5
businesses had adverse impact on daily economic activities of which many households were
solely dependent on. The impact on the livelihoods of women, who are largely dependent on the
informal economy and the agribusiness sector, resulted in the decrease or absence of income that
is critical to the maintenance of the family's food and health needs. Restriction measures also led
to an overall reduction in trade which had a heavy toll on the economies of the countries of the
region: many urban businesses (sources of employment in these areas but also employment for
seasonal migrants - rural migrants seeking income in the city) depending on external imports and
the unrestricted functioning of goods flows. African economies which are highly dependent on
imports of finished goods and mainly exporting raw materials whose market value drastically
declined because of the COVID-19 epidemic [17].
Vaccines remains the best hope for a permanent solution to controlling the pandemic,
making it a key strategic position at stopping the escalation of the COVID19 pandemic, but also
importantly is characterizing how vaccine efficacy could impact acceptance, given that actual or
perceived vaccine efficacy could be relatively low[18].
Understanding vaccine acceptance is as important as the production of the vaccine itself,
the relatively high vaccine hesitancy of the COVID-19 vaccines in relation to the large population
and relatively low vaccination coverage;[19] it would be of great Importance to consider the
behavioural attitudes of individuals to the vaccine. The World Health Organization (WHO) has
listed vaccine hesitancy, defined as the delay in acceptance or refusal of vaccines, as one of the
[20]
top ten threats to global health, even prior to the current COVID-19 pandemic. Factors
favouring hesitancy globally are majorly influenced by the social media,[21] distrust in governments
due to a view of the COVID-19 vaccine having a political nature, there’s the lack of trust in the
6
pharmaceutical industry or other non-mandatory administration,[22] In addition religious myths,
rumours and misinformation which spread quickly, distrust in the technology with which the
vaccine was produced by have all contributed to hesitancy portrayed by individual globally. [21]
Key drivers of public confidence in vaccines were identified as trust in the importance,
safety, and effectiveness of vaccines, along with the need for compatibility of vaccination with
religious beliefs, especially for a religious states as Nigeria, in which the belief that the COVID-
19 vaccine has been identified as the “mark of the beast”. These findings have resulted in the
development of a Vaccine Confidence Index survey tool to measure individual perceptions on the
safety, importance, effectiveness, and religious compatibility of vaccines health. [23]
The CDC Vaccine Confidence Survey tool contained about 7 domains and these domains
where targeted at getting feedbacks about what the various individuals thought and felt about the
Covid-19 vaccine. This is a community based approach, this would help in determining the fears,
anxieties, worries and problems the members of the community have about the vaccine. [21]
1.3 JUSTIFICATION
The novel corona virus disease (COVID-19) which is caused by a new strain of the Severe Acute
Respiratory Syndrome Coronavirus-2 (SARS-Cov-2) [4] has led to series of unfortunate events,
which began to unfold before the eyes of human beings all over the world, since December 2019
till date. About 220 countries and territories have been affected, with over 172,974,666
confirmed cases and 3,719,056 deaths. [5] In Nigeria, the number of cases as seen to be rising
rapidly, and as of 3rd June, 2021, the country recorded 166,560 positive cases of COVID-19 and
2099 deaths.[6] From the data, COVID-19 is known to affect large numbers of people,
irrespective of age, sex, race or religion, however, there has been found to be a higher level of
7
morbidity and mortality among the older population, and those with pre-existing medical
conditions, such as hypertension, diabetes mellitus, renal diseases, chronic obstructive
pulmonary diseases.[22] Some patients may remain asymptomatic throughout the course of the
illness, making it easier to transmit the virus across population groups.[23]
The COVID-19 pandemic has negatively affected economies worldwide, Nigeria not excluded.
Politics and social habits of human beings have also been affected. In Nigeria, there was a spike
in inflation rates, crisis of the economy and a lockdown of the Nation.[24] These have led to
increased cost of living, starvation, indebtedness and deaths. COVID-19 pandemic is a major
concern to the world.
There are four main types of COVID-19 vaccines in clinical trials, namely: whole virus, protein
subunit, viral vector and nucleic acid (RNA and DNA).[25] There are also various brands of the
vaccines, produced by pharmaceutical companies all over the world. In Nigeria, there have been
challenges of vaccine acceptance among her citizens, and even medical inclined individuals.
One of the major goals of vaccination is achieving herd immunity. According to the National
Primary Health Care Development Agency (NPHCDA), vaccination in Nigeria began on 5
March 2021, and on March 22 2021, only 122,410 Nigerians have been fully vaccinated. [26]
There has been little or no research that captures the attitude, knowledge and perception of
COVID-19 vaccination among Medical Students of Nigerian Universities in this geographical
zone of the country; this study seeks to answer this question. This study will add to the body of
research and medical knowledge. It therefore aims to assess the knowledge, attitude and practice
of COVID-19 vaccination, among Medical Students of Bingham University Teaching Hospital
(BhUTH) Jos Plateau State Nigeria.
8
1.4 AIM AND SPECIFIC OBJECTIVES
To determine the knowledge, attitude, and perception of COVID-19 vaccination, among Medical
Students of Bingham University Teaching Hospital (BhUTH).
Specific Objectives:
1. To assess the knowledge of medical students of Bingham University Teaching Hospital
(BhUTH) on the COVID-19 vaccination.
2. To determine the attitude of medical students of Bingham University Teaching Hospital
(BhUTH) towards the COVID-19 vaccination.
3. To determine the practices of medical students of Bingham University Teaching Hospital
on the COVID-19 vaccination.
1.5 SCOPE OF STUDY

This study is meant to assess the knowledge, attitude, and practices associated with Covid-19
Vaccination among medical students in Bingham University Teaching Hospital, Jos, Plateau
State.The study will span from June 2021 to December 2021 (6 months).
9
CHAPTER TWO
LITERATURE REVIEW
2.1 INTRODUCTION
Coronavirus Disease 2019 (COVID-19) also known as SARS-COV-2, is a respiratory disease
which has caused the greatest and most significant threat to global health, due to its ongoing
outbreak. Discovered in December of year 2019, it was shown to have been caused by a novel
coronavirus, structurally similar to the virus that causes SARS (severe acute respiratory
syndrome).33 The disease was first discovered in Wuhan City, in China, from where it quickly
spread to the rest of the world, infecting at least 48 million people, with a mortality of over 1.2
million in 215 countries.34The COVID-19 outbreak has greatly affected different global
sectorsꟷ public health, research, and medical communities; just as SARS (2002 and 2003) and
Middle East respiratory syndrome (MERS) did previously. 33
Coronaviruses can be described as enveloped, positive single-stranded large RNA viruses that
infect both humans and a significant range of animals, the former more than the latter. There are
four subfamilies including the alpha, beta, gamma and delta coronaviruses. The alpha and beta
coronaviruses originated from mammals, especially from bats, and the gamma and delta
coronaviruses originated from pigs and birds. SARS-COV-2 resembles SARS-COV virus, and it
falls under the B lineage of the beta-coronaviruses.35
Pneumonia was the first clinical sign of SARS-COV-2 -related COVID-19 disease that allowed
for case detection. Gastrointestinal symptoms and asymptomatic infections, particularly among
the younger population have been seen. The mean incubation period is 5-7 days and the median
incubation period is 3 days, with a range of 0-24 days. Within the first week of getting infected,
10
some symptoms that begin to manifest are fever, cough, fatigue, nasal congestion etc. As the
disease becomes severe, dyspnea and severe chest symptoms corresponding to pneumonia can be
seen in about 75% of patients, as seen by computed tomography. Even though some symptoms
of pneumonia can be seen as the disease progresses, it occurs mostly in the second or third week
of a symptomatic infection. Some important signs of viral pneumonia include a decrease in
oxygen saturation, blood gas deviations, ground glass abnormalities, patchy consolidation,
alveolar exudates and interlobular involvement.35
Studies have shown that elderly patients (those greater than 60 years of age) have a higher risk
than children of getting infected. Children may present with less serious complaints (symptoms)
or may even be asymptomatic. The case fatality ratios in France, United Kingdom, Canada,
United States and South Africa are 1.0%, 1.0%, 1.2%, 1.3% and 2.6% respectively.
According to the World Health Organization (WHO), “Vaccination is a simple, safe, and
effective way of protecting you against harmful diseases, before you come into contact with them.
It uses your body’s natural defenses to build resistance to specific infections and makes your
immune system stronger.
Vaccines train your immune system to create antibodies, just as it does when it’s exposed to a
disease. However, because vaccines contain only killed or weakened forms of germs like viruses
or bacteria, they do not cause the disease or put you at risk of its complications.”36
2.2 KNOWLEDGE OF COVID-19 VACCINATION

The knowledge of COVID-19 vaccination has been explored in several studies worldwide, and
several vaccines have been approved against the COVID-19 infection. There is a relatively high
level of knowledge (89.2%) on COVID-19 vaccination among HCWs in China.37 A study done
11
among 530 students revealed a high level of knowledge on COVID-19 and COVID-19
vaccination, and the COVID-19 pandemic has led to a series of unfavourable reactions especially
in those with pre-existing cases of anxiety.38 In Bangladesh, just slightly about half (56.6%) of
the respondents in a study had good knowledge on the above topic.39
In a study carried out among undergraduate students from Central and Southern Italy involving
3226 respondents, 96% were aware that 2 vaccine doses were required, and 64% knew the
vaccines contained the genetic information for viral antigen production. About half the
population felt the vaccine could cause some health effects, while more than 95% did not think
vaccination was a risk to privacy.
In a study carried out in North-Central Nigeria on 589 individuals, 99.5% had good knowledge
on COVID-19, gained through social media and television.40 A cross-sectional survey of the
general population including 1015 literate Nigerians was done. It revealed that 1.8% had poor
knowledge, 19.5% had intermediate knowledge and 78.7% had good knowledge. 81.2% of the
respondents with good knowledge were single (81.2%), females (55.1%), between the ages of 20
and 30 years (69.2%), and had nonmedicated-related education (69.8%).41
A cross-sectional study of 140 Onitsha residents revealed a high COVID-19 knowledge (60.7%),
good attitude towards COVID-19 management (56.4%), and good preventive practices (53.6%)42
2.3 ATTITUDE TOWARDS COVID-19 VACCINATION

Merriam-Webster defines attitude as “a feeling or a way of thinking that affects a person’s
behaviour; the way you think or feel about someone or something” Attitude can mostly be seen
as positive or negative There is a positive and encouraging attitude in the Philippines towards the
12
COVID-19 vaccination, with 81.32% willing to accept the vaccine. Those who were unwilling
had concerns about the safety of the vaccines.37 Likewise, in Vietnam, a high percentage of
people showed a 76.1% willingness to get vaccinated against COVID-19 infection.43 In the
United States of America, 68% were in favour of the COVID-19 vaccination, while those not in
favour of it also expressed concerns about the safety of the vaccines.44 The above demonstrates a
positive attitude, despite the slight decline in the percentages respectively.
In some parts of Africa and the Middle-East, 67% of respondents were willing to be vaccinated,
while 33% were against it.45 Across the 36 states in Nigeria, just about half of the population
(58.2%) are willing to receive the COVID-19 vaccines; the others either were against it or just
did not care.46 However, there is hesitancy in the South-Eastern parts of Nigeria, with majority
having negative and discouraging attitudes towards the COVID-19 vaccination. They did not
quite agree with the safety claim about the vaccines, due to a poor knowledge about the
vaccine’s safety in those regions.47
Most studies conducted in Nigeria on COVID-19 vaccination, did not include the attitude of
individual towards it. Most rather, are centered around the acceptance of the vaccine.
2.4 FACTORS THAT FACILITATE OR HINDER UPTAKE OF COVID-19

VACCINATION
Despite evidence of the high effectiveness of vaccination and immunization over the years, there
is still a lot of resistance and hesitancy to accepting vaccines. Three major factors which
significantly affected the uptake of the COVID-19 vaccination in the United States, were the
probability of protection against COVID-19, the probability of minor side effects and the
probability of serious adverse effects, with a respective decrease in the degree of effect on
13
uptake.48 In addition to the factors stated above, the length of vaccine testing was of great
concern. Furthermore, increased efficacy, increased testing time and development in the United
States increased vaccine uptake. When concerns of the population about the COVID-19
vaccinations were tackled, minds were put at ease, and uptake increased.44 In China, safety of the
COVID-19 vaccine is of concern, as people refused to accept the vaccine until the safety can be
confirmed.49
In some African and Middle-Eastern countries, fear of side effects, fear of getting sick after
receiving the vaccine and the absence of accurate vaccine promotion news were of great effect to
the uptake of the COVID-19 vaccination.13 In Nigeria, the perception of the vaccine being good,
positively affected the uptake.50
Uncertainties about the safety and efficacy, and the fear of side effects have been recurring
factors for the reduced uptake of the COVID-19 vaccination.
2.5 ACCEPTANCE OF COVID-19 VACCINATION

A global survey of potential acceptance of COVID-19 vaccine showed that acceptance rates
varied from 55% to 90%. In the survey, 71.5% of participants were somewhat willing to accept
the vaccine and 48.1% were willing to accept the vaccine based on their employer’s
recommendations.51 This correlates with the results from a French study, where 77.6% of
participants indicated they will certainly or probably agree to get vaccinated against COVID-19.
Older age, male gender, fear about COVID-19, being a healthcare worker and individual
perceived risk were associated with COVID-19 vaccine acceptance. In contrast, 36.4% of the
330 respondents strongly agreed or agreed to be vaccinated among International College
14
Students Studying in China52 as compared to 83.5% of participants in a national study on the
China Mainland.53
Meanwhile, in a study among a middle-eastern population, 36.8% of the participants were not
willing to take the vaccine when available and 26.4% were not sure. The main reasons for the
participants’ refusal or hesitancy were concerns regarding the use of vaccines and a lack of trust
in them.55
In the United Kingdom, 9.1% were unlikely to be vaccinated, 26.9% were uncertain about their
likelihood of vaccination, and 64.0% reported being very likely to be vaccinated.56
In a similar study among Egyptian medical students, the majority of the participants (90.5%)
perceived the importance of the COVID-19 vaccine, 46% had vaccination hesitancy, and an
equal percentage (6%) either definitely accepted or refused the vaccine.57
Local results in a similar study carried out in Plateau State, North-Central Nigeria showed that
almost half (46%) of the respondents had vaccine hesitancy.58
2.6 RELATIONSHIP BETWEEN SOCIODEMOGRAPHICS AND

ACCEPTANCE OF COVID-19 VACCINATION
In China, being male and married could increase the probability of accepting the COVID-19
vaccination.49 Similarly, willingness to accept the vaccine was relatively high among the married
in Saudi Arabia. Other important factors were older age, postgraduate educational level or
higher, being non-Saudi, having employment in the government sector.57 In the United States of
America (USA), some factors that decreased the likelihood of vaccine acceptance were lower
educational level, low income, and perceived threat of getting infected. Vaccine resistance was
15
also higher among African-Americans, Hispanics, those who had children at home, rural
dwellers, people in the North-Eastern U.S, and those who identified as Republicans.58
However, in Africa, young respondents (aged 18-20 years), males, elites at tertiary level of
education, students, Muslims, married, non-salary earners and rural dwellers were more likely to
accept the COVID-19 vaccination. This contrasts some of the socio-demographics which
promote and/or hinder vaccine acceptance.59 In Nigeria, being male is huge positive factor in
vaccine acceptance. In South-South Nigeria, males are twice as likely to receive the vaccine than
females.50
2.7 SOCIAL MEDIA AND ITS EFFECTS ON COVID-19 VACCINATION

UPTAKE
Vaccine hesitancy is a major threat to global health, because it leads to the resurgence of
formerly eliminated vaccine-preventable illnesses. There are many factors that can lead to
vaccine hesitancy, many factors that can also lead to an increased vaccine uptake. Here, social
media will be on the spot light. According to Merriam-Webster dictionary, social media are
“forms of electronic communication (such as websites for social networking and
microblogging) through which users create online communities to share information, ideas,
personal messages, and other content (such as videos).”60 Social media has infiltrated the
globe, with almost unrestricted access to both sanctioned and unsanctioned information. Due
to the amount of information found on social media, the population can get swayed in many
directions, and this can fuel COVID-19 vaccine hesitancy. There are a lot of information
about anti-vaccination which can compromise public confidence in future vaccine
development.61
16
In a study on about 87 YouTube videos, 65% expressed anti-vaccine sentiment, albeit, just a
little above 5% were made by professionals in government, and about 37% had no scientific
evidence. Even more videos contained baseless information. Content against vaccination are
constantly being shared across social media platforms, and exposure to such information may
directly affect the opinions of people and promote vaccine hesitancy. Even the littlest time
spent on social media on vaccine-critical sites can negatively influence COVID-19 vaccine
uptake.61
Organizations on social media has a great role to play in the doubts the public feel about the
safety of the COVID-19 vaccine, and also a relationship between foreign disinformation
strategies and a reduction in vaccine coverage.62
Even though the effect of social media has been seen to greatly affect the uptake of COVID-
19 vaccines, there is paucity of data in Nigeria about it.
17
CHAPTER THREE
METHODOLOGY
3.1 BACKGROUND TO THE STUDY AREA

Plateau is the twelfth-largest state in Nigeria. It was created on 3rd February 1976 and the capital
is Jos. It has an area totalling 30,913 km2 with a Per capita Gross Domestic Product (GDP) of
$1,587. 27 With natural formations of rocks, hills and waterfalls, it derives its name from the Jos
Plateau and has a population of around 3.5 million people. 28
Jos North Local Government Area of Plateau State was created in 1987. It is one of the state's
seventeen local government areas and it is mainly metropolitan. It has an area of over 291 km2
and a population of 429,300, projected from 2006 national and housing census, with 266,660
(62%) being Urban dwellers and 163,134 (38%) being rural dwellers. 29
The LGA has 20 political wards and consist of diverse ethnic groups which include Berom,
Annaguta, Mwaghavul, Rukuba and Ngas as the major ethnic groups, while the others comprise
Hausa and Fulani. 29
The study site was Bingham University Teaching Hospital, formerly known as ECWA Evangel
Hospital. It is a 250-bed facility located in Jos, Plateau State, Nigeria. It was founded in 1959 by
SIM (previously the Sudan Interior Mission and now known as Serving In Mission), to provide
Health care to the missionaries in Nigeria and also meet health care needs of the indigenous
populace. 30 The hospital is now managed under the auspices of the Evangelical Church Winning
All (ECWA).
18
In 2010, ECWA, the Proprietor, converted the hospital to the Teaching Hospital of Bingham
University College of Health Sciences. 30
3.2 STUDY DESIGN

The study was descriptive cross-sectional in nature, lasting for a period of six (6) months, on the
knowledge, attitude and practice of COVID-19 vaccination among medical students in this
location.
3.3 STUDY POPULATION

The study population involved male and female students of Bingham University Teaching
Hospital, Jos, Plateau State.
3.3.1 INCLUSION CRITERIA

Medical students within levels 400 to 600 of the college of Medicine and health sciences,
Bingham University Teaching Hospital, Jos, Plateau State Nigeria.
3.3.2 EXCLUSION CRITERIA

1. Medical students within levels 100 to 300 of Bingham University Karu, Nasarawa State
Nigeria.
2.All other non-medical students within the college of Medicine and health Sciences, Bingham
University Teaching Hospital, Jos, Plateau State.
3.4 SAMPLE SIZE DETERMINATION

This was determined, using Cochran’s formula 31
n=z2pq/e2
19
Where n = minimum sample size
z = standard normal deviation set at 1.96 (CI of 95%)
p = proportion of population having the characteristic of interest from a previous study = 23% 32
q=complementary probability (1-p) = 1-0.23 = 0.77
e = degree of accuracy required usually set at 0.05%
n = [1.962 x 0.23 x 0.77] / 0.052
n = 272
Attrition of 10% = 272/100 x 10 = 27.
Attrition of 10% = 27
Sample size = n + 10% of attrition
Therefore, 272 + 27 = 299
Hence, the minimum sample size was 299
3.5 SAMPLING TECHNIQUE

It was conducted by Stratified Random Sampling Technique.
20
Number of medical students in Bingham University Teaching Hospital = 453
Stage 1: Proportional allocation will be based on the number of students in each class:
Batch I = 48/453 x 299 = 32
Batch J = 58/453 x 299 = 38
Batch K = 126/453 x 299 = 83
Batch L = 85/453 x 299 = 56
Batch M = 136/453 x 299 = 90
Stage 2: By way of simple random sampling, participants were selected using balloting.
3.6 DATA COLLECTION TECHNIQUE

The data collection process involved the use of structured self-administered questionnaires
developed by the researchers. The questionnaire was pre-tested among medical students of Jos
University Teaching Hospital (JUTH). The questionnaire contained the following sections:
socio-demographic factors, knowledge of COVID-19 and COVID-19 vaccination, attitude
towards COVID-19 vaccination and practices towards COVID-19 vaccination.
3.7 DATA ANALYSIS

Data collected was cleaned, coded and analyzed using Statistical Package for Social Sciences
(SPSS) Version 20.0 Software. Descriptive statistics such as the socio-demographic composition
21
of the residents such as their age, religion, tribe, marital status, educational qualification and
occupation were represented on frequency tables, graphs and charts. The Pearson’s chi-square
was used for analyzing bivariate variables such as the association between socio-demographics
such as resident’s age, religion, tribe, educational qualification and occupation against the
knowledge, attitude and practices towards COVID-19. Using 95% confidence interval, p-value
of less than or equal to 0.05 was considered statistically significant.
3.8 ETHICAL CLEARANCE

Ethical clearance was obtained from the Ethics and Research Committee of Bingham University
Teaching Hospital. Permission was obtained from each respondent after the purpose of the study
was clearly explained to them. Informed consent was obtained from the participants and they
were informed that participation will be voluntary and anonymity will be ensured. In addition,
they were informed that they can willingly withdraw from the study at any point.
Participants’ privacy and confidentiality of information provided was ensured through
anonymizing the questionnaire and identification number given. All information obtained was
handled with confidentiality.
3.9 LIMITATIONS
1. Possible dishonesty among respondents concerning questions asked.
2. Some respondents refused to participate for personal reasons.
22
CHAPTER FOUR
RESULTS
Table 1: Socio-demographic characteristics of respondents (n=299)

Variable Frequency Percent (%)
Sex
Male 132 44.1
Female 167 55.9
Religion
Christian 295 98.7
Muslim 4 1.3
Age
16-20 28 9.4
21-25 245 81.9
26-30 26 6.7
Marital status
Single 293 98.0
Married 6 2.0
Batch
I 37 12.4
J 43 14.4
K 93 31.1
L 66 22.1
M 60 20.1
Tribe
Hausa 11 3.7
Yoruba 54 18.1
23
Igbo 48 16.1
Igala 33 11.0
Tangale 10 3.3
Others 143 47.8
Comments: Majority of the participants were females 167 (55.9%), almost all were Christians
295(98.7%), most belonged the age group 21-25 with 245 (81.9%), majority of the participants
were single (98%), relatively high responses came from Batch K of the 5 Batches (31.1%), and
majority of the participants came from minority tribes (47.8%)
24
Table 2A: Knowledge of COVID-19 vaccine by the participants
Variables Frequency Percent (%)
Are you aware of COVID-19 virus?

No 0 0
Yes 299 100
Mode of Transmission
Eating or contacting wild animals
True 93 31.1
False 171 57.2
I don’t know 35 11.7
Afebrile COVID-19 patients cannot
transmit the virus
True 15 5.0
False 263 88.0
Respiratory droplets of infected
individuals
True 294 98.3
False 4 1.3
Prevention practices
Hand hygiene 289 96.7
Vaccination 265 88.7
Drinking hot moringa 18 6.0
brew
Wearing facemasks 285 95.3
Physical distancing of at 281 93.4
least 1 – 2 meters
Drinking alcohol 3 1.0
Eating garlic 24 8.0
Others 34 11.4
25
Comments: All the respondents (100%) were aware of the Covid-19 virus. Almost all the
respondents (98.3%) believed that it was transmitted via respiratory droplets, 88% believed
afebrile COVID-19 patients can transmit the virus, and 31.1% believed the virus could be
transmitted by eating or contacting wild animals. Most (96.7%, 95.3% and 93.4%) believed that
COVID-19 infection could also be prevented by hand hygiene, wearing facemasks and physical
distancing respectively.
26
Table 2B: Knowledge of COVID-19 vaccine by the participants
Treatment options for COVID-19

infection
Supplemental oxygen
Strongly agree 110 36.8

Agree 175 58.5
Undecided 13 4.3
Disagree 1 0.3
Strongly disagree 0 0.0
Corticosteroids Strongly agree 48 16.1

Agree 153 51.2
Undecided 80 26.8
Disagree 16 5.4
Remdesivir
Agree 109 36.5
Undecided 146 48.8
Disagree 5 1.7
Antipyretics
Agree 177 59.2
Undecided 60 20.1
Disagree 6 2.0
27
Broad spectrum antibiotics
Agree 118 39.5
Undecided 91 30.4
Disagree 46 15.4
Conservative fluid management
Agree 165 55.2
Undecided 65 21.7
Disagree 9 3.0
Ginger and garlic brew
Agree 44 14.7
Undecided 71 23.7
Disagree 121 40.5
Antiviral drugs
Agree 175 58.5
Undecided 55 18.4
Disagree 20 6.7
Chloroquine/Hydroxychloroquine
± Azithromycin
Agree 144 48.2
Undecided 73 24.4
Disagree 17 5.7
28
Are you aware of COVID-19
vaccines?
Yes 299 100.0
No 0 0.0
How many types of the vaccines do
you know?
1 17 5.7
2 74 24.7
3 163 54.5
4 32 10.7
5 11 3.7
6 2 0.7
Comment: About two-third of the respondents agreed to Supplemental oxygen (58.5%),
Corticosteroid (51.2), Antipyretics (59.2%), Conservative fluid management (55.2%), and
Antiviral drugs (58.5%). While about two-fifth agreed to the use of
Chloroquine/Hydrochloroquine (48.2%), and broad spectrum antibiotics (39.5%), as treatment
options. All the respondents (100%) were aware of the Covid-19 vaccine, and about half (54.5%)
knew at least 3 vaccine types.
29
Table 2C: Knowledge of COVID-19 vaccine by the participants
Who is eligible to
receive the COVID-19
vaccine?
Infants <1 year of age Eligible 9 3.0
Not Eligible 183 61.2
Children and Eligible 128 42.8

adolescents <18 years
Adults >18 years Eligible 296 99.0

Not Eligible 3 1.0
Pregnant ladies and Eligible 52 17.4

lactating mothers
Patients with chronic Eligible 153 51.2

diseases
Patients with active Eligible 55 18.4

COVID-19 infection
30
Persons recovered from Eligible 222 74.2
COVID-19
Not Eligible 20 6.7
Persons with allergies Eligible 93 31.1

to food/drugs
Immunocompromised Eligible 76 25.4

patients
Healthcare workers Eligible 292 97.7

Not Eligible 1 0.3
How many doses is/are
sufficient to achieve
protective immunity
against COVID-19
infection in Nigeria
1 shot 2 0.7
2 shots 271 90.6
Do the vaccines have

adverse effects?
Yes 276 92.3
No 23 7.7
31
Comment: A majority (99%) believed that persons above the age of 18years were eligible for
vaccination, followed by 97.7% who believed healthcare workers were eligible, and 74.2% that
believed those who have recovered from COVID-19 infection were eligible. A significant number
(90.6%) believed 2shots/doses were sufficient to achieve immunity, with most (92.3%) believing
that the vaccine had adverse effects
32
250
200
150
100
50
0
Frequency
Figure 3: Sources of information regarding COVID-19 Virus amongst the respondents in
Bingham University Teaching Hospital.
Comment: Official International Health Organizations and Government sites and media (81.9%),
Schools (80.9%), Health facilities (80.3%) and News media (79.3%) were the highly reported
sources of information among the respondents.
33
299 294
300 270 273 275
258
246 240 235
250 226
207 206
200
157
150
94
100
50
Figure 4: Symptoms of COVID-19 infection as reported by the respondents in Bingham
University Teaching Hospital.
Comment: Fever (100%), Difficulty in breathing (98.3%), Body weakness (92%), Loss of taste
(91.3%), and Cough (90.3%) were the symptoms believed to be most associated with COVID-19
infection according to most respondents.
34
280
259
300 221
250
200
150
100 27 11 12
50
0
Frequency
Figure 5: Types of COVID-19 vaccines known amongst the respondents in Bingham
University Teaching Hospital
Comment: Majority of the participants are familiar with the Pfizer/BioNtech (280 respondents),
Oxford/AstraZeneca (254 respondents) and Janssen (Johnson &Johnson) COVID-19 vaccines.
35
Subcutaneous injection Intradermal injection
4% 1%
Others
Intrathecal injection 1%
0%
Intravenous injection
2%
Intramuscular injection
92%
Frequency Percent
Figure 6: How COVID-19 vaccines are administered as reported by the respondents in
Comment: Majority of the participants believe the COVID-19 vaccine is administered via
Intramuscular injection (92.0%).
36
250 228
196 197
200 174 169
129
150
100 77
32 28
50
3
0
Figure 7: Adverse effects of COVID-19 vaccination as reported by the respondents in
Comment: Majority of the respondents believe that the adverse effects caused by the COVID-19
vaccines include Pain/redness of injection site (228), Fever (197) Headache (196) and swelling of
injection site.
37
TABLE 3A: Attitude of participants towards the COVID-19 vaccine
COVID-19 vaccination can stop
the spread of the infection
Agree 150 50.2
Undecided 56 18.7
Disagree 22 7.4
COVID-19 vaccine is safe and
should be accepted
Agree 147 49.2
Undecided 74 24.7
Disagree 11 3.7
Everyone eligible should be
vaccinated
Agree 141 47.2
Undecided 57 19.1
Disagree 9 3.0
Young people don’t need to take
the vaccine
Agree 6 2.0
Undecided 52 17.4
Disagree 166 55.5
38
The vaccine is not safe and
should not be accepted
Agree 21 7.0
Undecided 70 23.4
Disagree 139 46.5
When an opportunity presents
itself, I will take the vaccine
Agree 133 44.5
Undecided 68 22.7
Disagree 14 4.7
I will prefer to acquire immunity
against the infection naturally
Agree 37 12.4
Undecided 43 14.4
Disagree 132 44.1
Comment: Majority of the respondents agreed; that the vaccine can stop the spread of the infection
(50.2%) , that the vaccine is safe and should be accepted (49.2%), that everyone eligible should be
vaccinated (47.2%), and that they would take the vaccine should an opportunity present itself
(44.5%), while majority of respondents disagreeing with; young people not getting vaccinated
(55.5%), vaccine not been safe and therefore shouldn’t be accepted (46.5%) and the preferring
natural immunity against the infection.
39
TABLE 3B: Attitude of participants towards the COVID-19 vaccine
To what extent do these

sources of information
influence your opinion
regarding vaccination?
News from national TV/radio Insignificant 40 13.4

Slightly significant 159 53.6
Very significant 100 33.4
Government agencies Insignificant 71 23.7

59 19.7
Social media Insignificant
Discussion amongst friends Insignificant 25 8.4

and family
Healthcare provider Insignificant 7 2.3

Comment: Most of the respondents said that their news from national radio (53.6%), Government
agencies (48.5%), social media (51.8%), and discussion amongst friends had slight significance
40
on their influence of opinion (57.2%), with information from healthcare provider having very
significant influence on their opinion.
41
TABLE 4: Acceptance of COVID-19 vaccine by participants
Variable Frequency Percent
(%)
Have you taken the COVID-19
vaccine?
Yes 107 35.8
No 192 64.2
If yes, how many doses?
1 35 11.7
2 72 24.1
In your opinion, are the
COVID-19 vaccines safe?
Yes 193 64.5
No 106 35.5
If no, what are your reasons?
The vaccine manufacturing 95 31.8
process was rushed
It has serious adverse effects 51 17.1
It is a bioweapon 23 7.7
It was not properly tested 64 21.4
The Nigerian government is 16 5.4
using it to reduce the
population
It can cause infertility 13 4.3
Others 20 6.7
Comments: About two-thirds of the respondents (64.2%) had not taken the Covid-19 vaccine,
11.2% had only one dose and 24.1% had 2 doses. 64.5% were of the opinion that the vaccine was
safe, and about a third of the respondents felt the vaccine manufacturing process was rushed
(31.8%)
42
TABLE 5: Facilitators of COVID-19 vaccine acceptance among participants.
I think there is no harm in
taking the COVID-19
vaccine
Agree 107 35.8
Undecided 72 24.1
Disagree 55 18.4
I believe the COVID-19
vaccine will be useful in
protecting me from
COVID-19 infection
Agree 146 48.8
Undecided 53 17.7
Disagree 23 7.7
COVID-19 vaccines are
available free of charge
Agree 188 62.9
Undecided 21 7.0
Disagree 4 1.3
My healthcare
professional has
recommended it to me
Agree 139 46.5
Undecided 58 19.4
43
Disagree 24 8.0
I feel the benefits of taking
the vaccine outweigh the
risks
Agree 139 46.5
Undecided 58 19.4
Disagree 24 8.0
I believe taking the
vaccine is a social
responsibility
Agree 150 50.2
Undecided 55 18.4
Disagree 24 8.0
There is sufficient data
released regarding the
vaccine’s safety and
efficacy
Agree 82 27.4
Undecided 66 22.1
Disagree 92 30.8
My people are taking the
vaccine
Agree 173 57.9
Undecided 39 13.0
44
Disagree 33 11.0
My role models/political
leaders/senior
doctors/scientists have
taken the vaccine
Agree 154 51.5
Undecided 65 21.7
Disagree 29 9.7
Comments: Majority of the respondents agreed that; there was no harm taking the vaccine (35.8%),
it was going to be useful in protecting them (48.8%), the vaccine was free (62.9%), it was
recommended by their healthcare professional (57.5%), the benefits of the vaccine outweighed the
risks (46.5%), it was a social responsibility (50.2%), their people were taking it (57.9%), and their
role model/political leaders/senior doctors/scientists also had taken it (51.5%). About a third
(30.8%) disagreed that there was sufficient data released about the vaccine’s safety.
45
TABLE 6: Hinderers of COVID-19 vaccine acceptance among participants.
Variables Frequency Percent
COVID-19 vaccine might not be
easily available to me
Agree 82 27.4
Undecided 38 12.7
Disagree 139 46.5
Strongly Disagree 25 8.4
I might have immediate serious side

effects after taking the COVID-19
vaccine
Agree 183 61.2
Undecided 38 12.7
Disagree 32 10.7
The vaccine may be faulty or fake
Agree 170 56.9
Undecided 49 16.4
Disagree 38 12.7
The vaccine was rapidly developed
and approved
Agree 176 58.9
Undecided 38 12.7
Disagree 16 5.4
46
I might have some unforeseen future
effects of the COVID-19 vaccine
Agree 151 50.5
Undecided 68 22.7
Disagree 30 10.0
COVID-19 vaccine is being
promoted for the commercial gains
of pharmaceutical companies
Agree 98 32.8
Undecided 89 29.8
Disagree 64 21.4
Comments: Majority of the respondents agreed that; the vaccine had immediate serious side effects
(61.2%), the vaccine was faulty or fake (56.9%), the vaccine was rapidly developed/approved
(58.9%), they might have unforeseen future effects (50.5%), and that it was promoted for
pharmaceutical commercial gains (32.8%). 46.5% disagreed to the vaccine not been easily
available to them.
47
TABLE 7A: Preventive Practices to COVID 19 among participants
After getting vaccinated, I don’t
need to wear a mask
Agree 20 6.7
Undecided 33 11.0
Disagree 138 46.2
Don’t need to complete doses of
the COVID-19 vaccine to be
fully immunized
Agree 8 2.7
Undecided 31 10.4
Disagree 142 47.5
need to use hand sanitizers
Agree 8 2.7
Undecided 21 7.0
Disagree 140 46.8
need to socially distance myself
in public
Agree 14 4.7
Undecided 28 9.4
Disagree 133 44.5
48
Comment: Nearly half of the respondents disagree that they don’t need to wear a mask after being
vaccinated (46.2%), that they don’t need to complete the doses to be fully immunized (47.5%),
that they don’t need to use hand sanitizers after vaccination (46.8%) and that they don’t need to
socially distance themselves in public after vaccination (44.5%).
49
TABLE 7B: Preventive Practices to COVID 19 among participants
In recent days, have you gone to any
crowded place?
Always 63 21.1
Never 12 4.0
Occasionally 224 74.9
In recent days, have you worn a face

mask when in contact with patients?
Always 213 71.2
Never 2 0.7
In recent days, have you washed your

hands after handling a patient?
Always 151 50.5
Never 7 2.2
In recent days, have you avoided
patients with signs and symptoms of
COVID-19?
Always 107 35.8
Never 39 13.0
Do you avoid unnecessary vacations
to prevent contracting and spreading
COVID-19?
Always 71 23.7
Never 65 21.7
50
Do you avoid public transportations
(taxi, bus, plane, train, etc.) to prevent
contracting and spreading COVID-
19?
Always 38 12.7
Never 92 30.8
Do you avoid handshaking, hugging
and kissing to prevent contracting and
spreading covid-19?
Always 47 15.7
Never 57 19.1
Do you pay more attention to your
personal hygiene than usual to
prevent contracting and spreading
COVID-19?
Always 184 61.6
Never 3 1.0
Do you use disinfectant to prevent
contracting and spreading COVID-
19?
Always 133 44.5
Never 15 5.0
Do you use herbal products and

traditional medicine to prevent
contracting and spreading COVID-19
Always 7 2.3
Never 240 80.3
51
Do you take vitamin supplements to
prevent contracting and spreading
covid-19?
Always 33 11.0
Never 140 46.8
Comment: About three-quarters (74.9%) have occasionally been to a crowded place in recent
times, 71.2% always wear a face mask when in contact with patients, 50.5% always wash their
hands after handling a patient, 51.2% occasionally avoid patients with signs and symptoms of
COVID-19, 54.5% occasionally avoid unnecessary vacations, 56.5% occasionally avoid public
transport, 65.2% avoid close body contact occasionally, 61.5% always pay more attention to their
personal hygiene than usual, 50.5% use disinfectants, 80.3% never use herbal products and
traditional medicine and 46.8% have never taken supplements to prevent contracting and spreading
COVID-19 infection.
52
TABLE 8: Respondents’ knowledge, attitude and practice of COVID-19 vaccine
Knowledge
Good 171 57.2
Fair 116 38.8
Poor 12 4.0
Attitude
Good 178 59.5
Fair 26 8.7
Poor 95 31.8
Practice
Good 28 9.4
Fair 109 36.5
Poor 162 54.2
Comment: Majority of the respondents (57.2%) had good knowledge of the Covid-19 vaccine,
with just 4.0% having poor knowledge of the vaccine. Most (59.5%) of respondents had good
attitude towards the vaccine, with 31.8% of the respondents having a poor attitude. Most of the
respondents (54.2%) had a poor COVID 19 preventive practices.
53
TABLE 9: Cross-tabulation between knowledge and attitude to COVID-19 vaccine
Knowledge Attitude Chi-square test
Good fair poor total
Good 116 18 37 171 X2 = 25.1

Fair 60 7 49 116 df = 4
Poor 2 1 9 12 p = 0.000
Total 178 26 95 299
Comment: There was statistically significant relationship between knowledge and attitude.
54
TABLE 10: Cross-tabulation between Socio-demographics and knowledge of the COVID-
19 vaccine.
Socio-demographics Knowledge Chi-square test
Good Fair Poor Total x2 =32.7
Age 16-20 10 17 1 28 df = 20
21-25 149 85 11 245 p = 0.036
26-30 12 14 0 26
Total 171 116 12 299
Sex Female 85 77 5 167 x2 = 8.8

Male 86 39 7 132 df = 2
Total 171 116 12 299 p = 0.012
Marital Married 42 0 6 48 x2 = 0.4

status
Single 167 114 12 293 df = 2
Total 171 116 12 299 p = 0.823
Tribe Hausa 9 1 1 11 x2 = 14.3

Igala 18 14 1 33 df = 10
Igbo 31 13 4 48 p = 0.160
Others 79 59 5 143
Tangale 37 10 10 47
Yoruba 31 22 1 54
Total 171 116 12 299
Religion Christian 168 116 11 295 x2 = 6.2

Muslim 3 0 1 4 df = 2
171 116 12 299 p = 0.044
Batch I 30 7 0 37 x2 = 12.9
55
J 25 16 2 43 df = 8
K 47 42 4 93 p = 0.117
L 39 25 2 66
M 30 26 4 60
Total 171 116 12 299
Comments: There was statistically significant relationship between age, sex, religion and
knowledge. However, there was no significant relationship between the sex, age, marital status,
tribe and batch with the knowledge.
56
TABLE 11: Cross-tabulation between Socio-demographics and attitude towards COVID-
19 vaccine.
Socio-demographics Attitude Chi-square test
Good Fair Poor Total
Age 16-20 11 6 11 28 x2 =37.6

21-25 156 16 73 245 df = 20
26-30 11 4 11 26 p = 0.010
Sex Female 89 16 62 167 x2 =6.2

Male 89 10 33 132 df = 2
p = 0.044
Marital Married 4 0 2 6 x2 =0.6

status
Single 174 26 93 293 df = 2
p = 0.745
Tribe Hausa 4 2 5 11 x2 =11.0

Yoruba 31 4 19 54 df = 10
Igbo 28 3 17 48 p = 0.355
Igala 15 3 15 33
Tangale 8 0 2 10
Others 92 14 37 143
Religion Christian 175 25 95 295 x2 =2.7

Muslim 3 1 0 4 df = 2
p = 0.260
Batch I 24 5 8 37 x2 =11.0
J 25 6 12 43 df = 8
57
K 56 4 33 93 p = 0.203
L 43 3 20 66
M 30 8 22 60
Total 178 26 95 299
Comments: There was a statistically significant relationship between the sex, age and attitude.
58
TABLE 12: Cross tabulation between doses of vaccines taken and attitude of participants
to COVID-19
Variable Attitude Chi-square test
Good Fair Poor Total
Doses taken
0 87 21 84 192 x2 =48.2
1 26 2 7 35 df = 4
2 65 3 4 72 p = 0.000
Total 178 26 95 299
Comments: There was statistically significant relationship between vaccine acceptance and the
attitude.
59
TABLE 13: Cross-tabulation between Socio-demographic factor and the level COVID-19
vaccine acceptance.
Variable Prevalence Chi-square test
Not 1 shot 2 shots Total
vaccinated
Age 16-20 27 0 1 28 x2 =46.4
21-25 151 30 64 245 df = 20
26-30 14 5 7 26 p = 0.001
Total 192 35 72 299
Sex Female 109 16 42 167 x2 =1.7

Male 83 19 30 132 df = 2
Total 192 35 72 299 p = 0.426
Marital Married 2 0 4 6 x2 =6.2

status
Single 190 35 68 293 df = 2
p = 0.044
Tribe Hausa 8 0 3 11 x2 =5.7

Yoruba 37 4 13 54 df = 10
Igbo 33 5 10 48 p= 0.828
Igala 5 1 4 10
Tangale 90 20 33 143
Others 192 35 73 299
Religion Christian 191 33 71 295 x2 =6.1
60
Muslim 1 2 1 4 df = 2
p = 0.049
Batch I 18 5 14 37 x2 =32.1
J 21 9 13 43 df = 8
K 70 10 13 93 p = 0.000
L 33 10 23 66
M 50 1 9 60
Total 192 35 72 299
Comments: There was statistically significant relationship between the age, marital status, religion
and batch with COVID-19 vaccine acceptance.
61
CHAPTER FIVE
DISCUSSION
5.1 SOCIO-DEMOGRAPHIC CHARACTERISTICS

COVID-19 is a public health problem that cuts across all races, religions, genders, and other
aspects of socio-demographics. Out of the 299 participants in this study, most (55.9%) were female
and a majority, (81.9%) were in the age bracket of 21 to 25 years. The mean age was 23±6 years.
This is consistent with the findings of other studies where the percentage of the female participants
1,4,5
were about three-fifth. However, contrasts with the findings of other studies from Babcock
and Adeleke Universities which showed a minority of females. 2 This study revealed that majority
of the participants were Christian. The percentage of Muslims was 1.3%, much lower than reported
by Sulaiman Al Habib where 15.7% were Christians.2 Bingham University is a Faith-based
institution, which explains the predominance of Christian respondents in our study. About one-
third of the participants were from Batch K. This could be because Batch K had one of the highest
number of students amongst all the batches in Bingham University Teaching Hospital.
5.2 KNOWLEDGE OF COVID-19 AND COVID-19 VACCINATION

All the respondents (100%) in this study knew what COVID-19 was, this finding is similar to that
of a study in Southern Ethiopia which (99.5%)19. The time gap of one year between both studies,
as well as the medical background of our respondents could be responsible for the slight increase..
Participants obtained information about the disease from different sources; the commonest sources
of information mentioned by the participants included sites and media from international and
62
Governmental organizations (81.9%). Most studies, however, report Social media as the highest
choice of information concerning COVID-19.20,21 The respondents in this study could be said to
rely more on official sites and media possibly because they believed they are more reliable and
will provide more accurate and correct information than other sources.
Concerning mode of transmission, this study showed a majority of the respondents believed eating
and having contact with wild animals will not predispose an individual to COVID-19 (57.2%); and
neither will afebrile COVID-19 patients (88%); a majority however, believed one can get infected
from respiratory droplets of infected individuals., This is consistent with the findings of a similar
study. 5 The similarity between the findings from a predominantly medically-oriented population
and a lay population indicates how aggressive the efforts have been to educate the lay population
on the health implications of the COVID-19 virus and vaccination.
Respondents in this study believed that fever was associated with COVID-19 infection. This
finding contrasts with that of a Jordanian population5. Difficulty in breathing (98.3%), Body
weakness (92%), loss of taste (91.3%), and Cough (90.3%) were other symptoms believed to be
most associated with COVID-19 infection according to most respondents in this study. Findings
from a similar study noted that more than 89% of respondents identified fever, cough, fatigue and
difficulty in breathing as the most common manifestations of the disease.22These similar findings
are explained by the medical knowledge of the respondents in both studies. Close to half of our
respondents were not aware of diarrhoea as a manifestation of the disease, as noted in a study in
Greece (38.3%)22. This is due to the atypical nature of the symptom in respiratory diseases.
A majority of the respondents in this study, believed that hand hygiene is a preventive practice
against COVID-19 infection. This is similar to the findings of a study by Walid A. Al-Qerem and
Anan S. Jarab5. Most of the respondents in this study (95.3%) believed that wearing a face mask
63
is important, this correlates with the Middle Eastern study (94%) but contrasts with a study in a
Greek population (46.7%)22 Physical distancing of at least 1 – 2 meters was also a popular option
among the respondents (93.4%) in this study, albeit, slightly lower than the Jordanian study at
97.6%. Vaccination was believed by the respondents in this study to be a preventive practice
against COVID-19 infection (88.7%), this is higher than recorded by a Chinese study (77.6%)3
and a study on medical, pharmacy, dentistry, nursing and physiotherapy students by Shimaa M.
4
Saied (56.5%). This could be explained by the fact that the respondents in this study, were
medical students.
Majority of the respondents in this study, agreed to supplemental oxygen (58.5%), Corticosteroid
(51.2), Antipyretics (59.2%), broad spectrum antibiotics (39.5%), conservative fluid management
(55.2%), Antiviral drugs (58.5%), Chloroquine/Hydrochloroquine (48.2%) as treatment options
for COVID-19 infection. Majority chose supplemental oxygen because the drive for ventilators at
the beginning of the pandemic sensitized the respondents to the fact that resuscitation is an
essential component of caring for COVID-19 patients. The use of corticosteroids in managing a
host of inflammatory respiratory disorders could explain why most respondents opted for it. The
presence of antivirals among the top choices is since most respondents believe the viral COVID-
19 infection ought to be managed with an appropriate antiviral. Even though Chloroquine and
Hydroxychloroquine are not highlighted on the management guidelines for COVID-19
management, both agents were largely discussed on Social Media as treatment options which
explains why almost half of the respondents agreed to them. 100% were aware of the Covid-19
vaccine, with 54.5% knowing at least 3 vaccine types, majority being familiar with the
Pfizer/BioNtech (93.6%), Oxford/AstraZeneca (86.6%) and Janssen (Johnson &Johnson) COVID-
19 vaccines. These three have had more hits on Social media in Nigeria which explains why most
64
of the respondents know them. It is worthy of note, however, that some participants believed some
made-up vaccines were COVID-19 vaccines such as May & Baker (37), Nirsal (11) and Posterivid
(12). This goes to show that a lot of medical students are not so conversant with the COVID-19
vaccines that are approved and currently in use.
Of those believed to be eligible, participants chose Adults ≥ 18 years (99%), Children and
adolescents < 18 years (42.8%), Patients with chronic diseases (51.2%), and persons recovered
from COVID-19 infection (74.2%). This is higher than 60.9% recorded in a similar study3 and this
is because the respondents in the latter study are a mix of medical and non-medical students, and
not all are familiar with the eligibility criteria of the COVID-19 vaccination. While 18.4% of our
participants believed persons with an active COVID-19 infection were eligible for vaccination,
this finding is lower than 35.5% recorded in a Chinese study. Majority of the respondents believed
that healthcare workers were eligible (97.7% in contrast to 22.1% in a Chinese study). An Egyptian
study shows a lower value (92.1%) compared to our study4. In the study on International students
studying in China, 74.5% believed vaccination was highly recommended to high-risk individuals
which contrasts with the finding in our study which ranged between 51.2% (patients with chronic
diseases) and 97.7% (healthcare workers). This is explained by the fact that all our respondents
are medical students.
Most of the respondents in this study demonstrated good knowledge of the vaccine administration
routes (92%) and 90.6% believed 2 shots/doses were sufficient to achieve immunity with majority
of the respondents believing that the adverse effects caused by the COVID-19 vaccines included
Pain/redness of injection site (76.3%), Fever (65.9%) and Headache (65.6%).
About half of our respondents (57.2%) had good knowledge which contrasts with a similar study
done in Plateau state with about a tenth (11.3%) of the respondents having good knowledge of the
65
importance of the vaccines.6 Lower values were also reported in Indonesia too. (48.3%)23 Medical
students in Bingham University Teaching Hospital receive lectures on COVID-19 as well as other
infectious diseases and this could explain the higher knowledge reported in our study.
There was statistically significant relationship between knowledge and attitude and 38.4% of the
respondents who had good knowledge of COVID-19 vaccination had good attitude towards it.
There was statistically significant relationship between age, sex, religion and knowledge.
However, there was no significant relationship between the marital status, tribe and batch with the
knowledge.
5.3 ATTITUDE OF RESPONDENTS TOWARDS THE COVID-19

VACCINE
From this study, about half of the respondents (50.2%) perceived that the vaccine could stop the
spread of infection. This is in keeping with a study done in the southern part of Nigeria, in which
about 53.5% had a positive perception towards the vaccine1.The finding from our study was in
keeping to a study done in Kuwait with 62.5% positive perception that the vaccine could protect
against the infection2, and also two-thirds (66.5%) of another study from Jordan showed that
participants strongly agreed that it is important to get the vaccine to protect people from COVID-
193. This could be due to the growing awareness about the importance and safety conferred by the
vaccine.
About half (49.2%) of the respondents from this study, agreed to the safety and acceptance of the
Covid-19 vaccine. This finding contrasts with that of a study with 86.6% acceptance rate in
Mozambique4. It also contrasted with the findings of another study which showed that 77.0%
disagreed to acceptance, with 71.8% showing concern as to the safety of the vaccine2.
66
From this study, about half (47.2%) of the respondents agreed to getting everyone vaccinated,
which was in keeping with a similar study (66.5%) from Jordan.3, Also a significant number
(55.5%) of respondents in this study, disagreed with the attitude of young people not needing the
vaccine, this is in the contrast to a study done Arkansas, United states, which showed less than half
(42%) of the population sample having a positive attitude to the vaccine5. This could be attributed
to the increased awareness of the importance of receiving the vaccine.
About half of the respondents (46.5%) in this study, disagreed with the statement that the vaccine
was not safe and it should not be accepted, this was in contrast to a study done at the United states,
in the year January 2021, in which 59% of the population sample disagreed with the safety of the
vaccine6.
About half the respondents (44%) in this study agreed that they would accept the vaccine, in
contrast to a study done in Ghana, where just 39.3% agreed with accepting the vaccine at any
presenting opportunity. 7, Also majority of the respondents (73.2%) in this study, recorded that the
information from their healthcare provider influenced very significantly their opinion, while the
rest had a slight influence, this is in keeping with a cross sectional study (45.4%) done at Jordan3.
This would be as a result in the peoples trust in the health system.
5.4 ACCEPTANCE OF COVID-19 VACCINE BY PARTICIPANTS

Most respondents (64.2%) in this study, were yet to take the vaccine, with 11.7% and 24.1%
receiving first and second doses respectively. More than half (64.5%) of respondent were of the
opinion that the vaccine is safe, with 35.5% objecting to taking the vaccine. this is in keeping to
67
the Nzaji et al study in the Democratic Republic of Congo where approximately 28% of health
care workers were willing to receive the COVID-19 vaccines if available8, this can be attributed
to the existing vaccine hesitancy amongst the healthcare workers.
5.5 FACILITATORS OF COVID-19 VACCINE ACCEPTANCE AMONG

PARTICIPANTS.
Majority of respondent (53.5%) in this study with varying degree of agreement thought the vaccine
was harmless. These contrasts with Pogue’s and colleagues’ finding where the majority of
participants (~63%) in the USA stated that they were worried about the side effects of the COVID-
19 vaccine9. Also, 71.9% of the respondent in this study, with varying degree of agreement,
believed it would be useful in protecting them. This is in keeping with a study from Lebanon which
had a 76.9% rate of acceptance10 and consistent with the findings of another study from Jordan
where 66.5% stated that receiving the vaccine was important in protect them against COVID-19.
3
This might be as a result of the increasing knowledge about the importance of the vaccine among
the clinical medical students’ of Bingham University
Most (91.3%) respondent with varying degree of agreement in this study, believed or felt the
vaccine is free and would positively affect their uptake. This contrasts with the findings of a study
from Jordan in which only 36.2% believed that the government will be able to provide the vaccine
for free. 3, This is responsible for the high acceptance of the vaccine amongst the medical student,
because students are more inclined to taking free things, remembering that an important factor to
consider when exploring vaccine acceptability is vaccine convenience in terms of its availability
and affordability.
68
Majority (69.6%) of the respondent with varying degrees of agreement in this study, had the
vaccines being recommended by their healthcare professionals, making them more likely to accept
the vaccines. This was in keeping with a report in December 2020; where about 85% of the U.S.
adults said they trusted their doctors or healthcare providers about the information and
recommendations related to COVID-19 vaccines. 9 This can be attributed to the functioning health
system where a good healthcare worker - patient relationship exist.
About two-fifth (40.2%) of the respondent in this study, had varying degrees of disagreement with
regards to the availability of sufficient data pertaining the safety of the vaccine. This is in keeping
with a study from Ghana with 65.5% having the same concern7. This could be as a result of paucity
of information in the study of safety of the vaccines; this should prompt the authorities to
encourage studies in vaccine safety, so that sufficient data can be available.
5.6 HINDERERS OF COVID-19 VACCINE ACCEPTANCE AMONG

PARTICIPANTS.
From this study, about a third of the respondents (32.4%) felt the vaccines might not be easily
available to them. This could have been due to some difficulties they or others had experienced
whilst trying to acquire the vaccine. Slightly above three-quarters (76.3%) and two-third (66.9%)
of the respondents in this study, with varying degree of agreement, felt they might have serious
side effects after taking the vaccine and some unforeseen future effects from the vaccine
respectively. This contrasts the findings of a similar study from Ghana which showed a 14.8% rate
of concern with adverse effect from the vaccine7. This could be due to the existing vaccine
hesitancy amongst the Bingham University Students’.
69
Most (69.3%) respondents with varying degree of agreement, felt the vaccine may be faulty or
fake, contrary to a study from Jordan in which about three-fifth of the participants (59%) had
confidence in pharmaceutical companies to develop safe and effective COVID-19 vaccines3. This
might be due to lack of trust in both the government and pharmaceutical companies.
5.7 PREVENTIVE PRACTICES TO COVID-19 VACCINATION AMONG

RESPONDENTS
This study explored the practice of COVID-19 vaccination, which could be viewed also, as the
preventive practices against COVID-19 infection. Knowledge of COVID-19 and COVID-19
vaccination, without the right practices creates an imbalance, negatively.
It was found that majority of the respondents (81.7%) in this study, believed that it is still
important to wear a mask after getting vaccinated. This could be attributed to the fact that Medical
students are informed to some degree on the importance of wearing a facemask regardless of one’s
vaccination status. Without a significant percentage of the population immunized, the virus still
poses a great risk to the wellbeing of the people. This is consistent with the findings of a study
which revealed that 90.74% of the respondents wear face mask outside of their homes.14 In a study
among healthcare professionals 93% wear facemask at work as a preventive practice, 15 and in
another similar study, only about 45% used facemasks at work.16
It was realized that 86.3% of the respondents in this study, were of the opinion that only complete
doses of the vaccines will confer full immunity against COVID-19 infection. The reason for this
might be that the students knew the number of doses meant to be administered for complete
vaccination status, and anything short of the complete doses would be a futile effort.
70
This study also revealed that 89.95% of the respondents do not support the notion that hand
sanitizers have no importance once a person is vaccinated. Knowledge on the mode of spread of
the virus, and the role of hand sanitizers in the control of spread might be important reasons for
this finding. This is consistent with the findings of a study which revealed that about half of the
respondents often used alcohol-based hand sanitizer.14
This study also revealed that 85% of the respondents supported social distancing even after getting
vaccinated against COVID-19 infection, while a few of the respondents (5.7%) did not think social
distancing in public settings was of any importance once a person had received the vaccine.
A large percentage of the participants (74.9%) in this study, when asked if they had in recent days,
gone to any crowded place, replied with ‘occasionally.’ This finding showed that they had
neglected the importance of avoiding crowded in the spread of COVID-19 virus. A similar study
revealed that 53.7% avoid going out of the house without justifiable cause.14
This study revealed that 71.2% of the respondent always wore face masks when in contact with
patients. This is important because it protects both the students and the patients, and reduces the
overall spread of the virus. Findings from another study was consistent with this, which revealed
that health practitioners wore facemasks while taking care of patients.15,14
Hand washing was also an important finding in this study, as just a little above half of the (50.5%)
of the respondents practiced good hand hygiene after handling a patient. This could be due to the
knowledge about the importance of hand washing in the spread of COVID-19 infection. This is in
line with a study which showed hand washing as a dominant practice in limiting the spread of the
virus.17 Findings from another study among healthcare professionals, revealed that 93% of them
practiced good hand hygiene, including hand washing for the prevention of the spread of COVID-
19 infection.2
71
In this study, 54.5% of the respondents had occasionally avoided patients with signs and symptoms
of COVID-19 infection. This could be attributed to the fact that some COVID-19 signs and
symptoms may be non-specific, and students may be unknowingly exposed to patients with
COVID-19. This is contrary to a study which revealed that 86.11% would stop going to work and
confine themselves if they came in contact with a COVID-19 positive/suspected person.1
Majority of the participants (54.5%) in this study, occasionally avoided unnecessary vacations to
prevent contracting and spreading COVID-19 infection, while about half of the respondents
(56.5%) avoided public transportation to limit the spread and contracting of COVID-19). This
could be attributed to the fact that they might have been informed of the importance of social
distancing and avoiding crowded places, especially places without COVID-19 restrictions.
This study revealed that 65.2% of the respondents avoided physical contacts with other humans,
such as kissing, hugging and handshaking. This can be attributed to the fact that medical students
are informed of the importance of limiting physical contact with people as much as possible. This
is in line with a study which revealed avoidance of handshaking as a major COVID-19 preventive
practice.17
Since the onset of the COVID-19 pandemic, a lot of personal changes have taken place., Findings
from this study, revealed that 61.6% of the respondents seemed to pay more attention to their
personal hygiene than usual to prevent contracting or spreading COVID-19. This is consistent with
the findings of another study, which revealed that the practice of personal hygiene among the
respondents was very important, as they washed fruits and vegetables before consumption,,
sanitized surfaces, and took precautions when purchasing these items.14
72
Findings from this study, revealed that about half (50.5%) of the respondents occasionally used
disinfectants to prevent contracting and spreading COVID-19. This is consistent with the findings
of a similar study.15
When the respondents in this study were asked if they used herbal products and traditional
medicine to prevent the contraction and spread of COVID-19, most (80.3%) responded with
‘never.’ In the same vein, 46.8% of respondents never took vitamin supplements to prevent
contracting and spreading COVID-19 infection. Findings from a study conducted in Saudi Arabia
contrasted this and revealed that about 22.1% of the respondents used herbal medications and
nutritional supplements to protect themselves from the disease.18
5.8 CONCLUSION
The study found that the knowledge and attitude among the medical students of Bingham
University ranged from ‘fairly-good’ to ‘good,’ but preventive practices to COVID-19 and
COVID-19 vaccination practices were poor.
5.9 RECOMMENDATION
The University authority of Bingham University should do more to properly educate its students
to:
1. Ensure adherence to standard preventive measures against COVID-19 infection
adequately and appropriately
73
2. Get completely vaccinated against COVID-19 infection.
3. Encourage other students about the benefits of getting vaccinated and adhering to
preventive measures.
4. Encourage family members and friends to get vaccinated against COVID-19
infection, and practice preventive measures.
5. Educate the students on the safety and efficacy of the vaccines, and the approved
types in Nigeria.
74
INDEX
6.1 REFERENCES
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Pandemics of the Last Four Decades: Pathophysiology, Health Impacts and Perspectives.
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doi: 10.3390/ijerph17249411
2. World Health Organization (WHO), South-East Asia Region, Western Pacific Region.
Asia Pacific strategy for emerging diseases: 2010. New Delhi: WHO-SEARO; Manila:
WHO-WPRO, 2011. (Available at: http://www.wpro.who.int/emerging_diseases
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3. Wolfe ND, Dunavan CP, Diamond J. Origins of major human infectious diseases. Nature.
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species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV
and naming it SARS-CoV-2. Nature Microbiology.2020; 5 (4): 536–
544. doi:10.1038/s41564-020-0695-z. PMC 7095448. PMID 32123347
5. Worldometer. Countries where COVID-19 Has Spread. (Available at:
https://www.worldometers.info/coronavirus/countries-where-coronavirus-has-spread/, published
2021 Feb 13 – accessed 3 June2021)
6. Nigeria Centre for Disease Control (NCDC). COVID-19 Nigeria. (Available at:
https://covid19.ncdc.gov.ng, published 3 June 2021 - accessed 3 June 2021)
7. Centers for Disease Control and Prevention (CDC). COVID-19 and Animals. (Available at:
https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/animals.html, published 3 June
2021 - accessed 3 June 2021)
75
8. Centers for Disease Control and Prevention (CDC). Ending Isolation (Available
at:https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html, published 13
February 2021 - accessed 3 June 2021)
9. Alhazzani W, Moller MH, Arabi YM, Loeb M, Gong MN, Fan E, et al. Surviving Sepsis
Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus
Disease 2019 (COVID-19). Crit Care Med. 2020; 46: 854 – 887. doi.org/10.1007/s00134-
020-06022-5
10. World Health Organization (WHO). Clinical management of COVID-19 (Interim
Guidance) (Available at: https://www.who.int/publications-detail/clinical-management-of-
covid-19, published 27 May 2020 - accessed3 June 2021)
11. Islam MS, Siddique AB, Akter R et al2021. Knowledge, attitudes and perceptions
towards COVID-19 vaccinations: a cross-sectional community survey in Bangladesh.
MedRxiv. 2020 February. (Available at https://doi.org/10.1101/2021.02.16.21251802,
published 20February 2021 - accessed 3 June 2021)
12. Global Pandemicity of COVID-19: Situation Report as of June 9, 2020Adekunle Sanyaolu,
ChukuOkorie, ZaheedaHosein, RishaPatidar, Priyank Desai, Stephanie Prakash,
UroojJaferi, Jasmine Mangat and Aleksandra Marinkovic. Received: May 8, 2020.
Accepted: June 16, 2020.
13. WHO. Novel coronavirus (2019-nCoV) situation reports—30. World Health Organization.
2020. Accessed June, 2020.[ Available at: https://www.who.int/docs/ default
source/coronaviruse/situation-reports/20200130-sitrep-10-ncov.pdf?sfvrsn=d0b2e480_2]
14. COVID‑19 Pandemic: A Global Health Burden. OluwatosinWuraolaAkande,
TanimolaMakanjuolaAkande. Department of Epidemiology and Community Health,
76
University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria Received: 18-05-2020,
Revised: 19-06-2020, Accepted: 21-06-2020, Published: 17-07-2020
15. Case Fatality Rate [Available at: en.m.wikipedia.org/wiki/Case_fatality_rate]
16. In Sub-Saharan Africa, about three quarters of the population don’t have access to basic
hygiene facilities at home. JMP, UNICEF, WHO, Progress on household drinking water,
sanitation and hygiene, 2000-2017.
17. Article on Risk of rising death toll in West Africa: COVID-19 meets hunger. Published 2nd
April 2020.
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6.2 INFORMED CONSENT
Dear Respondent,
We are 600 level undergraduate medical students of Bingham University, conducting a research
in this institution on; ‘’KNOWLEDGE, ATTITUDE AND PRACTICE OF COVID-19
VACCINATION AMONG MEDICAL STUDENTS IN BINGHAM UNIVERSITY
TEACHING HOSPITAL’’ for the award of degree of Bachelor of Medicine, Bachelor of
Surgery (MBBS). We will appreciate your participation in the research by kindly completing the
questionnaire.
CONFIDENTIALITY; any information provided by you will be kept confidential and will only
be used for the purpose of this study.
BENEFITS; There is no direct benefit to participants, but this study will ascertain the knowledge,
attitude and practices of COVID-19 vaccination among medical students of Bingham University
Teaching Hospital.
RISKS; no invasive procedures, and no sample will be obtained from you as part of this study.
VOLUNTARISM; participation in this study is voluntary and you are free to withdraw from the
study if you wish at any time without any penalty.
CONTACT INFORMATION; if you have any question about the study or your participation in
the study you can contact the leader of the team of researchers, LUKA Nehemiah (08101182415,
lukanehemiah@gmail.com).
I confirm that the above study has been explained to me. I agree to participate in the study
Interviewee’s signature…………………… Date…………
90
6.3 QUESTIONNAIRE
SECTION A: SOCIO-DEMOGRAPHIC CHARACTERISTICS OF PARTICIPANTS
(N/B; respondents to please check ( ) where appropriate
1. What is your gender?

a) Male ( )
b) Female ( )
2. What is your religion?
a) Christian ( )
b) Muslim ( )
c) Others ( )
3. What is your age as of last birthday?..................................
4. Marital status
a) Single ( )
b) Married ( )
5. What is your batch? ………………
6. What is your tribe?
a) Hausa ( )
b) Yoruba ( )
c) Igbo ( )
d) Igala ( )
e) Tangale ( )
f) Others …………………………….
7. Have you taken the COVID-19 vaccine?

a) Yes ()
b) No ()
8. If yes, how many doses?............................................
91
SECTION B: KNOWLEDGE OF COVID-19
AWARENESS OF AND SOURCE OF INFORMATION FOR COVID-19 INFECTION
9. Are you aware of COVID-19 virus?

a) Yes ( )
b) No ( )
10. What is/are your sources of information regarding COVID-19 virus? Please check as
many as appropriate.
a) Official international health organisation sites and media e.g.
i. WHO, CDC. ( )
b) Official government sites and media e.g. Ministry of Health-Nigeria. ( )merge a and
b
c) News Media e.g. TVs, radios, Magazines, Newspapers ( )
d) Social Media e.g. WhatsApp, Facebook, Twitter, Instagram ( ) merge c and d
e) Journals ( )
f) School ( )
g) Churches ( )
h) Health facilities ( )
i) Others…………………….
MODE OF TRANSMISSION
11. Please check as appropriate.
TRUE FALSE I DON’T KNOW
(11.1) Eating or contacting wild animals would result in
infection by the COVID-19 virus
(11.2) Persons with COVID-19 cannot transmit the virus
to others when a fever is not present
(11.3) The COVID-19 virus spreads via respiratory
droplets of infected individuals
SIGNS AND SYMPTOMS
12. What are the symptoms of COVID-19 infection that you know?
(check as many as appropriate).
4. Fever ( )
5. Cough ( )
92
6. Difficulty breathing ( )
7. Fatigue ( )
8. Loss of smell ( )
9. Loss of taste ( )
10. Sneezing ( )
11. Running nose ( )
12. Sore throat ( )
13. Diarrhea ( )
14. Abdominal pain ( )
15. Headache ( )
16. Body weakness ( )
17. Body pain ( )
18. Others…………………………………………
PREVENTIVE PRACTICES
13. COVID-19 can be prevented by

(check as many as appropriate)
a) Vaccination ( )
b) Hand hygiene ( )
c) Drinking hot moringa brew ( )
d) Wearing face mask ( )
e) Physical distancing of at least 1-2 meters ( )
f) Drinking alcohol ( )
g) Eating garlic ( )
h) Others.......................................................
93
Management of COVID - 19
14. Choose which treatment options you think apply to COVID-19 infection management
STRONGLY AGREE UNDECIDED DISAGREE STRONGLY
AGREE DISAGREE
(14.1)
Supplemental
oxygen
(14.2)
Corticosteroids
(14.3) Remdesivir
(14.4)
Antipyretics
(14.5) Broad
spectrum
Antibiotics
(14.6)
Conservative fluid
management
(14.7) Ginger and
garlic brew
(14.8) Antiviral
drugs
(14.9)
Chloroquine or
hydroxychloroqui
ne ± Azithromycin
SECTION C: KNOWLEDGE OF COVID-19 VACCINE
15. Are you aware of COVID-19 vaccines?
94
a) Yes ( )
b) No ( )
16. How many types of COVID-19 vaccines do you know?..........
17. Check appropriately, the type(s) of COVID-19 vaccines you know
a) May & Baker ( )
b) Oxford/AstraZeneca ( )
c) Pfizer/BioNTech ( )
d) Nirsal ( )
e) Janssen (Johnson & Johnson) ( )
f) Posterivid ( )
18. To what extent do these sources of information influence your opinion regarding
vaccination?
SOURCE OF INSIGNIFICANT SLIGHTLY VERY

INFORMATION SIGNIFICANT SIGNIFICANT
(18.1) News
from national
TV/radio
(18.2)
Government
agencies
(18.3) Social
media
(Facebook,
Instagram,
Whatsapp, etc)
(18.4)
Discussion
amongst friends
and family
95
(18.5)
Healthcare
Provider
19. In your opinion, are the COVID-19 vaccines safe?

a) Yes ( )
b) No ( )
20. If no, what are your reasons? Check as many as appropriate.
a) The vaccine manufacturing process was rushed ( )
b) It has serious adverse effects ( )
c) It is a bio-weapon ( )
d) It was not properly tested ( )
e) Nigeria's government is using the COVID-19 vaccine to reduce its population. ( )
f) There are microchips in the COVID-19 vaccine that allow people to be controlled. ( )
g) The COVID-19 Vaccine can cause infertility. ( )
h) Others…………………………………….
21. Who is eligible to receive the COVID-19 vaccine in Nigeria?

GROUP ELIGIBLE NOT DON’T
ELIGIBLE KNOW
(21.1) Infant <1 year

of age
(21.2) Children and
adolescents <18 years
of age
(21.3) Adults ≥18
years
(21.4) Pregnant ladies
and lactating mothers
(21.5) Patients with
chronic diseases like
diabetes,
96
hypertension and
heart diseases
(21.6) Persons having
an active COVID-19
infection
(21.7) Persons
recovered from
COVID-19 infection
(21.8) Persons
allergic to food
items/drugs
(21.9)
Immunocompromised
patients
(21.10) Health
workers
22. How are the vaccines given?

a) Intramuscular injection ( )
b) Intravenous injection ( )
c) Intrathecal injection ( )
d) Subcutaneous injection ( )
e) Intradermal injection ( )
f) Oral drop ( )
g) Other ( )
23. In Nigeria, what dose(s) is/are sufficient to achieve protective immunity against
COVID-19 infection?
a) 1 shot ( )
b) 2 shots ( )
c) Don’t know ( )
24. Do the vaccines have adverse effects?
a) Yes ( )
97
b) No ( )
25. If yes, check the appropriate adverse effects that apply.
a) Pain/redness of injection site ( )
b) Swelling of injection site ( )
c) Headache ( )
d) Fever ( )
e) Nausea ( )
f) Muscle ache ( )
g) Anaphylaxis ( )
h) Weakness ( )
i) Infertility ( )
j) Death ( )
k) Others…………………………
ATTITUDE TOWARDS THE COVID-19 VACCINE
check as appropriate:
S/N STRONGLY AGREE UNDECIDED DISAGREE STRONGLY

AGREE DISAGREE.
26. COVID-19
vaccination can stop
the spread of the
COVID-19 infection
27. COVID-19
vaccine is safe and
should be accepted
28. Everyone eligible

should be vaccinated
98
29. Young people
don't need to take the
vaccine
30. COVID-19
vaccine is not safe
and should not be
accepted
31. When an
opportunity presents
itself, I will take the
COVID-19 vaccine.
32. I will prefer to

acquire immunity
against COVID-19
naturally (by having
the disease or
subclinical
infection)
FACTORS THAT FACILITATE COVID-19 VACCINE ACCEPTANCE
33. Certain factors have motivated your choice to accept the COVID-19 vaccine either in the
past or future. Please check as appropriate.
I have taken/will STRONGLY AGREE UNDECIDED DISAGREE STRONGLY

take the COVID- AGREE DISAGREE
19 vaccine
because
(33.1) I think
there is no harm
99
in taking the
COVID-19
vaccine
(33.2) I believe
COVID-19
vaccine will be
useful in
protecting me
from COVID-19
infection
(33.3) COVID-19
vaccine is
available free of
charge
(33.4) My
healthcare
professional has
recommended it
to me
(33.5) I feel the

benefits of taking
the vaccine
outweigh the risks
(33.6) I believe
taking the vaccine
is a social
responsibility
(33.7) There is
sufficient data
released regarding
the vaccine’s
100
safety and
efficacy
(33.8) My people
are taking the
COVID-19
vaccine
(33.9) My role
models/political
leaders/senior
doctors/scientists
have taken the
vaccine
FACTORS THAT HINDER COVID-19 ACCEPTANCE
34. What reasons may hinder you from accepting the COVID-19 vaccines?
I am STRONGLY AGREE UNDECIDED DISAGREE STRONGLY

concerned AGREE DISAGREE
that:
(34.1)
COVID-19
vaccine might
not be easily
available to
me
(34.2) I might
have
immediate
serious side
effects after
taking
101
COVID-19
vaccine
(34.3)
COVID-19
vaccine may
be faulty or
fake
(34.4)
COVID-19
vaccine was
rapidly
developed and
approved
(34.5) I might
have some
unforeseen
future effects
of the COVID-
19 vaccine
(34.6)
COVID-19
vaccine is
being
promoted for
commercial
gains of
pharmaceutical
companies
102
SECTION D: PREVENTIVE PRACTICES
STRONGLY AGREE UNDECIDED DISAGREE STRONGLY
AGREE DISAGREE
35. After
getting
vaccinated, I
don’t need to
wear a mask.
36. I don't
need to get
complete
doses of the
COVID-19
vaccine to be
fully
immunized.
37. After
getting
vaccinated, I
don't need to
use hand
sanitizers.
38. After
getting
vaccinated, I
don't need to
socially
distance
myself in
public.
ALWAYS OCCASIONALLY NEVER
39. In recent days, have

you gone to any
crowded places?

you worn a face mask
when in contact with
patients?
you washed your hands
103
before and after
handling a patient?

you avoided patients
with signs and
symptoms suggestive of
COVID-19?
43. Do you avoid
unnecessary vacations
to prevent contracting
and spreading COVID-
19?
44. Do you avoid

public transportations
(taxi, bus, plane, train,
etc.) to prevent
contracting and
spreading COVID-19?
45. Do you avoid

handshaking, hugging
and kissing to prevent
contracting and
spreading COVID-19?
46. Do you pay more

attention to your
personal hygiene than
usual to prevent
contracting and
spreading COVID-19?
47. Do you use

disinfectant to prevent
contracting and
spreading COVID-19?
48. Do you use herbal

products and traditional
medicine to prevent
contracting and
spreading COVID-19?
49. Do you take

vitamin supplements to
104
prevent contracting and
spreading COVID-19?
105
6.4 ETHICAL CLEARANCE REQUEST LETTER
C
/o Department of Community Medicine and PHC
Faculty of Clinical Sciences,
College of Medicine and Health Sciences,
Bingham University
BHUTH Jos Campus, Jos
Plateau State
30th August 2020.
The Chairman,
Health Research and Ethics Committee,
Bingham University Teaching Hospital,
Jos, Plateau State
bhuthrec@gmail.com or askattah@yahoo.com
08032977949
Through: Dr Sunday Asuke (Project Supervisor)
Dear Sir,
REQUEST FOR ETHICAL REVIEW AND CLEARANCE FOR PROPOSED RESEARCH
We humbly write to request for ethical review and clearance to conduct this research:
MEDICAL STUDENTS OF BINGHAM UNIVERSITY TEACHING HOSPITAL This study is
a requirement for the award of MBBS Degree of Bingham University and will be carried out
among students of 400, 500 and 600 level of Bingham University, domiciled in Bingham
University Teaching Hospital, Jos North LGA of Plateau State. In line with requirements for this
review and provision of clearance, this application is accompanied with:
 Research proposal
 Questionnaire
 Consent for study participants as reflected in the first part of accompanying questionnaire.
There will be no invasive procedures that will expose study participants to any bodily harm, and
confidentiality of information to be collected from participants will be guaranteed through non
indication of identities of participants. The study is proposed to cover a period of four (4) weeks
We look forward to the Committee’s favorable response.
Thank you
Researchers:
KOLAJO, Boluwatiwi John BHU/14/01/03/0003 ………………………………………
LUKA, Nehemiah BHU/13/01/01/0098 ………...…………………………….
TENEBE, Mary-Clara Adesua BHU/14/01/01/0094 ………...…………………………….
106
6.5 ETHICS COMMITTEE CLEARANCE LETTER
107

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KNOWLEDGE, ATTITUDE AND PRACTICE OF COVID-19 VACCINATION AMONG

MEDICAL STUDENTS OF BINGHAM UNIVERSITY TEACHING HOSPITAL

TENEBE, MARY-CLARA ADESUA

KOLAJO, BOLUWATIWI JOHN

MEDICAL STUDENTS OF BINGHAM UNIVERSITY TEACHING HOSPITAL

LUKA, NEHEMIAH BHU/13/01/01/0098

TENEBE, MARY-CLARA ADESUA BHU/14/01/01/0094

KOLAJO, BOLUWATIWI JOHN BHU/14/01/03/0003

“SUBMITTED TO THE DEPARTMENT OF COMMUNITY MEDICINE, AND

PRIMARY HEALTH CARE, COLLEGE OF MEDICINE AND HEALTH

BINGHAM UNIVERSITY, NEW KARU, NASARAWA STATE, IN PARTIAL

FULFILMENT OF THE AWARD OF BACHELOR OF MEDICINE, BACHELOR

OF SURGERY (MBBS) OF BINGHAM UNIVERSITY”

University, New Karu, Nasarawa State, Nigeria.

31st January 2022

Dr. Sunday Asuke Date

Dr Oguntunde O. Olugbenga. Date

Degree, Bingham University, New Karu, Nasarawa State, Nigeria.

KOLAJO BOLUWATIWI JOHN DATE

LUKA NEHEMIAH DATE

TENEBE MARY-CLARA ADESUA DATE

dedicate this work to them for the chance given to us to fly.

through our academic pursuit.

Care, for ensuring we had a fruitful experience.

University, for their contributions towards our medical training.

the University, for providing an enabling environment of study.

life. A big thank you goes to our siblings, we love you.

TABLE 2A: Knowledge of COVID-19 vaccine by the participants ............................................ 25

TABLE 2B: Knowledge of COVID-19 vaccine by the participants……………………………26

TABLE 2C: Knowledge of COVID-19 vaccine by the participants……………...……….…….30

University Teaching Hospital. .................................................................................................................... 33

Figure 1: Symptoms of COVID-19 infection as reported by the respondents in Bingham

Government Area, Plateau State, Nigeria.

against dependent variables using a chi-square test at p less than 0.05.

participants came from minority tribes (47.8%)

knowing at least 3 vaccine types.

were immediate adverse effects associated with COVID-19 vaccines.

had a poor COVID-19 preventive practices.

COVID-19 preventive practices.

Keywords: COVID-19, Vaccination, Knowledge, Attitude, Practice

Coronavirus which emerged in China I 2019. [1]

have originated from animals. [2]

spillover events). [3]

recorded 166,560 positive cases of COVID-19 and 2099 deaths.[6]

with the Novel Coronavirus. [7]

generating procedures must be done with adequate protection and precautions.

conditions such as diabetes and kidney failure. [9]

community acceptance of COVID-19 vaccination is important with the worldwide distribution of

vaccines underway. A proportion of the Bangladeshi population is found to be hesitant about

vaccinate the vulnerable group of people as soon as possible. [11]

1.2 PROBLEM STATEMENT

declined because of the COVID-19 epidemic [17].

perceived vaccine efficacy could be relatively low[18].

Understanding vaccine acceptance is as important as the production of the vaccine itself,

safety, importance, effectiveness, and religious compatibility of vaccines health. [23]

conditions, such as hypertension, diabetes mellitus, renal diseases, chronic obstructive

illness, making it easier to transmit the virus across population groups.[23]

concern to the world.

Primary Health Care Development Agency (NPHCDA), vaccination in Nigeria began on 5

COVID-19 vaccination among Medical Students of Nigerian Universities in this geographical

of COVID-19 vaccination, among Medical Students of Bingham University Teaching Hospital

(BhUTH) Jos Plateau State Nigeria.

Students of Bingham University Teaching Hospital (BhUTH).