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Attitudes towards covid-19 Vaccine Among general public in the Eastern Region, KSA

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Acknowledgement

I am thankful to Allah for his infinite mercy upon me to the successful completion of

the writing of this project proposal. May peace and blessings of Allah be upon his prophet

Mohammed

I equally would love to thank ……… who is our director of the Prince Sultan

Military college of health sciences for continuously providing us with support that we need to

do this graduation project. I would equally love to thank the head of the Nursing department,

…, for the encouragement she/he continuously provided us with until this very moment. I

would in a special way want to thank our supervisor for being my source of inspiration. It is

really great honor and pleasure working with her. I equally thank my family as they give me

motivation to always be the best. I thank all my lecturers, my student colleagues, the clinical

instructors and all the individuals who have in one way or another contributed to my success

thus far.

Abstract

The Coronavirus disease, covid-19, which is primarily referred to as the SARS-COV-

2 is a disease that attacked the world. The disease was first discovered in Wuhan province in

China after cases of Pneumonia related symptoms were reported. The disease has been a

threat ever since and the different world health organizations across the world are trying their

best to cab the effects of the disease. The continued Covid spread necessitated the invention

of ways to manage it and one of the ways that further and future spread could be managed

was by the use of the Covid-19 vaccine. As the disease spread all over the world the vaccines

were developed having different rates of effectiveness to fight against the further spread of

the disease. The vaccine administration has however been met with various levels of

acceptance with individuals having different attitudes towards its administration. In the

Eastern province KSA of Saudi Arabia. The general public in the Eastern region have had
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different opinions on receiving the Covid jab which is generally a stumbling block towards

the achievement of a healthy nation. This study therefore targets to investigate the different

attitudes individuals have towards the administration of the Covid vaccines. The study would

involve a sample from the general population. A random sample of 1025 individuals would

be selected from the Eastern Region, KSA. The research design would be quantitative where

questionnaires would be administered to the select sample and answers collected. The

collected data will then be analyzed by the use of the identified statistical analysis tools

which would be SPSS. The research would highly observe the ethics of research. The ethical

issues regarding the participants consent and privacy would be highly respected and

anonymity exercised.

Chapter one: Introduction

Background of study

Severe Acute Respiratory Syndrome Coronavirus - 2 (SARS-CoV-2) pandemic is

equally referred to as the Covid-19. It is a respiratory infection that is characterized by

difficulty in breathing. The disease’s most common symptoms include; fever, cough,

tiredness, and the loss of sense of taste and sense of smell. The disease affects different

people in different ways. The most infected individuals generally develop mild to moderate

illnesses and generally manage to recover without necessarily being hospitalized. However

the disease presents some very serious symptoms in other people. These symptoms include;

sore throat, headache, aches and pains, diarrhea, a rash on the skin or generally being

discolored in the fingers and the toes and equally there is the likelihood of a red or irrigated

eyes. Individuals experiencing such symptoms are advised to visit the healthcare institution

before the conditions grow any worse (Ward et al., 2020). Chronic conditions of the virus

represent as difficulties in breathing with patients helped with the use of machines in
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breathing. The machine assisted breathing is the last step to undertake when patients present

issues in breathing with certain drugs recommended to manage the conditions. The

Coronavirus disease isn’t treatable, it is a viral infection and therefore it doesn’t have a

certain medication, the only solution for medics is the use of drugs that treat the symptoms

such as pain killers for severe headaches. Ultimately the evolving nature of the viral

infections make it quite hard to be able to establish a sudden medicine for a viral infection

such as the covid-19 infection.

The issues with developing a certain drug to manage the viral infection, Covid, called

for the development of vaccines that would help manage and control the infection rates

across the world. A vaccine refers to a biological preparation which generally does provide

an active acquired immunity to a given infectious disease (Shekhar et al., 2021). Vaccines

contain agents which generally look like the disease causing micro-organism and is often

made from the weakened or maybe the killed forms of the disease i.e. the microbe, its toxins

or one of the disease’s surface proteins to be prevented against. Vaccines therefore are there

to generally help against the onset of diseases. They help prevent infections by making the

body be able to fight an infection as the body’s immune system has already interacted with

such a microbe. The Covid-19’s only prevention procedure was therefore by the use of the

Covid vaccine. The world health organization and other health related organizations from all

over the world hastened the discovery of a vaccine that could most likely be able to control

the spread of the disease.

The covid-19 numbers up to the current date continue soaring with the world numbers

being a total of infected people close to 521 million individuals and deaths close to 6.26

million deaths. The number in Saudi Arabia stand at 759, 000 infected individuals with 9,116

deaths generally. The numbers slowed down with the use of the Coronavirus vaccines. The

covid-19 pandemic has caused a generally unimaginable harm to the general population in
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the Easter region, KSA. Covid-19 harmed the economy, led to unimaginable business losses

and even affected people’s health and wellbeing in terms of mental health and general health.

In this situation therefore the development of vaccines was very effective to help manage the

spread of the infectious disease (Sherman et al., 2021). The use of vaccines therefore

provided hope as it presented a decisive moment to help curb the spread and ensure the

resumption to the ordinary life. In the process of making vaccines, there was a representation

of close to 330 candidates of vaccines that were subjected to clinical testing and evaluation.

Out of all these numbers of vaccines, there were different rates of efficacy as earlier

determined by the trials.

The different well known vaccines that were authorized to be administered by the

world health agencies included the AstraZeneca vaccine which is an Oxford vaccine that

aims at protecting against Covid-19. Its efficacy of the vaccine was rated at 63%based on the

data provided by the manufacturer and based on the clinical trials conducted. The other

vaccine was the morderna vaccine, Moderna, Cambridge, MA, USA, which was rated as

94.1% effective for the Covid-19 infections (Praveen et al., 2021). Additionally the other

vaccine that was used in vaccination and is still being used was the Pfizer vaccine, Pfizer–

Biotech, Manhattan, NY, USA, with an efficacy of close to 95% which was considered

highly effective. The remaining mostly used vaccine that was applied in most nations was the

Johnson and Johnson vaccine, Johnson & Johnson–Janssen, Beerse, Belgium, and it was

rated 76.7% as by the data submitted by its developer. These vaccines were in the frontline

and most recommended in the management of the corona illness. The World health

organization authorized the use of these vaccines with different sets of side effects expected

while using them. The use of vaccines wasn’t however welcomed with the general population

worldwide easily as it wasn’t in the Eastern province, KSA. Most individuals presented

dissatisfaction in the use of the covid-19 vaccines due to many different reasons.
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The general vaccine hesitance that is followed by general reluctance to take the

vaccine or particularly refusal to take the vaccine despite the availability has been presented

as a major threat to the effectiveness of the vaccination programs. It drags the world behind

as the covid-19 disease is a world problem and was even declared as a pandemic. There is

therefore a very great debate and discussion regarding the approval and administration of the

coivid-19 vaccines. In a study conducted in both Turkey and the United Kingdom, the results

indicated that every one in every three people were quite unsure about receiving the vaccine

(Sherman et al., 2021). These individuals had different perceptions and attitudes towards the

administration of the vaccine.

The background, statement of the problem

The issuance of the Covid-19 vaccine is only meant to help and target at achieving a

healthy nation. The acceptance of the vaccine in the Eastern region KSA wasn’t as positive as

it was generally in the whole world. The vaccination against the covid-19 infection is targeted

at minimization of illnesses, hospitalizations, and even deaths due to the Covid-19 illness. to

make sure the Covid-19 infections are managed the government in compliance with the

healthcare agencies all over the world successfully came up with the health preventative

measures such as wearing of masks, exercising the one meter distance against each other i.e.

social distancing and effectively being able to report any cases or visiting a healthcare facility

when noticing any form of Corona related symptoms. These healthcare procedures were

effective even when the vaccination programs were launched as ways to be able to protect the

young and vulnerable against the disease. The vaccination programs accepted individuals

such as the pregnant and breastfeeding mothers, the young children below the age of ten

years, anyone with any complicated illnesses and the individuals who the vaccine was less

effective such as the individuals who were immunocompromised. All the other individuals

were liable to receiving a vaccine.

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The vaccine uptake is a very serious concern in the achievement of a long term

management of Covid-19. To this date close to only 17% of the whole world population have

been vaccinated with only 5% of the nation’s population facing the jab. The Eastern

province, KSA has equally been able to vaccinate some of its members but has been met with

a general resistance. The rates of vaccine uptake and supply were accelerated globally to be

able to enhance the general protection against the disease Covid-19. Vaccine hesitancy and

the general attitude towards the administration of Covid-19 is a major determinant towards

the vaccine uptake rates in the major population (Rzymski et al., 2021). The general attitude

towards administration of the Covid-19 vaccines is vague and hasn’t been welcomed with

excitement. Reluctance to receive vaccines is a dynamic well understood by researchers and

establish reasons as to why individuals generally hesitate to be vaccinated. The vaccine

hesitancy refers to a reduced confidence in vaccines that generally results in the refusal of or

generally the delay in the acceptance of administration of the vaccine.

Vaccine hesitancy and confidence are very complex factors in consideration and can

always be measured and determined by various determinants as identified by the strategic

advisory group of experts on immunization working group on the vaccine hesitancy issues.

The vaccine hesitancy issues are generally grouped into three major categories which are; the

contextual socio-political-cultural factors, the individual and group influences and the

vaccine specific factors (Sherman et al., 2021). Generally, the administration of the Covid-19

vaccines worldwide have been met with general resistance from the populations. Individuals

have many reasons regarding the use of these vaccines and whether they should be

administered to them.

There are different reasons against vaccination in general answering the question on

why the rates of vaccination across nations and in the Eastern Region KSA has generally

been low. To start with there are different reasons different countries are considering the use
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of the vaccine. Vaccine hesitance to date accounts of the major population and their regard

towards vaccination. The world health organization advised the different nations to be sure to

take the proactive responses towards the vaccine hesitancy based on the behavioral and social

insights. The attitude towards the reception of the coronavirus vaccine is therefore dull and

many people haven’t received it well. Some individuals have always argued towards

achieving of the herd immunity. Herd immunity is a type of immunity that’s a product of

several factors which include; the infectivity of the coronavirus, the effectiveness of the

vaccine and the given percentage of the population that will be vaccinated. Herd immunity is

a type of immunity that is achieved when the large portion of the population becomes

immune to a disease (Rzymski et al., 2021). The genera; spread of the disease therefore

becomes highly unlikely in the case that herd immunity is achieved. Some individuals

therefore bank on the herd immunity factor and count themselves as the select few who

wouldn’t be vaccinated to achieve herd immunity. Scientists however rated the chances of

achieving herd immunity with the consideration of Covid-19 and rated the chances as the

achievement of 67% immunity among the general population. It would therefore ensure that

the population achieves herd immunity.

The other consideration as to why the reception of the vaccines is so poor is because

people never trusted the general vaccine production process. People have a low attitude and

term the vaccines as poison as the time they took for production were very limited for a

normal medical research (Feleszko et al., 2021). The myths and misconceptions that

surrounded the vaccines were high and they spread across the world. People attributed the

vaccine administration process as being a hoax and therefore a perception was formed against

the general process which made people not to generally participate. Another consideration

regarding the low turnout in vaccine administration was due to the fact that many people

created fear and have fear towards vaccines. The case that one or two people die after the
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administration of a vaccine makes the other population generally fearful of the aftermath of

receiving the vaccines. A good number of individuals attribute their resistance towards the

administration of the Covd-19 vaccine towards the side effects that could possibly be

experienced after they receive these vaccines. The different vaccines have highlighted the

possible issues that could arise when vaccines are administered to a certain individual.

Headaches and general tiredness including nausea and loss of appetite being the major issues

as observed among many individuals. These side effects scare off people as other individuals

have been hospitalized after receding the Covid-19 vaccine. The administration of the

vaccine is therefore an issue towards the general population with the general attitude towards

receiving vaccines being negative.

Objectives of the study

The study generally aims at establishing the attitudes towards covid-19 among the

general public of the Eastern Region, KSA.

Specific objectives

1. To establish the general effects of the Covid-19 vaccination towards the general

public of the Eastern Region

2. To establish the general perceptions towards the administration of the Covid-19

vaccine in the general Eastern province region, KSA.

3. To establish the myths and misconceptions in the general public against the

administration of the Covid-19 vaccine in the Eastern region, KSA.

4. To find out the ways towards raising the attitudes towards the Covid-19 vaccine in the

general republic in the Eastern region, KSA.

Operational definitions

Covid-19 – Corona-virus disease, it’s an infectious disease that’s caused by SARS-CoV-2.

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Symptoms- A physical or mental feature that’s is generally regarded as indicating a condition

of a disease for instance a feature apparent to a patient

Vaccine – a biological preparation which generally provides the active acquired immunity to

a given infectious disease. It typically has an agent which resembles the disease causing

micro-organism and is often made from the weakened or killed forms of the microbe

Vaccination- the art of receiving a vaccine

Attitudes – A psychological construct i.e. a mental and emotional entity which inheres in or

does characterize a given individual. They are complex and generally can be an acquired state

through experience.

Hypothesis

H0: the general population of the eastern region, KSA, have a positive attitude

towards the administration of the Covid-19 vaccine

H1: the general population in the Eastern region, KSA, has a negative attitude towards

the administration of the covid-19 vaccine.

Chapter two: Literature review

Introduction

This section of the study seeks to address the different studies conducted regarding

the topic. The topic of this study aimed at establishing the attitudes there are towards the

covid-19 vaccination among the general public in the Eastern region, KSA. A review of the

existing technology is very crucial as it helps in the general comparison of the related

literature in handling a particular research. Covid-19 pandemic is a pandemic that took place

recently and not so much research has been done but many scholars have come forwards to

present their researches regarding the illness.

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The attitudes towards vaccination

Individuals have very varied reasons regarding vaccine usage. Because SARS-CoV-2

is a highly contagious virus that affects populations all over the world, vaccines are the most

significant public health intervention and the most effective technique for protecting the

population from COVID-19. The race to produce a COVID-19 vaccine to prevent the

disease's spread and disastrous consequences is still on. Fears of fresh strains of SARS-CoV-

2 emerging, as well as concerns about fading protection after doses of COVID-19

vaccination, have added to the pandemic's global uncertainty. Some new SARS-CoV-2

strains have shown the potential to cause major sickness and death, a concern that has been

mitigated by guaranteeing population vaccination coverage (Verger et al., 2021). Despite this,

immunization coverage in some communities remains inadequate. As a result, as much as

guaranteeing vaccination availability, understanding and working on the factors that

influence vaccine uptake can be considered a priority for public health. The covid-19

hesitancy has been peddled by many reasons with the major reason being the process of

making the vaccine.

According to, the vaccine formation process involves the clinical trial stage where

most individuals regard as very compromised in the development of the Covid-19 vaccine.

Generally the clinical trial phase involves; three phases. They are governed by a very strict

set of regulations. Every research programmer presented is periodically reviewed by the

relevant authorities including the GSK, the global safety board. The first phase in vaccine

development involves being given to a small number of healthy volunteers. In some cases

however, when the vaccines are being tested, they may at times be tested on individuals with

the illness themselves. The principle objective of the phase one is; making sure the new

medicine presents no major issues, clarification that the select new medicine could be able to

reach the select body area and make sure it could remain in those areas long enough to ensure
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it achieves its benefits and equally to make sure there is gaining of the preliminary evidence

that it could possibly offer therapeutic value or be able to prevent disease or the condition

itself.

In the case that the first phase of vaccine formation is successful, there will be

approval seeking for the trials that generally involve a larger number of individuals. The

second phase will but not necessarily involve a larger group of participants as opposed to the

very first stage of testing. The main aim of this stage is effectively being able to establish the

ways to treat the condition, effectively being able to establish the prevention of the condition

if the volunteers don’t already have the condition. The stage equally looks to establish the

required and recommended dosing levels. At this stage the process of treatment could as well

be compared to another patient receiving a placebo drug. A placebo refers to a treatment

which essentially looks the very same as the potential medicine but generally has no given

active ingredients. The third stage of this procedure is; if the results obtained from the

previous trial are encouraging, this trial would basically involve hundreds and more

participants. The stage takes place for the purposes of; demonstrating the effectiveness of the

new vaccine and the patients could use it, being able to confirm the effective dosing levels,

identification of the side effects or reasons why the given treatment ought not to be given to

people with other health conditions, being able to successfully build knowledge of the given

health benefits of the given medicine or vaccine and being able to compare it with any risks

arising, and eventually the stage involves the comparison of results against any current

achievements by other treatments (Lucia et al., 2021). This procedure of the vaccine clinical

trials is what most believe was compromised while coming up with the Covid-19 vaccines.

Despite the major groundbreaking inventions that targeted in the management of the

Covid-19 virus, there was a high skeptics, hesitancy, negative perspective and general

refusal to be administered the vaccine worldwide and equally in the Eastern region, KSA.
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With the discover of vaccines governments worldwide announced mass vaccination n

campaigns that aimed at sensitizing people and letting them understand the importance of

vaccination. The Eastern province, KSA was equally involved in mass vaccination and

sensitization of individuals getting vaccinated against the deadly disease. The mass

vaccination and sensitization however in the Eastern region, KSA was met with resistance

and refusal. People had different perceptions regarding the effectiveness of these vaccines

owing to the fact that they were developed in a hurry and didn’t follow the required

procedures. Some individuals argued that the vaccines didn’t meet the requirements of the

required number of clinical trials hence didn’t meet the criteria of being a vaccine. There was

equally a concern of how effective the vaccines were because of the fact that, the world

health agencies warned of the risk of vaccinated individuals conducting the new strains of the

virus. These dynamics brought about further resistance as people doubted how well the

vaccines could have been formulated (Ward et al., 2020). For instance the omicron variant

was identified in South Africa which was way back in November 2021 and with time became

the dominant variant. The Omicron variant when tested against the occurrence of the virus

found out that some of the very effective vaccines were just 65% effective with it. This posed

more fear regarding how effective the vaccines were.

Globally, vaccination uptake and supply have been accelerated in order to improve

overall protection against the disease Covid-19. Vaccine apprehension and general attitudes

concerning Covid-19 administration are key determinants of vaccine uptake rates in the

general public. The general public's perception of the Covid-19 vaccination is hazy, and it

hasn't been met with enthusiasm. Reluctance to accept vaccines is a dynamic that academics

are well-versed in, and they can pinpoint reasons why people are reluctant to get vaccinated.

Vaccine hesitation is defined as a lack of trust in vaccines that leads to the refusal or

postponement of vaccine administration (Lucia et al., 2021). Vaccine reluctance and

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confidence are complicated concerns that can be measured and determined by a variety of

circumstances, according to the strategic advisory group of experts on immunization working

group on vaccine hesitancy issues. The contextual socio-political-cultural variables,

individual and group influences, and vaccine specific factors are the three basic categories in

which vaccination hesitancy issues are classified. The delivery of Covid-19 vaccinations has

been faced with widespread resistance from populations around the world. Individuals have a

variety of reasons for wanting to know if these vaccines should be given to them.

The vaccine candidates are in the processes of being developed with the vaccination

having kickstarted in several countries all over the world (Biasio et al., 2021). The responses

towards the use of vaccines have elicited different feelings all over the world even as other

individuals volunteer to take the vaccines. Generally, individuals still have high doubts

regarding the safety and efficacy of using the vaccines which includes how well I can protect

against Covid-19 as there are many cases of reinfection reported. The protection levels of the

vaccines are in question as the world health agencies recommend the use of booster shots for

the vaccines given as an absurdity to prevent any further re-infection(Zhang et al., 2021). The

world health agencies however urge that the vaccines are safe and can be used by the human

population. There equally have been rumors or myths surrounding the use of these vaccines

while some individuals regard the vaccines to causing blood clots and thus could medically

lead to death. Some deaths have been reported upon the use of vaccines though a very small

number and therefore people hold onto these cases as reasons to avoid the use of the vaccine.

The deaths however could not be regarded to have been caused by the vaccine itself or any

underlying illnesses of the patients. Equally other individuals have had to be readmitted back

to hospitals after taking the jab which raises more fear and concern upon use of the vaccines.

Nevertheless the larger population has so far responded well, those who have successful used

the vaccine without any fail.

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Vaccine acceptance is therefore a very complex factor to put into consideration. The

vaccine acceptance rates therefore differ in many aspects i.e.; they are context specific tat

shift across time, geography, and generally a given community’s perceived behavioral nature.

A particular research carried out in Ireland on the healthcare acceptance rates found out that

the healthcare personnel did avoid the seasonal influenza immunization as there were

misunderstandings on the efficiency and trustworthiness of the vaccine the same case

witnessed with Covid-19 (Kwok et al., 2021). The vaccine acceptability in the China republic

is equally a matter of concern as it is majorly determined by demography and public attitudes

among the population. The major determinants towards the vaccine acceptance levels for

China, Hong Kong were established to be the anxiety levels of the population and the vaccine

uptake history (Bai et al., 2021). For instance, the historical influenza virus vaccination

acceptance determinants in the United States of America were found to include factors such

as; the vaccine effectiveness, the social influence of individuals, the health insurance of a

given person (Shekhar et al., 2021). Other studies carried out in the United States equally

found out that the higher vaccine uptake rates were generally associated with the greater

reluctance there was and in general there was greater vaccine uptake with a greater

confidence levels (Ward et al., 2020). A research carried out in the United Arab Emirates

looked at the parent attitudes towards the vaccination campaigns of their children and

established that there were only 12% of the parents population that were generally hesitant to

vaccinate their children. As by the study, the vaccination safety concerns raised by the

parents was 17% with others not being willing to take the vaccine because of the general

occurrence of side effects being at 35% and the fear of injections to the children being at

28% thus apprehending the vaccine for their children (Wang et al., 2020). Some parents

feared that the vaccine should only be given to the older generation as they are the ones with

high likelihood to be affected by the virus than their children who have a high immunity.
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Equally individuals who had earlier on been vaccinated against season flu had a highly

likelihood of indicating that they had a plan for vaccination.

Studies have equally been presented that have assessed the general public

preparedness in accepting or generally rejecting other virus vaccines such as the H1N1

vaccine. The research on H1N1 vaccine acceptance established very diverse crucial factors

for consideration. These factors included; the general people’s perceived risks towards

infection, the severity of the event, the given personal consequences, the previous vaccination

history of individuals and the ethnicity of the individual (Kourlaba et al., 2021).

Consequently a recent study carried out with regard to ensuring equitable distribution of

vaccines across the populations established that it is not easy to meet such a threshold as

pertains to the complex human behavior which has the general characteristic to always shift

over a given time and space. A meta-analysis carried out on the research equally established

that there are very different behavioral models of human beings and a consideration of

theories such as, ‘the theory for planned behavior” were given a higher consideration in

regard to these factors and found to be overly effective in the explaining of the vaccine

hesitancy factors. There have been quite a number of researches that have been recommended

towards the general study of how well to improve the targeted strategies and policies aimed at

boosting of the immunization rates.

There are general research gaps targeted at addressing the general attitudes of

individuals towards the acceptance of the Covid-19 vaccine (Sallam, 2021). There have been

few studies done that have effectively addressed the prevalence of the Covid-19 vaccine and

its acceptance rates among the population of the Eastern Region, KSA. This is because the

Virus is a new virus in the world and research is being done to better establish how well to

handle the virus. The vaccination programs presented are use of drugs that have been

established for the emergency use to help handle the spread of the virus among the
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population. It is therefore well to credit the health agencies and laboratories responsible for

the vaccine manufacture as it is under a short notice but equally it is important to consider the

general effectiveness of the drugs. Studies on vaccine acceptance in the United States show

that close to 50% of the population plan to refuse the vaccine uptake with many of them

being the elderly (Kourlaba et al., 2021). They are unwilling to receive the jab presenting

various reasons and attitudes.

Different governments are taking different considerations aimed at making sure their

populations take the vaccine. Despite the fact that vaccine uptake should entirely be driven by

the person’s acceptance, governments across the world accept that the acceptable levels of

vaccines are low and to make sure the world achieves herd immunity there is the need to

make the vaccines mandatory (Sallam et al., 2021). Different governments have therefore

taken the initiative to roll out mass vaccination with limitations to access certain government

services in the case an individual isn’t vaccinated. For instance the international travel in and

from different countries such as Saudi Arabia, there is the requirement of a covid-19

vaccination certificate to be presented at the different airports while departing and when

arriving. This means that any unvaccinated individual could not have the privilege of

international travel. Other countries such as Canada have asked their citizens to be able to

vaccinate so as to attend to their jobs (Islam et al., 2021). Such a measure was received with

high resistance attracting work boycott and resignations even in the healthcare institutions.

Nevertheless, vaccination is essential for all populations. This study therefore seeks to

establish the attitudes towards vaccination of Covid-19 among the Eastern Region, KSA, in

Saudi Arabia.

Summary of the chapter

The chapter generally presents previous studies conducted on the topic. There were

different studies presented above which tackle the general attitudes towards the covid-19
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vaccination. The vaccination rates of ovid-19 haven’t been met well among different

individuals which therefore calls for the study of the attitudes of individuals towards

vaccination. The research studies presented equally made use of different methodologies to

be able to test the attitudes of the Covid vaccine acceptance among the general republics

across the world including the United States. The research articles presented the different

assumptions and reasons towards the stifled covid-19 acceptance among the different

individuals. They showed the perceptions presented in different parts of the world regarding

Covid-19 acceptance, factors that will be of major help in determining the attitudes regarding

Covid-19 acceptance in the Eastern region, KSA.

Chapter three: Methodology

Research methodology is a representation of the different specific ways used in the

identification, selection, processing and the analysis of a given set of information concerning

a particular topic. In research, the methodology section gives allowance for the critical

evaluation of the reader’s overall validity and reliability. This section will therefore answer

two main questions, how the data was collected and how the data was analyzed.

Consequently, the research methodology does identify the overall patterns involved in the

structuring approach for the acquiring of relevant and most trusted data for the specific topic

at hand. For instance in this study the methodology section would help in answering the

research questions through the research design and methods.

The processes involved in the research methodology include; the research approach

to undertake, the description of the setting of research, the population in question, the given

sampling procedure, the tool creation, the content validity, reliability of the research design,

the different approaches to the data collection procedures including the data analysis plans.

The research target area of study will be in the Eastern Region, KSA, Saudi Arabia, most

specifically the Dammam, Al Khobar and Dhahran. The region is a perfect location for study
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on the attitudes of covid-19 vaccination among the general public in the area. The study to be

employed in this area will be a descriptive study. A descriptive study refers to a study where

information gets collected without a change of environment i.e. there is no manipulation

whatsoever on the data (Lawless & Heymann, 2010). In other words these studies are

referred to as correlational or observational studies. Descriptive studies are used to better

describe the given characteristic of a population of a particular phenomenon being studied.

The descriptive studies answer the “what” question. The research in the Eastern region, KSA,

will therefore target the general public. The descriptive research design would be

accompanied by the use of the quantitative research design. The quantitative research design

makes use of numerical data to provide solutions regarding a research issue with the use of

both the numerical data and the close ended questions (Aaron & Chew, 2021). Questionnaires

are the quantitative research methodologies considered in this study. After written agreement

is obtained, a prepared questionnaire in both English and Arabic will be given to examine the

general public's opinion toward the COVID – 19 vaccine.

Study sample

The quantitative research sampling procedure is a method used in the overall selection

of representative units from a given population. The study sample in a given research

represent the given presentation of individuals in a given study. Sampling is a process applied

in statistical analysis where a predetermined number of observations are gotten from a given

population. The type of methodology applied in sampling from a larger population does

generally depend on the type of analysis to be performed. In this case, the study sample

would be obtained from the general population of Eastern region, KSA. To select the study

sample the research will employ the use of simple random sampling (Taherdoost, 2016). The

general republic from the eastern region, KSA, of Saudi Arabia most specifically Dammam,

Al Khobar, and Dhahran will stand a chance to be asked to participate in the study after the
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ethical approval from PSMA IRB. The sample would be made up of a total of 1025

individuals who will be asked to take part in the study.

The proportion sample size calculation formula (Descriptive study)

ME from the formula represents is the desired margin of error

“z” is the z-score, 1.96 for a 95% confidence interval,

“p̂ “is our prior judgment of the correct value of p.

“n” is the sample size (to be found)

So in this case we set ME equal to 0.025, z = 1.96 and p̂ = 0.3,

0.0125 = 1.96[√ (0.3×0.7)]/ n

(0.3×0.7)/n = (0.025/ 1.96)2

(0.3×0.7)/n = 0.0002

n = (0.3×0.7) / .0002 = 1050

From the calculation, given the sample of 1050, we might go for 1050 +- 25. As a

result, the range is 1025 to 1075. Using the preceding technique, we arrived at a sample size

n that runs from 1025 to 1075.

Instrumentation

The data will be collected using a questionnaire that has been modified from past

studies to meet our research project. It will be available in both English and Arabic and is

divided into two sections: the first section contains questions about the respondents'

demographic data, and the second section contains questions that will assess the general
 21

public's attitude toward the Covid - 19 vaccine and identify reasons why some people accept

the vaccine while others are hesitant. Five experts in the subject are given an English version

of the questionnaire to examine the tool's validity. After receiving comments, ideas will be

implemented, and the English version of the questionnaire will be completed. For Arabic

translation, an English questionnaire will be provided. Once the questionnaire is in Arabic, it

will be delivered to someone who will translate it into English again to see if the English

questionnaire before it was translated into Arabic is the same or nearly the same as the new

Arabic to English questionnaire. After all of these steps are completed and the questionnaire

is produced in both English and Arabic, it will be distributed to 20 people who are eligible for

pilot testing. The results will be provided to a statistician to be analyzed statistically.

Concerns about ethics

In research investigations, ethics is extremely essential. The ethical considerations in

research are a collection of principles that drive research designs and methods in general.

Voluntary participation, informed permission, anonymity, secrecy, the potential for harm, and

the results of communication are all included in these principles. The study's ethical

considerations would be determined, and the relevant ethical permissions would be obtained

in accordance with the research policies. As a result, all of the research participants would

have to sign a formal consent form (Reijers et al., 2018). The study will be conducted with

ethical permission from PSMCHS's respective IRB, and written agreement from eligible

respondents will be sought. They will receive a questionnaire after signing the consent form.

Respondents will be asked to fill out a questionnaire, which will be kept confidential.

Procedures and Schedule

The qualifying individuals out of the general population will be given open-ended and

closed-ended questionnaires. Researchers will come up with a Google document that includes
 22

consent to participate in the study as well as questionnaires in both English and Arabic. They

will send a link to their contacts by email, and a hardcopy will be provided for those who do

not have an email address, particularly the elderly. Participants will either complete the

questionnaires in less than 10 minutes or be interviewed by the researchers. Researchers are

available, and contact information will be provided if participants have any questions or

require clarification. The variety of these questions is intended to meet the research

objectives and collect all essential data to back up the findings. The information gathered will

be examined and interpreted statistically. The entire research project took about four months

to complete.

Statistical analysis

Collected data will be analyzed using SPSS software package version 17.0

Project method

The project to kick start on May 2022.

 23

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