Understanding COVID 19 Vaccine Hesitancy Among Filipinos

DR. YANGA’S COLLEGES, INC.
COVID-19 Vaccine Hesitancy among Filipinos
Understanding COVID-19 Vaccine Hesitancy among Filipinos: An Exploratory

Qualitative Study
A Thesis Study Presented to the Faculty Members of
College of Health Sciences,
Dr. Yanga’s Colleges, Inc.
In Partial Fulfillment of the Requirements

for the degree of Bachelor of Science in Nursing
Cruz, Khristina Cassandra R.

Dela Cruz, Triscia Mae P.
Felizardo, Patricia Irish P.
Ortega, AB Czyde
Villanueva, Jasmin C.
December 2021
DR. YANGA’S COLLEGES, INC. 2
CHAPTER 1
THE PROBLEM AND ITS BACKGROUND
Introduction
The COVID-19 pandemic has seriously impacted people's lives worldwide.
People of different ethnicities, genders, and economic levels have been negatively
affected (Acuti et al., 2020). Within a year of the pandemic outbreak, one encouraging
sign of human resilience has been the development of effective and safe vaccines.
Vaccines are superior public health interventions that can contain outbreaks of dangerous
diseases when administered to a large enough population (Haque et al., 2020).
The development of vaccines against COVID-19 has advanced rapidly over the
last year, with three distinct vaccines demonstrating high efficacy against COVID-19 to
date. However, people are unwilling to participate in vaccination programs, making it
more challenging to get rid of the disease, particularly in the Philippines.
Prior to the outbreak, the World Health Organization named vaccine hesitancy
one of the top ten global health threats for 2019, and this conundrum has only gotten
worse in the aftermath of the COVID-19 outbreak (Geoghegan et al., 2020). Because of
this global problem, vaccine compliance and immunization programs have been put at
risk.
Vaccine hesitation is a new term in the socio-medical literature that refers to a
strategy for making vaccine decisions. It recognizes a spectrum between complete

acceptance and outright refusal of some or all vaccinations, and it casts doubt on the
traditional categorization of individuals or groups as either anti- or pro-vaccine
Numerous studies have previously demonstrated the importance of
sociodemographic characteristics (e.g., lower vaccination acceptability) in adopting the
COVID-19 vaccine and vaccines for other diseases (Salali & Uysal, 2020). Uncertainty
about studies and vaccinations (e.g., rapid development, unfavorable adverse reactions,
and other unpleasant events) was a frequently stated reason for vaccine hesitation
(Palamenghi et al., 2020).
According to surveys conducted in 2021, between 50% and 60% of all
respondents worldwide would accept a COVID-19 vaccination, with significant variation
across countries. Last March 1, 2021, and December 3, 2021, a total of 90,640,665 doses
of the COVID-19 vaccine were administered to Filipinos. (National COVID-19
Vaccination Dashboard, 2021). The total number of initial dosages was 52,628,592, and
the total number of subsequent dosages was 37,568,088. Meanwhile, 443,985 Filipinos
received the third dose.
Being vaccinated can help save your life and the life of another. COVID-19
vaccination protects against severe disease, hospitalization, and even death. A substantial
body of evidence indicates that vaccination can help reduce the risk of spreading the
illness to others. Immunization may be a more effective form of prophylaxis than non-
immunization (World Health Organization, 2021). As a result, it is critical to understand
the predictors of vaccination compliance to develop strategies to reduce vaccine

hesitancy. Thus, this study seeks to close the vaccine hesitancy gap by identifying
vaccine-hesitant individuals' barriers, facilitating factors, and characteristics. The study
will aid in developing effective behavior modification communication campaigns to
increase acceptance of the COVID-19 vaccine.
Theoretical Framework
The theories related to the researcher's study were shown and explained in this
part of the research.
Theory of Planned Behavior
Icek Ajzen pioneered the Theory of Planned Behavior (TPB) in order to predict
human behavior. According to the TPB, attitude toward the behavior, subjective norm,
and perceived behavioral control could affect choice as influenced by behavioral
intention (Kan & Fabrigar, 2017).
As a result, this theory is predicated primarily on the premise that individuals
make rational, reasoned decisions about which behaviors to engage in based on the
available information. The desire to engage in a behavior and the perception that the
behavior is within their authority influence how the behavior is performed (Kan &
Fabrigar, 2017).
Concerning the study, any action a person does is directed by three sorts of
considerations: Belief structure consists of attitude toward COVID-19 vaccine (perceived
necessity, benefit, and effectiveness), subjective norms (as to if significant others support
receiving a COVID-19 vaccine), and perceived behavioral control (how the COVID-19
vaccination is viewed under the individual's control).
Statement of the Problem
The purpose of this study is to gain an in-depth understanding of vaccine
hesitancy among Filipinos aged 18 years and older. Particularly, it needs to answer the
sub-problems:
1. What are the insights of Filipinos about the COVID-19 vaccine?
2. What are the barriers to getting vaccinated against COVID-19 among Filipinos?
3. What are the facilitating factors to getting vaccinated against COVID-19 among
Filipinos?
Scope and Limitations
The study focuses on the issue of COVID-19 vaccine hesitancy among Filipinos
in the province of Bulacan. The research, which is limited to municipalities in Bulacan
province, focuses on the viewpoints of vaccine skeptics through interviews.
The target informants of the study will be unvaccinated Filipinos aged 18 years
and older. Between March 1, 2021 and December 8, 2021, a total of 95, 201, 533 doses
have been administered. The Filipino population is fully vaccinated in 36.87 % and 49.82
% have received their first dose (DOH, 2021). The chosen informants will be
interviewed at the place where the study will be conducted and provide information and
additional knowledge that will be beneficial to the study.
The researchers took an exploratory approach in order to gain a thorough
understanding of informants' perspectives on vaccine hesitancy. To gather informants
based on this statement, judgmental or purposive sampling were used. The data collection
method was a semi-structured interview in a face-to-face setting. It was based on data
saturation, which meant that interviews and gathering of data had to stop when there were
too many redundancies of information.
As a result, this study is qualitative in nature, concentrating solely on the narrative
responses of the informants. Since it is confined to a specific region, this study does not
seek to provide definitive generalizations for the entire Philippines.
Significance of the Study
The findings of this study will benefit the following entities:
Nursing Students – This research will contribute insights into the hesitation and refusal
factors in individuals' decision-making processes regarding the COVID-19 vaccination.
As a concluding remark, the nursing students will be able to comprehend different
people's viewpoints on the COVID-19 vaccine and devise methods to educate and tell
each person about the need to receive a COVID-19 vaccine.
Nurse Practitioners – This study will guide nurses to understand why individuals are
hesitant to use the COVID-19 vaccine. They will be able to comprehend the reasons for
their reluctance to receive the COVID-19 vaccine due to health, belief, age, and religion,
which enables them to develop and implement strategies for increasing vaccination rates.
Community People – This study has the potential to raise public awareness about the
importance of having a COVID-19 vaccine. This study will provide answers and
explanations to the community's hesitation about having a COVID-19 vaccine and will
help to increase vaccination awareness.
Researchers – This study could give researchers more excellent knowledge and insight
regarding the reasons behind people's reluctance to get the COVID-19 vaccination by
allowing researchers to understand the point of view of each individual on this matter. As
a result of this study, they will increase their research skills.
Future Researchers – This study can serve as the basis for future studies. This research
can be used to strengthen the findings of future research. This may also give an idea on
how to conduct a qualitative, exploratory study.
Definition of Terms
The following terminologies were operationally defined by the researchers based
on their use in this research study.
COVID-19 - Term used to describe the disease caused by a new coronavirus that causes
respiratory illnesses to spread quickly.

Hesitancy - this terms covers the outright refusal to vaccine that could make it more
difficult to stop COVID-19 from spreading around the world.
Vaccines - Vaccines help the bodies build up resistance to the virus that causes COVID-
19 without having to get sick with it first.
Vaccine-hesitant - These are the people who have not been vaccinated yet and are
hesitant of getting the COVID-19 vaccine.
Review of Related Literature
Foreign Literature
The COVID-19 Vaccine and How People Reacted to It
As shown in the study, many individuals want to be vaccinated against the COVID-
19. As stated, there are still 35% of people who are still in doubt and have questions
about the vaccine (M. Detoc et al., 2020). Based on the online survey conducted, there
are estimated three-quarters of people would want to accept the COVID-19 vaccine
(2020, p. 7003). This reveals that more people would like to receive the COVID-19
vaccine despite the issues and doubts. In this view, people's points of the COVID-19 may
be caused by their political allegiances. Those who are in the position in government may
think that the COVID-19 infection does not engage in promoting their health behaviors
(2020, p.6505).
COVID-19 vaccines for all
Vaccines allow us to come together and return to our normal lives. Over 7.5 billion
doses of COVID-19 vaccines have been administered worldwide. However, only 4.5
percent of people in low-income countries received at least one dose (Unicef, 2021).
Unlike them, some rich countries have an adequate supply of vaccines. Some wealthy
countries pledged to donate one billion vaccines in June 2021. Some of these promises
have yet to be fulfilled. The longer this virus infects people, the more likely it will die.
The COVAX wanted to ensure that there were enough doses for everyone to achieve
equal treatment for all. Some low-income countries are suffering when it comes to
funding because they do not know where they will get the money to get enough doses for
everyone. Countries that received donated vaccines should make the doses available to
their citizens.
COVID-19 Vaccine Hesitancy in High-Income Countries
Being hesitant about COVID-19 vaccines can be a barrier to achieving a safe
environment for all. Some of the factors that may contribute to the growing number of
vaccine skeptics include: younger age, females, non-white ethnicity, and a lower level of
education. Some of the common group/individual factors influencing the rising number
of vaccine-hesitant: a lack of recent history of influenza vaccination, a lower self-
perceived risk of contracting COVID-19, a lower fear of COVID-19, a belief that
COVID-19 is not severe, and a lack of chronic medical conditions. Their beliefs that
vaccines are unsafe or ineffective are the most common vaccine-specific factors (Aw,
2021).
Motivational interviewing for vaccine hesitant parents
The vaccination has resulted in a significant reduction in potentially fatal infectious
diseases. Vaccine apprehension has recently increased. Measles and pertussis outbreaks
have heightened awareness of this critical healthcare issue. Motivational interviewing is a
popular counseling technique studied for its efficacy in preventative medicine and
psychological disorders. It seeks to motivate people to make behavioral changes through
collaborative relationships with their providers by demonstrating how their current
actions do not match their health goals (Jason & Meredith, 2017).
In addition, many parents are concerned about vaccine safety, regardless of vaccine
hesitancy. Parents who are vaccine-skeptical do so for various reasons, including
philosophical and religious beliefs, conspiracy theories, and safety concerns. Parents
believe that providers do not adequately address their concerns. According to providers,
there is a lack of training in dismissing parental concerns. The majority of parents regard
their child's pediatrician as the most trustworthy source of vaccine information. Parents
who receive vaccine information from a provider are more likely to adhere to the
recommended childhood vaccine schedule. The best way to approach parents about
vaccinations has yet to be discovered. (Jason & Meredith, 2017)
COVID-19 Vaccination Hesitancy in Healthcare Workers
Given the significant frequency of COVID-19 vaccine reluctance among healthcare
professionals, vaccination should examine communication and education strategies and
clinical worker mandates to enhance COVID-19 immunization uptake in these people.
Healthcare professionals can help reduce the Pandemic's impact by modeling protective
behaviors and aiding in the vaccination of others. This scoping study of healthcare
professionals' resistance to COVID-19 vaccination discovered that 22.51% of the 76,417
HCWs worldwide were suspicious of available vaccinations. Their main concerns (safety,
effectiveness, and side effects) were roughly equal to those of the general population.
They were being male, older, and having a greater level of education all aided in the
uptake of COVID-19 immunization. Healthcare personnel has a moral obligation and a
moral necessity to play a vital role in public and healthcare colleague acceptance of
COVID-19 immunization. Given this group's high rate of COVID-19 vaccination
hesitancy, the government should implement education and policy-based interventions to
ensure that healthcare workers receive available COVID-19 vaccinations. There are
severe dangers to the general public and healthcare workers if healthcare personnel does
not comply with COVID-19 immunization requirements (Biswas, 2021).
Vaccine confidence in mass roll out meets local vaccine hesitancy
The race for vaccinations continues, with the early pacesetters demonstrating the
need to address minority group challenges. Finally, as the virus spreads and mutates, it is
a race between humanity and the virus. For public health professionals, the race is
between expanding our societies' organized efforts to promote the broadest population
protection and justice to reach universal coverage while contending with the brakes of
community skepticism and system disruption.
In 2010, Bennett, Calman, and his co-authors revised their views on the social
amplification of risk, as well as fright variables and media triggers. COVID-19
vaccinations are subject to six of their eleven fear factors, including genetically modified
vaccines and fertility issues. Fear factors include concerns about perceived health hazards
that come from unexpected sources, pose a long-term risk to pregnant women and future
generations, or are the subject of contradictory assertions from credible sources (Reid &
Mabhala, 2021).
Vaccine Hesitancy among People with HIV
The psychometric features of a modified version of the VHS adapted for COVID-
19 in a group of PWH in the United States were investigated in this study. Overall, this
modified VHS displayed adequate reliability, internal consistency, and construct validity,
as well as high psychometric qualities when used to assess adult PWH attitudes toward
COVID-19 vaccination. Convergent validity was proven; individuals who believed a
COVID-19 vaccine would successfully prevent illness and were willing to be vaccinated
showed considerably less hesitancy. Those who refused to obtain the COVID-19 vaccine
despite provider advice and those who expected to be obliged to receive it for everyday
activities were also more likely to be reluctant to vaccinate.
It was, furthermore, assessing and responding to COVID-19 vaccination reluctance
in communities with risk factors related to higher morbidity and death. The use of the
modified VHS among PWH revealed that providing support and perceived health risk
was associated with lowering vaccination hesitation and higher perceived importance of
getting vaccinated. A validated technique for detecting reluctance to a COVID-19
vaccine is crucial for minimizing vaccine resistance and assisting clinicians, public
policymakers, and targeted immunization campaigns (Rodriguez et al., 2021).

Trends in COVID-19 Vaccine Hesitancy
Location, socioeconomic status, occupation, beliefs, and safety and efficacy
concerns have all had a significant impact on COVID-19 vaccine acceptance. Lin et al.
reported that from March 2020 (>70%) to October 2020 (50%), there was a decrease in
general COVID-19 vaccine receptivity (regardless of vaccine manufacturer). Brazil,
Denmark, South Africa, and the United Kingdom were the most accepting of COVID-19
vaccines at the time, with 80% acceptance. Russia and France, on the other hand,
exhibited a significantly high level of uncertainty regarding COVID-19 vaccines, with
vaccine acceptance rates of around 55%. The most important factors influencing the
acceptance of these new vaccines are concerns about vaccine safety and effectiveness, as
well as perceived risk. Fear of side effects, concerns about vaccine safety, and concerns
about COVID-19 vaccine effectiveness were all common reasons for people to be
skeptical of COVID-19 vaccines (Rane et al., 2021).
Furthermore, low rates of COVID-19 vaccine acceptance were associated with the
belief that vaccines are unnecessary, insufficient information, and unknown/limited
duration of immunity. Conspiracy theories and distrust in government or healthcare
professionals are factors that contribute to increased skepticism and opposition to
vaccination (Chowdhury et al., 2021).
Factors that Influence Vaccine Acceptance During COVID-19
People's trust in information spread through media and social networks is low,
according to surveys analyzed, Citizens, on the other hand, believe in their ability to
distinguish between false and accurate information (Marco-Franco et al., 2021). The
public's fear of COVID-19 vaccine side effects is influenced and increased by the
constant dissemination of false news, raising additional questions and concerns about the
vaccines.
In September 2020, survey respondents in the United Kingdom had encountered
information or news about the COVID-19 that they believed was false or misleading, and
a large portion of them had received false news several times per week. YouTube is a
source of false and misleading information. It was founded that 65 percent of those who
tracked down the phrase "safety of vaccines" and "vaccines and children" on YouTube
are anti-vaccine (Basch et al., 2017). Misleading info in top YouTube videos with over
60 million views by having to search terms such as "COVID-19" and "Corona Virus”
weas discovered (Puri et al., 2021). COVID-19 and the accompanying global Pandemic
have dominated social media content (Basch et al., 2017).
Psychological Profile of COVID-19 Vaccine Hesitant
COVID-19 vaccine-hesitant or resistant individuals were distinguished from vaccine
accepting counterparts by being more self-interested, distrust of authorities and experts
(i.e., scientists, health care providers, and the state), are more likely to have strong
religious views (perhaps because these kinds of ideas are connected with higher levels of
success). With a skepticism toward the scientific worldview, as well as conspiratorial and
paranoid beliefs (which demonstrate a lack of belief in the desire of others). They also
had a more disagreeable, emotionally unstable, and less conscientious demeanor, as well
as a more impulsive way of thinking (Murphy et al., 2021).

Local Literature
Vaccine Hesitancy Among Schools’ Stakeholders
This article talks about the COVID-19 vaccination in relation to the readiness of
the schools in the Philippines to open for face-to-face classes. This suggested to the
schools to continue to encourage and to make sure that the students already had the doses
of the COVID-19 vaccine. The reason that gathered the highest percentage in having the
vaccines is they believed that the vaccine could help them to be immunized from having
the COVID-19, while their reasons why they are hesitant in having the vaccine is that the
vaccine might have affected them genetically (Robledo et al., 2021).
The role of religiosity in COVID-19 vaccine hesitancy
Religious views impact medical and scientific data, resulting in a variety of
responses to vaccination, such as vaccine reluctance. According to one research, religious
teachings stress prayers above health, resulting in vaccine hesitation among devotees.
This, along with a lack of proper understanding about existing vaccinations, leads
believers to adopt alternative techniques to illness treatment, such as the use of holy
water and prayers. Despite the government's attempts to develop a vaccination program,
some individuals are still afraid to receive the vaccine due to potential negative effects.
Furthermore, the effectiveness of immunizations is still being debated. Individuals in the
Philippines are especially wary because of the Dengvaxia issue, which erupted in
February 2018 when a false vaccination resulted in the deaths of over 100 people. Due to
the Pandemic's anxiety, Filipinos, according to Fr Nicanor Austriaco, OP, no longer
depend only on science. Rather, individuals have more faith in the leaders of their
Church. As a result, the CBCP supports and collaborates with the Philippine Government
in vaccinating 70 million Filipinos against the new coronavirus in 2021 in order to attain
herd immunity. The early involvement of government officials and Church leaders in
encouraging individuals to take part in COVID-19 immunizations. The interaction
between the Government and the Church will build a powerful collaboration aimed at
promoting the need for vaccinations not just in the Philippines but also in other
religiously affected countries (Garcia et al., 2021).
From Dengvaxia to Sinovac: Vaccine Hesitancy in the Philippines
Early this year (March 2021), the first batch of vaccines arrived. At first, many
people had doubts when it came to having the vaccine because they thought that the
vaccine was not done yet, and they thought if it was really effective or not. The success
of the vaccination programs conducted in the Philippines is not that good because the
people are still scared of taking it because of the Dengvaxia incident last 2016. This
vaccine is for the anti-dengue immunization in the three regions in the Philippines, which
was led by the Department of Health. Many children died after having the anti-dengue
vaccine because of various reasons. Until now, the government is still battling because of
controversies of the Dengvaxia vaccine, yet they managed to conquer it, and many people
already have the COVID-19 vaccine, and their anxiety and fear are already gone (Alfonso
et al., 2021).
Vaccination Unwillingness Among Families with Children Aged 2 and Under
One-third of respondents from two densely populated areas of Manila,
Philippines, was found to be anti-vaccination. The major reasons for parents rejecting at
least one vaccination for their children were unfavorable media coverage and worries
about vaccine safety and side effects; the most prevalent negative media content
identified by respondents was connected to the Dengavaxia® vaccine.
Vaccine fear endangers both individuals and public health. Recent occurrences
involving the dengue vaccine Dengvaxia® have been blamed for a loss of vaccination
trust in the Philippines; however, data to support this assertion is insufficient, particularly
in many low- and middle-income nations. Many possible reasons for vaccination anxiety
have been found, including thoughts and attitudes about vaccine effectiveness and safety
(Migriño et al., 2020).
Vaccine hesitancy among caregivers in Cavite
Fears resulting from the Dengvaxia controversy played a prominent role in this
study, highlighting the critical need to investigate further how vaccine fear could indeed
influence narratives about vaccines and healthcare systems. In this case, fears of the
negative effects of 'new vaccines' (i.e., Dengvaxia) had spilled over to other childhood
vaccines, affecting immunization efforts nationwide. According to research conducted
among parents of Dengvaxia-vaccinated children, the vaccine does more damage than
benefit, exposing the government's incompetence in managing immunization programs.

Likewise, a conducted study of two metropolitan neighborhoods in the country's
capital, Manila, and discovered that parental unwillingness to administer at least one
childhood immunization was associated with unfavorable media information and safety
concerns about the dengue vaccine (Migrio et al., 2020). These findings offer caregivers a
voice and emphasize how the emotional trauma of vaccination scares persists within the
family and has severe and long-lasting impacts, as has been documented in the
Philippines and elsewhere in regard to vaccine anxieties brought on by misinformation
(Landicho et al., 2021).
Scared, powerless, insulted and embarrassed: hesitancy towards vaccines
According to the study, findings suggest that caregivers view health care
personnel as disrespectful, unresponsive, or contemptuous when it comes to answering
inquiries or concerns about vaccines. As a result, caregivers are more likely to depend on
other sources of information, such as their own social group or social and media
(Landicho et al., 2021).
Role of governments in enhancing public trust
The COVID-19 vaccination program is successful to this day, yet there is still a
shortage of vaccines around the world, especially in the Philippines. The government is
giving reassurance that the people are safe when the doses are already given to them. The
hesitancy of the COVID-19 vaccine is still evident. For the vaccination program to
succeed, the government should give priority to addressing the issues about the vaccines'
efficiency. The trust of the people when it comes to vaccines is really tested because of
cases of not-so-good effects of vaccines on other people (OECD, 2021).
Rebuilding public trust
Because of misleading pieces of information about the COVID-19 vaccines, some
Filipinos are having trouble trusting their efficacy. The government should be doing
programs that can build the trust of the Filipinos when it comes to vaccines and their
effectiveness. They should be providing facts with regards to the vaccine so that the
Filipinos do not believe in fallacies and fake news. Public officials should be role models
in this kind of issue. They should not get tired of giving information to the people so that
all their anxiety and fear will be overcome and so that the whole country can be prepared
and the people are free from the worst scenarios that can happen when the COVID-19
infection infected them (Cordero, 2021).
Vaccine Hesitancy and virus mutation
Experts say that "The longer we wait to get vaccinated, we are giving more time
for the virus to mutate." It was according to Dr. Gianne Eduard Ulanday, a virologist
from the University of the Philippines. He added that one of the most critical aspects of
the vaccine is its timeliness. The brand is not important. The vaccines can not be
administered to people without enough clinical trials. The people just depend on the
brand, but they are all effective. There is still at least one percent chance that vaccines are
not effective, but there is still a ninety-nine chance that this is effective. People should
stop comparing brands of vaccines because all vaccines provide protection to all. As of
this year, there are ninety-three vaccines that are being tested in clinical trials in people,
and as of now, there are thirty candidates of the COVID-19 vaccine that have already
reached the final stage (DOST, 2021).
Interrogating COVID-19 Vaccine Hesitancy in the Philippines
Due to increasing rates of COVID-19 infection, the Philippines has undergone a
nationwide vaccination program to reduce the number of infected all over the country.
Nola Pender's The Health Belief Model (HBM) says that people are adopting the
prevention of the disease, and they accept medical interventions like vaccines when there
is enough assurance from the health care practitioners. A large number of people only
want to receive the vaccine when others have already received it, and nothing bad
happens to them except for the normal side effects when the vaccine is administered
(Caple, 2021).
Synthesis
The researchers came up with the notion of how people would react to the
COVID-19 vaccination and if it would be available to everyone. As demonstrated, a large
number of individuals support the COVID-19 viral vaccination. There are a limited
minority of cases who are hesitant about receiving the vaccination. In this instance,
individuals are eager to be vaccinated in order to be protected against the virus. Also, one
of the reasons why individuals are hesitant to receive the vaccination is because they have
previously heard misinformation about it. The government should present them with facts
so that they are not misled by the information they are provided. The COVID-19
vaccination is supported by a large number of people in the United States and France.
Their acceptance is consistent with the articles that might help people learn more about
the vaccination.
From another viewpoint, parents are anxious about the safety of immunizations
for their children. Philosophical and religious views, conspiracy theories, and safety
concerns were all held dear by the parents. There is still a gap of knowledge about it.
When it comes to vaccinations for their children, parents consider physicians to be the
most trustworthy source. Healthcare providers are having difficulty persuading parents to
have their children inoculated.
Furthermore, being afraid to receive the COVID-19 vaccination might be a barrier
to providing a safe workplace for all individuals. There are several reasons that may be
examined when determining why people are afraid to get the COVID-19 vaccination.
People felt that the vaccination was not as terrible and severe as it was. Vaccines were
also thought to be unsafe or useless, according to the public.
Based on these findings, the study seeks to understand why Filipinos are hesitant
to get the COVID-19 vaccination, how they overcame the difficulties and hurdles along
the way, how they felt, and what they have learned from their experiences.
CHAPTER 2
RESEARCH METHODS
This study aims to better understand Filipinos' attitudes toward vaccine hesitancy
during the COVID-19 Pandemic. This chapter elaborates on and contains all of the
critical information, as well as how the study was created in order to provide significant
saturation and contribute conclusions to society's existing knowledge. This section also
clarifies the researchers' reasons for selecting their methods, location, informants, tool
construction, and how the research would be processed.
Research Design
The researchers were involved in a qualitative method approach of research with
the use of exploratory design. Consequently, the researchers wanted to decipher COVID-
19 vaccine hesitancy by looking at the perspective of those Filipinos involved in such
problem in the light of pandemic to explore its breadth.
With this point, this research study would explore COVID-19 vaccine hesitancy
by doing a qualitative method approach of research with the use of exploratory type of
research design. As per definition, The goal of conducting exploratory research is to gain
a better understanding of the problem, and there is no guarantee that the research will
yield any conclusive results (Bhasin, 2020).
Research Locale
The researchers conducted the study on the chosen town wherein the study will be
justified. The locale was chosen for the study to be executed in the Province of Bulacan
for the reason that this locale is topping the list of areas with the highest number of
COVID-19 cases.
Bulacan has a population of 3, 708, 784 people, according to the Bulacan
Provincial Health Office (2021). Between March 8, 2021, and December 1, 2021, a total
of 3, 130, 718 doses were administered: 1, 378, 469 of the population was fully
vaccinated, and 1, 752, 249 received the first dose vaccination.
The researchers decided to conduct the study in this location after considering
their options and the availability of informants, as well as their convenience and
accessibility.
Research Informants
The research was carried out in several locations around Bulacan, with the chosen
informants being COVID-19 vaccination skeptics with specific health behavior concerns
needed for the study.
In order to generate informants, the researchers relied on municipal health records
and looked for those who claimed to be vaccine-hesitant.
This study specifically focused among unvaccinated Filipinos aged 18 years and
older. The researchers intend to understand what these people think about the vaccination
and how they feel about it.

Purposive sampling, a non-probability sampling method, was chosen by the
researchers because it allows them to select respondents whom they believe can answer
their questions and provide the information required for the research. The informants
chosen by the researchers will be the ones who respond to the questions posed by the
researchers, but it is up to the people whether or not they want to participate in the
research.
Meanwhile, the requirements for COVID-19 vaccination hesitant are as follows:
(1) those who subjectively claimed that they are hesitant to take the vaccine, (2) they
must be aged 18 years and older and (3) they must be residents of the researchers' chosen
location.
Research Instrument
To collect the necessary data, the researchers decided to conduct a semi-structured
interview. In this type of interview, the researchers will ask a series of guide questions to
the informants, and then they will add more open-ended questions based on their
responses to go along with the discussion.
The questions were created with the assistance of previous studies, journals, and
articles related to the study that were read.
The researchers also used a written agreement, which is a document that informs
the informants about the research process, purpose, and all necessary detailed
information. A letter requesting the informant's permission to participate in the research
study is also
included. Their signature attests that they read and comprehended the research and
volunteered to participate in the interview as part of the research. The approval that
explains the intent of the interview, as well as the deal between the informant and the
researcher with regards to the confidentiality of the informants, are indicated inside the
letter.
Additionally, there are some instructions on how they could answer the questions
for the interview, and the limitations were given to the informants before the interview.
During the interview phase, an audio recording was used by the researchers to gather the
information that would support the study and would serve as a backup purpose.
Data Gathering Procedure
Figure 1. Data Gathering Procedure
Look for informants in the

chosen town
Securing a letter of intent in

conducting research
Introduction and explanation

of the purpose, securing Face-to-face interview
informed consent and
ensuring data confidentiality Audio recording
Analysis and interpretation of

Thematic Coding
gathered data
Qualifications were raised in order to screen informants based on the scope of the
research. The researchers decided to use judgmental or purposive sampling to gather
informants based on this statement.

Researchers will present the informants with a letter of approval outlining the
agreement between the researcher and the informant on the scope of the questions, the
goal, and purpose of the research, and the confidentiality of the informants' identity and
responses.
The researchers used a semi-structured type of interview because the design of the
research study is exploratory, and its goal is to look at the informants' perspective on
COVID-19 vaccine hesitancy; and to be specific, the researchers used a semi-structured
type of interview wherein there are already prepared initial questions to be used as a
guide.
Data Analysis
To gain a better understanding of the study, the researchers will assess and dissect
the data after collecting all relevant material. Thematic coding will be used to generate
data in the study in which will be simplified to make complex information easier to
understand. The common idea generated from the recorded remarks of the informants
will be sorted according to their similarities in this method, and the material collected
from multiple informants was grouped.
The researchers will use the interview as their research instrument for the first
phase of the interview, which focuses on perspectives on vaccine hesitancy, to personally
ask questions to the informants and to observe well their emotions and reactions while
conducting the interview, because the researchers believe that emotions are also a
significant element in collecting information as it gives reliability to the data.
Following the completion of the first phase of the interview, the researchers will
make use of the audio recordings for the informants to listen to in order for them to
provide their insights and perspectives on the informants' viewpoint on vaccine hesitancy.
Ethical Considerations
In this study, informants were asked to provide answers to researchers about their
views on COVID-19 vaccine hesitancy. The wording used to ask questions during the
interview was carefully chosen to avoid offending or insulting the informants. The
researchers assured the informants that the information they obtained would be used only
for their study and would be kept confidential. In the audio and field notes, the
researchers kept the informants' identities completely hidden. The informants' rights are
anonymous, and their identities are unknown. Only the researchers will benefit from the
information presented and provided by the informant, and they are not expected to share
it with anyone else. Researchers also confirm that correspondence letters regarding the
conduct of interviews are signed by teachers and school staff. Above all, the researchers
ensure that the studies and literature used for this research have a citation or author
recognition as a follow-up and to avoid plagiarism.

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COVID-19 Vaccine Hesitancy among Filipinos