HOLY ANGEL UNIVERSITY

ANTI-VACCINATION ATTITUDES AND ANXIETY OF THE WORKING CLASS OF

PAMPANGA AGAINST THE COVID-19 VACCINES

A Correlational Study Presented to the Faculty of the School of Arts and Sciences in

Field Methods in Psychology

Submitted by:
Hermoso, Alyssa

Maravilla, Estefannie S.

Talavera, Allysa Madelaine J.

P-303

Submitted to:

Professor Ian Fel D. Metal, RPsy

Date Submitted:

November 12 2011
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Acknowledgement

The completion of this research paper could not be possible without the

assistance and participation of several people. Their contributions are sincerely

appreciated and gratefully acknowledged. However, the group would like to extend

their deep appreciation particularly to the following:

We would like to express our sincere gratitude to our advisor, Prof. Ian Fel D.

Metal, RPsy, MSPsy. for the assistance and encouragement to pursue and complete

this study. We appreciate the learning opportunities you provided to us.

Also, we extend our gratitude to our parents for their support and kind

understanding spirit during the process of our research study.

We sincerely acknowledge the efforts of our relatives, friends, and all those

who directly and indirectly helped us to complete our study successfully.

Above all, we thank the Almighty God for blessing the group with knowledge

and strength to finish this research study successfully.

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Abstract

The primary focus of the study was to determine the degree of the relationship

between the anti-vaccination attitudes and anxiety of the workers in Pampanga

against the COVID-19 vaccines. It aims to answer the following questions: (1) How

can the participants be described in terms of the following vaccine attitudes: (a)

mistrust of vaccine benefit, (b) worries about unforeseen future effects, (c) concerns

about commercial profiteering, and (d) preference for natural immunity?; and (2) Is

there a significant relationship between anti-vaccination attitudes and anxiety? The

researchers made use of purposive sampling for data collection, gathering up to

forty-five (45) respondents, and gave them structured questionnaires. Bivariate

correlation analysis was used for data analysis. A correlation was found between the

anti-vaccination attitudes and anxiety, especially with the subscale “worries over

unforeseen future effects” at 0.535<0.01 (moderate correlation). The re-educating of

the public regarding the COVID-19 vaccines as well as fact-checking are

recommended actions to combat the anxiety they feel towards the vaccines. The

Philippine government must continue amplifying the call tailored to the masses to

achieve herd immunity. This research may be conducted in other provinces with

more participants and may also be approached with the qualitative research method.

Keywords: covid-19 vaccines, anti-vaccination attitudes, anxiety, workers

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Table of Contents

TITLE PAGE……………………………………………………………………………… i

ACKNOWLEDGEMENT………...……………………………………………….………1

ABSTRACT…………….…………………………………………………………….…...2

TABLE OF CONTENTS.………………………………….……………………..………3-4

INTRODUCTION……………………………………………………………...…….……5-14

Background of the Study…………………………………………………………………5

Review of Related Literature……….………………………………………….…….…..6-13

Purpose of the Study…………………………………………………………….……….13-14

Statement of the Problem………..…………………………………………..………….14

Research Hypothesis………………………….…………………………………………14

METHODOLOGY………………………………………….……………………………15-20

Research Design………………………………………………………………………..15

Participants Criteria……………………………………………………………………..15-16

Sampling…………..……………………………………………………………………..16
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Instruments………………………………………………………………………………16-18

Data Collection Procedure……………………………………………………………..18-19

Data Analysis Procedure……………………………………………………………….19

Ethical Considerations…………………………………………………………………. 19-20

Scope and Delimitation……………………………………………………………...….20

RESULTS………………………………………………………………………………..20-23

DISCUSSION……………………………………………………………………………23-26

Conclusion……………………………………………………………………………….27

Recommendations……………………………………………………………………...27-28

REFERENCES………………………………………………………………………….29-37

APPENDICES………………………………………………………………………….38-

Informed Consent………………………………………………………………………38-39

Survey Form/s…………………………………………………………………….........39-41

Reflexivity Journals……………………………………………………………………..41-44
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ANTI-VACCINATION ATTITUDES AND ANXIETY OF THE WORKING CLASS OF

PAMPANGA AGAINST THE COVID-19 VACCINES: A CORRELATIONAL STUDY

It was in late December of the year 2019 when the fifth pandemic was

documented since the flu pandemic of 1918. It was initially known as the novel

human coronavirus disease COVID-19 before officially being named severe acute

respiratory syndrome coronavirus 2 (SARS-CoV-2) by the International Committee

on Taxonomy of Viruses. It was first reported in Wuhan, China before it would

eventually be spread worldwide. It is believed that this coronavirus adapted the

ability of transmitting from human to human from a spillover of an animal

coronavirus. While human coronaviruses typically cause mild upper respiratory

diseases, this type has caused severe pneumonia and death in humans (Liu et al.,

2020). In the Philippines, the first suspected case was investigated on January 22,

2020. Later on March 1, 633 suspected cases were reported (Edrada et al., 2020).

With such a deadly virus, there is no doubt that the scientists and researchers would

attempt to create a vaccine to combat this. Through the knowledge obtained from

past coronaviruses, the vaccine’s development process was sped up and in time,

they were distributed across the world (Centers for Disease Control and Prevention,

2020). However, even with these vaccines available, it is still left to the person if they

would like to get vaccinated or not.

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Review of Related Literature

A. History of the Anti-Vaccination Movement

It was found out that the anti-vaccination movement preceded the first

established vaccine by Edward Jenner which was for smallpox. The countries of

Africa, China, India and the Ottoman Empire made use of variolation which is done

by inoculation of an uninfected person with pus from someone with smallpox in the

1970s. In 1706, an African slave known as Onesimus was said to have taught this

technique to the Puritan pamphleteer, Cotton Mather. This practice was introduced

to England with a different name called inoculation. This was brought about by Lady

Mary Wortley Montagu after witnessing the practice in Turkey in 1717. While she

encouraged the inoculation of children to the government against this disease, an

intense debate commenced between proponents and opponents of the practice. The

people supporting the practice often wrote in a cool and factual manner with the

encouragement of the Royal Society, with reason frequently appealed, with the

modern progression of science progressing and with the courtesy residing among

gentlemen. Meanwhile, the anti-inoculators intentionally wrote with the use of scare

stories and heated tones to spread paranoia (Iannelli, 2021).

According to Lynam and Johnson (2019), the existence of vaccines had the

anti-vaccination movement reside along with it. Anti-vaxxers of the 18th century

brought up similar arguments carried by anti-vaxxers of the present day. This

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movement was propagated through the religious leaders found in the United States

who described them as the devil’s work. This campaign continued to expand in the

19th and 20th centuries as an issue of human rights. The United Kingdom’s

Vaccination Act of 1853 dictated mandatory vaccinations for newborn children up to

3 months old. This age requirement was extended to 14 years old through the Act of

1867, with the addition of penalties when the vaccine is refused. Numerous citizens

immediately resisted these laws, demanding that they had the right to control their

own bodies and the bodies of their children. The Anti-Compulsory Vaccination

League and the Anti-Vaccination League were created in retaliation for these

mandatory laws, along with the publishing of several anti-vaccination journals (The

History of Vaccines, 2018).

In the year 1998, former medical doctor Andrew Wakefield brought up a

suggestion about the possibility of MMR (Measles, Mumps and Rubella) vaccination

and autism in children being linked. A respected scientific journal of that time known

as “The Lancet” published his research but would later on be withdrawn in 2004

once an investigation uncovered significant flaws in his study. The former doctor was

unable to disclose plenty of conflicts of interests and got involved in a lawsuit for his

claim linking MMR and autism. A later investigation conducted by a British Medical

Journal discovered that Mr. Wakefield and his research team selected data that

complemented their case and falsified established facts in their studies, ruling him

guilty of deliberate fraud. The General Medical Council of the United Kingdom ended

up revoking his medical license as he had abused his position and triggered a false
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controversy due to his unethical actions. This scandal has affected MMR

vaccinations, showing a decline that remains to be seen in the present date. There is

still no existing scientific study linking MMR and autism (Kandola, 2020).

While their claims are illogical as they are not based on science, their

influence has no doubt spread among the population. The anti-vaccine movements’

success is reflected not only in the re-emergence of measles, which was stated to

be gone in the United States in the year 2000, but also poses a threat to reject the

progress steadily built to combat other dangerous communicable diseases. Despite

the evolution of vaccines that have controlled or eliminated contagious disease

which lead to the improvement of the quality of life, how legitimate they are has been

assaulted by the lack of proper and adequate information (Lynam & Johnson, 2019).

A philosophy expert at the University of Guelph, Ontario named Maya Goldenberg

studied the phenomenon of vaccine hesitancy. According to her, it has more to do

with the mistrust of the general populace in their scientific institutions and

government and less with people misunderstanding the science. In addition, a

medical historian at the University of Bristol in England named Agnes Arnold-Forster

stated that the people who were victims of oppression and harm in historical times

were the likeliest to resist vaccines (Haelle, 2021).

In a study entitled “Fact vs Fallacy: The Anti-Vaccine Discussion Reloaded,”

the researchers concluded that the anti-vaccination movement demonstrated a

large-scale tendency of people thinking critically and independently, labeling it as a

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promising feature of human development. They did emphasize that this was a

display of the people doing research and arriving to independent conclusions when it

comes to health-related topics, not saying that the arguments are correct however.

What drives the anti-vaccination movement are fear, misinformation and mistrust

(Stolle et al., 2020).

B. Anti-Vaccination in the Philippines

The COVID-19 pandemic has been a challenge across the globe, including

the Philippines. It caused a major shift in the everyday life of Filipino citizens.

However, the existence of scientific and medical professionals all over the world

made a breakthrough in the development of vaccines for COVID-19, which they

claim to be an effective way to protect and reduce the possible severe cases in the

community (Department of Health, 2021). While the available vaccines are among

the solutions in our current situation, many people opted to leave their job rather

than be vaccinated because of their fear and anxiety during this health crisis.

The Philippines is facing its most alarming problem yet, vaccine hesitancy.

Despite having the worst cases rates in Southeast Asia. Westerman (2021) stated

that there are many reasons why many Filipinos do not want to get vaccinated. One

of those is the rampant misinformation passed by word-of-mouth or different

conspiracy theories spread online. In addition, the government’s information

regarding vaccines is sometimes unclear and confusing.

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The beginning of the vaccination in the Philippines, particularly to the

healthcare workers, was crucial because of their distrust of the government vaccine

campaign. Addition to that, being a lower middle-income country, rich countries

bought the supplies for other vaccines such as Pfizer and Moderna which is why the

Philippines was struggling because they can only administer what is available. Given

the fact that healthcare workers are the top priority for vaccinations, it was reported

that there is a massive number of resignations in hospitals particularly in Makati

Medical Center in Metro Manila (Mccarthy, 2021).

In accordance with Regencia (2021), the vaccine hesitancy of health care

workers cannot convince other workers to be part of the vaccination program. More

so, the government publicized that the main vaccines that will be used in the

Philippines are Sinovac doses from China despite the absence of its reliable data

and incomplete trials which feared the people. Also, with the previous experience of

the Filipinos about the 2016 anti-dengue vaccine Dengvaxia under the Aquino

administration therefore, they could not trust the government anymore. Further, Dr.

Nisperos, a professor at University of the Philippines (UP), College of Medicine

stated that the Duterte administration might be making the same mistake in the past

administration. However, he believes that the Filipino citizens deserve the safest and

most effective vaccine that is available.

One of the most influential people to promote COVID-19 vaccinations are the

health care workers. However, even with the vaccine development and distribution,
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hesitancy and anxiety among health care workers are evident in their population.

According to research, workers are hesitant to be vaccinated because of their lack of

trust in vaccine safety and their little or conflicting information about the vaccines

(Gennaro et al,. 2021).

According to Social Weather Stations, cited by Tomacruz (2021), only 32% of

adult Filipinos are willing to get vaccinated if they will be given a chance slot for a

free vaccination. SWS added that one’s educational level was not dependent on

their willingness to get vaccinated. The Filipino people being reluctant of the vaccine

is causing a derailment to the government’s target. With that, lawmakers in the

Philippines have encouraged the Department of Health, local government, and

pandemic officials to urgently intensify informing the public to curb the rising

hesitancy of getting vaccinated, which is a key to prevent hospitalizations and

deaths.

As the Philippines is currently distributing COVID-19 vaccines, it is coupled

with the vaccine hesitancy of some Filipino people to get vaccinated due to the

confusing information regarding vaccine efficacy. With that, the government needs to

accumulate public trust to convince people to get vaccinated. Recent studies

indicate that a more localized public education can help public officials and health

care workers build and intensify public trust (Cordero, 2021). Nevertheless, this

necessitates a lot of clarification to enlighten some Filipinos if applied in the current

condition of vaccine distribution in the Philippines, where information regarding

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efficacy is fully executed online. In the same way Sec. Andanar (current secretary of

the Presidential Communications Operations Office) acknowledged that the lack of

comprehension continues to be a widespread problem in the Philippines, especially

in the middle of the pandemic. More so, the spread of false information makes it

more complicated for some individuals and groups who claim that vaccination is not

a good and safe option for virus immunization (Carlos, 2021). On January 19,

Andanar’s office and the Philippine Information Agency, launched the

“Explain.Explain.Explain” campaign, which aims to encourage the public to receive

the COVID-19 vaccine.

C. Anxiety and COVID-19

According to Dr. William Orme, cited by McCalum (2021), the feeling of

nervousness and anxiety about the vaccine brands is understandable despite the

available safety data. He added that people want to know what they are getting into ,

especially with their health and bodies. There are many what-ifs an individual could

ask oneself before getting vaccinated and all those what-ifs can reasonably cause

anxiety. In line with this, those who fear needles will be at a great advantage as it

stops them from receiving the vaccine, which is called trypanophobia. It is a

psychiatric condition where irrational stress and fear of being pricked by the needles

cause severe feelings of anxiety (Prather, 2021). Prather added that even hearing

daily news broadcasts about the need to get vaccinated can induce panic and fear in
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them. Thus, people with trypanophobia are a group that can highly refuse the

COVID-19 vaccine.

The COVID-19 pandemic raises anxiety disorders and it is now evident to

anxiety about the vaccine because everyday news about it is changing. Health

Clinical Psychologist Kaye Harmanson stated that the anxious feeling of an

individual is valid because there is a reason to be frightened especially with the

uncertainties about the flux information in vaccines (UC Davis Health, 2021). In line

with the massive cases of anxiety among the people, specifically those who are in

the working class, the National Institute of Health has termed the anxiety disorder

related to COVID-19 as “corona phobia” (Tugman, K. & Ballin, G, 2021). As the

vaccine rollout across the globe started, many mental disorders such as anxiety

affects vaccine compliance in the community. Whereas, it can be considered as a

big issue because most of the people who refuse to be vaccinated are those who

are in the working class which may prevent the country from reaching herd

immunity. However, people have their reason for their reluctance to get the vaccine

because they feel like the vaccines are developed quickly and everyone has their

own opinions, doubts, and beliefs that causes their anxiety toward the vaccines

(Rush, 2021).

Purpose of the Study

With the outbreak of the COVID-19 virus, the medical community strived to

create the vaccine that would hinder its further spread to the global population.
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According to the official website of the Department of Health (DOH), AstraZeneca

vaccines exceeding 480,000 doses first arrived in the Philippines from the COVAX

Facility last March 4, 2021, the country being among the first countries in the

Southeast Asia region to receive them. On July 25, 2021, the Our World in Data’s

statistics of the Philippines showed that 16.4 million doses have been given and 5.56

million have been fully vaccinated, leading to 5.1% of the population being fully

vaccinated. One of the possible reasons for the slow vaccination rate might have

stemmed from anti-vaccination attitudes. This study aims to conduct a survey if the

workers in the province of Pampanga portray a relationship between anxiety and

anti-vaccination attitudes.

Statement of the Problem

This study aims to determine the degree of the relationship between anti-

vaccination attitudes and anxiety of workers in Pampanga against the COVID-19

vaccines. This study will specifically aim to address the following questions:

1.) How can the participants be described in terms of the following vaccine

attitudes:

a. Mistrust of vaccine benefit

b. Worries about unforeseen future effects

c. Concerns about commercial profiteering; and

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d. Preference for natural immunity?

2.) Is there a significant relationship between anti-vaccination attitudes and

anxiety?

Research Hypothesis

There is a significant relationship between the anti-vaccination attitudes and

anxiety of the working class in Pampanga against the COVID-19 vaccines.

Methodology

Research Design

The focal point of the study is the predictive relationship between anti-

vaccination attitudes and anxiety of the working class of Pampanga against COVID-

19 vaccines. The researchers concluded that the research design that would be the

perfect fit for this study is the correlational research design, which is a type of non-

experimental design to assess the relationship of the two variables with the use of

quantitative methods of collecting data (Bhandari, 2021).

Participants Criteria

The researchers will select 45 respondents whose ages range from 18 years

old and above. More so, there will be a criterion in participation of the study because

the participants must be in the working class or those who are employed residing in

Pampanga. In addition to that, this sampling method occurs to meet the objectives
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of the study because the selection is based on the characteristics of the respondents

needed for the study (Crossman, 2020).

Table 1

Demographic Characteristics of Respondents

Demographics Frequency Percentage

GENDER
Male 29 64.6%
Female 15 33.3%
Bisexual 1 2.2%
Total 45 100%
Age
18-22 20 44.6
23-27 19 42.2%
28-32 2 4.4%
33-37 0 0%
38-42 1 2.2%
43-47 1 2.2%
48-52 2 4.4%
Total 45 100%

Sampling

Purposive sampling will be used in the study. This sampling method relies on

the researchers’ judgement when it comes to who will be the best source of

information to succeed in obtaining the objectives of the study. The researchers

need to concentrate on people who share the same variables and are willing to

participate in the study (Etikan, 2017). In this case, we are intentionally for workers
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situated in Pampanga as our study centers on the attitudes and anxiety of these

people when it comes to the COVID-19 vaccines.

Instruments

Questionnaires will be utilized in this study. These instruments are composed

of successive questions anchored to collect the needed information from

respondents (McLeod, 2018). This method enables the researchers to gather data

indirectly and to have no face-to-face contact with the respondents (Trigueros et al.,

2017). This is a needed procedure as this study occurs during the COVID-19

pandemic wherein people are suggested to stay indoors to lessen contact with other

people to avoid catching and passing the virus. Google Forms, an online platform,

will be used to acquire information.

The following scales will be used:

The Vaccination Attitudes Examination (VAX) Scale is a 12-item scale

(comprising 4 subscales) utilized to evaluate anti-vaccination attitudes. The scale is

stated to be an efficient tool for identifying people who resist vaccination, with the

four subscales enabling a more detailed understanding of the essence of these

views. Each of the items on the scale are scored from “1 = strongly disagree, 2 =

disagree, 3 = somewhat disagree, 4 = somewhat agree, 5 = agree, and 6 = strongly

agree.” These four subscales are: (a) relate to mistrust of vaccine benefits (#1-3); (b)

to worries over unforeseen future effects (#4-6); (c) to concerns about commercial

benefits (#7-9); and (d) to preference for natural immunity (#10-12). Two adult
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samples in the United States established sufficient convergent validity and internal

reliability (Cronbach’s alphas = 0.77-0.93) for all four subscales (Martin & Petrie,

2017) while another sample in the United Kingdom established the same adequate

validity and internal reliability (Cronbach’s alpha=0.92) (Wood et al., 2018).

Garnering high total scores from the test implies more negative attitudes towards

vaccines. Each of the four subscales were grouped as follows: high levels (a score

of 5-6 on a scale of 1-6); intermediate levels (score of 3-4); and low levels (score of

1-2) of negative attitudes towards vaccines. The researchers plan to have a Filipino

translation of the questions next to the English ones and also modify the 12 items to

directly address COVID-19 vaccines.

The Generalized Anxiety Disorder Assessment (GAD-7) is a 7-item scale

utilized to measure the severity of generalized anxiety disorder (GAD). Scores of 0,

1, 2, and 3 are respectively assigned to the response categories with “not at all,”

“several days,” “more than half the days,” and “nearly every day.” Each item rates

the severity of the respondent’s symptoms over the past two weeks. These will be

added together for the seven questions. The range of the total score is from 0 to 21.

The scores represent the following: minimal anxiety (0-4); mild anxiety (5-9);

moderate anxiety (10-14); and severe anxiety (15-21). It was shown to have an

excellent internal consistency, good test-retest reliability, and strong criterion validity

(Child Outcomes Research Consortium, 2021). It also has a good reliability as well

as construct, procedural, and factorial validity (Spitzer et al., 2006). A Filipino

translation of the scale is already available and free to use.

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Data Collection

Upon the appropriate dissemination of the tool used for the study, the

researchers had to think of possible and convenient ways to collect data in these

trying times without compromising the researchers' and participants' safety. With

this, the utilization of media is the best to use. In this quantitative study, data

gathering is held through an online survey form to achieve the desired number of

participants, which is fifty (50). The survey method is a type of correlational study

used to gather data in which the participants fill questions focused on the subject of

interest (Cherry, 2020). With the benefit of the internet, the data collection proper

has a more accessible approach to reach the target participants, fast and practical

with all the people involved since it does not require any financial demands and the

fact that the participants get to choose their preferred time in answering the survey

form.

Data Analysis

After the gathering of data, the scores of each participant will then be placed

into the SPSS software. According to Alchemer (2021), most researchers consider

SPSS (Statistical Package for the Social Sciences) as the best-of-class solution for

in-depth statistical analysis as to why it can easily handle and operate information

regarding the gathered data. Due to the study's research design, the researchers will

use Bivariate Correlation to analyze the results, which gives the interpretation of all

variables, including the demography of the participants, the raw scores, the mean,
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and the standard deviation. Bivariate Correlation refers to the statistical techniques

used to determine the relationship between two variables (Allen, 2017).

Ethical Considerations

Throughout the process of the study, the researchers aim to prioritize the

safety of the participants where there will be no harm, by all means possible,

imposed on any individuals who will be participating in the entire duration of the

study. Upon answering the Google survey form, the researchers will be giving

informed consent and brief the participant to ensure that there will be no coercion

present while conducting data collection. Thus, the participants are welcome and

advised of any concerns regarding the procedure and nature of the study. The

participants also have the liberty to choose their time preference and withdraw

whenever they feel uncomfortable and unsafe. Above all, the identification and

responses of the participants will be treated with utmost confidentiality. The data

gathered will be kept secured by the person in charge, and all given documents will

be solely used for the demands of the study alone and will not partake in any activity

that does not relate to the study.

Scope and Delimitation

This study only covers the relationship between anti-vaccination attitudes and

anxiety against COVID-19 vaccines. In addition, this study will only cover the

working class residing in Pampanga.

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Results

This chapter presents the results obtained from the data gathering. It includes

its descriptive statistics, and correlational analysis.

Table 2

Descriptive Statistics

Rating Range
Vaccination
Attitudes Standard
N Mean Minimum Maximum
Examination Deviation
(VAX) Scale
Mistrust of vaccine 1 6
45 2.61 1.11
benefits
Worries over 1 6
unforeseen future 45 4.95 1.21
effects
Concerns about 1 6
commercial 45 3.25 1.28
benefits
Preference for 1 6
45 3.07 1.43
natural immunity
VAX Scale 45 3.47 1.26 1 6

Anxiety Scale 45 9 4.59 0 21

Valid N (listwise) 45

The descriptive statistics results showed the following: The subscales for the

vaccination attitudes examination scale showed that when it came to mistrust of

vaccine benefits, the rounded off mean is 3 (intermediate); worries over unforeseen
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future effects had a rounded off mean of 5 (high); concerns about commercial

benefits had a rounded off mean of 3 (intermediate); and lastly was the preference

for natural immunity having a rounded off mean of 3 (intermediate). The total scale

score is 3 (rounded off from 3.47), indicating there is an intermediate level of

negative attitudes when it comes to vaccination.

On the other hand, the mean score when it came to the anxiety of the

respondents was 9 (rounded off from 9.26), landing at the level of mild anxiety.

Table 3

Correlation Analysis

1 2 3 4 5
1. Extraversion Pearson
1 .493** .396** .438** .104*
Correlation
Sig. (2-tailed) .001 .007 .003 .499
N 45 45 45 45 45
2. Worries over unforeseen Pearson
. 493** 1 .489*** .448* .535**
future effects Correlation
Sig. (2-tailed) .001 .001 .002 .000
N 45 45 45 45 45
3. Concerns about Pearson
.396** .489** 1 .395** .187
commercial benefits Correlation
Sig. (2-tailed) .007 .001 .007 .220
N 45 45 45 45 45
4. Preference for natural Pearson
.438** .448** .395** 1 .311*
immunity Correlation
Sig. (2-tailed) .003 .002 .007 .037
N 45 45 45 45 45
5. Anxiety Pearson
.104* .535** .187** .311* 1
Correlation
Sig. (2-tailed) .499 .000 .220 .037
N 45 45 45 45 45

Correlation is significant at the 0.01 level (2-tailed). **

Correlation is significant at the 0.05 level (2-tailed).*

Correlation among the subscales of the Vaccination Attitudes Examination

(WAX) scale and anxiety scale has been checked through correlation analysis.
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A strong correlation is found between worries over unforeseen future effects

and anxiety when it was set at the 0.01 level. Another notable correlation is found

between preference for natural immunity and anxiety, which is said to be a medium

correlation at 0.05 level.

The result indicated that one out of the four subscales have a statistically

significant relationship at (p<0.01). It was worries over unforeseen future effects that

had the positive and strongest correlation to anxiety (0.535).

With the gathered data, the researchers chose to reject the null hypothesis.

Discussion

This chapter presents the findings, discussion and analysis of the study

obtained from the questionnaires distributed to the respondents. The research

questions are answered in the order they were presented in the statement of the

problem.

1.) How can the participants be described in terms of the following vaccine

attitudes:

a. Mistrust of vaccine benefit

Based on the gathered data, findings obtained showed that most of the

participants (N=45) showed mistrust of vaccine benefits (M=2.61) which also

indicates an intermediate average score. Addition to that, the dispersion of scores is

at (SD=1.11) which shows that the individual responses of the participants is on an

average point. With this given result, we can say that most of the participants, which
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are the working class in Pampanga, are still hesitant and do not trust the possible

benefits of COVID-19 vaccines. A study conducted by Centre for Business

Intelligence & Data Analytics shows that there are many factors that drive vaccine

hesitancy and commonly it is their mistrust to the safety and effectiveness of the

vaccines that are available, therefore this could be a challenge in the implementation

of vaccine programs across the globe (Centre for Business Intelligence & Data

Analytics, 2021). Further, the public announcement of vaccine efficacy is more likely

a contributing factor to this behavior. There are vaccines who have an efficacy rate

of 95 and 75 percent and these vaccines are administered globally. However, data

reveals that vaccines with 75 percent efficacy are mostly distributed to people who

work lower wage jobs and those who lack access to health care (Buaron, 2020).

b. Worries about unforeseen future effects

In terms of worries about future effects, which is also a subscale for the

vaccination attitude examination scale, participants (N=45) showed the highest

average score of (M=4.95) which indicates that this factor highly contributed to their

anti-vaccination behavior. Further, research shows that most of the people who have

not signed to be vaccinated are worried about the possible unknown long-term effect

of the vaccines. To illustrate, the Johnson & Johnson vaccine whereas health

officials learned that people who received the vaccine may experience serious blood

clotting problems. The distribution of this vaccine was stopped globally despite a

high number of people who received the vaccine (Health Care, 2021). These people

are concerned about their health as they know that when a vaccine was released
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side effects may show months or years, resulting in a common pattern of behavior

which are doubt and worries.

c. Concerns about commercial profiteering; and

Based on the descriptive statistics, one of the subscales for the vaccination

attitudes examination scale, which is the concerns about commercial profiteering,

shows a total mean of 3.25 with a standard deviation (SD) of 1.28, indicating an

intermediate level of the negative attitude of the working class of Pampanga when it

comes to the vaccine. In the Philippines, vaccines are said to be provided by the

Philippine government, prioritizing the frontliners. Hence, the workers (Tomacruz,

2021). According to Manalo et al. (2021), as COVID-19 becomes available in the

Philippines, the Department of Labor and Employment (DOLE) issued Advisory

No.03 Series of 2021 or the Guidelines on the Administration of the COVID-19

vaccines in the worksites. The guidelines address the rules that apply to any

vaccination policy implemented in the workplace by employers and covered

establishments. With this, no immunization costs in the workplace shall be charged

to or passed on to employees, either directly or indirectly. However, David (2021)

stated that there had been reports in the country that some people have been selling

COVID-19 vaccines or vaccine slots illegally for monetary gain, even if the vaccines

are free to the public.

d. Preference for natural immunity?

For the subscale of preference for natural immunity, the mean score is 3.07

with a standard deviation (SD) of 1.43, which also shows an intermediate level of the
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negative attitude of Pampanga workers. As stated in the Makati Medical Center

(2021) article, natural immunity needs to be addressed to achieve herd immunity.

Many people believe that natural immunity helps people acquire resistance to the

virus. When the body is exposed to a contagious sickness and eventually recovers,

the body's natural response is to produce antibodies to fight the virus or bacterium.

Those who survive infection are usually rendered immune to future conditions. Even

so, it is perilous and could lead to widespread disease and, worse, death. It is

impossible to say how long a person will be protected against reinfection once they

have recovered from the virus. Even if the person has antibodies, there is a potential

to become infected with COVID-19 again.

Moreover, the healthcare system could be quickly overburdened if the people

rely on natural immunity. To combat COVID-19, almost 70% of the population would

have to recover. When the frequency of infections increases and affects those most

vulnerable (e.g., the elderly and those with pre-existing medical issues), which can

do more harm than good.

2.) Is there a significant relationship between anti-vaccination attitudes and

anxiety?

There is indeed a correlation found between the anti-vaccination attitudes and

anxiety, especially with the subscale “worries over unforeseen future effects” at

0.535<0.01 (moderate correlation). A comparison study about the impact of COVID-

19 pandemic on the physical and mental health between the Philippines and China

revealed how the former had significantly higher levels of depression, anxiety, and
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stress than the latter. It was shown how Filipino respondents were more likely to

report recent usage of but with lower confidence on medical services, concerns

about family members contracting COVID-19, and dissatisfaction with health

information. The following were associated with their adverse mental health:

dissatisfaction with health information, long daily duration spent on health

information, low confidence in doctors, ostracization, student status, worries about

family members contracting COVID-19, and unnecessary worries about COVID-19

(Tee et al., 2021).

Conclusion

The study provides results that can efficiently explain the relationship of

vaccination resistance and anxiety among the working class in Pampanga that leads

to the understanding of this behavior to the ongoing COVID-19 vaccination program.

In line with the collected data from the participants (N=45), researchers produced a

result of strong correlation between anti-vaccination behavior and anxiety; the given

data resulted in rejecting the null hypothesis of the study. This implies that there are

various factors that contribute to the vaccination resistance of the working class in

Pampanga, and it also significantly impacts their mental well-being that causes

stress, anxiety, and lower confidence to participate in the vaccination program.

Addition to that, we should also note that the results have backed up similar studies

that can be used to further expand knowledge and understand the topic.

Recommendations
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● The research results from our data collection process exhibit a moderate

positive correlation between the anti-vaccination attitudes and anxiety,

especially with the subscale “worries over unforeseen future effects.”

Therefore, the researchers recommend that the public educate themselves

regarding the COVID-19 vaccine and practice fact-checking to steer clear of

vaccine hesitancy and further protect themselves from the COVID-19.

● However, looking at the outcome of the study from anti-vaccination and

anxiety. The working class of Pampanga indeed possessed vaccine

hesitancy; that is why the Philippine government must amplify the call tailored

to the masses to achieve herd immunity.

● Due to time constraints, the researchers were only able to reach a

manageable number of subjects, a total of 45 workers of Pampanga. As a

result, a higher number of participants in the future study would be

considerably more beneficial in increasing credibility and support in the

results and discussion sections. In addition, this research may be conducted

in other provinces and also be undertaken through the qualitative research

approach.
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Appendices

I. Informed Consent

Confidentiality and Anonymity

Your answers will be collected and kept to help with the identification of the

relationship between the anti-vaccination attitudes and anxiety of the working class

of Pampanga. Responses will be kept and treated with utmost confidentiality and

anonymity. Your email, along with other identifying information, will not be disclosed

to third parties nor brought up in the parties nor brought up in the discussion of the

results or any part of the paper in accordance with Data Privacy Act of 2012. You

may choose to back out from answering the questionnaire if a circumstance ever

arises wherein you feel uncomfortable in continuing. The answer will only be

accessible to the researchers. These records will be permanently deleted after the

study has been completed.

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Rights as Participants

Your contribution to this research is entirely voluntary. You are free to decline

to participate for any reason. If you decide to participate in this study, you will be

asked to sign a consent form. And suppose you choose not to participate in this

study; you can withdraw your consent and discontinue your participation. It will not

affect the relationship you have, if any, with the research. If any, with the researcher.

If you withdraw from the study before data collection is completed, your data will be

returned to you or destroyed.

Benefits and Risks

Answering our questionnaire could be a means of self-evaluation to think

about how you feel about the vaccines, especially when it comes to learning if you

are anxious about them. Your responses may help us learn more about the research

we are conducting and future researchers will also benefit from it.

This study does not involve any risk. There are possible questions that may

cause discomfort. There are no foreseeable risks involved in participating in this

study. You may refuse or decline to answer the given questions by not responding to

the test anymore.

Your responses and participation are vital in conducting our research study.

We would like to thank you in advance for your time and participation. Please be

reminded to answer the questions with utmost honesty and integrity.

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II. Survey Form/s

● Vaccination Attitudes Examination (VAX) Scale

1. Naramdaman 'kong ligtas ako matapos akong bakunahan. / I feel safe after
being vaccinated.

2. Maaasahan ko ang mga bakuna upang maiwasan ang mga malubhang sakit na
nakakahawa. / I can rely on vaccines to prevent serious infectious diseases.

3. Naramdaman 'kong protektado ako matapos mabakunahan. / I feel protected

after getting vaccinated.

4. Bagat karamihan sa mga bakuna ay mukhang ligtas, maaring may mga

problema na hindi pa natutuklasan. / Although most vaccines appear to be safe,
there may be problems that we have not yet discovered.

5. Ang mga bakuna ay maaring maging sanhi ng hindi inaasahang problema sa

mga bata. / Vaccines can cause unforeseen problems in children.

6. Nababahala ako sa mga hindi pa nalalamang epekto ng mga bakuna sa

hinaharap. / I worry about the unknown effects of vaccines in the future.

7. Malaki ang perang nakukuha mula sa mga bakuna na napakikinabangan ng

mga pharmaceutical companies at hindi ng mga regular na tao. / Vaccines make a
lot of money for pharmaceutical companies, but do not do much for regular people.

8. Hinihikayat ng mga awtoridad ang pagpapabakuna para sa perang kikitain nila

at hindi para sa pangkalusugang kapakanan ng mga tao. / Authorities promote
vaccination for financial gain, not for people's health.

9. Ang programa sa pagbabakuna ay isang malaking panloloko lamang. /

Vaccination programs are a big con.

10. Ang natural immunity o likas na imunidad ay mas tumatagal kaysa sa

pagpapabakuna. / Natural immunity lasts longer than a vaccination.

11. Ang natural na pagkakalantad sa bayrus at germs ay maituturing na

pinakamabisang proteksyon. / Natural exposure to viruses and germs gives
the safest protection.

12. Mas magiging ligtas ang immune system ng tao kung ito ay na-expose sa sakit
sa natural na paraan kumpara sa taong na-expose sa paraan ng
pagpapabakuna. / Being exposed to diseases naturally is safer for the immune
system than being exposed through vaccination.
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● Generalized Anxiety Disorder Assessment (GAD-7)

1. Pakiramdam na ninenerbiyos, nababalisa o tensiyonado. / Feeling nervous,

anxious or on edge.

2. Kawalan ng kakayahan na pigilan o kontrolin ang pag-aalala. / Not being able to

stop or control worrying.

3. Labis na pag-aalala tungkol sa iba’t ibang bagay. / Worrying too much about
different things.

4. Hirap na makapag-relax. / Trouble relaxing.

5. Labis na hindi mapakali kaya nahihirapang manatili sa kinatatayuan. / Being so

restless that it is hard to sit still.

6. Nagiging madaling mayamot o mairita. / Becoming easily annoyed or irritable.

7. Pakiramdam na natatakot na baka may mangyaring masama. / Feeling afraid as

if something awful might happen.

III. Reflexivity Journals

Hermoso, Alyssa F.

After identifying the variables in our study and with the research designs that

we chose, it is expected of us to see if there is a relationship between the anxiety of

Filipino workers and their hesitancy to get the vaccines during COVID-19 Pandemic.

My impression right now, specially that we are not yet in the process of data

collection, I think that we can easily find our respondents because they are from the

working class in our society, on the other hand, I think that it will be hard for us to

ask for their time especially during this time when they are busy providing for their
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family. Given the fact that our respondents are the working class in the Philippines, I

believe that they will be more cooperative, and they will be honest in answering the

instruments that we will use because they will understand that our study will be

beneficial to them because we are addressing the issues involving them. As a

researcher, I must be responsible enough to know my role in the whole process of

our research. I must provide facts specially during the collection of related literature

to support our study. Also, I must comply with ethical considerations in writing our

research as well as during the interaction with our respondents. This is important

because research should be followed with scientific methods so I must be aware of

these things. We specifically chose our research study because we believe how

important the working class is in our society and how crucial it is for them to be part

of the vaccination program without certainty on what will happen. With that said, I

value the information that we will produce, and I know that this will add to the

knowledge of other people and to other researchers.

Maravilla, Estefannie S.

My expectation and goal in our current study is that we will be able to

determine the possible reasons for the slow vaccination rate that might have

stemmed from the anti-vaccination attitudes and anxiety of the working class in

Pampanga. With regards to my impression of the respondents before the interview, I

can tell that they are very much willing to participate in our study and willing to

answer all the questions prepared by the researchers. After the interview, their
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willingness to participate becomes more vivid as to why it seems like they answered

the questions honestly, without a hint of being coerced, which is compulsory. In

relation to the participants 'honestly answering all the questions, the assumption I

have in mind is that we, as the researchers, can tell if the workers in the province of

Pampanga display a negative belief against the vaccination rate through conducting

a survey. My role in the research process is to constantly educate myself about our

topic and coordinate with my co-researchers for us to achieve successful outcomes

or findings. As a citizen of the Philippines, it is one of the many duties I must do to

educate myself further with all the happenings that I could share with others.

Talavera, Allysa Madelaine J.

I am expecting that our study on the attitudes and anxiety of workers in

Pampanga when it comes to COVID-19 vaccines will be useful information to

families and community leaders. For me, the goal is to learn what these workers

think about these vaccines since these are required to be administered to them. This

is especially applicable to them because of their need to go out and continue

working to earn a living. I think we might experience a delay in gathering data since

these workers might not be tech-savvy when it comes to answering online

questionnaires. I am hoping that they have someone around them that can help

them answer or understand what they need to do. Given that they are workers,

some of them might not have the time to spare to answer our forms. After the

interview, I hope some of them would be willing to reach out and ask about our
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results so they could get a consensus of what most workers in Pampanga think

about the COVID-19 vaccines. I am thinking that some of them might not like seeing

that the questions are in English. I’m considering having the questions translated

into Filipino to make it easier for them to understand.I am assuming that the findings

will show that there might be a small amount of people who are anxious about

getting vaccinated. I believe there could be a larger number of people who are

looking forward to getting vaccinated. As the leader of the group, I believe it is my

role to oversee the research process. I need to go through the resources and

references we used; check if our paper didn’t have plagiarized content; see if our

participant count has reached its maximum limit; and designate tasks to other

members. My relationship with this knowledge is my want to know how these

workers think and feel about these vaccines. Given that some of them could be

parents, it could affect their line of thinking and decision if they want their children

and other family members to get vaccinated.