Barriers Affecting COVID-19 Booster Shot Acceptability

Among College Students In San Luis Pampanga

Group 3:

Alonzo, Andrei Peter

Bartolome, Renz Tjay

Camas, Marvey Jamielle

Mandap, Michelle Jane

Mata, Crystelle Anne

Taruc, Lucia Erika

Introduction

All along the journey of this pandemic, there was a massive development in fighting the

virus with the use of vaccines. Everyone wants to end this pandemic as soon as possible

to return the life, the way it was before. Even though COVID-19 is still ongoing, there

are lots of ways to lessen its effects by using the resources that every nations has, such as

these vaccines. Between the first and second doses, most citizens did not anticipate that a

third dose would be advised in order to ensure that everyone would have stronger

protection against the COVID-19 virus. The COVID-19 booster shot completes the

sequence of vaccinations that provides each person with a defense against the virus. The

COVID-19 booster shot is the vaccine that is administered following the first and second

doses of the initial shots (Maragakis & Kelen, 2022).

Vaccines play a vital role as a solution for immunization in this pandemic. The strong

protection that a vaccine holds against serious illness, hospitalization, and even death

from COVID-19 was provided by the vaccine according to the (World Health

Organization [WHO], 2022). In addition to the first two doses, booster shots were

introduced to the public as the third dose that provides immunity that the first two do not

and failing to protect them against new variants may be advised to get the booster shot.

The booster shot completes the series of COVID-19 vaccinations as of this moment.

Since COVID-19 continuously produces new variants and has become more dangerous to

humans, expecting that someday new vaccines may be needed, just like the booster shot.
COVID-19 virus mutates over time and makes different variants, such as Omicron, Delta,

and more including their subvariants, that are being watched as time goes by. Because of

their characteristics as contiguous and easily transmissible, these variants may affect the

properties of the virus to be stronger, such as its ease of transmission and the severity of

the associated illness (World Health Organization [WHO], 2022). Recommending the

series of COVID-19 vaccinations simply ensures that you have given a long-lasting

protective immunity against the virus.

Around 71.5 million Filipinos in the Philippines had received the entire COVID-19

vaccine as of September 22, 2022. Those who received single-dose vaccinations are

included in this. On the other hand, 70 million people were still waiting for their second

vaccination. While, around 19.18 million people have previously received a booster shot

(Statista Research Department, 2022).

However, several barriers that affect COVID-19 booster shot acceptability are widely

spread worldwide. Hesitancy in taking the vaccine is very prominent due to some factors,

including beliefs, trust and confidence, vaccine-related knowledge, misinformation, and

the side effects of the vaccine (Marzo et al., 2022). Additionally, COVID-19 booster

dosages will eventually be crucial to the public health response to the epidemic.

The ,general populace's acceptance of a booster dose, however, becomes a possible

worry. Due to hesitation and suspicion upon vaccination, COVID-19 immunization

attempts have been hindered.

COVID-19 booster doses will eventually be essential for the public health response to the

outbreak the outbreak of this pandemic. However, it becomes possible to be concerned

about how the general public may react to a booster dose. The attempt to immunize

against COVID-19 has been hampered by reluctance and mistrust (Organization for

Economic Co-operation and Development [OECD], 2021).

Corona Virus disease 2019 (COVID-19)

A coronavirus is a kind of common virus that causes an infection in your nose, sinuses, or

upper throat. Most coronaviruses aren't dangerous. In December 2019, pneumonia

brought on by an infection with the SARS-CoV-2 coronavirus first appeared in Wuhan

City, Hubei Province, China. The World Health Organization (WHO) will formally refer

to the illness brought on by SARS-CoV-2 infection as coronavirus disease by February

11, 2020. (COVID-19). Fever, a dry cough, and exhaustion are the most common clinical

symptoms of COVID-19, and pulmonary involvement is frequently evident. Being

extremely contagious, SARS-CoV-2 can infect the majority of people in the general

population. Currently, the main sources of the disease, which is spread through

respiratory droplets and direct contact, are infected individuals and wild animal hosts

( Journal of Zhejiang University-SCIENCE, 2020).

The (World Health Organization [WHO], 2020) declared a pandemic on March 12, 2020,

due to the SARS-CoV-2 virus's widespread distribution and the thousands of deaths

brought on by COVID-19. To date, the epidemic has cost the world dearly in terms of
lost human lives, negative economic effects, and rising levels of poverty. In this review, it

covers epidemiology, genetic and serological diagnosis, the origin of SARS-CoV-2 and

its capacity to infect human cells, as well as safety concerns. Then, all individuals

concentrate on the COVID-19 epidemic's effects on the way of life, the available

treatments for the disease, the creation of vaccines, the use of artificial intelligence to

manage the pandemic and stop the virus' spread, the impact of the epidemic on our

lifestyle, and preparation for a potential second wave (Ciotti et al., 2020).

An illness caused by a virus called SARS-CoV-2-virus The virus can be transmitted via

spread of droplets or small particles that contain virus from the mouth of an infected

person that can be acquired through sneezing, coughing, and personal communication

with others (MedlinePlus, 2019).

According to the study of Capone et al. (2022), coronavirus disease 2019 (COVID-19)

causes a complex set of symptoms that primarily affect the respiratory system, but often

also affects multiple organs, leading to life-threatening conditions and It can even lead to

death. Like many other viruses, SARS-CoV-2 tends to mutate over time. The

nomenclature currently in use divides variants into four classes. Variant Being Monitored

(VBM), Variant of Interest (VOI), Variant of Concern (VOC), and Variant of High

Consequence (VOHC).

The majority of individuals who are infected with the COVID-19 virus will experience

mild to severe respiratory diseases and will recover without special care from healthcare
professionals. However, some people will get serious illnesses and need to see a doctor.

Being aware of how the virus can be transmitted and how to slow down or stop the

transmission of this virus can prevent its spread. Keeping a distance of at least one meter

between people, wearing a mask that fits properly, and often washing your hands or using

alcohol can prevent the spread of viruses to both yourself and other people. In addition,

when it is your turn, get your vaccination and abide by local guidance (World Health

Organization [WHO], 2020).

COVID-19 Booster Shot

Based to the (World Health Organization [WHO], 2022) with the support of the Strategic

Advisory Group of Experts (SAGE), has recommended that booster doses be made

available based on evidence that doing so would significantly reduce hospitalization,

serious illness, and mortality as well as protect healthcare systems. Data currently

available for (WHO, 2022) COVID-19 vaccine products suggest that vaccine

effectiveness and immunogenicity are lower in immunocompromised persons (ICPs),

compared to those who are not immunocompromised. Some nations already provide

additional booster doses in addition to the initial booster dosage.

The booster shot is simply an addition of vaccine that completes the series of COVID-19

vaccination. When the rate of immunity and clinical protection in a population that has

received the primary vaccination series which are the first and second dose of COVID-19

vaccine falls below what is considered to be a suitable level over time, booster doses are
given. A booster dose's purpose is to increase the effectiveness of the vaccine once it is

determined to be insufficient over time (WHO, 2020).

Abramson (2021) stated that, It is advised that everyone who qualifies receive a booster.

According to a review published in 2021 in The New England Journal of Medicine,

getting booster lowers the possibility that you'll contract COVID-19 or that you'll get

seriously ill if you do. The CDC states that any fully immunized person older than 16 can

receive an mRNA booster shot. While receiving a booster it is crucial for halting the

development of COVID-19, it is unclear exactly when someone is "completely boosted"

following that dose.

Over time, the immunity to infection decreases; but the boosters bring your immunity

level back to about where it was after the second dose (Burki, 2021). In short, COVID-19

booster shot boosts your immunity once the first and second dose wanes over time.

According to the study of Achrekar et al. (2022), given the advent of novel SARS-CoV-2

variations, worries about diminishing protection, and the frequency of breakthrough

infections, the majority of nations around the world have thought considering

administering extra booster doses of the COVID-19 vaccine. The booster dosage can

have systemic as well as local adverse effects, such as painful arms, headaches, chills,

fatigue, and nausea.

Vaccine Acceptability
According to Sirikalyanpaiboon et. al (2021), vaccine acceptability is the degree in which

a person accept, doubt, or resist the vaccination. The acceptability of vaccine influences

vaccination uptake rate, in which in turn effect the effectiveness of vaccine distribution. It

is the ability of an individual to make a choice whether they accept or refuse the

vaccination.

Despite the widespread recognition that vaccination against SARS-CoV-2 is one of the

most important pandemic prevention strategies, some people are still unsure about

vaccination. The general public's willingness to receive the vaccine and the factors that

influence this decision have been the subject of numerous studies (Capone et al., 2022).

Vaccine hesitancy remains a major obstacle to achieving optimal immunization coverage

worldwide. Concerns about the safety of various vaccines are growing as public

awareness of the importance of booster administration increases. Depending on the

information received, a person who believes that he would be at high risk of contracting

COVID-19 without a booster dose can easily opt for a booster dose. This suggests that,

despite concerns, people tend to accept booster doses when the benefits outweigh the

risks (Alshahrani et al., 2022).

At some point, the public health response to the outbreak will depend heavily on the use

of booster doses. However, it becomes conceivable to be concerned about how the

general public may react to a booster dose. Initiatives for the COVID-19 booster shot are
anticipated to run into the same challenges as COVID-19 vaccination campaigns have:

resistance and mistrust (Yadete et al., 2021).

Factors, can be used to describe the causes of vaccine unwillingness. Future vaccination

efforts must take into account and address these context-specific aspects in both their

design and evaluation because vaccine hesitancy is a complex and dynamic issue.

According to many experts, it is better to address vaccine reluctance at the population

level (Williams, 2014).

Barriers In Vaccination

Systemic problems known as structural barriers may restrict an individual's access to

immunization services. The structure and funding mechanisms of the healthcare system

and the industries that produce it could be altered in order to remove these kinds of

obstacles (U.S. Department of Defense, 2020).

However, attitudinal barriers are beliefs or perceptions that may reduce one's willingness

to seek out or accept a vaccine service. Addressing these barriers involves working with

individuals and communities to build partnerships, listening to concerns and allaying

fears, combatting misinformation, providing education to allow people to make fully

informed decisions, and building trust (U.S. Department of Defense, 2020).

Vaccine misconceptions can arise as a result of a lack of knowledge. Beliefs and

perceptions are two other individual factors that influence vaccine acceptance (Dubé ,et

al. 2019). Low educational levels, limited information access, a lack of digital literacy, a

lack of reliable information, and cultural perspectives were also barriers to the COVID-

19 vaccine. (Budiyanti, et al. 2021)

On the other hand, It was stated that The primary concerns about the vaccine were

potential side effects, safety, how well it worked, and their lack of trust in the

government. (Biwas et al. 2021) Fear of side effects was the most common barrier to

operating COVID-19 vaccines. (Afrifa-Anane et al., 2021), were more likely to cause

hesitation it also stated that most people who refused vaccinations were worried about

negative effects. (Magadmi & Kamel, 2021).

Conceptual Framework

This section provides the study’s underlying research which served as a manual for the

researchers in reaching the study’s main goals, ultimately leading to the development of

the ideal mean Barriers Affecting COVID-19 Booster Shot Acceptability among College

students.

This conceptual framework incorporates the concepts of Input, Process, and Output.

Under Input, researchers gathered the demographic profile of College students in San

Luis, Pampanga, including their name, age, gender, year level, school, and will be
followed by specific questions regarding to their vaccination profile. Furthermore, the

researchers distributed questionnaires/surveys through google forms.

Participants were identified, data was collected from them, the information was then

processed and treated statistically, and the collected data was analyzed and interpreted.

In the final section, the results discovered the barriers affecting COVID-19 booster shot

acceptability among college students in San Luis, Pampanga.

based on the findings of Input and Process.

Input Process Output

Respondents profile
according to:
Name:
Survey Questionnaire
Age: Barriers affecting
Sex: COVID-19 boosteer
Data gathering and shot acceptability.
Year level: data analysis
Vaccinated or non-
vaccinated
Brand of vaccine if
vaccinated

Figure 1. Conceptual paradigm

Statement of the Problem

The study aims to determine the barriers that effects student`s acceptability upon taking

the COVID-19 booster shot among the college students who are at least eighteen (18)

years old.

Specifically, it seeks to answers to the following question:

1. What are the possible barriers why third dose of COVID-19 vaccine are not

accepted?

2. What motivates people to receive third dosage of the COVID-19

vaccine?

3. How may the decision and perspectives of individual affects the decision of

others?

Hypothesis

The following null hypothesis will be further tested in the study:

H0: There are no significant barriers that affect students' acceptability choice upon taking

the COVID-19 booster shot.

Methodology

This study is a non-experimental type of quantitative research since the researchers will

employ survey questionnaires as an instruments in order to gather data to assess the

Barriers Affecting COVID-19 Booster Shot Acceptability among the college students
who are at least eighteen (18) years old and above. This study underlies into descriptive

type of non-experimental research. When describing events of interest, descriptive

research methods can make use of a range of data formats, including frequency

distributions, percentages, averages, central tendencies, and observed variability to

provide insight into what could have been occurring at the time of observation (IvyPanda,

2020).

Participants

The researchers made use of a Non-Probability Sampling Method. The sampling is

known as Quota Sampling. Only those people who meet the criteria for becoming a

respondent are selected and also the individuals are selected in the sampling based pn

availability for them to participate in the study of Barriers Affecting COVID-19 Booster

Shot Acceptability.

For this purpose, there will be 30 participants in this study. The participants were divided

into two groups: those who expressed doubt about getting the COVID-19 booster shot

and those who showed no hesitancy at all. The study’s participants must be at least

eighteen (18) years old and currently enrolled in college (in any year and courses) and

currently addressed in San Luis, Pampanga. The participants are selected to get identify

the barriers affecting COVID-19 booster shot acceptability among the college students of

San Luis, Pampanga.

Instruments

In this study, The data-gathering instrument for this investigation was a survey

questionnaire distributed online using Google Forms. The questionnaire is divided into

two sections: demographic information and survey questions. First, the demographic

profile includes the Participant's names, ages, gender, and year level and will be followed

by specific questions regarding to their vaccination profile. Then, for the second part, The

researchers formulated (15 )questionnaires aligned with the statement of the problem and

set of questions that are relevant to the purpose of this study. The Survey questionnaire

focuses on finding out the Barriers affecting COVID-19 Booster Shot Acceptability

among College Students in San Luis, Pampanga.

Procedure

After the research proposal is completed and accepted, the researchers will create the

survey questionnaires and request consent from the study's participants. With the use of

various social media platforms such as Gmail, Messenger, or Instagram will then be used

to distribute the survey questions. If they are willing to participate in the study, the

responders will need to complete an informed consent form.

In this investigation, the researchers will ensure that there are no conflicts of interest. The

research team's members are all on hand to assist participants in understanding the

survey's questions during the survey. The study team will respond to any inquiries made
by the participant during this investigation. In the whole study, neither the volunteers nor

the researchers never asked for or claimed any expenses. This study in intended for

educational purposes only. The study's collected data will be handled with the utmost

secrecy. All the gathered data from the study will be treated all utmost confidentially.
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 QUESTIONNAIRE

Part 1: Basic Demographic Profile

1. Name (Optional):
_____________________________________________
2. Age: ___

3. Sex:
❏Male ❏ Female

4. College Year Level:

❏ First year college
❏ Second year college
❏ Third year college
❏ Fourth year college

Specific Questions:

Please read and answer the following questions carefully. Rest assured that all data
received will be kept completely confidential:

Are you fully vaccinated with COVID-19 vaccines already?

a)Yes b) No

If yes, What brand of COVID-19 vaccine?

a)Sinovac b) Pfizer c) Moderna d) Johnson and Johnson
e) AstraZeneca f) Sputnik V

Are you willing to get COVID-19 booster shot?

a)Yes b) Uncertain c) No

Part 2: Barriers Assessment

Please mark your answer to the statements based on how much you agree or
disagree with each statement.
Statements Strongly Disagree Neutral Agree Strongly
Disagree Agree
(5) (4) (3) (2) (1)
The effectiveness of the
vaccine may decrease
overtime that is why it’s
necessary to take booster
shots
The community I belong
administers COVID-19
Booster shots
The information I know
about COVID-19 booster
shot are enough for me to
get one

My friends and family

encourage me to get
booster shots

My choice to take booster

injections was influenced
by what I saw on social
media

I trust the advice of

medical professionals in
getting booster shots
I am aware that receiving a
COVID-19 booster shot
will aid in extending my
body's immune system's
capacity to provide defense.

I am hesitant to take
booster shot because I am
afraid of needles

I worry that the booster

injections will have serious
side effects.
Receiving third (booster)
dose of
COVID-19 vaccine
decreases my
chance of getting COVID-
19 or its complications
Third (booster) dose of
COVID-19
vaccine is a good idea
because I feel less worried
about catching COVID-19
Vaccination against
COVID-19 is a reliable
method of preventing and
managing the disease

I am concerned about the

safety of Third dose
I am not fully aware about
the existence of COVID-19
booster shot