SOURCE AND KNOWLEDGE OF COVID-19 VACCINES IN

MCPHERSON COMMUNITY
CHAPTER ONE- INTRODUCTION
1.1 Background to the Study
Coronavirus disease 2019 or COVID-19 is caused by a newly discovered coronavirus, SARS-

CoV-2. This new infection was believed to have emerged from Wuhan City, Hubei Province,

China in December 2019 (Coccia, 2022). On March 11, 2020, the World Health Organization

(WHO) declared COVID-19 as a pandemic (Balak et al., 2021). Until early June 2021, this

emergent disease has infected more than 170 million people around the world and caused more

than 3 million deaths (Coccia, 2022). The rate of infection had not seemed to slow down in most

of the affected countries, and varying degrees of lockdowns have been issued in the effort to

contain the spread of the virus.

About 11 months after the emergence of the disease, the Food and Drug Administration (FDA)

has approved the use of Pfizer/BioNTech and Moderna COVID-19 vaccines in a mass

immunization programme. Phase three clinical trials for Pfizer/BioNTech vaccines enrolled

43,661 participants, while Moderna vaccines involving 30,000 participants (Huang et al., 2021).

There are also other companies in the race for vaccine development and in the final stages of

trials. The United Kingdom was among the first countries that have start mass immunization

COVID-19 vaccine Chadwick et al., 2021). Apart from Moderna and Pfizer that use mRNA as

the active substance, other vaccines use various other types of antigens such as viral vector,

attenuated virus, and inactivated virus. The use of mRNA is a new technology for vaccine

development, where the vaccine contains messenger RNA instructs cells to produce a protein

that acts as an antigen (Meo et al., 2021).

As safe and effective vaccines are being made available, the next challenge will be dealing with

vaccine hesitancy. Vaccine hesitancy, identified as one of the ten most important current health

threats, is defined as the reluctance or refusal to vaccinate despite the availability of vaccines.

Wong et al. (2021) conducted a population-based study in Hong Kong on the acceptance of the

COVID-19 vaccine using the health belief model (HBM) and found that perceived severity,

perceived vaccine benefits, cues to action, self-reported health outcomes, and trust were all

positive indicators of acceptance. Perceived vulnerability to infection had no significant

association with acceptance, whereas perceived access barriers and harm were negative

predictors. In addition, another community-based study found that people’s desire to get

vaccinated against COVID-19 has fallen dramatically during the pandemic, with over half of the

population were hesitant or unwilling to get vaccinated.

Misinformation and unsubstantiated rumours regarding COVID-19 vaccines have been around

and repeatedly shared on social media platforms even before the release of an effective vaccine.

The use of mRNA genetic material in several vaccines have been sensationalized by some, with

the false claims that the vaccine can alter human DNA (Kricorian, Civen, & Equils, 2021).

Additionally, the rapid development of COVID-19 vaccines has reportedly raised concerns

regarding the safety and long-term effects, even among the medical staffs. Findings from studies

among healthcare workers (HCWs) are alarming, as a small percentage of HCWs do not intend

to get the COVID-19 vaccine (Horton, 2020).

The Nigeria government has procured COVID-19 vaccine through the COVID-19 Global

Vaccine Access (Covax) Facility. This study will determine the source and knowledge of the

COVID-19 vaccine among Nigerians in the McPherson community. The findings from this study
will provide data and crucial information for the university management to find strategies to

increase public understanding and the uptake of COVID-19 vaccine.

1.2 Statement of the Problem

In May 2020, the 73rd World Health Assembly issued a resolution recognizing the role of

extensive immunization as a global public-health goal for preventing, containing, and stopping

transmission of Covid-19. As of January 17, 2022, there had been 251,178 confirmed cases of

Covid-19 reported in Nigeria. Despite the awareness and media support at the beginning of the

vaccination exercise, the turnout has been decreasing. Various reports in the media show that

some Nigerians are refusing to be vaccinated. This has resulted in the Federal Government

considering a sanction on eligible Nigerians who refuse COVID-19 vaccination. Vaccine

hesitancy will not only threaten COVID-19 response but prevent Nigeria from achieving herd

immunity.

The reluctance of people to receive safe and recommended available vaccines was already a

growing concern before the COVID-19 pandemic. Promoting the uptake of vaccines (particularly

those against COVID-19) will require understanding whether people are willing to be

vaccinated, the reasons why they are willing or unwilling to do so, and the most trusted sources

of information in their decision-making.

Hence, it is crucial to explore the acceptance of COVID-19 vaccines and its predictors as well as

the attitudes towards COVID-19 vaccines among Nigerians. To date, there has been no prior

study among the general population of McPherson investigating their knowledge, attitudes, and

perceptions towards COVID-19 vaccine. This study can thus highlight the importance of

vaccination to the community and encouraging vaccine uptake and acceptance, especially by

vulnerable patients to stop further deaths and to confine the spread of the pandemic.
1.3 Objectives of the Study

This study is aimed at examining the source and knowledge of Covid-19 vaccines in McPherson
Community. The specific objectives are:

1. Assess the knowledge of McPherson community on Covid-19 pandemic.

2. Investigate the attitudes of the McPherson community towards Covid-19 vaccines.
3. Examine the factors associated with the acceptance of vaccines in McPherson community
4. Investigate the prevalence of miscommunication in Covid-19 vaccination usage.
5. Assess the impact of public health campaigns on the knowledge and perception about
Covid-19 vaccination among McPherson community members.

1.4 Research Questions

1. What is the knowledge level of McPherson community about Covid-19 pandemic?

2. What are the sources of information on Covid-19 vaccine?
3. How prevalent is miscommunication in the usage of Covid-19 vaccinations?
4. How does public health campaigns influence the knowledge and perception of Covid-19
vaccination among McPherson community members?

Hypothesis

Ho: There is no relationship between the source and knowledge of Covid-19 vaccination

Hi: There is a relationship between the source and knowledge of Covid-19 vaccination

1.5 Significance of the Study

This study will elucidate the influence existential knowledge on the use of vaccines. The findings

would help the McPherson University management and stakeholders understand the challenges

in vaccination administration in this challenging times.

This study will also provide insight into the McPherson community’s acceptability and

perception regarding COVID-19 vaccines. Knowledge about vaccines vary according to various

socio-demographic strata. The findings herein can help the university management and its public

health department plan for future efforts to increase vaccine uptake that may eventually lead to

herd immunity against SARS-CoV-2.

1.6 Scope of the Study

This study will be conducted at Seriki-Sotayo, Ogun state because this is where McPherson
University is located. Cola Nigeria. The study will solely focus on the source and knowledge of
community members about Covid-19 vaccination.

1.8 Operational Definition of Terms

Covid-19: an infectious disease caused by the SARS-CoV-2 virus. Most people infected with the

virus will experience mild to moderate respiratory illness and recover without requiring special

treatment.

Vaccine: a substance used to stimulate the production of antibodies and provide immunity

against one or several diseases, prepared from the causative agent of a disease, its products, or a

synthetic substitute, treated to act as an antigen without inducing the disease.

McPherson University: a private Christian university in Abeokuta, Seriki-Sotayo, Ogun State.

Nigeria. It was founded by the Foursquare Gospel Church in Nigeria in 2012

Nigeria: a country in West Africa. It is the most populous country in Africa; geographically

situated between the Sahel to the north, and the Gulf of Guinea to the south in the Atlantic

Ocean.
Pfizer Vaccine: The Pfizer-BioNTech COVID-19vaccine sold under the brand

name Comirnaty, is an mRNA based Covid-19 vaccine developed by the German company

BioNTech and for its development collaborated with American company Pfizer, for support

with clinical trials, logistics, and manufacturing.

Moderna Vaccine: The Moderna COVID-19 vaccine is used to provide protection against

infection by the SARS-CoV-2 virus to prevent COVID-19. The vaccine is given by

intramuscular injection into the deltoid muscle on the shoulder. The initial course consists of two

doses.

Public Health: the health of the population, especially as the subject of government regulation

and support.
 CHAPTER TWO

LITERATURE REVIEW

2.0 Introduction
Today, according to many public health experts, public confidence in vaccines is waning.
Researchers investigating this phenomenon are now abandoning expressions such as “vaccine
resistance” or “vaccine opposition”, increasingly replacing them by the new term “vaccine
hesitancy” (VH) to describe the spread of vaccine reluctance. Several literature reviews have
already been devoted to this issue. Articles using the VH terminology have mainly been
published in journals specialized in vaccination or pediatric issues, but also in more generalist
journals.

In this section, the concept of vaccine hesitancy and the attendant knowledge implications about
vaccines is discussed. The gaps in literature are then laid bare. Finally, we propose a theoretical
framework related to two different concepts: health culture and distrust toward health authorities
and mainstream medicine.

2.1 Conceptual Review

Vaccine and Vaccine Hesitancy
Despite demonstration of individual and collective benefit and cost effectiveness of vaccination,

one of the contemporary challenges in providing medical care is the increasing proportion of

vaccination refusal. Paterson et al (2016) through their finding show that it is not a surprise

that parents’ refusal to vaccinate their children can cause collective harm by raising unprotected,

susceptible individuals in the community. The authors maintain that with herd immunity

compromised, devastating disease outbreaks may occur. In these settings, individuals are morally
obligated to accept vaccination to prevent harm to others. Apart from this, in a specific

humanitarian crisis or in disaster, failure to provide a vaccine violates the principle of non-

maleficence. Moreover, only vaccines having proven effectivity and safety are to be considered

for mass administration. Such vaccines confer additional benefit through herd immunity apart

from protecting people against specific diseases when administered on a largescale.

Jacobson, Sauver and Rutten (2015) looked at a long-term investment in health care, the statistics

illustrate the benefits and economics of vaccines and disease eradication. For an example, the

authors indicate that smallpox eradication has saved millions of lives over the decades, and

millions of dollars in terms of quarantine and treatment. From a human rights perspective,

vaccination equitably promotes and protects public health. However, access to vaccination is still

not achievable universally.

Vaccine Hesitancy has been defined by MacDonald (2015) as a set of beliefs, attitudes,

behaviours, or some combination of them, exhibited by lay people regarding their own or their

children’s immunizations, but also sometimes by healthcare professionals. MacDonald sees

Vaccine Hesitancy as an attribute ascribed to a large and heterogeneous category that regroups

people who share varying degrees and motives of indecision and who hold an intermediate

position along a continuum ranging from full support for vaccination to strong opposition to any

vaccine. Khubchandani et al (2021) argues that vaccine hesitant people are characterized by

reluctant conformism and vaccine-specific behaviors. They may decline a vaccine, but they may

also delay it or even accept it in due time despite their doubts. In other words, they may endorse

a wide range of non-specific behaviors, all of which can result from something else than VH.

This behavioral outcome can vary from one vaccine to another: they may accept one vaccine, but

decline another, as they base their decision on vaccine-specific features.

Finding the right definition for vaccine hesitance may be a herculean task. Definitions that try to

describe VH as it is used by researchers tend to be very broad and to embrace heterogeneous

people/situations and many different explanatory factors (including historic, political, and socio-

cultural contexts, as well as individual/social group influences. Scholars such as Larson et al

(2015) and Yang, Penders and Horstman (2020) have found quite contrasting profiles of attitudes

among those who could be categorized as vaccine hesitant. While some authors such as Razai et

al (2021) argue that it is something new, distinct from old-fashioned anti-vaccination, Yang,

Penders and Horstman (2020) state that it is as old as vaccination itself. Second, some authors

(Biswas, Mustapha, Khubchandani and Price, 2021) consider that VH corresponds to an

intermediate position, in the middle of the continuum between the pro-vaccination and anti-

vaccination positions, while others (Chirumbolo, 2021) consider that VH includes strong

opposition to vaccination. Nonetheless, Machekanyanga et al (2017) argue that VH is due to

ignorance, misperceptions, or disinformation. The authors even state that VH is driven basically

by emotions and irrationality and vaccine refusers should be liable for the harm they cause to

others. Finally, while some empirical studies report that VH is more frequent among people with

a high socioeconomic status (SES), others report the opposite or observe no relation, especially

regarding educational level. Such inconsistent results are disturbing for social scientists, as SES

is supposed to strongly shape our beliefs, attitudes, and behaviors, in meaningful ways.

These different attitudes tend to assort into specific profiles; for example, those who consider

VH an old phenomenon that encompasses anti-vaccination attitudes often attribute it to

ignorance, misinformation, or irrationality, while those who describe it as a new attitude, distinct

from strong opposition to vaccination, also argue that it is positively correlated with vaccine-

related knowledge.
More generally, VH is not really an empirical concept, as the term “concept” traditionally refers

to a general mental representation derived from the variety of perceived objects and defines what

is common to them: the features necessary and sufficient for membership in the concept, through

comparison, reflection, and abstraction. The current definitions of VH, rather than delineating a

set of core elements, cover a wide range of heterogeneous, and even sometimes contradictory,

elements.

2.3 Review of Related Empirical Studies

Immunization and Communities

Literature is replete with studies on how non-health workers encourage people to seek

immunization services, or increased access to immunization services by bringing services to

communities, and additionally in some cases by increasing demand through educating

communities. Many of such scholars such as Shaw et al (2018) documented how the

involvement of community members can improve immunization utilization. For example,

Lahariya (2014) stated that strengthening demand for immunization services was part of the

Integrated Child Development Services Program in India which began in 1975. In this program

one village woman for every 1000 population was selected to provide health information to

village residents, maintain lists of women and children who needed immunizations, motivate

families to bring children for immunizations, assist with immunizations, and follow-up on

immunization side effects, as well as to provide other community services. After more than five

years of implementation, the proportion of vaccinated children was higher in the intervention

group than in the control group for every antigen, ranging from a 35% difference for DPT3

vaccine to a 43% difference for Bacille Calmette-Guerin (BCG).

For Chowdhury et al (2003) some countries are focused on developing tools to assist community

workers in tracking their home visits. The authors’ observational study in Bangladesh evaluated

using semi-literate and illiterate local women in an urban setting to track defaulters using a color-

coded tracking system, to refer them to services and accompany mothers to immunization

clinics. During the intervention, 87% percent of children referred by these volunteers completed

the recommended immunization series and 96% of women that were referred received tetanus

vaccine. Kuhn & Zwarenstein (1990) discussed a similar program in South Africa giving record

cards to Village Health Workers (VHWs) to record home visits over a one-year period (1988) in

an intervention district. VHWs used the cards to identify children to visit, document visit

frequency, and track health interventions including immunizations. Sixty-seven percent of

children born during the program had completed their third dose of Oral Polio Vaccine (OPV) by

eight months of age compared with 50% in the cohort of children (13 to 24 months) born before

the program was implemented. However, coverage with measles vaccine by 10 months of age

among children aged 13 to 24 months was higher compared to children exposed to the program,

In the two papers discussed above, the use of home visits for education and service delivery was

evaluated. Le Gargasson et al (2015) focused on Ghana where non-health workers conducted

door-to-door visits and referred all children less than five years of age to routine immunization

clinics. In addition, a health worker conducted home visits for children who failed to finish their

immunization series. Over a six-month period, the percentage of FVC increased from 60% to

85% in the intervention group, whereas in the control group coverage increased from 61% to

67%. In a similar study conducted in Mexico by Trumbo et al (2018), trained community

members were used to conduct home visits during which immunization education was provided

along with needed vaccines. This intervention increased the percentage of FVC less than one
year of age from 21% to 77% in five months (1994), compared with the control group where

coverage increased only from 30% to 35%.

Hinman and McKinlay (2015) discussed other successful strategies focused on increasing access

to immunization services. In Kenya, school buildings were utilized as immunization centers,

with an educational component provided by schoolchildren who circulated immunization

information within their communities. Furthermore, mobile teams were used to increase access.

Coverage outcomes varied according to population density. In high population density areas the

percentage of FVC increased from 54% to 82% and in low density areas it increased from 25%

to 57% over an unspecified period. Coverage at follow-up in comparison high density areas was

69% compared to the 82% and in low population density areas 27% compared to the 57%. In a

district of Papua New Guinea, health post staff were trained in administering immunizations to

permit vaccines to be given closer to rural communities. In this study, conducted between 1983

and 1987, measles coverage increased from 4% to 75% in the intervention district, compared

with the control district where coverage increased from 5% to 58%. Concomittantly, in Nigeria,

as discussed by McArthur-Lloyd et al (2016), access to immunization services was improved by

increasing the number of locations offering immunizations and adding mobile clinics in the

evenings.

Information Dissemination for Vaccination

Information can be provided through numerous channels to either increase awareness of the

benefits of immunization or to promote participation. Hussain, Ali, Ahmed, and Hussain (2018)

argue that adequate strategies increase demand for vaccination without changing the service

delivery. The authors state that mass communication campaigns have the potential to reach large

numbers of people, if access to the type of media selected is good. In selected case studies by the
paper, an increase in immunization coverage was linked to the use of inter-personal

communication among mothers participating in a non-government organization (NGO) credit

program that encouraged child immunization without providing additional immunization

services. Increased coverage of several antigens was reported among the children of women who

participated in the NGO program relative to the children of women who did not participate in the

NGO program. Providing information at the local level through training community members

regarding immunizations and providing resource rooms with information on immunization did

not increase vaccine coverage, however the timeliness of immunizations, defined as children

receiving vaccines at the appropriate age, improve.

Rowlands (2014) focused on the importance of quality health facility. Improved quality of health

facility practices help increase coverage through reducing dropout (children that start the

vaccination series but did not complete the series) and missed opportunities (children that were

available for vaccination, but that were not vaccinated). Rowland highlighted that the use of

reminder stickers for parents can result in decreasing dropout between DPT1 and DPT2. The

author compared two methods to reduce missed opportunities for vaccination: moving the

immunization location close to the consultation room in the health facility to provide immediate

immunizations to children who had recently been seen in consultation, and having the physician

write a prescription for immunizations during curative visits. Each method resulted in an increase

of 32% more children being vaccinated during the intervention week than during the week prior

to the intervention. A health center can thus increase coverage of children fully vaccinated by

one year of age by 18% through reducing wait times by creating a quick immunization line. The

missed opportunities for immunization can also be reduced by immunizing all hospitalized

children who were not up to date with their vaccines.

2.3.1 Gap in Literature

A striking finding from this literature review was the paucity of well-conducted studies

examining ways in which routine vaccination programs in developing countries may be

improved through interventions at the community or facility level. Despite an exhaustive

literature search through which this research identified greater than 3,000 papers, only 25 were

ultimately eligible for inclusion in this review, of which only four projects were conducted in the

last ten years. Furthermore, many of these 25 papers were of only moderate scientific quality.

This may be in part because scientific research was not the primary purpose of the activity that

many of the papers reported. Nonetheless, this situation is surprising because the Expanded

Program on Immunization (EPI) has existed for more than a quarter of a century, and the

importance and cost-effectiveness of achieving high population coverage with vaccines has been

repeatedly recognized.

Although every paper included in this review aimed to show an improvement in vaccination

usage, a wide range of indicators were used to measure success. A meta-analysis could not be

conducted due to the variety of indicators reported. Some strategies were implemented in areas

where baseline coverage was relatively high, thus limiting the potential increase in coverage.

Other strategies were evaluated in places with low baseline coverage, and thus had the potential

to result in large coverage increases. For these reasons, it is difficult to determine which

strategies were most successful. Furthermore, some strategies may be more successful in certain

social or health care settings than others. It is challenging to determine the generalizability of the

findings, as less than half of the papers included a complete discussion of findings including

topics such as comparison of findings from other similar studies.

In general, the sustainability of interventions as perceived by papers’ authors was not addressed

in the papers reviewed, and few programs were evaluated for enough time to determine

sustainability. Given the number of interventions relying on volunteers, sustainability is of

particular concern. Researchers should evaluate the residual impact of the intervention, to better

understand the sustainability of the project. For example, evaluating if the program resulted in

change in infrastructure or practices that would continue to improve immunization coverage after

the project was over.

2.2 Theoretical Framework: Theory of Planned Behavior

The Theory of Planned Behaviour (TPB) is an extension of the Theory of Reasoned Action

(TRA) (Fishbein & Ajzen 1975, Ajzen & Fishbein 1980). The succession was due to the

discovery that behavior is not completely voluntary and cannot always be controlled; therefore,

perceived behavioral control was added to the model, and with this addition, the theory was

renamed the TPB. Both models are based on the premise that individuals make logical, reasoned

decisions to engage in specific behaviours by evaluating the information available to them.

According to the TPB, any action a person takes is guided by three types of considerations:

behavioral beliefs (beliefs about the probable consequences of the practiced behavior), normative

beliefs (beliefs about the normative expectations of other people), and control beliefs (beliefs

about the presence of factors that may enable or obstruct the performance of the behavior).

Behavioral beliefs normally result in a favorable or unfavorable attitude toward a specific

behavior, normative beliefs result in perceived social pressure or subjective norms, and control

beliefs trigger perceived behavioral control. The performance of a behaviour is determined by

the individual’s intention to engage in it (influenced by the value the individual places on the

behaviour, the ease with which it can be performed and the views of significant others) and the
perception that the behaviour is within his or her control. Usually, the greater the favorable

behavior, subjective norm, and perceived control, the stronger the person’s intention to perform

the behavior in question (Strating et al 2006).

However, a challenge in TPB measurement is the difficulty in conceptualising and capturing

attitudes. While other constructs that are related to adherence could be added to the TPB to

enhance it (Ajzen, 1991), it has been suggested that adding more variables will limit any

progress in the development of the model (Sniehotta, Presseau, & Araújo-Soares, 2014).

Adherence to prescribed medications is influenced by several factors other than patient-related

factors, including social and economic, therapy related, and health system factors (WHO, 2003);

thus, for a theory to successfully improve medication adherence, it must be able to accommodate

these complex components. The TPB is applicable to many health behaviors, but its ability to

predict medication adherence behavior in people with chronic diseases seems to be limited.

Therefore, further research must be conducted to test the ability of other theories to predict

medication adherence so that they may be incorporated into interventions and applied in clinical

practice.

The TPB has been widely tested and successfully applied to the understanding of a variety of

behaviors (Conner and Sparks, 2015; Armitage and Conner, 2001; McEachan et al., 2011). The

theory incorporates several important cognitive variables which appear to determine health

behaviors (intentions, expectancy-values, perceived behavioral control/self-efficacy). Also, the

role of social pressure from others is incorporated in the model in the form of subjective norms.

Recent work in this area has focused on the value of splitting each of attitude, subjective norms,

and perceived behavioral control into two components to form the Reasoned Action Approach

(Fishbein and Ajzen, 2010). Research with the RAA has focused on the six predictors of
intentions and behavior. Although the RAA suggests that the six predictors should only affect

behavior via intentions, meta-analyses (McEachan et al., 2016) and empirical studies (Conner

et al., 2017) suggest that experiential attitudes, descriptive norms, and capacity may also directly

influence behavior independent of intentions. Future research might usefully explore the impact

of changing each of the six predictors on changing behavior, although as noted earlier it may be

that the components cannot be independently manipulated. Other research has suggested that

anticipated affective reactions be added to the TPB to further represent the influence of affective

factors on intentions and behavior (Conner et al., 2015).

Further issues with the TPB/RAA include a focus on post-intentional processes. Models like the

Health Action Process Approach (HAPA) have considered processes such as planning and

coping with failure as mediators between intention and behavior. Other research has examined

moderators of the intention-behavior relationship such as the temporal stability of the intention.

In general the focus of both approaches has been on increasing the amount of variance in

behavior that can be explained.

The application of this theory can be used in all different sorts of fields and industries ranging

from the healthcare field, politics, and even general businesses and organizations. This theory is

based around understanding and predicting human behaviors, which allows for such a wide range

of uses. Within the healthcare field, it can be used to study disease prevention, pharmacology

companies, birth control, and even family planning (Martin, 2017).

2.4 Summary of Literature

The 25 papers identified reveal how community and facility-based strategies to strengthen

routine vaccination programs may result not only in increased vaccination coverage, but in other

benefits. For example, projects designed to increase coverage were associated with improved
timeliness of vaccination, improved knowledge regarding vaccines, improved quality, and

increased equity.

Evidence from the papers suggests non-health workers can provide numerous services including

education, mobilization, and tracking of target populations. Often these non-health workers are

very successful because of their community knowledge, the respect they are given by the

community, and the fact that they have access to community members who may not be reached

by mass media such as radio or television. Community members can be used to promote specific

antigens based on their expertise; for example, Traditional Birth Attendants (TBAs) may be best

at increasing coverage of vaccines delivered early in life (i.e., BCG, DPT1). Home visits by non-

health worker volunteers can be very successful at motivating parents to utilize immunization

services. During house visits, these volunteers can identify families not utilizing services; these

families can then be followed-up by health workers.

This literature review has some limitations. Although an attempt was made to conduct a

thorough search for papers, those not readily available through databases, or on the web may

have been missed. Furthermore, the literature-gathering process was conducted through the use

of a computer; a more complete review may have been achieved through visiting locations to

access literature in person. The methods used to assess the quality of papers and thus determine

their eligibility for inclusion in this review may have been biased toward published papers as

many gray literature papers did not discuss the study methodology used in enough detail to allow

it to be assessed. As such, no gray literature papers were included in this review. Furthermore,

many papers, published and unpublished, reported positive results, thus excluding opportunities

to learn from unsuccessful interventions.

 CHAPTER THREE: METHODOLOGY

3.0 Introduction

Research methods include all the techniques and methods which have been taken for conducting

research whereas research methodology is the approach in which research troubles are solved

thoroughly. Methodology shows the techniques and approaches of collecting data. This chapter

of this study is the research methodology which emphasizes the research design adopted for the

study as well as how gather data for analysis including the justification of the theoretical

framework.

3.1 Research Design

The study will adopt a survey design. Survey research is defined as “the collection of

information from a sample of individuals through their responses to questions” (Check & Schutt,

2012, p. 160). The survey method will be adopted because this involves an organized gathering

and presentation of data to give a concise representation of a given situation. It will also create an

opportunity for the researcher to narrate a given circumstance, within a defined period and place,

given a significant amount of detailed information. Furthermore, the survey approach is

considered because the study also centered around the attitudes and insights of people on the

concept of vaccination in McPherson community, Nigeria. Consequently, the importance of

primary data cannot be over emphasized in this research work when collecting and analyzing

questionnaires.

3.2 Population of the Study

According to the information available at the McPherson University website, there are

approximately 1,000 students and staff in the McPherson community. As such, this study

considered the figure as the population of the study. The entire population is taken into

cognizance considering the topic of study.

3.3 Sample Size and Sampling Technique

The simple random probability technique is a probability technique which adopts the principle of

randomization where all the elements in the population would be given equal chance of being

selected (Taherdoost, 2016). It would be used in gathering respondents for the distribution of the

questionnaire. Considering the need for a representative sample without bias or favour for any

one section of the population, simple random sampling is ideal. It gives equal opportunity for

representation of different views.

The sample size is the number of elements that are being selected to make them truly

representative of the target population from where they were drawn (Oni, 2010). The Taro

Yamani formula will be used to determine the sample size; this formula is stated as follows:

n= N_______

1+N (e)2

Where n = sample size

N= the total population

1=constant

(e) Limit of sampling error = 0.05

Computed as shown below:

n= 1000

1+1000(0.05)2

= 1000

1+1000(0.0025)

= 1000

1+2.5

= 4800/3.5

= 285

Hence, a total of two hundred and eighty-five (285) respondents will be randomly selected to

participate in responding to the questionnaires for this study.

3.4 Research Instrument

To assess the source and knowledge of the respondents, a total of 10 items will be in a structured

questionnaire. All questions will be based on validated questions in previous literature (Zingg

and Siegrist, 2012; Ricco et al., 2017).

The knowledge section will comprise 5-items with three possible responses (i.e., “Yes”,

“No” and “Don’t know”) (e.g., Does vaccination increase allergic reactions?). The ‘yes’ response

will be coded as 1, while the ‘No/ Don’t know’ responses will be coded as 0. The total score will

be obtained by summating the raw scores of five items and ranged from 0 to 5, with the higher

score indicating the greater level of knowledge towards COVID-19 vaccinations. In addition, an

additional question will be asked about the source of their knowledge about COVID-19 vaccines

(i.e., How you came to know about COVID-19 vaccines first?) with some possible answers (e.g.,

mass media [radio/television], newspaper, internet, social media [Facebook, Twitter], family and

relatives, friends, and neighbors). The answers to this question are useful for policy makers in

terms of disseminating COVID-19 vaccination information in the future in McPherson.

The attitude section will consist of 5-items (e.g., The newly discovered COVID-19 vaccine is

safe; I will take the COVID-19 vaccine without any hesitation, if it is available.), and the

response of each item will be indicated on a three-point Likert scale (i.e., 0 = Disagree, 1 = 

Undecided, and 2 = Agree). The total score will be calculated by summating the raw scores of the

six items ranging from 0 to 12, with an overall greater score indicating more positive attitudes

towards COVID-19 vaccine.

3.5 Validity and Reliability of the Instrument

To ensure empirical validity of the instrument, the researcher will give the questionnaire to the

research supervisor for approval and correction of areas of deficiencies in the questions and

grammatical accuracies before the questionnaire will be distributed. Other professionals relative

to the study, including the faculty will also considered. The reliability of the measuring

instrument will be conducted by carrying out a Cronbach’s alpha analysis of each of the sections

of the questionnaire using the SPSS Version 26.

3.6 Sources of Data

Primary Sources of Data Collection: This will be carried out through questionnaire

administration which will be administered by the researcher.

Secondary Sources of Data Collection: Secondary data will be collected from government

documents, journals relative to the study, newspaper articles, books and internet resources.

3.7 Method of Data Collection

Data collection is the process of gathering and measuring information on variables of interest, in

an established systematic fashion that enables one to answer stated research questions, test

hypotheses, and evaluate outcomes Moises, 2020).

Regardless of the field of study or preference for defining data (quantitative, qualitative),

accurate data collection is essential to maintaining the integrity of research. Both the selection of

appropriate data collection instruments (existing, modified, or newly developed) and clearly

delineated instructions for their correct use reduce the likelihood of errors occurring.

The study will adopt the structured questionnaire in data collection. Questionnaire will be used

because it helps the researcher to collect large amount of data in large areas within a short time

thus saving time for the study (Orodho, 2003). The questionnaires will contain basically close-

ended questions which will be based on the research questions and objectives of the study.

3.8 Method of Data Analysis

The data analysis will be performed using Microsoft Excel 2019 and SPSS version 25.0.

Microsoft Excel will be used for data cleaning, editing, sorting, and coding. Descriptive statistics

and analysis will be performed using SPSS. Likewise, t-tests or one-way ANOVA tests will be
performed to determine significant relations of the mean knowledge and scores with socio-

demographic information. All statistical tests will be analysed based on their significance level.

3.9 Ethical Consideration

In the conduct of this research, the researcher will adhere strictly to the ethics of research by

seeking the consent of respondents while ensuring that the confidentiality of information gotten

is guaranteed.

Reference

Shaw, J., Mader, E. M., Bennett, B. E., Vernyi-Kellogg, O. K., Yang, Y. T., & Morley, C. P.
(2018, June). Immunization mandates, vaccination coverage, and exemption rates in the United
States. In Open Forum Infectious Diseases (Vol. 5, No. 6, p. ofy130). US: Oxford University
Press.
Lahariya, C. (2014). A brief history of vaccines & vaccination in India. The Indian journal of
medical research, 139(4), 491.
Chowdhury, A. M. R., Bhuiya, A., Mahmud, S., Salam, A. A., & Karim, F. (2003).
Immunization divide: who do get vaccinated in Bangladesh?. Journal of Health, Population and
Nutrition, 193-204.
Kuhn, L., & Zwarenstein, M. (1990). Evaluation of a village health worker programme: the use
of village health worker retained records. International journal of epidemiology, 19(3), 685-692.
Le Gargasson, J. B., Nyonator, F. K., Adibo, M., Gessner, B. D., & Colombini, A. (2015). Costs
of routine immunization and the introduction of new and underutilized vaccines in
Ghana. Vaccine, 33, A40-A46.
Trumbo, S. P., Contreras, M., García, A. G. F., Díaz, F. A. E., Gómez, M., Carrión, V., ... &
Velandia-González, M. (2018). Improving immunization data quality in Peru and Mexico: Two
case studies highlighting challenges and lessons learned. Vaccine, 36(50), 7674-7681.
Hinman, A. R., & McKinlay, M. A. (2015). Immunization equity. Vaccine, 33, D72-D77.
McArthur-Lloyd, A., McKenzie, A., Findley, S. E., Green, C., & Adamu, F. (2016). Community
engagement, routine immunization, and the polio legacy in northern Nigeria. Global Health
Communication, 2(1), 1-10.
Hussain, A., Ali, S., Ahmed, M., & Hussain, S. (2018). The anti-vaccination movement: a
regression in modern medicine. Cureus, 10(7).
Rowlands, G. (2014). Health literacy: ways to maximise the impact and effectiveness of
vaccination information. Human vaccines & immunotherapeutics, 10(7), 2130-2135.
MacDonald, N. E. (2015). Vaccine hesitancy: Definition, scope, and
determinants. Vaccine, 33(34), 4161-4164.
Khubchandani, J., Sharma, S., Price, J. H., Wiblishauser, M. J., Sharma, M., & Webb, F. J.
(2021). COVID-19 vaccination hesitancy in the United States: a rapid national
assessment. Journal of Community Health, 46(2), 270-277.
Larson, H. J., Jarrett, C., Schulz, W. S., Chaudhuri, M., Zhou, Y., Dube, E., ... & Wilson, R.
(2015). Measuring vaccine hesitancy: the development of a survey tool. Vaccine, 33(34), 4165-
4175.
Taylor, S., Landry, C. A., Paluszek, M. M., Groenewoud, R., Rachor, G. S., & Asmundson, G. J.
(2020). A proactive approach for managing COVID-19: the importance of understanding the
motivational roots of vaccination hesitancy for SARS-CoV2. Frontiers in psychology, 11, 2890.
Dubé, E., Laberge, C., Guay, M., Bramadat, P., Roy, R., & Bettinger, J. A. (2013). Vaccine
hesitancy: an overview. Human vaccines & immunotherapeutics, 9(8), 1763-1773.
Razai, M. S., Chaudhry, U. A., Doerholt, K., Bauld, L., & Majeed, A. (2021). Covid-19
vaccination hesitancy. bmj, 373.
Biswas, N., Mustapha, T., Khubchandani, J., & Price, J. H. (2021). The Nature and Extent of
COVID-19 Vaccination Hesitancy in Healthcare Workers. Journal of Community Health, 1-8.
Yang, R., Penders, B., & Horstman, K. (2020). Addressing vaccine hesitancy in china: A scoping
review of chinese scholarship. Vaccines, 8(1), 2.
Chirumbolo, S. (2021). Vaccination hesitancy and the “myth” on mRNA‐based vaccines in Italy
in the COVID‐19 era: Does urgency meet major safety criteria?.  Journal of Medical
Virology, 93(7), 4049-4053.
Machekanyanga, Z., Ndiaye, S., Gerede, R., Chindedza, K., Chigodo, C., Shibeshi, M. E., ... &
Kaiser, R. (2017). Qualitative assessment of vaccination hesitancy among members of the
apostolic church of Zimbabwe: a case study. Journal of religion and health, 56(5), 1683-1691.
Paterson, P., Meurice, F., Stanberry, L. R., Glismann, S., Rosenthal, S. L., & Larson, H. J.
(2016). Vaccine hesitancy and healthcare providers. Vaccine, 34(52), 6700-6706.
Jacobson, R. M., Sauver, J. L. S., & Rutten, L. J. F. (2015, November). Vaccine hesitancy.
In Mayo Clinic Proceedings (Vol. 90, No. 11, pp. 1562-1568). Elsevier.