PERCEPTIONS OF AND HESITANCY TOWARD COVID-19 VACCINATION IN

ELDERLY NAVALENEOS: A QUALITATIVE STUDY

Kristel Cumpio, Grace Arriane K. Torceno, Jian Lou D. Lerios, and Justine Paul

V. Custodio

Biliran Province State University

1 Introduction

1.1 Nature and Importance of the Study

Elderly people are the among of the first people to be vaccinated because

research shows that older people are more likely to become very ill and die as a

result of the virus, the simplest and most basic explanation is that they are especially

vulnerable to morbidity and death as a group. During this epidemic, ageism in our

culture has been highlighted more than normal. Many older adults face the decision

of whether to receive a vaccine with ease: they choose to get all recommended

vaccines, or they refuse vaccines entirely. Others, however, find the decision more

complex and make it on a case-by-case basis. Experts consider this middle group of

adults, who selectively choose which vaccines to accept, to be “vaccine hesitant”

(McSpadden, Vaccine Hesitancy among Older Adults, with Implications for COVID-

19 Vaccination and Beyond, 2021).

According to the study conducted by Siu, Cao, Shum (2022), the Chinese

participants' perceptions of and aversion to vaccination were influenced by a

combination of factors at the individual, intermediate-social, and macrosocial levels.

Despite the fact that data saturation was attained, the findings of this study have
limited generalizability and hence cannot be applied to other communities' older adult

populations.

The necessity for this study arises from the fact that no one has undertaken a

study in Naval province to determine the causes for hesitation, and this would allow

for a more thorough knowledge of why old individuals refuse to get vaccinated or are

hesitant to be vaccinated.

In order to address the gaps, the researchers are going to conduct this study

about hesitancy on vaccination of elderly people in Naval.

1.2 Objectives

The present study looks up to find the answers to the problem: To determining

the views and understanding the hesitancy of the elderly people of Naval towards the

COVID-19 vaccination.

2 Theoretical Framework

The research is anchored on Theory of Planned Behavior (TPB) which

suggests that behavior is determined by intentions, attitudes (beliefs about a

behavior), and subjective norms (beliefs about others' attitudes toward a behavior).

The Theory of Planned Behavior (TPB) posits that health behaviors can be predicted

by intentions to perform them (Ajzen, 1991).

In Theory of Planned Behavior intentions are determined by three variables.

One is how we feel about a Personal Attitude. It encompasses all the knowledge,

attitudes, and prejudices. When we consider behavior, we consider both positive and

negative aspects. This would mean that people would consider their knowledge
about the vaccine from the people around them and used to make their decision on

hesitating to be vaccinated. Second is Subjective Norms, this takes into account how

we perceive other people's views on a given conduct, such as vaccination. It is our

perception of others' attitudes, not what they think. Some elders might be influenced

by their family towards their attitude of vaccine. Third and lastly, Perceived

Behavioral Control. This is how much we feel we have control over our actions.

According to the idea, our perception of behavioral control has two effects: it

influences our intentions to behave in a given manner, i.e. the more control we

believe we have over our conduct, the greater our intention to do it. It also has a

direct impact on our conduct; if we believe we have a high amount of control, we will

work harder and longer to achieve our goals. The more hesitant they are, the more

they are not willing to be vaccinated (Brookes, 2021).

3 Methodology

The chapter contains the discussion on the research design and sampling,

data collection procedure and data analysis of the study. This research will utilise a

phenomenology approach to understand the elderly people's views of Naval, Biliran

on vaccination.

3.1 Research Design and Sampling

The researchers will make use of Case Study research design. A qualitative

case study is a research approach that aids in the examination of a phenomena in a

specific setting using numerous data sources, and it does so through a range of

lenses to show multiple sides of the phenomenon (Baxter & Jack, 2008). Our study
is about the hesitancy of elderly people to receive COVID-19 immunization, we

chose a case study as our research design to investigate the evolution of a particular

event, circumstance, in this case the hesitancy of the individual across time in more

depth and detail.

Furthermore, purposive random sampling will be used in this study. In random

purposive sampling, the researcher selects cases at random from a sampling frame

that includes a pre-selected sample. That is, the researcher first collects a list of

people who are interested in the study using one of the other purposive sampling

methods, and then picks a desired number of people at random from the list

(Omona, 2013).

Samples are selected according to the predetermined criteria, which is the

participant must be an elderly people of Navaleneos. That ranges from 45 years and

older. We are going to rank from those people who are accepted in the criteria of

how hesitant they were and compare them to others. And finally round them off to

15-30 participants for the case study (Boddy, 2016).

3.2 Data Collection Procedure

The researchers seek to interview elder people in Navaleneos who are

hesitating towards COVID-19 vaccination. The researchers will begin the interview

with a permit from the authorities of Biliran Province State University before

interviewing research participants.

Researchers will work on the research questionnaire that will be validated by

the research adviser after obtaining an approved letter of request. After the request

is approved, the interview of participants will begin while adhering to the health
guidelines and protocols. Interviews shall be conducted carefully to create reliable

results.

The researchers will conduct a semi-structured, interview through

questionnaires with 15 - 30 participant’s elderly people. That ranges from 45 years

old and older that lives in Naval. This will allow the researchers to know more about

the experiences of the respondents by giving follow-up questions. Researchers will

also give structured questions to know the respondents’ demographics. The

interviews will be done in giving a questionnaire.

The interviewers will take handwritten notes or voice record for future

references. After conducting the interview, the researchers will compile the

information and be able to summarize the findings of the data collection.

3.3 Data Analysis

Thematic analysis is a qualitative data analysis process that involves

searching a data set for, evaluating, and reporting recurrent patterns (Clarke &

Braun, 2006).

First, the researchers will be gathering the questionnaires from the

respondents. Then, the researchers will look through the data and review each

answer of the elderly people. Afterwards, we start to code or highlight the answers of

the elderly people. Next, we start to identify patterns and generate themes and will

be given labels and definitions to see if the researchers will not miss any bit of

information. Finally, the researchers will start to interpret the data to specifically

understand the views of the elderly people and to concentrate on their opinions and

viewpoints (Caulfield, 2019).

3.4 Ethical Consideration

As the initial stage in the interview process, the researcher will remind

participants of the study's purpose, research protocols, anticipated benefits, their

right to withdraw from the study at any time, and confidentiality security. The

researcher will also inquire whether the participants have any reservations regarding

the research study or the research method. In order to communicate successfully

and acquire their confidence, the researcher will also offer personal details (Patton,

1980). The researchers shall ask for the participant’s consent with the use of

Informed Consent. Its goal is for human participants to engage research freely

(voluntarily), with full knowledge of what it entails for them to participate, and to

provide their agreement before doing so (Research Support).

4. Literature Cited

Ajzen, I. (1991). The theory of planned behavior. 179-211. Retrieved from

https://www.sciencedirect.com/science/article/abs/pii/074959789190020T
Baxter, P., & Jack, S. (2008). Qualitative Case Study Methodology: Study Design
and Implementation for Novice Researchers. doi:10.46743/2160-
3715/2008.1573
Boddy, C. R. (2016, September 12). Sample size for qualitative research.
doi:10.1108
Brookes, E. (2021, July 22). The Theory of Planned Behavior. Retrieved from
https://www.simplypsychology.org/theory-of-planned-behavior.html
Caulfield, J. (2019, September 6). How to Do Thematic Analysis | A Step-by-Step
Guide & Examples. Retrieved May 17, 2022, from
https://www.scribbr.com/methodology/thematic-analysis/#:~:text=Thematic
%20analysis%20is%20a%20method,meaning%20that%20come%20up
%20repeatedly.
Clarke, V., & Braun, V. (2006). Thematic Analysis: A Practical Guide. Retrieved from
https://doi.org/10.1191/1478088706qp063oa
McAteer, J., Yildirim, I., & Chahroudi, A. (2020, April 13). The VACCINES Act:
Deciphering Vaccine Hesitancy in the Time of COVID-19. Retrieved from
https://academic.oup.com/cid/article/71/15/703/5819529
McSpadden, J. (2021, February 26). Vaccine Hesitancy among Older Adults, with
Implications for COVID-19 Vaccination and Beyond. Retrieved from
https://www.aarp.org/ppi/info-2021/vaccine-hesitancy-among-older-adults.html
Meniano, S. (2021, August 31). DOH directly delivers Covid-19 vaccines to Biliran.
Retrieved from Philippine News Agency:
https://www.pna.gov.ph/articles/1152085?
fbclid=IwAR1tt0ZxWzqTlbkDMYxafKn03D_60doDe-
mSIJBzXYHYqgUKcFUZlPaa88w
National Foundation for Infectious Disease. (2021, September 24). Why
Vaccinations Are Vital for Older Adults. Retrieved from
https://www.nfid.org/2021/09/24/why-vaccinations-are-vital-for-older-adults/?
fbclid=IwAR2dIzOrj2I0KVp5b9EnwwJlZ8QqxjnE-
5fUeW23q5aIgw6awZr3wgI2Mng#:~:text=Vaccines%20can%20help
%20prevent%20flu,get%20vaccinated%20for%20COVID%2D19
Nickerson, C. (2021, October 12). Symbolic Interaction Theory. Retrieved May 17,
2022, from Simply Psychology: https://www.simplypsychology.org/symbolic-
interaction-theory.html
Omona, J. (2013, July). Sampling in Qualitative Research: Improving the Quality of
Research Outcomes in Higher Education. doi:10.4314/majohe.v4i2.4
Patton, M. Q. (1980). Qualitative research and evaluation methods.
Research Support. (n.d.). Informed Consent. Retrieved May 17, 2022, from
https://researchsupport.admin.ox.ac.uk/governance/ethics/resources/
consent#:~:text=Informed%20consent%20is%20one%20of,before%20they
%20enter%20the%20research.
Siu, J.-M., Cao, Y., & Shum, D. (2022, April 6). Perceptions of and hesitancy toward
COVID-19 vaccination in older Chinese adults in Hong Kong: a qualitative
study. Retrieved from https://pubmed.ncbi.nlm.nih.gov/35387602/
Sokolowski, R. (2000, January). Cambridge University Press.
doi:10.1017/CBO9780511809118