Factors Associated with COVID-19 Vaccine Hesitancy in Mongolia: A Web-Based Cross-Sectional Survey
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Population
2.2. Data Collection
2.3. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | Vaccinated/Will Be Vaccinated | Hesitated | No, Will Not Be Vaccinated | p-Value | |||
---|---|---|---|---|---|---|---|
No. | % | No. | % | No. | % | ||
Age group | 0.0001 | ||||||
18–29 | 468 | 54.7% | 288 | 33.7% | 99 | 11.6% | |
30–39 | 559 | 67.3% | 214 | 25.8% | 57 | 6.9% | |
40–49 | 523 | 77.1% | 121 | 17.8% | 34 | 5.0% | |
50+ | 413 | 80.7% | 83 | 16.2% | 16 | 3.1% | |
Sex | 0.5863 | ||||||
Male | 361 | 67.7% | 138 | 25.9% | 34 | 6.4% | |
Female | 1602 | 68.4% | 568 | 24.3% | 172 | 7.3% | |
Place of residence | 0.0001 | ||||||
Urban | 1668 | 73.6% | 459 | 20.2% | 140 | 6.2% | |
Countryside | 295 | 48.5% | 247 | 40.6% | 66 | 10.9% | |
Religion | 0.0080 | ||||||
Yes | 218 | 60.2% | 125 | 34.5% | 19 | 5.2% | |
No | 321 | 50.1% | 273 | 42.6% | 47 | 7.3% |
Education | Vaccinated/Will Be Vaccinated | Hesitated | Will Not Be Vaccinated | p-Value | |||
---|---|---|---|---|---|---|---|
No. | % | No. | % | No. | % | ||
0.0040 | |||||||
Uneducated | 2 | 66.7% | 1 | 33.3% | 0 | 0.0% | |
Primary | 3 | 23.1% | 6 | 46.2% | 4 | 30.8% | |
Lower secondary | 29 | 56.9% | 15 | 29.4% | 7 | 13.7% | |
Secondary | 134 | 51.1% | 109 | 41.6% | 19 | 7.3% | |
Vocational/College/ | 45 | 58.4% | 24 | 31.2% | 8 | 10.4% | |
Undergraduate/Bachelor degree/ | 254 | 53.2% | 199 | 41.7% | 24 | 5.0% | |
Graduate /Master’s degree and above/ | 72 | 60.0% | 44 | 36.7% | 4 | 3.3% |
Enrollment of Other Vaccinations | Vaccinated/Will Be Vaccinated | Hesitated | Will Not Be Vaccinated | p-Value | |||
---|---|---|---|---|---|---|---|
No. | % | No. | % | No. | % | ||
0.0001 | |||||||
Mandatory immunization | 224 | 70.0% | 86 | 26.9% | 10 | 3.1% | |
Immunization due to an epidemiological indication | 151 | 62.4% | 77 | 31.8% | 14 | 5.8% | |
Voluntary immunization | 193 | 50.1% | 171 | 44.4% | 21 | 5.5% | |
Supplemental immunization | 60 | 61.2% | 35 | 35.7% | 3 | 3.1% | |
I don’t know | 61 | 32.4% | 101 | 53.7% | 26 | 13.8% |
Variables | Vaccinated/Will Be Vaccinated | Hesitated | Will Not Be Vaccinated | p-Value | |||
---|---|---|---|---|---|---|---|
No. | % | No. | % | No. | % | ||
Personal belief | 0.0001 | ||||||
Vaccine should not be mandatory | 387 | 51.1% | 327 | 43.1% | 44 | 5.8% | |
Vaccine should be mandatory | 122 | 80.3% | 26 | 17.1% | 4 | 2.6% | |
I do not know | 30 | 32.3% | 45 | 48.4% | 18 | 19.4% | |
Other vaccines | 0.0001 | ||||||
Accept all vaccines | 310 | 73.8% | 102 | 24.3% | 8 | 1.9% | |
Accept all vaccines, but do not completely trust | 125 | 41.9% | 156 | 52.3% | 17 | 5.7% | |
Accept vaccines, but refuses sometimes | 94 | 43.3% | 103 | 47.5% | 20 | 9.2% | |
Do not trust most of the vaccines and refuse | 7 | 18.9% | 24 | 64.9% | 6 | 16.2% | |
Do not accept at all | 3 | 9.7% | 13 | 41.9% | 15 | 48.4% |
Current Source of COVID-19 Vaccine Information | Vaccinated/Will Be Vaccinated | Hesitated | Will Not Be Vaccinated | p-Value | |||
---|---|---|---|---|---|---|---|
No. | % | No. | % | No. | % | ||
0.0001 | |||||||
Official information source of the Government and Ministry of Health | 1430 | 73.0% | 422 | 21.5% | 107 | 5.5% | |
Official information source of WHO | 442 | 77.1% | 103 | 18.0% | 28 | 4.9% | |
Social media /Facebook, Twitter, WhatsApp/ | 942 | 66.9% | 372 | 26.4% | 94 | 6.7% | |
Website (ikon.mn, zarig.mn, etc.) | 448 | 62.1% | 215 | 29.8% | 58 | 8.0% | |
Online newsletter and magazine | 72 | 62.6% | 37 | 32.2% | 6 | 5.2% | |
Daily or weekly printed newsletter | 55 | 69.6% | 18 | 22.8% | 6 | 7.6% | |
Research articles and papers published in professional journals | 139 | 77.7% | 33 | 18.4% | 7 | 3.9% | |
FM, Radio | 37 | 71.2% | 14 | 26.9% | 1 | 1.9% | |
TV channels | 841 | 66.4% | 331 | 26.1% | 94 | 7.4% | |
Colleagues | 284 | 71.7% | 87 | 22.0% | 25 | 6.3% | |
Family members | 227 | 63.1% | 98 | 27.2% | 35 | 9.7% | |
Friends | 177 | 63.9% | 78 | 28.2% | 22 | 7.9% | |
Have not received any information regarding COVID-19 vaccine | 20 | 69.0% | 7 | 24.1% | 2 | 6.9% |
Variables | Vaccinated/Will Be Vaccinated | Hesitated | Will Not Be Vaccinated | p-Value | |||
---|---|---|---|---|---|---|---|
No. | % | No. | % | No. | % | ||
Preferred type of information source to receive COVID-19 vaccine info | 0.0001 | ||||||
Manuals | 502 | 69.0% | 181 | 24.9% | 45 | 6.2% | |
Brochure/leaflets | 224 | 70.2% | 74 | 23.2% | 21 | 6.6% | |
Flyer/poster | 269 | 72.1% | 88 | 23.6% | 16 | 4.3% | |
Short video | 879 | 68.2% | 338 | 26.2% | 71 | 5.5% | |
Infographics | 372 | 76.1% | 94 | 19.2% | 23 | 4.7% | |
Tweets | 81 | 63.8% | 35 | 27.6% | 11 | 8.7% | |
Facebook live streams, interviews, podcasts | 646 | 63.3% | 298 | 29.2% | 76 | 7.5% | |
TV channels | 1124 | 67.5% | 425 | 25.5% | 116 | 7.0% | |
FM, Radio | 131 | 64.9% | 57 | 28.2% | 14 | 6.9% | |
Type of information need regarding COVID-19 vaccine | 0.0001 | ||||||
Vaccine quality | 1109 | 65.2% | 485 | 28.5% | 106 | 6.2% | |
Vaccine safety | 1163 | 65.8% | 494 | 28.0% | 110 | 6.2% | |
Vaccine storage and transportation | 500 | 64.4% | 227 | 29.2% | 50 | 6.4% | |
Vaccine consequences | 1101 | 65.5% | 467 | 27.8% | 112 | 6.7% | |
Vaccine side effects | 1022 | 63.0% | 473 | 29.2% | 126 | 7.8% | |
Immunity development process | 896 | 71.9% | 278 | 22.3% | 73 | 5.9% | |
Vaccine contraindications | 768 | 66.6% | 312 | 27.0% | 74 | 6.4% | |
Vaccine administration time and place | 550 | 68.7% | 210 | 26.2% | 41 | 5.1% | |
How to choose the vaccine type | 565 | 64.4% | 261 | 29.7% | 52 | 5.9% | |
Types of COVID-19 vaccines | 498 | 62.6% | 239 | 30.1% | 58 | 7.3% | |
Other | 24 | 49.0% | 19 | 38.8% | 6 | 12.2% |
Four Most Effective Methods | Vaccinated/Will Be Vaccinated | Hesitated | Will Not Be Vaccinated | p-Value | |||
---|---|---|---|---|---|---|---|
No. | % | No. | % | No. | % | ||
0.0001 | |||||||
Vaccination | 447 | 69.6% | 182 | 28.3% | 13 | 2.0% | |
Wearing face mask | 491 | 54.0% | 357 | 39.3% | 61 | 6.7% | |
Lockdown | 127 | 43.5% | 144 | 49.3% | 21 | 7.2% | |
Social distancing | 295 | 54.4% | 213 | 39.3% | 34 | 6.3% | |
Improve air circulation and ventilation | 192 | 52.5% | 150 | 41.0% | 24 | 6.6% | |
Detecting and isolating people infected with COVID-19 | 139 | 50.9% | 118 | 43.2% | 16 | 5.9% | |
Detecting and isolating contacted people | 100 | 49.3% | 94 | 46.3% | 9 | 4.4% | |
Hand washing, sanitizing, and disinfecting | 325 | 55.1% | 232 | 39.3% | 33 | 5.6% | |
Avoid mass gatherings | 299 | 52.2% | 242 | 42.2% | 32 | 5.6% | |
I do not know | 3 | 20.0% | 9 | 60.0% | 3 | 20.0% |
Knowledge of Side Effects | Vaccinated/Will Be Vaccinated | Hesitated | Will Not Be Vaccinated | p-Value | |||
---|---|---|---|---|---|---|---|
No. | % | No. | % | No. | % | ||
0.0001 | |||||||
General or local reactions after COVID-19 vaccination | 262 | 61.8% | 145 | 34.2% | 17 | 4.0% | |
Pain, swelling, and redness in the injected area | 287 | 63.8% | 144 | 32.0% | 19 | 4.2% | |
Loss of appetite, vomiting | 102 | 63.0% | 50 | 30.9% | 10 | 6.2% | |
Anaphylactic shock | 50 | 58.1% | 31 | 36.0% | 5 | 5.8% | |
Allergic reactions | 143 | 57.2% | 94 | 37.6% | 13 | 5.2% | |
Headache | 230 | 62.8% | 116 | 31.7% | 20 | 5.5% | |
Fever and chills | 299 | 60.5% | 171 | 34.6% | 24 | 4.9% | |
Shiver | 98 | 56.0% | 66 | 37.7% | 11 | 6.3% | |
Fatigue | 134 | 60.4% | 78 | 35.1% | 10 | 4.5% | |
Muscle aches | 135 | 58.7% | 84 | 36.5% | 11 | 4.8% | |
Seizure | 35 | 61.4% | 22 | 38.6% | 0 | 0.0% | |
I don’t know | 100 | 35.6% | 154 | 54.8% | 27 | 9.6% |
Variables | Vaccinated/Will Be Vaccinated | Hesitated | Will Not Be Vaccinated | p-Value | |||
---|---|---|---|---|---|---|---|
No. | % | No. | % | No. | % | ||
Importance of vaccination | 0.0001 | ||||||
Prevent from COVID-19 infection | 363 | 60.1% | 204 | 33.8% | 37 | 6.1% | |
Reduce spread of COVID-19 infection within the population | 289 | 61.1% | 160 | 33.8% | 24 | 5.1% | |
Develop immunity against COVID-19 | 307 | 60.4% | 182 | 35.8% | 19 | 3.7% | |
Prevent from death and severity of COVID-19 | 165 | 66.3% | 76 | 30.5% | 8 | 3.2% | |
Prevent from transmitting COVID-19 | 196 | 57.3% | 128 | 37.4% | 18 | 5.3% | |
Vaccine importance | 0.0001 | ||||||
Very important | 344 | 78.2% | 87 | 19.8% | 9 | 2.0% | |
Somewhat important | 174 | 36.6% | 268 | 56.4% | 33 | 6.9% | |
Unimportant | 6 | 30.0% | 9 | 45.0% | 5 | 25.0% | |
I don’t know | 15 | 22.1% | 34 | 50.0% | 19 | 27.9% |
Variables | Hesitated | Will Not Be Vaccinated | ||||||
---|---|---|---|---|---|---|---|---|
cOR (95% CI) | p-Value | aOR a (95% CI) | p-Value | cOR (95% CI) | p-Value | aOR a (95% CI) | p-Value | |
Age group | ||||||||
18–29 | 3.26 (2.46–4.32) | <0.0001 | 1.79 (1.04–3.08) | 0.035 | 5.46 (3.17–9.41) | <0.0001 | 1.90 (0.62–5.79) | 0.261 |
30–39 | 2.00 (1.50–2.67) | <0.0001 | 1.43 (0.81–2.51) | 0.216 | 2.63 (1.49–4.65) | 0.001 | 0.76 (0.22–2.64) | 0.661 |
40–49 | 1.21 (0.89–1.65) | 0.231 | 1.14 (0.63–2.08) | 0.666 | 1.68 (0.91–3.08) | 0.095 | 0.65 (0.16–2.62) | 0.542 |
50+ | ref | ref | ref | ref | ||||
Gender | ||||||||
Male | 1.08 (0.87–1.34) | 0.499 | 0.83 (0.60–1.16) | 0.281 | 0.88 (0.60–1.29) | 0.505 | 0.71 (0.35–1.41) | 0.321 |
Female | ref | ref | ref | ref | ||||
Residence | ||||||||
Rural | 3.04 (2.50–3.71) | <0.0001 | 1.83 (1.32–2.53) | 0.000 | 2.67 (1.94–3.66) | <0.0001 | 3.25 (1.77–5.96) | <0.0001 |
Urban | ref | ref | ref | ref | ||||
Other vaccines | ||||||||
Do not accept at all | 13.17 (3.68–47.14) | <0.0001 | 4.17 (1.07–16.22) | 0.039 | 193.75 (46.62–805.17) | <0.0001 | 24.34 (4.84–122.36) | <0.0001 |
Do not trust most of the vaccines and refuse | 10.42 (4.36–24.90) | <0.0001 | 4.05 (1.58–10.40) | 0.004 | 33.21 (9.08–121.48) | <0.0001 | 10.25 (2.36–44.49) | 0.002 |
Accept vaccines, but refuses sometimes | 3.33 (2.33–4.76) | <0.0001 | 1.49 (0.98–2.28) | 0.072 | 8.24 (3.52–19.32) | <0.0001 | 4.68 (1.75–12.47) | 0.002 |
Accept all vaccines, but do not completely trust | 3.79 (2.74–5.25) | <0.0001 | 1.82 (1.23–2.66) | 0.003 | 5.27 (2.22–12.52) | <0.0001 | 3.49 (1.31–9.31) | 0.012 |
Accept all vaccines | ref | ref | ref | ref | ||||
Vaccine importance | ||||||||
I don’t know | 8.96 (4.67–17.19) | <0.0001 | 5.72 (2.81–11.67) | <0.0001 | 48.41 (18.79–124.78) | <0.0001 | 13.30 (4.32–40.94) | <0.0001 |
Unimportant | 5.93 (2.06–17.11) | 0.001 | 4.50 (1.47–13.76) | 0.008 | 31.85 (8.18–123.96) | <0.0001 | 10.08 (1.90–53.37) | 0.007 |
Somewhat important | 6.09 (4.50–8.24) | <0.0001 | 4.81 (3.38–6.84) | <0.0001 | 7.25 (3.39–15.49) | <0.0001 | 5.06 (2.12–12.10) | <0.0001 |
Very important | ref | ref | ref | ref | ||||
Source of information | ||||||||
Friends/Family/ Colleagues | 1.34 (0.56–3.25) | 0.510 | 5.27 (0.74–37.74) | 0.095 | 5.61 (2.34–13.43) | <0.0001 | 35.88 (3.42–376.50) | 0.003 |
TV/Radio/ Newspaper | 1.78 (1.02–3.11) | 0.043 | 1.39 (0.61–3.13) | 0.419 | 5.52 (2.93–10.40) | <0.0001 | 5.34 (1.77–16.09) | 0.003 |
Social media/Websites | 1.76 (1.18–2.63) | 0.005 | 2.11 (1.03–4.33) | 0.043 | 1.94 (1.02–3.72) | 0.044 | 1.68 (0.44–6.36) | 0.446 |
Official source | ref | ref | ref | ref | ||||
Education | ||||||||
Primary | 1.88 (0.59–5.99) | 0.287 | 2.28 (0.59–8.79) | 0.233 | 9.31 (2.37–36.66) | 0.001 | 7.57 (1.27–45.17) | 0.026 |
Secondary | 1.02 (0.77–1.36) | 0.889 | 1.09 (0.77–1.54) | 0.624 | 1.86 (1.05–3.27) | 0.032 | 3.08 (1.13–8.41) | 0.028 |
College | 0.72 (0.42–1.21) | 0.209 | 0.91 (0.49–1.67) | 0.749 | 2.07 (0.89–4.82) | 0.092 | 1.41 (0.70–2.82) | 0.732 |
Graduate | ref | ref | ref | ref |
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Dambadarjaa, D.; Altankhuyag, G.-E.; Chandaga, U.; Khuyag, S.-O.; Batkhorol, B.; Khaidav, N.; Dulamsuren, O.; Gombodorj, N.; Dorjsuren, A.; Singh, P.; et al. Factors Associated with COVID-19 Vaccine Hesitancy in Mongolia: A Web-Based Cross-Sectional Survey. Int. J. Environ. Res. Public Health 2021, 18, 12903. https://doi.org/10.3390/ijerph182412903
Dambadarjaa D, Altankhuyag G-E, Chandaga U, Khuyag S-O, Batkhorol B, Khaidav N, Dulamsuren O, Gombodorj N, Dorjsuren A, Singh P, et al. Factors Associated with COVID-19 Vaccine Hesitancy in Mongolia: A Web-Based Cross-Sectional Survey. International Journal of Environmental Research and Public Health. 2021; 18(24):12903. https://doi.org/10.3390/ijerph182412903
Chicago/Turabian StyleDambadarjaa, Davaalkham, Gan-Erdene Altankhuyag, Unurtesteg Chandaga, Ser-Od Khuyag, Bilegt Batkhorol, Nansalmaa Khaidav, Oyunbileg Dulamsuren, Nadmidtseren Gombodorj, Avirmed Dorjsuren, Pramil Singh, and et al. 2021. "Factors Associated with COVID-19 Vaccine Hesitancy in Mongolia: A Web-Based Cross-Sectional Survey" International Journal of Environmental Research and Public Health 18, no. 24: 12903. https://doi.org/10.3390/ijerph182412903