What Determines the Intention of COVID-19 Vaccination in Aceh?

Meutia Dwi Novita Sari^*, Fathurrahman Anwar and Hendra Halim

Fakultas Ekonomi dan Bisnis Universitas Syiah Kuala, Indonesia

INTRODUCTION

At the beginning of 2020, the world was shocked by the outbreak of a new virus called Coronavirus Disease 2019 (COVID-2019). COVID-19 is an irresistible infection caused by a recently found sort of coronavirus. This modern infection and its causes were obscure recently; the flare-up started in Wuhan, China, in December 2019. COVID-19 is presently widespread in numerous nations around the world.

Based on information from the World Health Organization (WHO), universally, as of Admirable 6, 2021, there were 200,840,180 affirmed cases of COVID-19, counting 4,265,903 passings detailed to WHO. As of Eminent 4, 2021, a add up to of 3,984,596,440 measurements of the vaccine have been managed. Meanwhile, in Indonesia, from January 3, 2020, to August 6, 2021, there were 3,607,863 confirmed cases of COVID-19, with 104,010 deaths reported to WHO. As of August 2, 2021, a total of 69,645,812 doses of vaccine have been administered.

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Figure 1 Number of COVID-19 Cases in Indonesia

Source: WHO, 2021

The slant of positive cases of COVID-19 in Indonesia has not appeared a critical decrease. The Indonesian government has arranged different measures to expect the spread of COVID-19 in 2021. To ensure that the public is fully compliant. First, the enforcement of this discipline against COVID-19 will continue until the whole community gets the vaccine and achieves herd immunity. Then by strengthening the testing, tracing, and treatment (known as 3T) for every type of COVID-19 case that emerges.

The government makes this effort to ensure that the community is safe from COVID-19 and that positive near contacts can be identified more rapidly and get wellbeing care concurring to measures. This exertion is anticipated to decrease the number of dynamic cases, diminish the passing rate, and increment the remedy rate. Besides, on the off chance that positive cases are still tall, the final one is to limit people's versatility.

In addition to the efforts made above, the government is also aggressively implementing national vaccines. Vaccines are one of the most effective and economical ways to prevent infectious diseases. So, it is necessary to make the development of vaccines more effective to weaken the coronavirus infection. So distant, more than 40 pharmaceutical companies and scholarly education around the world have propelled their immunization improvement programs against the COVID-19 infection. (Makmun and Hazhiyah 2020).

The Ministry of Health of the Republic of Indonesia announces the results of a survey report that describes the level of discipline in implementing health protocols and the level of public willingness to participate in the COVID-19 vaccination program, which the Indonesian government is intensively implementing at this time. The survey, conducted from January 10 to March 31, 2021, showed that 80.8% were willing to receive the COVID-19 vaccine. Public scepticism about getting the vaccine has decreased from 28.6% to 19.2% during the January-March 2021 period. However, behind the high number of people's willingness to vaccines in Indonesia, vaccine acceptance in Indonesia is the lowest at only 46%.

Many factors cause the low rate of vaccine acceptance, one of which is the lack of knowledge about the COVID-19 vaccine. The Covid-19 Vaccine Acceptance Survey in Indonesia conducted by the Ministry of Health, WHO, and UNICEF in September 2020 showed that around 79% of the public wanted to hear much information about vaccines. That shows that 79% of the public is still ignorant about the COVID-19 vaccine. Health workers and medical staff are considered the most trusted (57%) in guiding respondents who are still unsure whether to get COVID-19 vaccinated or not. In expansion, family individuals are the moment choice of respondents who need to allude to others. However, respondents too needed to induce more data around the security and viability of immunizations through scholastics and researchers, therapeutic diaries and articles; social media and the web; doctors, and volunteers who gotten the COVID-19 immunization as the portion of the clinical trial prepare.

Many studies have discussed the relationship between knowledge, awareness, and intention (Ahmad et al., 2015; Baharuddin et al., 2015; Hassan et al., 2018; Pramajaya & Haryanto, 2021; Sadeeqa et al., 2013; Said et al., 2014; Aziz & Chok, 2013; Carlson et al., 1988). However, a concept of the relation of knowledge and awareness influencing vaccine intention has limited investigation, specifically discussing COVID-19 vaccine intention. Therefore, the present research has four detailed objectives: (1) to examine the influence of knowledge on awareness; (2) to examine the influence of knowledge on COVID-19 vaccine intention; (3) to examine the influence of awareness on COVID-19 vaccine intention; (4) to examine awareness mediating the influence of knowledge on COVID-19 vaccine intention.

In the next section, the three major constructs in the study (knowledge, awareness, and COVID-19 vaccine intention) are described in theoretical review and the research hypotheses presented after the relationship between variables. Following that, the methodology employed in the research is described. Finally, the results and discussion derived from the online survey and Hierarchy Linear Modelling (HLM) statistical analysis are then provided along with theoretical and practical implications for researchers.

LITERATURE REVIEW

Knowledge and COVID-19 Vaccine Intention

A few ponder from vaccine-related writing have inspected the coordinated impact of vaccine-related information in advancing inoculation purposefully, proposing that the superior understanding of the antibody, the more likely individuals might select to be immunized (Karlsson et al., 2021a). The knowledge-attitude-behavior hypothesis presumes that individuals’ wellbeing information and data serve as a vital establishment for deliberate to perform a health-related behavior (Kallgren & Wood, 1986). More particularly, individuals who have adequate information about a specific immunization can better get it its potential benefits and significance, which would assist positive shape convictions almost the antibody and fortify belief in immunization. As such, they would not see inoculation as a hazardous behavior (MacDonald et al., 2012) and found that the impact of common information approximately immunizations on immunization behavior is positive and reliable over six distinctive immunizations, such as lockjaw, pertussis, measles, and flu. Another study in China-proposed that more information about antibodies is related with a more grounded purposeful to urge inoculation (Liu & Yang, 2021).

Some research about relationship between knowledge and intention found knowledge directly affects the purchase intention (Ahmad et al., 2015; Baharuddin et al., 2015; Hassan et al., 2018; Pramajaya & Haryanto, 2021; Sadeeqa et al., 2013; Said et al., 2014) and upheld by a few thinks from vaccine-related writing have inspected the coordinated impact of vaccine-related information in advancing inoculation purposefully, proposing that the superior understanding of the immunization, the more likely individuals might select to be immunized (Inkeroinen et al., 2021; Nancy Chen, 2015a; Schulz & Hartung, 2021a) But, research by (Luo et al., 2021) found vaccine-related knowledge was not straightforwardly related to vaccination intention. Consequently, they consider they proposed the theories based on these discoveries. Hence, it is imperative to investigate the part of vaccine-related knowledge in activating vaccination intention within the setting of the COVID-19 widespread.

H₁: Knowledge influences COVID-19 vaccine intention.

Knowledge and Awareness

Several previous research results show a positive and significant relationship between knowledge and awareness (Munawar et al., 2019; Purnamasari & Oktaviani, 2020; Saad & Asaad, 2015; Yuliani et al., 2021). A basic open wellbeing communication technique amid a plague is to raise open awareness around the illness and give data on anticipating disease. It has appeared that constrained open knowledge and awareness of COVID-19 can increment the chance of transmission (Alsoufi et al., 2020). Khatib et al., (2014) found lack of knowledge was the most common barrier to hypertension awareness. Subsequently, based on the over discourse, the taking after speculation is displayed:

H₂: Knowledge influences awareness

Awareness and COVID-19 Vaccine Intention

According to Hasibuan (2012), awareness is a person's attitude who voluntarily obeys all the rules and awareness of their duties and responsibilities. Investigate demonstrates that halal awareness illustrated by non-Muslim shoppers had positive impacts on intention to buy halal items (Aziz & Chok, 2013). This contention is upheld by other thinks about in medical writing and wrongdoing avoidance, where increased awareness specifically impacts intention to assist behavior (Carlson et al., 1988). The natural perception and evaluation of EVs has a significant impact on Model I's willingness to buy. This means that EV ratings and environmental awareness will lead to increased purchase intent in the future (Okada et al., 2019). Previous studies have shown that brand awareness influences item purchase decisions. The more well-known a brand is, the more likely it is that it will be a buyer's buying option (Lu et al., 2014). Dabbous & Barakat (2020) found that brand awareness has become an important variable influencing shoppers' brand awareness. Therefore, it is possible that a well-known brand may affect the purchase intention (repurchase intention) of the product. As a result, you will see that you take over the theory:

H₃: Awareness influences COVID-19 vaccine intention

Awareness Mediates the Influences of Knowledge on Influences COVID-19 Vaccine Intention

The intent of vaccination of health care workers is related to their knowledge, beliefs and attitudes (GoodyearSmith et al., 2009; Petousis Harris et al., 2005; Taylor et al., 2002). This result linked higher awareness, logical evidence-based beliefs, and more positive attitudes towards vaccination with higher vaccination intent among healthcare professionals, Herzog et al. , (2013) is consistent with the study. According to a study by (Zhou et al., 2019), knowledge and consciousness were regarded as positive determinants of intention, and consciousness was a partial mediator. Therefore, based on these findings, contemplation suggested ingestion after guessing:

H₄: Awareness mediates the influences of knowledge on influences COVID-19 vaccine intention

METODHOLOGY

Research models and hypothesis

Operational variables in this study are divided into knowledge (X) as an independent variable and the following dependent variables COVID-19 vaccine intention (Y), along with a moderator variable awareness (Z). Figure 1 shows the theoretical structure utilized in this review. The review markers were adjusted from recently distributed sources to guarantee content legitimacy. To measure knowledge, awareness, and intention adapted from Min Zhou et al., (2019). The instrument of the momentum research was planned in a five-point Likert-type scale where one means total disagree and five means total agrees.

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Figure 2 Conceptual Framework

Population and sample

According to Simamora (2004), a population is a group of units on which analysis can be performed that contains the information expected to be found. The population can be classified into a definite population and an indefinite population. The information for this think about was assembled through surveys from the people of Aceh. In selecting respondents, this takes into account the use of a targeted sampling approach in which Criterion (i) is vaccinated with both first and second doses. (Ii) Willing to be a respondent. Probability sampling methods cannot be used because accurate information about the size and area of ​​this population is not available: use a convenient method to determine the test. Convenience sampling is used to select reachable people in the population and is selected by a deliberate sampling method. As to measure, even though at first 317 surveys were collected, a few had to be rejected since they were shown not accurately filled in, at last coming about in a test of 300 valid respondents. It may be the least number recommended by (Hair et al., 2019) in inquiring about that utilizes discriminant investigation devices. Of the palatably completed surveys, 45.3% of the test were male respondents, whereas 54.7% represent female respondents. The sample profile is displayed in Table 1.

Table 1 Characteristics of Respondents

Source: Primary Data, 2021 (processed)

Most respondents (43%) were at senior high school level plus 1,7% in master’s degree level regarding education level. The majority of respondents were between 18-59 years old (69%). Concerning the occupation of the respondents as private-sector employees is the highest 31%, followed by student 27,3%. Finally, regarding vaccine status, most respondents (61,4%) second dose vaccine and 38,6% first dose vaccine.

RESULT AND DISCUSSION

Table 2 appears the legitimacy test result was comprising the marker, stick figure, and the data of each pointer. Using Confirmatory Factor Analysis (CFA), every pointer to each evolution has a critical stack count in the direction of evolution of the measurement. CFA can be a multivariate fact-finding strategy used to test how well measured factors predict many developments. In this case, all configurations received a stacking variable of> 0.40. Therefore, all development is important (Black & Baby, 2019). Cronbach's alpha reliability test found a knowledge score of 0.720, an awareness score of 0.881, and a vaccination intent score of 0.959.

Table 2 Items Loadings and Cronbach Alpha

Table 3 suggests that the imply cost of the elements used withinside the weighting ranged from three.3913 to three.8010, with the extent of information distribution starting from 0.62797 to 1.11344. The vaccination goal variable become the maximum terrific many of the 4 elements observed. This end result demonstrates that respondents perceived a fine goal to are looking for vaccination in opposition to COVID-19.

Table 3 Mean, Standard Deviation, and Correlation between Variables

Table 4 indicates the relationships among the examined variables. Knowledge has a high quality and big impact on vaccination motive with a probability <0.05 with a regression coefficient (β) of 0.734 and a variance of understanding of 0.537 with a coefficient of determination (adjusted R²). In different words, the aim variable of the vaccine is 53.7%. Explained via way of means of understanding variables, the last 46.3% are defined via way of means of different variables now no longer defined on this study. In this way, we will finish that speculation 1 is supported. The results highlighted the respondent's perception that the effects of COVID19 would not be sustained for life. Some studies in the vaccine literature have investigated the direct impact of vaccine knowledge on the promotion of vaccination intentions and have suggested that people with greater understanding of a vaccine are more likely to opt for vaccination (Karlsson et al., 2021b). ; Nancy Chen, 2015b; Schultz and Hartung, 2021b). These findings are also supported by some studies of the relationship between knowledge and intention. Discovered knowledge has a direct impact on purchase intentions (Ahmad et al., 2015; Baharuddin et al., 2015; Hassan et al., 2018; Pramajaya & Haryanto, 2021; et al., 2013; Said et al., 2014).

Table 4 Analytical Regression

Additionally, Table 4 showed that knowledge had a significant impact on perceptions of a COVID19 vaccine and that its progression was further positive with a probability of 0.710 and a probability of <0.05. The knowledge variable improves variance for perception with a factor of 0.502 (adjusted R²). This means that the knowledge variable can be explained by 50.2% of the knowledge variable, while the remaining 49.8% is explained by other variables not discussed in this study. Hence, these come about give critical proof to accept the second hypothesis. The discoveries demonstrate that knowledge is a fundamental factor that drives respondents to awareness of getting the COVID-19 vaccine. Therefore, the stakeholders are responsible for increase people’s knowledge so that raise awareness. This result is in line with past studies conducted by (Munawar et al., 2019; Purnamasari & Oktaviani, 2020; Saad & Asaad, 2015; Yuliani et al., 2021), who showed a significant relationship between knowledge and awareness.

The data also show that cognitive variables have a strong impact on vaccination intent. The direction is positive, the regression coefficient (β) is 0.878, and the probability is & lt ;. 0.05. The variance is explained by the perception of the coefficient of determination (adjusted R²) of 0.771. This indicates that the vaccination intent variable is defined by 77.1% of the cognitive variables and the remaining 22.9% by other variables not described in this study. Therefore, we can conclude that the third hypothesis is confirmed. Overall, the current findings suggest that awareness is significantly more potent in the intention-to-vaccinate process. These results can easily be targeted as vaccination interventions that focus on increasing public awareness of the importance of COVID-19 vaccination. For example, stakeholder providers should educate the public about the safety and efficacy of vaccination and constantly remind the public to pay attention to the vaccination schedule. These are in line with the studies of (Aziz & Chok, 2013b). Furthermore, it also supported the studies of Carlson et al (1988) which found that in the medical literature and in crime prevention, increased awareness directly affects intention to help behavior.

_{Table 5} Mediation Effects of Awareness

*Significance at level p<0.05

Hypothesis 4 predicts mediating effects using regression analysis. at the table. The regression coefficient of knowledge of vaccination intent is (β) 0.734, the probability is 0.05, and the value is (β) 0.223. Therefore, hypothesis 4 is supported, as it can be concluded that the influence of knowledge on vaccine intent is in part mediated by variable cognition (partial mediation). This is consistent with studies (Zhou et al., 2019) that reported knowledge and perception are considered positive determinants of intention and that perception is a partial parameter.

Table 6 Research Hypothesis Testing Results

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Figure 3 Relationship among the constructs

CONCLUSIONS

The results show that knowledge has a great influence on the intent of vaccination against COVID19 (H₁ support), knowledge has a great influence on consciousness (H₂ support), and consciousness has a great influence on the intent of vaccination against COVID-19 (H₃ support). It shows that. The results of the structural equation analysis also show that consciousness mediates the effect of knowledge on the intent of COVID19 vaccination (H₄ support). These findings indicate that to escalate COVID-19 vaccine intention, stakeholders must disseminate information to the public to increase knowledge and awareness. Hoax news circulating in the community is one of the reasons why people are reluctant to vaccinate against COVID-19.

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