Acceptance of COVID-19 Vaccination and Vaccine Hesitancy Among People with Chronic Diseases in Thailand: Role of Attitudes and Vaccine Literacy Towards Future Implications

Sirirat Leelacharas, Wantana Maneesriwongul, Nipaporn Butsing, Kamonrat Kittipimpanon, Poolsuk Janepanish Visudtibhan Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, ThailandCorrespondence: Wantana Maneesriwongul, Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Thung Phaya Thai, Ratchathewi, Bangkok, 10400, Thailand, Email [email protected]: Vaccination is an important strategy to prevent or reduce hospitalizations and mortality caused by COVID-19 infection. However, some people with chronic diseases are hesitant to get the COVID-19 vaccination.Objective: This study aimed to assess the acceptance of COVID-19 vaccination and associated factors among people with chronic diseases.Methods: A cross-sectional online survey was conducted between May and August 2021. A sample of 457 Thai adults living with one or more chronic diseases was drawn from a larger online survey.Results: Participants were 19 to 89 years old. The three most commonly reported chronic diseases were hypertension, diabetes, and obesity. The acceptance rate of COVID-19 vaccination was 89.1%. Forty-six percent of respondents had received the COVID-19 vaccination, and 43.1% intended to get the vaccine. Reasons for vaccine hesitancy/refusal included concerns about adverse side effects from the vaccines including long-term effects that might complicate their disease condition. Multiple logistic regression analyses revealed that having a bachelor’s degree or higher [aOR 4.40; 95% CI: 2.12– 9.14], being employed [aOR 2.11; 95% CI: 1.03– 4.39], and having positive attitudes [aOR 2.36; 95% CI: 1.69– 3.29] and negative attitudes [aOR 0.38; 95% CI: 0.27– 0.55] predicted acceptance of the COVID-19 vaccination. Vaccine literacy was significantly associated with acceptance of COVID-19 vaccination in binary logistic regression analyses, but it was not retained in the multiple logistic regression model.Conclusion: Vaccine literacy and attitudes influence acceptance of COVID-19 vaccination in people with chronic diseases.Keywords: COVID-19, vaccine, vaccine literacy, attitudes, acceptance of COVID-19 vaccination, chronic diseases, Thailand