Document Type : Original Article


1 Department of Internal Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

2 Department of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

3 Department of Internal Medicine, Division of Diabetic and Metabolism, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India


BACKGROUND: Coronavirus disease rapidly spreads across the entire world in < 2 months and
gravely jeopardizes the regular human routine. The medical fraternity recommends a vaccine as one
of the best solutions to save the universe. However, to be effective, the population should reflect an
encouraging attitude to accept it. The study aimed to measure vaccine acceptability and reason for
hesitancy among the public.
MATERIALS AND METHODS: Eight hundred and forty one adults visiting a tertiary care hospital
responded to a pretested validated questionnaire on vaccine acceptability and hesitancy. The Chi‑square
test and independent t‑test, followed by multinomial logistic regression, were used to analyze the findings.
RESULTS: Overall, 53.4% (n = 445) of participants interested to take vaccine, 27.2% (n = 229)
were not sure, and the remaining 19.4% (n = 163) did not intent to vaccinate. Gender (P = 0.013),
information on the vaccine (P = 0.022), chances to get coronavirus disease in the next 6
months (P < 0.001), awareness on India COVID‑19 vaccine (P < 0.001), Indian manufacturing
company of vaccine (P < 0.001), family history of the laboratory‑confirmed case (P < 0.001), and
health status (P = 0.011) found a significant association with intention to vaccination (a response
“yes” vs. “no” and “not sure”). Reasons for vaccine hesitancy included specific antivaccine attitudes
and beliefs, a concern of fear and phobia, lack of information, and safety issues on the vaccine.
CONCLUSIONS: This institute‑specific survey revealed that approximately every 4 in 8 people were
not sure to take the vaccine, and one in five people refused to be vaccinated. The study recommends
using target‑based health education to understand and address vaccine‑specific concerns to enhance
vaccine coverage, and boost confidence among the population.


1. Malik AA, McFadden SM, Elharake J, Omer SB. Determinants
of COVID‑19 vaccine acceptance in the US. EClinicalMedicine
2. Dong E, Du H, Gardner L. An interactive web‑based dashboard
to track COVID‑19 in real time. Lancet Infect Dis 2020;20:533‑4.
3. Singh K. COVID‑19 Has Pushed the Indian Economy Into a
Tailspin. But There’s a Way Out. Available from: https://‑19‑india‑economic‑recovery. [Last
accessedon 2020 Dec 31].
4. Helen S. Hunting down the Rumors of COVID‑19; 2020. Available
features/huntingdown‑rumours‑covid‑19. [Last accessed on 2020
Dec 31].
5. Bairwa M, Kumar R, Yadav P, Bahurupi Y, Kant R. Awareness,
perception, and mitigating measures on COVID‑19: Do we
still need to educate our masses on COVID‑19? J Edu Health
Promot 2021. Available from:
masses_on_COVID‑19. [Last accessed on 2021 Mar 14].
6. Kumar R, Singh V, Mohanty A, Gupta PK. Corona health‑care
warriors in India: Knowledge, attitude, and practices during
COVID‑19 outbreak. J Edu Health Promot 2021;10:44.
7. BikdeliB, TalasazAH, RashidiF, Sharif‑KashaniB, FarrokhpourM,
Bakhshandeh H, et al. Intermediate versus standard‑dose
prophylactic anticoagulation and statin therapy versus placebo
in critically‑ill patients with COVID‑19: Rationale and design
of the INSPIRATION/INSPIRATION‑S studies. Thromb Res
8. Lahariya C. A brief history of vaccines & vaccination in India.
Indian J Med Res 2014;139:491‑511.
9. New Delhi: Government of India and UNICEF. United
Nations International Children’s Fund. Coverage
E v a l u a t i o n S u r v e y : A l l I n d i a R e p o r t 2 0 0 9 ; 2 0 1 0 .
Available from: http://www.indiaenvironmentportal. _logo.pdf. [Last accessed on 2021 Jan 12].
10. Palamenghi L, Barello S, Boccia S, Graffigna G. Mistrust in
biomedical research and vaccine hesitancy: The forefront
challenge in the battle against COVID‑19 in Italy. Eur J Epidemiol
11. Harrison EA, Wu JW. Vaccine confidence in the time of COVID‑19.
Eur J Epidemiol 2020;35:325‑30.
12. Fisher KA, Bloomstone SJ, Walder J, Crawford S, Fouayzi H,
Mazor KM. Attitudes toward a potential SARS‑CoV‑2 vaccine :
A survey of U.S. adults. Ann Intern Med 2020;173:964‑73.
13. Fine P, Eames K, Heymann DL. “Herd immunity”: A rough guide.
Clin Infect Dis 2011;52:911‑6.
14. Zhang J, Xie B, Hashimoto K. Current status of potential
therapeutic candidates for the COVID‑19 crisis. Brain Behav
Immun 2020;87:59‑73.
15. Zimmer C, Corum J, Wee SL, Coronavirus Vaccine
Tracker. The New York Times. 2020; 2020. Available from:
coronavirus‑vaccine‑tracker.html. [Last accessed on 2021 Jan 14].
16. IBM Corp. IBM SPSS Statistics for Windows. Ver. 23.0. Armonk,
NY, USA: IBM Corp; 2011.
17. PM Modi to Launch Covid‑19 Vaccination Drive on January
16; 2021. Available from:
ry‑16‑7146073/. [Last accessed on 2021 Feb 17].
18. Banerjea A. India has Flattened COVID‑19 Curve, no New Cases in
One‑Fifth of Country: Govt; 2021. Available from: https://www.‑has‑flattened‑covid‑19-curveno-new‑cases‑in‑one‑fifth‑of‑country‑govt‑11611824857809.
html. [Last accessed on 2021 Feb 17].
19. Lazarus JV, Ratzan SC, Palayew A, Gostin LO, Larson HJ, Rabin K,
et al. A global survey of potential acceptance of a COVID‑19
vaccine. Nat Med 2021;27:225‑8.
20. World Health Organization. Weekly Epidemiological Update – 16
February 2021. Available from:
publications/m/item/weekly‑epidemiological‑update‑‑‑16february‑2021. [Last accessed on 2021 Feb 18].
21. Bell S, Clarke R, Mounier‑Jack S, Walker JL, Paterson P.
Parents’ and guardians’ views on the acceptability of a future
COVID‑19 vaccine: A multi‑methods study in England. Vaccine
22. Royal Society of Public Health. New Poll Finds BAME
Groups Less Likely to Want COVID Vaccine; 2020.
Available from:‑us/news/
html. [Last accessed on 2021 Feb 17].
23. Wilson SL, Wiysonge C. Social media and vaccine hesitancy. BMJ
Glob Health 2020;5:e004206.
24. The Economic Times. Address Doctors’ Vaccine Anxiety.
Available from:
et‑editorials/address‑doctors‑vaccine‑anxiety/. [Last accessed
on 2021 Feb 18].
25. Tens of Thousands Skip India’s COVID Vaccination Drive.
Available from:
tens‑of‑thousands‑skip‑indias‑covid‑vaccination‑drive. [Last
accessed on 2021 Feb 18].
26. LockyerB, IslamS, RahmanA, DickersonJ, PickettK, SheldonT, etal.
Understanding Covid‑19 misinformation and vaccine hesitancy
in context: Findings from a qualitative study involving citizens
in Bradford, UK. medRxiv 2020. :1‑14. Available from: http://
abstract. [Last accessed on 2021 Feb 18].
27. Larson HJ. Politics and public trust shape vaccine risk perceptions.
Nat Hum Behav 2018;2:316.
28. Hungerford D, Macpherson P, Farmer S, Ghebrehewet S,
Seddon D, Vivancos R, et al. Effect of socioeconomic deprivation
on uptake of measles, mumps and rubella vaccination in
Liverpool, UK over 16 years: A longitudinal ecological study.
Epidemiol Infect 2016;144:1201‑11.
29. Hrynick T, Ripoll S, Schmidt‑Sane M. Rapid Review: Vaccine
Hesitancy and Building Confidence in COVID‑19 Vaccination.
Social Science in Humanitarian Action Platform; 2020. Available
rapid‑review‑vaccine-hesitancy‑and‑building‑confidence‑incovid-19-vaccination/. [Last accessed on 2021 Feb 18].
30. Lu PJ, Srivastav A, Amaya A, DeverJA, Roycroft J, Kurtz MS, et al.
Association of provider recommendation and offer and influenza
vaccination among adults aged≥18 years – United States. Vaccine
31. Wray RJ, Jupka K, Ross W, Dotson D, Whitworth AR, Jacobsen H.
How can you improve vaccination rates among older African
Americans? J Fam Pract 2007;56:925‑9.
32. Loomba S, de Figueiredo A, Piatek SJ, de Graaf K, Larson HJ.
Measuring the impact of COVID‑19 vaccine misinformation
on vaccination intent in the UK and USA. Nat Hum Behav
33. Bernstein S. Most Americans Would Take Coronavirus Vaccine
if Deemed Safe: Reuters/Ipsos Poll. Available from: https://‑health‑coronavirus‑usa‑pollidUSKBN22I019.[Last accessed on 2021 Feb 18].