Abstract

Objective:

To identify the driving and inhibiting factors and to find a prototype of community involvement in the COVID-19 vaccine.

Method:

Data sources from PubMed database, Google Scholar, Web of Science, and ProQuest. The data were obtained based on searches using the keyword COVID-19 (n=11,.599), focusing on community acceptance (n=813), community involvement (n=86), and types of articles (n=46). Articles that meet the inclusion criteria are seven, and the data were analyzed with ATLAS Ti.9 software.

Results:

Engagement and driving factors have the highest correlation (0.38). The drivers, perceptions of vulnerability, and inhibiting factors determine community involvement. The perception of exposure can be a supporting or inhibiting factor influenced by information reinforcement.

Conclusions:

Strengthening positive information can alter the sense of community vulnerability, making it a driving force for participation in the COVID-19 vaccine campaign. This finding is an appropriate strategy to expand the reach and resolve public doubts about accepting the vaccine.

Keywords:
COVID-19 vaccine; Community involvement; Community support; Community engagement prototype; Trust; Strengthening health information; Perception of vulnerability

Resumen

Objetivo:

Identificar los factores impulsores e inhibidores y encontrar un prototipo de participación comunitaria en la vacuna contra la COVID-19.

Método:

Fuentes de datos de las bases de datos PubMed, Google Scholar, Web of Science y ProQuest. Los datos totales se basan en búsquedas con la palabra clave COVID-19 (n=11.599), centrándose en la aceptación de la comunidad (n=813), la participación de la comunidad (n=86) y los tipos de artículos de investigación (n=46). Los artículos que cumplieron con los criterios de inclusión fueron siete. Los datos se analizaron con elsoftware ATLAS Ti.9.

Resultados:

El compromiso y los factores impulsores tienen la correlación más alta (0,38). La participación de la comunidad está determinada por tres factores: impulsores, percepciones de vulnerabilidad e inhibidores. La percepción de vulnerabilidad puede ser un factor de apoyo o de inhibición que se ve influido por el refuerzo de la información.

Conclusiones:

Fortalecer la información positiva puede cambiar la percepción de vulnerabilidad de la comunidad para que se convierta en un factor motivador para que esta se involucre en la vacuna contra la COVID-19. Este hallazgo es una estrategia adecuada para ampliar el alcance y resolver las dudas del público sobre la aceptación de la vacuna contra la COVID-19.

Palabras clave:
Vacuna COVID-19; Participación comunitaria; Apoyo comunitario; Prototipo de participación comunitaria; Confianza; Fortalecimiento de la información en salud; Percepción de vulnerabilidad

Introduction

The COVID-19 pandemic has changed all aspects of human life. Every nation attempts to prevent the spread by boosting widespread immunity through vaccination programs. The target population for the distribution of vaccines in Indonesia is 208,266,720 individuals. Dose 1 and 2 that has been administered to 124,156,167 (19.61%) and 78,114,072 (37.51%) recipients on November 6, 2021 did not meet this target.¹1. Kemenkes. Cakupan Vaksin COVID-19 di Indonesia. Published online 2021. Available at: https://vaksin.kemkes.go.id/#/vaccines.
https://vaksin.kemkes.go.id/#/vaccines... ^,22. Putranto W. Cakupan Vaksin Dashboard 6 Nov 2021. Published online 2021. Available at: https://www.tribunnews.com/corona/2021/11/06/updatecapaian-vaksinasi-covid-19-ri-78-juta-orang-sudah-disuntik-dosis-lengkap.
https://www.tribunnews.com/corona/2021/1... Meanwhile, vaccine acceptance rates in several countries were recorded, and China was the highest recipient country at 91.3%, followed by European countries and the United States at 74% and 67%.³3. Sethi S, Kumar A, Mandal A, et al. The UPTAKE study: a cross-sectional survey examining the insights and beliefs of the UK population on COVID-19 vaccine uptake and hesitancy. BMJ Open. 2021;11:1-11. Distrust and doubt in the government are the main obstacles to the failure of the vaccine.⁴4. Bogart LM, Ojikutu BO, Tyagi K, et al. COVID-19 related medical mistrust, health impacts, and potential vaccine hesitancy among Black Americans living with HIV. J Acquir Immune Defic Syndr. 2021;86:200-7. This literature study has a distinct benefit over prior studies, specifically the development of grounded theory through qualitative analysis with ATLAS.ti9.

The reason for the reluctance to get involved in the vaccine is the concern about the effect⁵5. Gatto NM, Lee JE, Massai D, et al. Correlates of covid-19 vaccine acceptance, hesitancy and refusal among employees of a safety net california county health system with an early and aggressive vaccination program: results from a cross-sectional survey. Vaccines. 2021;9:1-22. due to a history of past diseases such as heart and respiratory⁶6. Ismail SNA, Abdul Halim Zaki I, Noordin ZM, et al. Clinical characteristics and risk factors for mortality in patients with COVID-19: a retrospective nationwide study in Malaysia. Proc Singapore Healthc. 2022;0:1-8. and the reluctance to receive vaccines. People who lack adequate documentation fear being humiliated, rejected, and made a burden on the state if they visit vaccination centers.⁷7. Carson SL, Casillas A, Castellón-López Y, et al. COVID-19 vaccine decision-making factors in racial and ethnic minority communities in Los Angeles, California. JAMA Netw Open. 2021;4:e2127582. The same opinion was conveyed by previous research on reluctance due to doubts and inequality of vaccines. Furthermore, political and religious conspiracy theories discourage Pakistanis from receiving vaccines.⁸8. Perveen S, Akram M, Nasar A, et al. Vaccination-hesitancy and vaccinationinequality as challenges in Pakistan's COVID-19 response. J Community Psychol. 2021;50:1-18.

Based on this data, the formulation of the problem in writing a literature review is: what are the driving and inhibiting factors for community involvement in the COVID-19 vaccine? How is the community involved in the vaccine? Therefore, this literature review is useful as a strategy to succeed and support the implementation of the vaccine program.

Carson et al.,⁷7. Carson SL, Casillas A, Castellón-López Y, et al. COVID-19 vaccine decision-making factors in racial and ethnic minority communities in Los Angeles, California. JAMA Netw Open. 2021;4:e2127582. described community involvement in the COVID-19 vaccine as determined by trust in medical personnel, perception of infection, and safety. Sethi et al.⁹9. Sethi S, Kumar A, Mandal A, et al. The UPTAKE study: implications for the future of COVID-19 vaccination trial recruitment in UK and beyond. Trials. 2021;22:1-12. explored the driving and inhibiting factors for the absorption and conducted a quantitative analysis. The main obstacle to the vaccine's success was dispelling public doubts about the side effect.⁹9. Sethi S, Kumar A, Mandal A, et al. The UPTAKE study: implications for the future of COVID-19 vaccination trial recruitment in UK and beyond. Trials. 2021;22:1-12. This literature review has an advantage that previous research has not conducted, namely developing grounded theory through qualitative analysis using ATLAS.Ti9 software after analyzing several selected articles. Therefore, this literature review is a development of previous theoretical concepts that are systematic and can be accounted for their objectivity and validity.

The theoretical basis for building this prototype uses the Health Belief Model theory, adding to the perception of vulnerability. A person will take action to prevent disease and be willing to be vaccinated when they have low confidence and are susceptible to disease. Vaccines are believed to reduce their susceptibility to COVID-19 and encourage them to take positive action.¹⁰10. Jones C, Jensen J, Scherr C, et al. The health belief model as an explanatory framework in communication research: exploring parallel, serial, and moderated mediation. Health Community. 2016;30:154-76.

This literature review aims to identify the factors that encourage and discourage community participation in the vaccine program. Therefore, this literature review found the right strategy to expand the reach and resolve public doubts on receiving the vaccine.

Method

The literature review uses secondary data from previous studies, and data collection was carried out for 1 week. The data search was conducted through the PubMed database, Google Scholar, Scopus, Web of Science, and Proquest. The search used the “boolean searching” method using the keywords “community engagement” AND “COVID-19 vaccine” AND “vaccine program” AND “vaccine acceptance” AND “community participation”. The tracing steps for determining samples using PRISMA developed by Page et al.¹¹11. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. are described inFigure 1.

The total search for data based on the COVID-19 vaccine (n=11,599) focused on public acceptance (n=813) and community involvement (n=86), then searched by type of article (n=46). Furthermore, from 46 types, the selected articles were analyzed based on the PICOS inclusion criteria: 1) community population; 2) without intervention; 3) without comparison; 4) outcome: factors supporting, inhibiting, and accepting the vaccine; 5) research articles; 6) articles published in 2021; and 7) English.

Each article was studied and analyzed according to the inclusion criteria. Many articles were eliminated because they did not meet the criteria, including an intervention. The results section did not describe the specified variables, and the research year was not 2021. The articles were analyzed using the qualitative software ATLAS.Ti9 after carrying out the identification, screening, and criteria determination stages. Articles that meet the criteria are stored in one folder and inputted into the ATLAS.Ti9 software for further data analysis.

A total of seven international articles met the criteria and were sampled for synthesis and analysis. The inclusion criteria “outcome” was determined according to the purpose of writing a literature review. Variables were included in the PICOS method to reveal the factors that supported the community being involved and the vaccine. The issues that prevented the population from receiving immunizations were also identified, and the rationale for receiving the vaccine was examined in depth.

The seven articles that fit the criteria were examined, synthesized, and displayed inTable 1.

Results

The literature review results were obtained after carrying out the stages of identification, screening, and determining criteria until seven articles were analyzed. The articles were analyzed using the qualitative software ATLAS.Ti9. A literature review showed encouraging, inhibiting, and community involvement in the COVID-19 vaccine.

In accordance with writing to show community involvement, a variable construct was built based on the Health Belief Model theory, supported by Adebisi et al.¹²12. Adebisi YA, Alaran AJ, Bolarinwa OA, et al. When it is available, will we take it? Social media users' perception of hypothetical COVID-19 vaccine in Nigeria. Pan Afr Med J. 2021;38:230. and Jones et al.¹⁰10. Jones C, Jensen J, Scherr C, et al. The health belief model as an explanatory framework in communication research: exploring parallel, serial, and moderated mediation. Health Community. 2016;30:154-76., which describes that messages or information can optimally achieve behavior change when they target obstacles. Therefore, factors that hinder the administration of the COVID-19 vaccination should be investigated in depth based on several prior research. According to Jones et al.¹⁰10. Jones C, Jensen J, Scherr C, et al. The health belief model as an explanatory framework in communication research: exploring parallel, serial, and moderated mediation. Health Community. 2016;30:154-76., self-efficacy can affect barriers, while self-confidence plays an important role in acting. This was described in the campaign (self-efficacy (perceived inhibition) scheme.

The three themes that became the purpose of writing a literature review were driving factors, inhibiting factors, and perceptions of vulnerability¹²12. Adebisi YA, Alaran AJ, Bolarinwa OA, et al. When it is available, will we take it? Social media users' perception of hypothetical COVID-19 vaccine in Nigeria. Pan Afr Med J. 2021;38:230.. As illustrated inFigure 2, seven themes or constructs were obtained.

The results of data analysis showed that seven themes are related to driving factors, inhibiting factors, and perceptions of community vulnerability. Previous studies analyzed seven articles with similarities and differences. In several countries such as America, Carson's research⁷7. Carson SL, Casillas A, Castellón-López Y, et al. COVID-19 vaccine decision-making factors in racial and ethnic minority communities in Los Angeles, California. JAMA Netw Open. 2021;4:e2127582. found that people's reluctance to participate in vaccination programs results from one day of lost productivity. Green et al.¹³13. Green MS, Abdullah R, Vered S, et al. A study of ethnic, gender and educational differences in attitudes toward COVID-19 vaccines in Israel - implications for vaccination implementation policies. Isr J Health Policy Res. 2021;10:1-12. states that the inhibiting factor for people to receive the vaccine is their beliefs and doubt. Seale et al.¹⁴14. Seale H, Heywood AE, Leask J, et al. Examining Australian public perceptions and behaviors towards a future COVID-19 vaccine. BMC Infect Dis. 2021;21:120. explained that Australians are involved in the vaccine because they are susceptible to the disease. Therefore, people with chronic diseases are 1.4 times more likely to strongly agree to be vaccinated, in addition to family support. The results are the basis for the perception of vulnerability which is a variable between the driving and inhibiting factors. Based on research by Jones et al.¹⁰10. Jones C, Jensen J, Scherr C, et al. The health belief model as an explanatory framework in communication research: exploring parallel, serial, and moderated mediation. Health Community. 2016;30:154-76., Green et al.¹³13. Green MS, Abdullah R, Vered S, et al. A study of ethnic, gender and educational differences in attitudes toward COVID-19 vaccines in Israel - implications for vaccination implementation policies. Isr J Health Policy Res. 2021;10:1-12. and Seale et al.¹⁴14. Seale H, Heywood AE, Leask J, et al. Examining Australian public perceptions and behaviors towards a future COVID-19 vaccine. BMC Infect Dis. 2021;21:120., it is important to add the perception of vulnerability as a constructed variable in the prototype.

Some of the themes were found using the ATLAS.Ti9 software is the basis for developing the theory. The next phase in producing this theory is to examine the tight relationship between the literature study's themes and create a prototype model based on grounded theory. Meanwhile, the co-occurrence values are shown inTable 2.

The theme that has a very strong relationship is community involvement with driving factors (p=0.38), family support (p=0.13) and information reinforcement (p=0.10). The inhibiting factor has a strong relationship with the theme of rejection (p=0.32), conflicting information (p=0.25), drug distrust (p=0.25), perception of vulnerability (p=0.14), and conflicting information (p=0.10). Furthermore, vaccine refusal was caused by distrust of the drug (score=0.14), and conflicting information is related to reinforcement (p=0.18).

The novelty of this research is the development of a grounded theory in the form of community involvement in the COVID-19 vaccine (Fig. 3).

Figure 3 explains that community involvement is caused by driving factors, inhibiting factors, and perceptions of vulnerability. It is related to strengthening information, conflicting information, and perceptions of vulnerability. Family support and perceptions of vulnerability encourage people to administer the COVID-19 vaccine. There were four causes of inhibiting factors, namely distrust of drugs, uncertainty, rejection, and conflicting information.

Discussion

Community involvement in the COVID-19 vaccine is determined by drivers, perceptions of vulnerability, and inhibiting factors. The perception of vulnerability can be a supporting or inhibiting factor influenced by information reinforcement. Strengthening positive information can alter the impression of community vulnerability, making it a compelling element for the community to participate in the COVID-19 vaccine. Family support and information reinforcement encourage community involvement. The incentive to encourage people to be vaccinated must be bolstered because they have been dissatisfied with previous medical care, resulting from informational uncertainty.⁷7. Carson SL, Casillas A, Castellón-López Y, et al. COVID-19 vaccine decision-making factors in racial and ethnic minority communities in Los Angeles, California. JAMA Netw Open. 2021;4:e2127582. Intention to receive vaccines is influenced by motivation and psychological factors.¹⁵15. Barello S, Nania T, Dellafiore F, et al. 'Vaccine hesitancy' among university students in Italy during the COVID-19 pandemic. Eur J Epidemiol. 2020;35:781-3.

The perception of vulnerability to being exposed to COVID-19 is an influential factor in community involvement in vaccine programs. As supported by earlier research, people with a low perception of becoming infected are reluctant to obtain the vaccine. The study explains the great confidence associated with involvement in the vaccine program. The people with confidence not to be exposed are reluctant to join the vaccine program.¹⁶16. Reid JA, Mabhala MA. Ethnic and minority group differences in engagement with COVID-19 vaccination programmes - at pandemic pace; when vaccine confidence in mass rollout meets local vaccine hesitancy. Isr J Health Policy Res. 2021;10:1-9.^,1717. Thompson HS, Manning M, Mitchell J, et al. Factors associated with racial/ethnic group-based medical mistrust and perspectives on COVID-19 vaccine trial participation and vaccine uptake in the US. JAMA Netw Open. 2021;4:e2111629.

The inhibiting factors for community involvement in vaccines are conflicting information, mistrust of drugs due to uncertainty, and vaccine resistance. Relevant to previous research, the attitude of choosing not to play a role is significant to a lack of trust in doctors and nurses.¹⁸18. Abdelhafiz AS, Abd ElHafeez S, Khalil MA, et al. Factors influencing participation in COVID-19 clinical trials: a multi-national study. Front Med. 2021;8:1-12. The combination of health workers, professionals, and the role of the media is important to stop the pandemic.¹⁹19. Hoq MI, Sime MHR, Hossain MM, et al. COVID-19 pandemic: the existing challenges and available solution; evidence from a systematic review. Unnes J Public Health. 2021;10:16-37.

The prototype model of community involvement is the government's strategy to increase the reach of the vaccine program by strengthening information. In line with these findings, Schoch-Spana et al.²⁰20. Schoch-Spana M, Brunson EK, Long R, et al. The public's role in COVID-19 vaccination: human-centered recommendations to enhance pandemic vaccine awareness, access, and acceptance in the United States. Vaccine. 2021;39:6004-12. stated that the government and policymakers in the health sector are expected to find solutions to overcome this crisis. The acceptance strategy dispelled doubts about the vaccine's effect,⁹9. Sethi S, Kumar A, Mandal A, et al. The UPTAKE study: implications for the future of COVID-19 vaccination trial recruitment in UK and beyond. Trials. 2021;22:1-12. and the public has considerations to deciding on vaccines, efficacy, safety, and public distrust of medical personnel. Perceptions of the risk of contracting COVID-19, emotional state, socio-political, mistrust, economic stability, and mental disorders.⁷7. Carson SL, Casillas A, Castellón-López Y, et al. COVID-19 vaccine decision-making factors in racial and ethnic minority communities in Los Angeles, California. JAMA Netw Open. 2021;4:e2127582.

Strengthening information is a driving factor for community involvement in the COVID-19 vaccine, and the wide acceptance through large-scale campaigns is important to consider.²⁰20. Schoch-Spana M, Brunson EK, Long R, et al. The public's role in COVID-19 vaccination: human-centered recommendations to enhance pandemic vaccine awareness, access, and acceptance in the United States. Vaccine. 2021;39:6004-12. It is difficult to build public trust in vaccines, hence health workers need to open information posts and provide brochures containing correct information about vaccines.⁷7. Carson SL, Casillas A, Castellón-López Y, et al. COVID-19 vaccine decision-making factors in racial and ethnic minority communities in Los Angeles, California. JAMA Netw Open. 2021;4:e2127582. A survey by the Ministry of Health noted that respondents with low education had little knowledge about vaccines. The knowledge increases with increasing education and socioeconomic status.²¹21. Kemenkes, ITAGI, WHO, UNICEF. Survei Penerimaan Vaksin COVID-19 di Indonesia. Satuan Gugus Tugas Penanganan COVID-19. 2020; (November): 1-26. Available at: https://covid19.go.id/storage/app/media/Hasil Kajian/2020/November/vaccine-acceptance-survey-id-12-11-2020final.pdf.
https://covid19.go.id/storage/app/media/...

Safe and quality vaccines are a challenge for all countries worldwide, and public communication is a key factor to be considered. The people of Indonesia and the rest of the world distrust vaccines and choose not to obtain their respective vaccinations. Meanwhile, people with good awareness of vaccines will voluntarily be vaccinated.²²22. Sigalingging YE, Santoso APA. Analisis Yuridis Pengaturan Sanksi Bagi Penolak Vaksinasi Covid-19. JISIP (Jurnal Ilmu Sos dan Pendidikan). 2021;5:478-85. Available at: http://ejournal.mandalanursa. org/index.php/JISIP/article/view/2192.
http://ejournal.mandalanursa. org/index.... The reasons for rejection based on a survey conducted in Indonesia were dominated by vaccine safety (30%), doubting the effectiveness (22%), not believing in the effect (13%), fear of side effects (12%), and religious factors (8%).²¹21. Kemenkes, ITAGI, WHO, UNICEF. Survei Penerimaan Vaksin COVID-19 di Indonesia. Satuan Gugus Tugas Penanganan COVID-19. 2020; (November): 1-26. Available at: https://covid19.go.id/storage/app/media/Hasil Kajian/2020/November/vaccine-acceptance-survey-id-12-11-2020final.pdf.
https://covid19.go.id/storage/app/media/... Relevant to the results,²³23. Syan SK, Gohari MR, Levitt EE, et al. COVID-19 vaccine perceptions and differences by sex, age, and education in 1,367 community adults in Ontario. Front Public Health. 2021;9:719665. the reasons for not being willing to receive the vaccine were due to side effects (65.5%) and lack of trust (55.2%). A previous study on 537 samples (91.2%) of COVID-19 vaccine recipients reported side effects.²⁴24. Sari IP, Sriwidodo S. Perkembangan Teknologi Terkini dalam Mempercepat Produksi Vaksin COVID-19. Maj Farmasetika. 2020;5:204. Available at: https://jurnal.unpad.ac.id/farmasetika/article/view/28082.
https://jurnal.unpad.ac.id/farmasetika/a...

Community participation in stopping the spread of COVID-19 is in the form of support for the environment, complying with large-scale social restrictions, and implementing health protocols. Bangladesh is carrying out a massive campaign to mobilize public participation in the program of up to seven million doses. However, most people are hesitant to receive the vaccine out of fear.²⁵25. Biswas B, Ullah MN, Roy SK, et al. Students' perception towards COVID-19 vaccination program in Bangladesh: a study on university students. Budapest Int Res Critics Linguist Educ J. 2021;4:911-21.^,2626. Jiménez ME, Rivera-Núñez Z, Crabtree BF, et al. Black and Latinx community perspectives on COVID-19 mitigation behaviors, testing, and vaccines. JAMA Netw Open. 2021;4:e2117074.

Vaccine doubt is a big problem in the world,²⁷27. Goldman RD, Staubli G, Cotanda CP, et al. Factors associated with parents' willingness to enroll their children in trials for COVID-19 vaccination. Hum Vaccines Immunother. 2021;17:1607-11.

28. Al-Mohaithef M, Padhi BK. Determinants of covid-19 vaccine acceptance in Saudi Arabia: a web-based national survey. J Multidiscip Healthcare. 2020;13:1657-63.

29. Van Khuc Q, Nguyen T, Nguyen T, et al. Young adults' intentions and rationales for covid-19 vaccination participation: evidence from a student survey in Ho Chi Minh City. Vietnam. Vaccines (Basel). 2021;9:794.

30. Do TVC, Thota Kammili S, Reep M, et al. COVID-19 vaccine acceptance among rural Appalachian healthcare workers (Eastern Kentucky/West Virginia): a cross-sectional study. Cureus. 2021;13:e16842.^-3131. Panda DS, Giri RK, Nagarajappa AK, et al. Covid-19 vaccine, acceptance, and concern of safety from public perspective in the state of Odisha, India. Hum Vaccines Immunother. 2021;17:3333-7. and in Indonesia, community participation in the programs is still low.³²32. Nugrahaeni DK, Mauliku NE, Budiman B, et al. Partisipasi dalam Pencegahan dan Penanggulangan Covid-19. J Kreat Pengabdi Kpd Masy. 2021;4:941-53. Available at: http://ejurnalmalahayati.ac.id/index.php/kreativitas/article/view/4042.
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33. Setiawan AAR, Susanto H, Adjie FT, et al. Modeling social, health, and vaccines intervention in time of Covid-19 pandemic impacted in Jakarta Indonesia. Unnes J Public Health. 2021;10:45-60. Available at: https://journal.unnes.ac.id/sju/index.php/ujph/article/view/43065.
https://journal.unnes.ac.id/sju/index.ph... ^-3434. Yulita W, Dwi Nugroho E, Habib Algifari M, et al. Analisis Sentimen Terhadap Opini Masyarakat Tentang Vaksin Covid-19 Menggunakan Algoritma Naïve Bayes Classifier. Jdmsi. 2021;2:1-9. Available at: https://ejurnal.teknokrat.ac.id/index.php/JDMSI/article/download/1344/672.
https://ejurnal.teknokrat.ac.id/index.ph... Doubts on vaccines have prevented people from participating in clinical trials of COVID-19 vaccines.¹³13. Green MS, Abdullah R, Vered S, et al. A study of ethnic, gender and educational differences in attitudes toward COVID-19 vaccines in Israel - implications for vaccination implementation policies. Isr J Health Policy Res. 2021;10:1-12.^,3535. Zaid Z, Shinta A, Aufa M, et al. Public perception on COVID-19 vaccination intention. Int J Public Health Sci. 2021;10:906-13. Contrary to previous studies, vaccine coverage is still low (37.5%) in the United Kingdom. The government's policy to prioritize vaccines for elderly groups vulnerable to the pandemic spread was accepted by 86% of respondents.³3. Sethi S, Kumar A, Mandal A, et al. The UPTAKE study: a cross-sectional survey examining the insights and beliefs of the UK population on COVID-19 vaccine uptake and hesitancy. BMJ Open. 2021;11:1-11. Older age and the male gender were more likely to participate in vaccine trials. Likewise, health care personnel at risk and likely to engage in vaccination clinical trials are eligible. The willingness to receive vaccines in the elderly group is higher.²⁸28. Al-Mohaithef M, Padhi BK. Determinants of covid-19 vaccine acceptance in Saudi Arabia: a web-based national survey. J Multidiscip Healthcare. 2020;13:1657-63.^,3636. Amelia L, Syakurah RA. Analysis of public search interest towards immune system improvement during the COVID-19 pandemic using google trends. Int J Public Health Sci. 2020;9:414-20.

Various factors determine vaccine acceptance at different rates. The COVID-19 pandemic emergency response strategy built solidarity to foster public awareness, trust, and participation. Furthermore, drug mistrust due to uncertainty is an obstacle to vaccine programs. Community leaders are involved in preventing the spread of COVID-19 infection by planning, building trust, and supervising the implementation of health protocols and vaccine programs.³⁷37. Gilmore B, Ndejjo R, Tchetchia A, et al. Community engagement for COVID-19 prevention and control: a rapid evidence synthesis. BMJ Global Health. 2020;5:1-11.

38. Azis AA, Siantoro G. Covid-19 Pandemic impact study on student learning and physical activities in MAN Kota Blitar. Bircu Journal. Published online. 2020:1006-19. Available at: https://www.bircu-journal.com/index.php/birle/article/view/2238.
https://www.bircu-journal.com/index.php/... ^-3939. Nikolovski J, Koldijk M, Weverling GJ, et al. Factors indicating intention to vaccinate with a COVID-19 vaccine among older US adults. PLoS One. 2021;16:1-14. Positive public perception in Osun State Nigeria is significantly related to the willingness to receive vaccines.⁴⁰40. Akinyemi PA, Owoade IA, Fajobi O, et al. Determinants of willingness to pay for COVID-19 Vaccines among residents of Osun State, South-West Nigeria. J Community Med Prim Health Care. 2021;33:1-18. Accurate information about vaccines is the main factor in increasing public acceptance of Saudi Arabia. Samples with reliable information are more willing to be vaccinated than those unaware of the advantages of vaccines.⁴¹41. Fares S, Elmnyer MM, Mohamed SS, et al. COVID-19 vaccination perception and attitude among healthcare workers in Egypt. J Prim Care Community Health. 2021;12, 21501327211013303. Meanwhile, vaccine awareness is high due to getting the right information.⁴²42. Shahil Feroz A, Ali NA, Feroz R, et al. Exploring community perceptions, attitudes and practices regarding the COVID-19 pandemic in Karachi, Pakistan. BMJ Open. 2021;11:1-8.^,4343. Bell S, Clarke R, Mounier-Jack S, et al. Parents' and guardians' views on the acceptability of a future COVID-19 vaccine: a multi-methods study in England. Vaccine. 2020;38:7789-98.

Community involvement in receiving the COVID-19 vaccine differs in each country, depending on the socio-cultural background. The rejection of vaccines in the United States is influenced by religious, cultural, and political aspects. Conflict exists between liberal groups who reject vaccines and conservative groups who support the movement.⁴⁴44. Maudisha AR. Faktor Pemicu Resistensi Masy AS-Indonesia Pemberian Vaksin Anti-Covid-19 UI-2022. Published online 2022:1-3. Available at: https://www.ui.ac.id/?s=Faktor+Pemicu+Resistensi+Masy+AS-Indonesia+Pemberian+Vaksin+Anti-Covid-19+UI-2022.
https://www.ui.ac.id/?s=Faktor+Pemicu+Re... Socioeconomic disparities and fear of different treatment between black and white races hinder the wide coverage of the vaccine in America.⁷7. Carson SL, Casillas A, Castellón-López Y, et al. COVID-19 vaccine decision-making factors in racial and ethnic minority communities in Los Angeles, California. JAMA Netw Open. 2021;4:e2127582. A survey in the United Kingdom in September 2020 involving 4,884 respondents found that vaccine coverage was influenced by government policies prioritizing the elderly, groups at risk for COVID-19 complications, educational background, and high awareness of the importance of eliminating doubts about receiving vaccines because of the information received, and the imbalance between the number of deaths.⁹9. Sethi S, Kumar A, Mandal A, et al. The UPTAKE study: implications for the future of COVID-19 vaccination trial recruitment in UK and beyond. Trials. 2021;22:1-12.

Indonesian society adheres to the religious value of 96%, but the rejection of science is minimal. The reasons for the refusal are religion, health, ideology, and culture.⁴⁴44. Maudisha AR. Faktor Pemicu Resistensi Masy AS-Indonesia Pemberian Vaksin Anti-Covid-19 UI-2022. Published online 2022:1-3. Available at: https://www.ui.ac.id/?s=Faktor+Pemicu+Resistensi+Masy+AS-Indonesia+Pemberian+Vaksin+Anti-Covid-19+UI-2022.
https://www.ui.ac.id/?s=Faktor+Pemicu+Re... In a study of 900 participants in Israel, the low acceptance rate in the Arab population is significant to the development of vaccines and misinformation from the media.¹³13. Green MS, Abdullah R, Vered S, et al. A study of ethnic, gender and educational differences in attitudes toward COVID-19 vaccines in Israel - implications for vaccination implementation policies. Isr J Health Policy Res. 2021;10:1-12. Since building public trust in vaccines is difficult, it is necessary to convey information through public communication and counseling.⁴⁵45. Dewi SAE. Komunikasi Publik Terkait Vaksinasi Covid 19. Health Care J Kesehat. 2021;10:162-7. Available at: https://www.jurnal.payungnegeri.ac.id/index.php/healthcare/article/view/119.
https://www.jurnal.payungnegeri.ac.id/in... ^,4646. Harapan H, Wagner AL, Yufika A, et al. Acceptance of a COVID-19 vaccine in Southeast Asia: a cross-sectional study in Indonesia. Front Public Health. 2020;8:1-8. The correct information is essential to adopting vaccines, as highlighted by several prior research.

Concerning the limitations of the literature review, it is necessary to demonstrate or prove the underlying reality of this theory by original research on the subject since the outputs are grounded theory rather than generic judgments on the subject group. Testing the theoretical concept requires confirmatory factor analysis and structural testing models. Another limitation is that the selected articles determine research results. Therefore, the accuracy of setting the PICOS criteria determines the quality of research results.

Conclusions

Community involvement in the COVID-19 vaccine is influenced by driving factors, perceptions of vulnerability, and inhibiting factors. Information reinforcement becomes a driving factor that will increase awareness, and trust, eliminate doubts and strengthen perceptions of vulnerability to suppress inhibiting factors. Therefore, the media, religious leaders, and other social organizations should be used more effectively to disseminate information to increase vaccination rates.

Acknowledgements

Thank you to the Center for Academic Writing, Universitas Islam Negeri Sumatera Utara, which has facilitated, and provided training in writing systematic literature review techniques for scientific publications.

Availability of databases and material for replication

Research data available to the author.

References

Publication Dates