Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Mohan Z Mani

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On Sep 2018

Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."

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Ex-Member, Governing Body, National Neonatology Forum, New Delhi
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Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018

Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."

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Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
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Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
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Professor and Head
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Saraswati Dental College
On Sep 2018

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Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
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Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
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Muzaffarnagar Medical College,
On Aug 2018

Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".

Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
On Aug 2018

Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".

Dr. Mamta Gupta
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018

Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.

Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."

Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
On May 11,2011

Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."

Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
On April 2011

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.

Dr. Anuradha
On Jan 2020

Important Notice

Original article / research
Year : 2022 | Month : December | Volume : 16 | Issue : 12 | Page : IC05 - IC13 Full Version

Knowledge, Attitude and Practice regarding COVID-19 Vaccination in a Tertiary Care Centre of Tiruvannamalai, Tamil Nadu: A Cross-sectional Study

Published: December 1, 2022 | DOI:
DP Punitha, DP Sudhagar

1. Senior Assistant Professor, Department of General Medicine, Government Tiruvannamalai Medical College and Hospital, Tiruvannamalai, Tamil Nadu, India. 2. Associate Professor, Department of General Medicine, School of Professional Studies, Garden City University, Bengaluru, Karnataka, India.

Correspondence Address :
Dr. DP Punitha,
Tiruvannamalai Medical College, Outer Ring Road, Vengikkal, Tiruvannamalai Taluk, Tiruvannamalai District, Tiruvannamalai, Tamil Nadu, India.


Introduction: Coronavirus Disease 2019 (COVID-19) is one of the worst pandemics witnessed across the globe. COVID-19 vaccination is one of the best available strategies to minimise the severity of the infection and reduce mortality rates. Active participation and involvement of the stakeholders in taking the COVID-19 vaccine are key aspects of the vaccination’s success. Lack of knowledge, negative attitude, and willingness to vaccinate may pose a significant challenge for the health authorities to complete the vaccination drives.

Aim: To assess the Knowledge, Attitude, and Practice (KAP) about COVID-19 vaccination among people of Tiruvannamalai, Tamil Nadu, India.

Materials and Methods: The present cross-sectional study was conducted in a tertiary care centre of Tiruvannamalai district, Tamil Nadu, India, in November 2021. Overall, 478 respondents aged above 18 years were included in the survey using a structured questionnaire. The questionnaire was administered to assess the KAP regarding the COVID-19 vaccine among study subjects. The study used descriptive statistics such as frequency, percentage, and sentiment analysis.

Results: Out of total sample, 99% of the study participants had taken the COVID-19 vaccine, 81% had taken the second dose, predominately 51% of the participants had taken the COVID-19 vaccine at a Government hospital, 74% of the participants mentioned that it was their responsibility to take COVID-19 vaccine. Regarding KAP, the knowledge score was 10 out of a total score of 14, the attitude score was 8 out of 10, and the total score of the COVID-19 related practice was 10 out of 10.

Conclusion: The findings of the study indicate that the vaccination drive in the population will be highly effective since the vaccine acceptance among the stakeholders was good due to sound knowledge, positive attitude, and safe COVID-19 practice.


Behaviour, Coronavirus disease-2019, Mortality, Pandemic, Questionnaire survey, Vaccination

The emergence of the novel Coronavirus Disease 2019 (COVID-19) was found in the seafood market in Wuhan City in the Hubei province of China in December 2019 (1). Since its emergence, COVID-19 has hit 215 countries/territories/areas worldwide (1). India’s COVID-19 death toll is estimated to be four million, considered ten times higher than the official count (2).

India did not face a severe second wave of the COVID-19 pandemic, which showed increasing signs of COVID-19 cases (3). Regular exercise and eating healthy food were the main protective measures against the protection from novel COVID-19 (4). The report also indicated that 65% of the study participants practised the regulations and recommendations released by World Health Organisation (WHO), such as frequent hand washing and wearing masks. Nearly, 50% of the respondents consumed homemade immunity boosters and remedies. Interestingly, only 34% of the respondents mentioned that they had undertaken vaccines (5). The primary measure in controlling and managing COVID-19 is to practice prevention protocols and take the COVID-19 vaccine to reduce the severity and mortality (5). It is mentioned that more than one billion COVID-19 vaccines are successfully administered across different geographical locations in India, but the current population of India is estimated to be 1,398,198,335 (6). As per the instructions given by the Government of India, anyone 18 years and older are only eligible to get the COVID-19 vaccine (6).

Coronavirus Disease 2019 vaccine is not entirely administered to all the population above 18 years and older in India, and individuals below 18 years are yet to be vaccinated. There may be several reasons for the non accomplishment of 100% in the vaccination drive, including vaccine hesitancy. Understanding the KAP about the COVID-19 vaccine will provide vital information to the health care service providers, COVID-19 vaccine administrators, and health policymakers to develop strategies to scale up the vaccination through enhanced participation from the public and thereby leading to 100% vaccination in the country.

The present study is novel in terms of developing an original survey questionnaire based on focus group discussion to measure KAP. The focus group discussion included health authorities, doctors, policymakers, and researchers. Based on the recommendations of the statements given by the focus group discussion health authorities, the KAP for the present study was developed. In addition, the present study has compared different studies such as across the globe related to the COVID-19 vaccine KAP to understand the previous study’s outcomes and draw inferences in relation to the present study (7),(8). Hence, the present study was aimed to understand the COVID-19 vaccine KAP among citizens of Tiruvannamalai, Tamil Nadu, India.

Material and Methods

This cross-sectional research was conducted in the Tiruvannamalai district, Tamil Nadu, India, for one month in November 2021. The study was approved by the Institutional Ethics committee (IEC no- 02 /FA-2022). Written informed consent was taken from all the participants before inclusion in the study.

Inclusion criteria: Any subjects aged above 18 years, irrespective of gender, who were willing to participate in the study were included in the study.

Exclusion criteria: Subjects below 18 years and who refused to provide consent for the study were excluded from the study.

Sample size calculation: The sample size was calculated based on a confidence level of 95% and a margin of error of 5%. The formula used to determine the sample size was=({z2*p(1-p)}/e2/1+{z2*p(1-p)}/e2*N).

In the formula,
‘p’ denotes the standard deviation,
‘e’ indicates the margin of error,
‘z’ refers to the z-score and
N is the size of the population.

Based on this calculation, the study should collect 218 survey responses from the study participants. Using convenience sampling, the data was collected from the respondents across Tiruvannamalai district, Tamil Nadu, India.

Data Collection

An online survey with the help of a structured questionnaire was used to collect the data. The questionnaire included: the respondents’ demographic details, COVID-19 vaccine-related behaviour, and KAP about the COVID-19 vaccine. The questionnaire for the survey was developed based on the results of the focus group discussion conducted with the experts in the field. Content validity was checked with the experts and the 15 pilot study respondents, and then the questionnaire was refined based on the comments and feedback received from the concerned. The reliability of the questionnaire developed for the study based Cronbach’s alpha value indicated a good internal consistency with a value of 0.88. The knowledge-related question was based on multiple choice questions with one correct answer and three wrong answers. For every correct answer, 1 point was assigned and 0 points were assigned to every wrong answer.

Using the concept of sentiment analysis, the overall score of the KAP was determined. In total, 14 questions were covered under the knowledge factor. Score of 12 and above was considered to be good knowledge about the COVID-19 vaccine. Under attitude, 10 questions were asked to the study participants. A positive response was assigned 1 point, and a negative response was assigned with 0 points. A score of 8 and above is considered a positive attitude toward COVID-19. Finally, under the practice, 10 questions were asked to the respondents. A score of 1 was assigned for every correct practice, and for the wrong practice score of 0 was assigned. Score of 8 and above was considered to be good practice for the COVID-19 vaccine. For the overall computation of the KAP score, any question secured by over 70% of subjects was assigned a value of 1, and below 70% was assigned with a value of 0 for the purpose of this study only. The final score of KAP was calculated based on the overall values received for each question.

Statistical Analysis

The study employed descriptive statistics, including frequency and percentage, to analyse the data related to eight demographic details and four COVID-19 vaccine-related behaviours.


Predominantly the respondents of the present study were females from the age group of 21-30 years living in urban areas, and the occupation of respondents was students from the Undergraduate (UG) programme. In addition, the majority of the respondents were unmarried from a nuclear family with an annual income below two lakhs (Table/Fig 1).

The majority of the respondents had taken the COVID-19 vaccine, predominantly the respondents have taken the second dose of the COVID-19 vaccine, Government hospitals and the COVID-19 vaccination camps were the main places where the respondents took the vaccine and most of the respondents have mentioned that it is their responsibility to take the COVID-19 vaccine (Table/Fig 2).

The knowledge score was 10 out of a total score of 14. The knowledge-related questions such as ‘how to handle unusual reactions after the COVID-19 vaccine, perception such as severe allergic reactions to the first dose of the COVID-19 vaccine, usage of painkillers such as paracetamol before receiving the COVID-19 vaccine and suitability of the COVID-19 vaccine’ are the areas which require interventions and improvement (Table/Fig 3).

The attitude score was 8 out of 10. It is considered to be a good score. This is mainly indicating the trust of the respondents towards the COVID-19 vaccine. The areas in attitude that need intervention and improvement are the perception of the long-term health complications related to the COVID-19 vaccine, and the cost of the COVID-19 vaccine is assumed to be high (Table/Fig 4).

With the reference to (Table/Fig 5), the total score of the COVID-19-related practice was 10 out of 10. This indicates that the respondents are well informed about what needs to be done, how it should be done, and their roles and responsibilities regarding the COVID-19 vaccine (Table/Fig 5).


The results of the study indicate that regarding knowledge of the COVID-19 vaccine, more awareness is required to handle the unusual reaction after the COVID-19 vaccine, severe allergic reactions to the first dose of the COVID-19 vaccine, and painkillers such as paracetamol before receiving the COVID-19 vaccine to prevent side-effects and safe intake of COVID-19 vaccines. Perception of the respondents, such as long-term health complications and the cost of the COVID-19 vaccine under attitude, also warrants a need to conduct awareness. Interestingly, all the practice questions related to COVID-19 have secured more than 100%, meeting the eligibility to consider good practice.

Syed Alwi SAR et al., found that social media was the main source of information about COVID-19 (7). The overall acceptance of the COVID-19 vaccine was high, accounting for 83.3%. Only in the case of elders (60 years and above) and pensioners the COVID-19 vaccine acceptance percentage is relatively lowest. The main reason for the non acceptance of the COVID-19 vaccine was due to side-effects, safety, lack of information, effectiveness, and religious and cultural factors. The study also reported that participants with diabetes mellitus and hypercholesterolaemia showed hesitancy to take COVID-19 vaccine. Age, religion, and residence were the main predictors of COVID-19 vaccine hesitancy.

Mohamed NA et al., included the participants with a mean age of 37.07 years. The results of their study indicate that 62% displayed poor knowledge about the COVID-19 vaccine, and only 64.5% were shown a willingness to get COVID-19 vaccine (8). Interestingly, the study found that higher knowledge of the COVID-19 vaccine was due to the factors such as higher education, higher income, and the participants who were living with individuals with severe risk of contracting COVID-19. The study also reported that participants representing lower age groups, higher educational qualifications, and female gender were more likely to get COVID-19 vaccines.

Interestingly, Magadmi RM and Kamel FO highlighted that only 44.7% of the respondents were ready to accept the COVID-19 vaccine if provided and 55.3% of the respondents had displayed hesitancy in taking the COVID-19 vaccine (9). The study reported that respondents in a young age group, male gender, and the respondents who had received seasonal influenza vaccine showed more likelihood to take the COVID-19 vaccine. Concern about the side-effects of the COVID-19 vaccine was the main barrier to accepting the COVID-19 vaccine. The respondents were willing to accept the COVID-19 vaccine if there could be studies assuring COVID-19 safety and effectiveness.

Contrary to this finding, Sharma M et al., found that 47.5% of the respondents displayed hesitancy to take COVID-19 vaccine (10). The MTMs initiation model used in the study had three variables: behavioural confidence, participatory dialogue, and changes in the physical environment. The study found that all the variables influenced COVID-19 acceptance among the respondents who did not have any hesitancy to take COVID-19 vaccine, and the model explained 54.8% of the variance. The authors mentioned that MTMs could be used to formulate strategies for college students to increase their acceptance of the COVID-19 vaccine.

In the student context, Barello S et al., reported that 86.1% of the students had shown positive intention to get the COVD-19 vaccine, whereas 13.9% of the students did not show intention to get the COVID-19 vaccine (11). The study did not observe any differences in the intention to get COVID-19 vaccines among the healthcare and non healthcare students. The author mentioned that knowing the student’s perspective on the COVID-19 vaccine and their support towards health engagement and consciousness might help plan multidisciplinary educational strategies. In the context of the mothers, Walker KK et al., reported that perception of the COVID-19 threat influenced the mother’s decision to follow the COVID-19 protective behaviours (12). But the mothers were hesitant to take the COVID-19 vaccine due to reasons such as the safety of the COVID-19 vaccine, the efficacy of the COVID-19 vaccine, and confusion caused due to conflicting information about the COVID-19 vaccine.

Joshi A et al., reviewed 22 eligible studies available in PubMed (13). The study found that 82% of the studies were conducted with the general population. From the 22 study finding, gender, age, education, and occupation were the main socio-demographic variables influencing vaccine acceptance. The factors such as trust in authorities, risk perception of COVID-19 infection, efficacy of the COVID-19 vaccine, influenza vaccination status, and vaccine safety affected the acceptance of the COVID-19 vaccine. The study reported that the COVID-19 vaccine acceptance globally in March 2020 was 86%, but it dipped to 54% in July 2020 and enhanced to 72% in September 2020. Regarding vaccine hesitancy, the study reported that the average vaccine hesitancy in April 2020 was 21%, in July 2020 was 36% and in October 2020 was 16%. The authors reported that these fluctuating vaccine acceptance or vaccine hesitancy might hamper the effort to control or eliminate COVID-19. The authors also highlighted the importance of paying attention to the barrier and facilitators of the COVID-19 vaccine to formulate strategies for the maximum coverage of the COVID-19 vaccine.

AlShurman BA et al., used 48 articles related to the COVID-19 vaccine. The selected articles were focused on research outcomes such as demographics, social factors, vaccination beliefs and attitudes, vaccine perceptions, perceptions related to health, perceived barriers related to the COVID-19 vaccine, and the recommendation for the COVID-19 vaccine. The analyses revealed that age, gender, education level, race/ethnicity, the safety of the COVID-19 vaccine and its effectiveness, previous influenza vaccination history, and self-protection from COVID-19 were the critical factors that influenced the use of the COVID-19 vaccine. Most reviewed studies reported a high intention to get COVID-19 vaccination, ranging from 60-93%. Zahid HM and Alsayb MA reported that the overall COVID-19 vaccine acceptance rate was 79.2% (14),(15). The study found that the respondent’s age, sex, and nationality significantly influenced their vaccination status. The reason the respondents who had been vaccinated or had the intention to get vaccinated was due to the perception such dangerous infection of the COVID-19 vaccine varies from person to person, the safety of the COVID-19 vaccine, and the need to get the COVID-19 vaccination. The main factors influencing the motivation to opt for the vaccine were confidence in government decisions and responsibility towards stopping the pandemic. The study also reported that the demotivating factors for the COVID-19 vaccine were due to a lack of clinical trials and information about the side-effects. The residents of Saudi Arabia had shown good acceptance of the COVID-19 vaccine.

Al-Wutayd O, et al., highlighted that only 35.8% of the respondents was hesitant to receive COVID-19 vaccine (16). The main reason for the hesitancy towards the COVID-19 vaccine includes side-effects, belief in conspiracy theories and negative perception of the inefficacy of the COVID-19 vaccine. Other factors such as urban residency, reservations about vaccine safety, uncertainty about vaccine efficacy, the COVID-19 vaccine’s failure to decrease hospitalisation and death, and the unrealised need for vaccination awareness were the reasons for higher vaccine hesitancy. Factors such as one chronic disease, awareness of someone who tested COVID-19 positive, and trust in the information from the health ministry and physicians were associated with reducing the hesitancy of the COVID-19 vaccine. Musa S et al., reported that age groups, nationalities, and recovery from COVID-19 were the main predictors that determined the vaccine hesitancy level (17). Interestingly, the study reported that parents of adolescents from North African, African, Asiatic, and European/American/Oceanian were less likely to have vaccine hesitancy when compared to parents of adolescents from the Gulf countries. The author recommended effective communication mainly targeting the Gulf countries, parents of younger children aged 12 years, and of those with chronic disease or individuals infected with COVID-19, which will enhance the trust/vaccine confidence leading to enhancing the COVID-19 intake.

Tahir MJ et al., reported that 70.8% of the respondents were willing to take the COVID-19 vaccine, and 66.8% of the respondents displayed a positive attitude toward vaccination (18). Barry M et al., reported that 33.27% of the respondents had already received the vaccine/enrolled to get the vaccine, and 66.73% did not enroll to get the Vaccine (19). The non enrollment for the vaccine was seen more in the female gender when compared to males. Yu Y et al., found positively associated factors for the PSCV, which include the perceived protection effect of vaccination, self-perceived physical fitness for vaccination, compulsory COVID-19 testing experience, perceived need to travel, general trust toward the Government and trust toward the government vaccination programme, and negatively associated factors include perceived low efficacy of vaccination, concerns about side-effects and chronic disease status (20).

Finney Rutten LJ et al., found that there was a significant vaccine hesitancy in general public attitudes in the United States of America (USA) towards the COVID-19 vaccine (21). The authors reported that building on efforts was essential at the policy and community level to ensure population access to COVID-19 vaccination. The author also recommended that a strong healthcare system is vital to enhance vaccine hesitancy. Taye BT et al., indicated that the percentage of COVID-19 vaccine acceptance was 69.3%. The main reason for COVID-19 vaccine acceptance was attributed to the knowledge and status of the health science student and part of the family practicing COVID-19 prevention (22). Salerno L et al., reported that vaccine hesitation or resistance among the students was due to higher endorsements or conspiracy statements and negative perceptions about vaccines (23).

Taye BT et al., and Dratva J et al., one-third of the participants intended to take COVID-19 vaccine, and 68% were unsure about getting the COVID-19 vaccine (22),(24). The study found that apart from the demographic characteristics, vaccination history, travel vaccination, trust in vaccination, and 5C dimensions were associated with vaccination intention. Sharma M et al., found that perceived advantages and behavioural confidence were higher among the vaccine non hesitant group than the hesitant ones (25). Kumari A et al., developed a 39-item questionnaire to assess the knowledge, attitude, practices, and concerns regarding the COVID-19 vaccine, and Cronbach’s alpha value was 0.86, indicating good internal consistency (26). Based on the above literature, it is evident that studies related to the COVID-19 vaccine are limited in the Indian context. The present study will contribute to bridging the gap in the literature.

With reference to (Table/Fig 6), while comparing the previous research studies on COVID-19 vaccine knowledge, attitude, acceptance, and hesitancy, the results of the present indicate a higher knowledge, positive attitude, and practice towards the COVID-19 vaccine (7),(8),(9),(10),(13),(15),(18),(21),(22),(24).


The study used convenience sampling to collect the data from the respondents. Hence, the results of the study cannot be generalised.


Study subjects had good knowledge about the COVID-19 vaccine, a positive attitude, and excellent COVID-19 vaccine-related practices. This finding will provide more confidence to the stakeholders involved in the administration of COVID-19, which includes the health authorities, doctors, and policymakers, to conduct the COVID-19 vaccine drive across the country actively. The study results can be used to develop health promotion strategies to promote the COVID-19 vaccine.

More COVID-19 vaccine related behaviour can be included in future studies. In addition, a study can be explicitly conducted with the population below 18 years of age since the population below 18 is not yet vaccinated. The KAP of these populations could be different, which may be highly required for the various stakeholders involved in the vaccination administration.


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DOI and Others

DOI: 10.7860/JCDR/2022/60673.17379

Date of Submission: Oct 09, 2022
Date of Peer Review: Nov 02, 2022
Date of Acceptance: Nov 28, 2022
Date of Publishing: Dec 01, 2022

• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA

• Plagiarism X-checker: Oct 11, 2022
• Manual Googling: Nov 21, 2022
• iThenticate Software: Nov 25, 2022 (5%)

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