CORONAVIRUS DISEASE (COVID-19) VACCINATION AWARENESS AMONG

HEALTH SCIENCES LEARNERS

ACBANG, MARVIN S.
GARCIA, JOHN ARVIN L.
JIMENEZ, MILDRED R.
PIZARRO, CARL JANSEN C.
SALES, VANESSA TRACY V.
BSN III-C
Group 1 Cluster 1

BACHELOR OF SCIENCE IN NURSING

Mariano Marcos State University

College of Health Sciences
Department of Nursing
2906 City of Batac, Ilocos Norte

2022
 ACKNOWLEDGEMENT

The researchers would like to express their deepest recognition and

heartfelt gratitude to all the people who contributed and were part of the success and
realization of this venture. This would never be possible without their realizable efforts and
cooperation:
Prof. Ryan Dean T. Sucgang, the OIC-Dean of the College and also the Chairman
of the University Research Ethics Review Board, for the suggestions and approval.
Prof. Judith P. Valenzuela, the Chair of the Department, for the approval of the
research study, his contribution of knowledge, and constant motivation to the researchers
in pursuing the study.
Prof. Rosemarie G. Asuncion, the research adviser, for her unending support and
patience as well as her commendable efforts in assisting, supporting, recommending, and
giving constructive criticisms for the actualization of this study.
Dr. Elmer A. Santos, Prof. Josephine P. Ceria and Mr. Jayflor L. Ronquillo and the
members of the panel, for directing and mentoring the researchers during the processing
of the study and for giving suggestions and recommendations for the fulfillment and
accomplishment of such.
Mr. Ruween Nicky Guzman, their dedicated and very patient statistician, for his
remarkable efforts in helping and assisting the researchers in the statistical analysis of
data as well as computing the result of the gathered data.
Dr. Shirley C. Agrupis, the President of Mariano Marcos State University, for
allowing and permitting the researchers to conduct this study.
The Respondents, who willingly shared their time with the researchers to answer
all the questions required in the questionnaire despite their busy schedules and for
rendering their cooperation which greatly contributed to the accomplishment of this study.
The Parents of the Researchers, for their endless love, and sacrifices, genuine
guidance and continuous financial support that led the way to the completion of this study.
The Alma Mater as well as the Instructors of the Department of Nursing, for the
guidance and support from the start until the very end.
Above all, to our Almighty God, for the good health, patience, intelligence,
enlightenment and encouragement needed in the completion of the research study.
Thank you very much and may God bless you all.

i
 ABSTRACT

ACBANG MS, GARCIA JAL, JIMENEZ MR, PIZARRO CJC, SALES VTV.
Mariano Marcos State University, College of Health Sciences, Department of Nursing.
June 2022. Coronavirus Disease (COVID-19) Vaccination Awareness among Health
Sciences Learners.
Major Adviser: Prof. Rosemarie G. Asuncion
COVID-19 is a disease caused by a virus called SARS-CoV-2. Most people with
COVID-19 have mild symptoms, but some people can become severely ill. The
Commission on Higher Education and a state university in Ilocos Norte province launched
a mass vaccination against COVID-19 among its students in preparation for the conduct
of face-to-face classes. Thus, this study was conducted to determine the profile, level of
awareness of the health sciences learners on the components of MMSU COVID-19
vaccination program and the relationship between these variables.
The researchers utilized descriptive-correlational research design and Electronic
survey questionnaires (Google Forms) were used as a primary tool in gathering the data.
The study was conducted in Mariano Marcos State University (MMSU), College of Health
Sciences (CHS) at Brgy. #16 Quiling Sur Batac, Ilocos Norte where 303 respondents were
selected using stratified random sampling. In analyzing the gathered data to attain the
objective of this study, frequency count and percentage, mean rating, and Spearman rho
correlation analysis was utilized.
From the results of the study, a big majority of the respondents are aged 19-22,
female, BS in Nursing, level 1 students and they use social media (Facebook) as a source
of information. The respondents are extremely aware of all the components of the COVID-
19 vaccination program (registration, counseling, screening, vaccination, post-
vaccination). There is a significant relationship between the profile of the respondents to
the awareness of the vaccination program. Specifically, age and year level are significant
predictors on their awareness on all components of the program while sex, program, year
level and source of information have significant relationships to some of the components.

Keywords: COVID-19, awareness, components, vaccination program

ii
 TABLE OF CONTENTS
Title Page
Acknowledgement i
Abstract ii
Table of Contents iii
List of Tables and Figures iv
CHAPTER I. THE PROBLEM
Rationale 1
Statement of the Objectives 5
Significance of the Study 6
Scope and Limitation of the Study 7
Operational Definition of Terms 8
CHAPTER II. REVIEW OF RELATED LITERATURE AND STUDIES
Related Literature 10
Related Studies 38
Theoretical Framework 47
Conceptual Framework 50
Research Hypotheses 52
CHAPTER III. METHODOLOGY
Research Design 53
Research Locale 53
Population and Sampling Procedure 54
Research Instrument 55
Ethical Consideration 56
Data Gathering Procedure 57
Statistical Analysis 58
CHAPTER IV. PRESENTATION, ANALYSIS, AND INTERPRETATION OF DATA 60
CHAPTER V. SUMMARY, CONCLUSIONS AND RECOMMENDATIONS
SUMMARY OF FINDINGS 75
CONCLUSIONS 78
RECOMMENDATIONS 79
BIBLIOGRAPHY 80
APPENDICES 92
CURRICULUM VITAE 106

iii
 LIST OF TABLES

TABLE TITLE PAGE

1 Profile of Respondents 60

2 Awareness of the Respondents on the Components 63

of the MMSU COVID-19 Vaccination Program

3 Correlation Between the Profile of the Respondents 70

And the Level of Awareness on the Components of the

MMSU Vaccination Program on COVID-19.

LIST OF FIGURES

FIGURE TITLE PAGE

1 The Research Paradigm 51

iv
 CHAPTER I

THE PROBLEM

Rationale

COVID-19 is a disease caused by a virus called SARS-CoV-2. Most people with

COVID-19 have mild symptoms, but some people can become severely ill. Although most

people with COVID-19 get better within weeks of illness, some people experience post-

COVID conditions. It has greatly affected the lives of the people and the nation (Centers

for Disease Control and Prevention, 2021).

Most of the world’s existing crop of COVID-19 vaccines offer high protection

against severe COVID-19, hospitalization, and deaths. They also offer considerable

protection against symptomatic disease, and modest protection against infections and

transmission of the disease. They are designed to give us immunity without the dangers

of getting the disease (Vashishtha, 2021).

There are already many vaccines against COVID-19 and they are given free by

the government. Like other vaccines, the Centers for Disease Control and Prevention

(2021) also stated that COVID-19 vaccines are safe and effective because they have

undergone extensive testing and monitoring. Furthermore, they are not experimental

because they went through all the required stages of clinical trials.

However, many people are still hesitant in getting vaccinated despite the many

risks and threats brought by the disease. Results of the survey from Statista Research

Department (2021) as of May 2021 showed that for those unwilling to receive vaccinations

against the coronavirus (COVID-19), the majority of Filipinos cited the possible side effects

of the vaccine as the main reason not to be vaccinated. Around 20 percent of respondents

expressed fears of dying due to the vaccine or heard reports of fatality which discouraged
 2

them to be vaccinated. On the other hand, eight percent of Filipino respondents said that

they do not like or need the vaccine.

The World Health Organization has developed and disseminated a vaccine

introduction readiness assessment tool. This key instrument guides all countries to be

strategic in COVID-19 vaccination rollout that includes decisive planning and

implementation, data and monitoring, supply and logistics, and acceptance and demand.

Then, the Philippines had a bill called House Bill 9252 or “Mandatory COVID-19

Immunization Act of 2021” which sought to require all Filipinos to receive the vaccine for

free at any government hospital or health center, except for those persons unfit due to

medical conditions. (Cardenas, 2021).

Survey studies on COVID-19 vaccine acceptance rates were found from 33

different countries. Among adults representing the general public, the highest COVID-19

vaccine acceptance rates were found in Ecuador (97.0%), Malaysia (94.3%), Indonesia

(93.3%) and China (91.3%). However, the lowest COVID-19 vaccine acceptance rates

were found in Kuwait (23.6%), Jordan (28.4%), Italy (53.7), Russia (54.9%), Poland

(56.3%), US (56.9%), and France (58.9%). Only eight surveys among healthcare workers

(doctors and nurses) were found, with vaccine acceptance rates ranging from 27.7% in

the Democratic Republic of the Congo to 78.1% in Israel. In the majority of survey studies

among the general public stratified per country (29/47, 62%), the acceptance of COVID-

19 vaccination showed a level of ≥70%. Low rates of COVID-19 vaccine acceptance were

reported in the Middle East, Russia, Africa and several European countries. This could

represent a major problem in the global efforts to control the current COVID-19 pandemic.

Currently, the Philippines shows a gradual progress but slow vaccination rollout. With the

previous arrival of vaccine doses from Sinovac-made ‘CoronaVac’ and Sputnik V. (PMC

US National Library of Medicine, 2021).

 3

As of March 29, 2022, around 65.8 million people were already fully vaccinated

from the COVID-19 virus in the Philippines. This includes those who received single-dose

vaccines. In contrast, roughly 71 million people were still waiting for their second dose of

the vaccine. Meanwhile, about 11.95 million already received a booster shot. (Statista,

2022).

Over five million doses of COVID-19 vaccines were already administered to

residents in the Ilocos region, data from the regional Department of Health (DOH) showed

on Monday, Jan. 3, 2022. The Department of Health stated that at least 2,615,605

individuals were already fully vaccinated against the disease while 3,206,656 had received

at least one dose of the vaccines. Some 64,444 residents in the region had also received

their COVID-19 booter shots, the same data showed. The region is targeting to vaccinate

at least 3,719,256 individuals to achieve herd immunity against the disease, the DOH said.

Minors receive COVID-19 vaccines at a facility in Ilocos Norte province. Additionally, in

Ilocos Norte, the provincial government said 86 percent of the 431,801 target population

for herd immunity had been fully vaccinated. (Mugas, 2022).

Malipot (2021) stated in her article that the Commission on Higher Education

(CHED) on Tuesday, Sept. 28, 2021, confirmed that limited face-to-face classes will now

be allowed in other higher education degree programs other than medicine and allied

health sciences. This after getting the approval of President Duterte approved the CHED’s

request for the expansion of limited face-to-face classes to other degree programs that

require hands-on experience in higher education institutions (HEIs). CHED Chairman

Popoy De Vera said that, “The urgent need for hands-on experience and the safety of

students taking up medicine and allied health courses, who were permitted by the national

government to conduct limited face-to-face classes since January 2021, is the key for

CHED to recommend on the expansion proposal.” Since January 2021, only schools that

offer medical and allied health sciences were allowed to hold limited face-to-face classes.
 4

In addition, the Commission on Higher Education included 24 Higher Education

Institutions approved to re-open for limited face-to-face classes which included Mariano

Marcos State University (MMSU). These 24 Higher Education Institutions complied with

the CHED-DOH guidelines and have been inspected by CHED and their LGUs so they

can now bring their 3rd and 4th year students for hands-on training and laboratory classes

in a limited face-to-face system. They also have passed stringent retrofitting and health

standards imposed by CHED, the Department of Health (DOH) and the COVID-19 Inter-

Agency Task Force for the Management of Emerging Infectious Diseases (IATF-EID).

The Commission on Higher Education and a state university in Ilocos Norte

province launched on Monday (Nov. 8, 2021) a mass vaccination against COVID-19

among its students in preparation for the conduct of face-to-face classes, officials said.

The vaccination drive in Mariano Marcos State University (MMSU) aims to vaccinate at

least 800 students, according to Dr. Shirley Agrupis, university president, in a speech

during the ceremonial vaccination. Dr. Agrupis appealed to the deans and student

coordinators to help the university to reach out to unvaccinated students as it is “the only

protection that we could get to sustain the viability of the education system in the region.”

Furthermore, the provincial government announced that Ilocos Norte would be under

COVID-19 Alert Level 2 beginning Monday. This means that limited in-person classes for

50-percent capacity in the province would already be allowed under three conditions which

include a high vaccination rate among students and faculty. Dr. Gretchen Ranada,

vaccination team leader of nearby Mariano Marcos Hospital, said at least 27,000 doses of

COVID-19 vaccines had already been administered to the employees of the university

since June. (Mugas, 2021).

Dr. Ricardo S. Guanzon, dean of the College of Medicine, presented in a meeting

the latest COVID-19 statistics to the participants; while Dr. Gretchen Ranada, coordinator

of MMMH-MC COVID-19 vaccination program, explained the importance of getting

 5

vaccinated. Also, Mr. Jhey-ar O. Mangati, health education and promotions officer,

discussed the 10 frequently asked questions on COVID-19 vaccination, including its

procedures. An open forum was also conducted to address MMSU employees’ inquiries

regarding the vaccination roll-out in the university. MMSU President Shirley C. Agrupis

thanked the MMMH-MC and the Department of Health (DOH) for their commitment to

vaccinate 1,000 university employees. She also considers this move as a big step toward

becoming a truly COVID-resilient university. Dr. Ranada emphasized that the successful

implementation of the vaccination program in MMSU determines the possible provision of

vaccine doses, which may lead to achieving herd immunity in the university. Dr. Guanzon

reiterated that “the best COVID-19 vaccine is the one available now.” (Tapaoan, 2021).

With this, the researchers aimed to determine the profile, level of awareness of the

health sciences learners on the components of MMSU COVID-19 vaccination program

and the relationship between these variables because they are the ones who are having

face-to-face and will be the future health care professionals and frontliners who will be

exposed to patients. Thus, this study will help to determine proper actions to take,

especially in health promotion and disease prevention. It will further strengthen the

program such as in pertinent information dissemination. Hence, the researchers wanted

to pursue this study.

Statement of the Objectives

Generally, this study determined the awareness of the COVID-19 vaccination

program among health sciences learners of MMSU. Specifically, this study aimed to:

1. Assess the profile of respondents as to:

1.1 Age

1.2 Sex

1.3 Program
 6

1.4 Year level

1.5 Source of information in availing the vaccine

1. Determine the level of awareness of the respondents on the components of

the MMSU vaccination program on COVID-19 in terms of:

2.1 Registration

2.2 Counseling

2.3 Screening

2.4 Vaccination

2.5 Post-vaccination monitoring

3. Find out the significant relationship between the profile of the respondents

and the level of awareness on the components of the MMSU vaccination

program on COVID-19

Significance of the Study

This study deals with the awareness of the COVID-19 vaccination program among

health sciences learners of MMSU. The results of the study could benefit the following:

Health Sciences Learners. The study will help the learners appreciate and

enhance their awareness on the components of MMSU COVID-19 vaccination program in

terms of registration, counseling, screening, vaccination and post-vaccination monitoring.

DOH Vaccination Implementers. The result of the study will help them

understand how aware the learners are regarding the COVID-19 vaccination program.

This would help them formulate and recalibrate their ways and strategies to further

increase the awareness of the learners.

Health Sciences Faculty. The findings of the study would help the faculty to

understand how aware the learners are regarding the COVID-19 vaccination program.
 7

The given data would rule out ideas that would help them formulate measures to enhance

the knowledge of the learners to become fully aware.

Parents. This study would help them gain understanding of how much their

children are aware of the COVID-19 vaccination program. This would help them to be

clarified on the extent of the COVID 19 vaccination program towards their sons/daughters

in health sciences courses.

Researchers. Findings of this study will provide future researchers a broader

understanding as to the awareness of learners on the COVID-19 vaccination program and

use it as their basis to have better results on their future related studies.

Scope and Limitation of the Study

This study focused on determining the level of awareness regarding the COVID-

19 vaccination program among health sciences learners of MMSU. This was conducted

in Mariano Marcos State University (MMSU) - College of Health Sciences situated in

Batac, Ilocos Norte. Respondents included the health sciences learners from the

departments of Nursing, Pharmacy, and Physical Therapy from levels I to IV for the

academic year 2021-2022 and excluded were those learners who didn't want to

participate in the study, considered irregular students, and the fifth year learners of the BS

in Physical Therapy. Questionnaire was utilized in the data gathering procedure which

was given and collected through Google Forms.

 8

Operational Definition of Terms

For better understanding and clarification of this study, the following terms were

conceptually defined:

Awareness. Knowledge and understanding regarding COVID-19 vaccination

program.

Benefits. A good or helpful result of the COVID- 19 vaccination.

Counseling. A phase of the COVID-19 vaccination program where advice and

health education is given to vaccine recipients and answer queries about the vaccine.

COVID-19. A disease that is caused by the SARS-CoV-2 virus which can spread

from small liquid particles through coughing and sneezing.

COVID-19 Vaccination Program. A mass immunization program of Mariano

Marcos State University in response to the ongoing pandemic in the country caused by

severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Management. Way/s to relieve the side effects of the COVID-19 vaccine.

MMSU Health Sciences Learners. These are the students of Mariano Marcos

State University under the College of Health Sciences in the departments of Nursing,

Pharmacy, Physical Therapy at all levels.

Post-vaccination monitoring. A phase of the COVID-19 vaccination program

where the vaccine recipient will be observed for any adverse effects after being vaccinated

for thirty minutes to one hour.

 9

Program. It is a set of planned activities to be done or things to be achieved during

the MMSU COVID-19 vaccination program.

Registration. A phase of the COVID-19 vaccination program where all potential

vaccine recipients shall be registered with their personal information and necessary

documents.

Screening. A phase of the COVID-19 vaccination program where they assess

and detect potential health disorders or diseases on vaccine recipients before the vaccine

is administered to prevent adverse reactions.

Side Effects. Signs and symptoms that are being experienced after being

vaccinated.

Source of information. Someone or something that provides information to the

Health Sciences Learners regarding the COVID-19 vaccination program.

Vaccination. A phase of the COVID-19 vaccination program where the vaccine

is being administered to improve the immunity of an individual against COVID-19.

 CHAPTER II

REVIEW OF RELATED LITERATURE AND STUDIES

This chapter presents a discussion on the review of related literature, studies, theoretical

framework, conceptual framework, and hypothesis of the study.

Related Literature

COVID-19 Vaccination Program Legal Basis

On March 11th of 2020, the World Health Organization (WHO) declared COVID-

19 as a pandemic, with over 118,000 cases in more than 110 countries around the world.

In response to the global coronavirus disease 2019 (COVID-19) emergency, clinical trial

research assessing the efficacy and safety of experimental vaccines to prevent COVID-

19 are emerging at an unprecedented rate. The aim of the systematic reviews is to

summarize the preliminary experiences and ongoing clinical trials of the major candidates

and challenges of the vaccine strategies in humans (WHO, 2021).

As an integral part of its plan to respond to the COVID-19 pandemic, the national

government has always maintained its stance of ensuring the vaccination of at least

seventy percent (70%) of the local population in the near future. In order to reach its

national vaccination goal, the national government consistently underscores the need for

a whole-of-society approach, where employers in the private sector and other local private

organizations are engaged to collaborate and work closely with the government to achieve

a unified and co-ordinated COVID-19 vaccination programme (De Guzman, Logronio, &

Valdecantos, 2021).
 11

Republic Act No 11525 (RA 11525) The COVID-19 Vaccination Program Act 2021.

The national government recently passed this act establishing the Coronavirus

Disease 2019 (COVID-19) Vaccination Program expediting the vaccine procurement and

administration process to establish general guidelines for administering the vaccine which

also sets specific limitations on the use and administration of COVID-19 vaccines. This

act was established in response to the adverse impact of COVID-19 (De Guzman,

Logronio, & Valdecantos, 2021)

The Department of Health in 2021 had released the Philippine National

Deployment and Vaccination Plan for COVID-19 vaccines by the Philippine Government

under the leadership of President Duterte. This was created to provide operational

direction for the deployment and vaccination program for COVID-19 vaccines. Various

government agencies were involved in the plan's development, ensuring that policies and

plans were aligned across agencies and that the plans were integrated into national

governance processes. With the help of specialists from several government agencies,

the goal is to provide operational advice for the deployment and immunization of the

COVID-19 vaccine in the country at its core.

According to WHO (2021), WHO, with support of the world’s top immunization

experts, continuously reviews data about the different vaccines being used in COVID-19

vaccination programs worldwide. WHO’s Strategic Advisory Group of Experts on

Immunization (SAGE) has published guidance on the use of the Pfizer BioNTech vaccine,

and based on new data, SAGE also updated its interim guidance on the use of the

AstraZeneca – Oxford University vaccine. Pfizer and AstraZeneca are two of the vaccines

in use in Malaysia, together with other vaccines also approved and used by the National

Pharmaceutical Regulatory Agency.

As of mid-October 2021, over 6.6 billion COVID-19 vaccine doses have been

administered worldwide. The distribution of the vaccines and the vaccination rates across
 12

countries are probably the top health news right now, outweighing the rather analytical

tracking of coronavirus cases and deaths or the emergence of potentially perilous new

variants of the virus. Furthermore, he stated that currently, the United Arab Emirates',

Cuba's, Uruguay's and Israel’s coronavirus vaccination campaigns are the most

successful worldwide based on doses per population. In terms of sheer numbers, China

and India are the leading nations, with over 2.2 billion doses and around 980 million doses

administered, respectively. Since the United Kingdom is no longer part of the European

Union, it has significantly accelerated its approval processes and started its vaccination

program earlier than most other countries. As a consequence, the UK's vaccination

coverage was one of the fastest worldwide. (Mikulic, 2021).

The effective vaccines against COVID-19 remain the only foreseeable means of

both containing the infection and returning to pre-pandemic social and economic activity

patterns. Globally, several vaccines have been licensed and vaccination programs have

been initiated in several countries including China. However, in the near future, the

projected global production and delivery capacities are likely to be inadequate to provide

COVID-19 vaccines to all individuals who are still susceptible to SARS-CoV-2 infection.

The effectiveness of COVID-19 vaccination campaigns will depend on several factors,

including vaccine supply, willingness to receive the vaccine, and strategies for vaccine

allocation and deployment. (Yu, J., et al. 2021).

On November 8, 2021, Commission on Higher Education (CHED) in Region I

launched their massive vaccination campaign at Mariano Marcos State University

(MMSU). Furthermore, he also stated in his article that it was held at the MMSU Covered

Court. The program aimed to encourage college students to get vaccinated and to

strengthen the university’s preparedness for face-to-face classes. To successfully conduct

the program, there was a partnership between the Department of Health (DOH),

Department of Interior and Local Government (DILG), Provincial Government of Ilocos

 13

Norte (PGIN), and the Mariano Marcos Memorial Hospital and Medical Center (MMMH-

MC). Dr. Gretchen Ranada, in-charge of Resbakuna campaign at MMSU, said that the

program will intensify the Resbakuna campaign of the DOH through the MMMH-MC at

MMSU, which started last June which involved the personnel and employees of MMSU.

MMMH-MC administered Sinovac CoronaVac, Pfizer BioNTech, and Johnson &

Johnson's Janssen vaccines following the government’s priority listing, taking in

consideration that a number could have also received doses in their respective Local

Government Unit (LGU). (Tapaoan Jr., 2021).

Profile of respondents

Age. The risk for severe illness with COVID-19 increases with age, with older

adults at higher risk. The risk increases for people in their 50s and increases in 60s, 70s,

and 80s. People 85 and older are the most likely to get very sick ( CDC, 2021).

According to the Department of Health (2021), the required age for vaccination

depends on the vaccine. For instance, those currently available, Sinovac can be given to

clinically healthy individuals 18-59 years old, while Astrazeneca can be given to those 18

years old and above, including senior citizens.

Vaccine supply is still limited hence, prioritization strategies are required which

includes non-professionals like students in health and allied professions courses with

clinical responsibilities are part of Priority Group A (DOH, 2021 ).

These students entering college in the Philippines before are usually aged 17-20

but with the implementation of the K-12 program in 2012, another two years is added to

basic education before a student proceeds to college (Quality Assurance Agency for

Higher Education, 2018). The age distribution among college students in fall 2017 is also

reported by The Chronicle of Higher Education (2019) which states that nearly 60 percent

of undergraduates were ages 21 and under, and only 16 percent were older.
 14

Going further, some countries also include an age criteria for prioritization to save

most lives and to maximize years of life saved. There are lower rates at younger ages and

increasing rates after mid-adult ages therefore, the sheer volume of lives saved among

the elderly adds to a large number of years of life saved, in contrast to a very small number

of potential lives to be saved at younger ages (Castro and Singer, 2021).

COVID-19 vaccines are safe and effective and everyone 5 years and older is now eligible

to get a free COVID-19 vaccination (CDC, 2022).

Older adults are said to be hesitant to be vaccinated in several nations however,

this is unlikely to be the case for the 4.9 million Filipinos aged 60 and up who agreed to

one treatment but have yet to receive the second. The lack of vaccination coverage is

mostly due to the government's own failure. Six hundred thousand people aged 60 and

up have not received a single dose, and 5.5 million (45 percent) have not had a second.

Over 197 million doses have been administered to those who are not frontline health

professionals. The Philippines government ordered 10 million more vaccination doses on

January 12, 2022, to satisfy the needs of children aged five to eleven (Lloyd-Sherlock et

al., 2022).

Sex. Strategies for vaccine delivery across the life course and via different

modalities (e.g. campaign, routine) need to be designed with gender dynamics and other

equity concerns in mind. The many gender-related barriers that can affect regular

immunization services will also come into play for COVID-19 vaccines, that is, quality of

services, provider attitudes, education and health literacy, decision-making, autonomy and

agency, access and control over resources (e.g., time and money) and mobility, gender-

based violence (known to have increased during the pandemic) and other harmful

practices. (Heidari & Goodman, 2021)

 15

Women were significantly more likely to express a desire to delay or reject the

Covid-19 vaccine than men were. Women were also more likely than men to state that the

vaccine was too new, that they were fearful of side effects, and that they had a medical

contraindication to the vaccine. (Bellon, M. 2020).

According to Philippine Statistics Authority (2018), The health profession is

dominated by women (75%). Moreover, Nursing and allied health professions in the UK

are typically dominated by women. More than 90% of adult nursing students in England

are female. Men are also under-represented in most allied health professions. (Research

Works Limited, 2020).

Furthermore, according to the International Labour Organization (2020), the most

female-dominated occupations are personal care workers, such as health care assistants

and home-based personal workers. In fact, health care dominates the occupations that

are mostly filled by women. Around three-quarters of health associate professionals

assistants in areas such as pathology, imaging and pharmacy are women, and 69% of

health professionals such as general medical doctors and nurses are women.

Program. University students can be a source of increased health awareness and

health education not only for themselves but also for those around them as they take part

in the dissemination of pandemic-related knowledge supporting the prevention and control

of the pandemic. Recent studies from Pakistan, Saudi Arabia and Japan have shown that

medical students have sufficient knowledge, positive attitudes, and proactive practices

during the crisis. (Baniyas et al. 2021).

As the risk of COVID-19 becomes more widespread, people should take steps to

safeguard themselves from infection and limit its spread to others. Though the students

from medical and allied health sciences are not directly involved in managing COVID-19

patients, they can serve as an information provider. They can sensitize community people
 16

about maintaining personal hygiene, symptoms of COVID-19 and how to prevent its

spread. Students must possess the basic knowledge about the novel Coronavirus and be

able to clear the myths pertaining to COVID-19. (Science Direct, 2021).

Year Level. The relationship between education and health is evident. Educational

attainment predisposes a person to experience more positive health outcomes both in

their ability to navigate their own healthcare and to make positive decisions related to

personal health behaviors. The Higher the year level or attainment of a person, the more

aware and knowledgeable a person is when it comes to health. Higher level of education

certainly exposes people to a wealth of information that might prompt them to make

healthier choices. (University of Massachusetts Global, 2019).

In Jeanne Chall’s Stages of Reading Development. Different stages are identified

across a reader’s development and different characteristics and abilities are prominent at

each. Based on their age, in relation to higher educational attainment, students should

have reached the highest stage, Construction and Reconstruction. At this stage, students

should be able to construct their understanding based on text analysis and synthesis. The

reality, however, is that some of students enters classes without this ability. The literacy

levels for college students are on average score, significantly higher than the general adult

population in all literacy types, the average score is characterized at

the intermediate literacy level. (Dreon, 2019).

Source of Information

School Administrators and Faculty. Teaching students is what schools and their

staff do best. Discussions and lessons about COVID-19 and vaccination can be

incorporated. They can discuss basic facts about bacteria and viruses and how to reduce

the likelihood of infection and how to combat COVID-19 and vaccine information with
 17

lessons that build media literacy. They equip students with knowledge of how the COVID-

19 vaccine works and why it is important. They seek to address questions and address

misinformation about the COVID-19 vaccine with their students and their families by

developing or sharing materials from credible sources. Additionally, they inform parents

and students through a school’s communication channels or pages about the dates and

places of COVID-19 vaccination events or on-going clinics. Send out electronic sign-up

links to register for a COVID-19 vaccination appointment. Establishing partnerships can

be helpful for many COVID-19 vaccine-related activities. Partners may include local health

departments, municipal governments and local healthcare providers. (Centers for Disease

Control and Prevention, 2021).

Department of Health. The national government is working in partnership with the

local governments to get the vaccines for everyone. The local government unit arranges

the registration and scheduling of vaccination. Every municipality is given links to access

the vaccination registration portals of the provinces/cities/municipalities of the regions in

the country. (Department of Health, 2021).

The information campaign for COVID-19 vaccine deployment is led by the

Presidential Communications Operations Office, through the Philippine Information

Agency that includes key messages on vaccine safety and efficacy and target key

populations and communities addressing vaccine hesitancy. The communication plan

helps inform the Filipino people about the national strategy of delivering the COVID-19

vaccine faster while still safeguarding the national standards for safety and effectiveness

as with any other vaccine. (Department of Health, 2021).

The prioritization framework for COVID-19 vaccination based on the World Health

Organization (WHO) Strategic Advisory Group of Experts (SAGE) on Immunization,

together with the recommendations of independent bodies of experts including the Interim

National Immunization Technical Advisory Group (iNITAG) and the Technical Advisory
 18

Group (TAG), was formulated due to the limited global supply of COVID-19 vaccine

products. With the guidance of this principle, the Philippine National Deployment and

Vaccination Plan formulated strategies and contingencies to ensure the equitable

distribution of vaccine products for all Filipinos. (Department of Health-Philippines, 2021)

The Department of Health (2021) has released the development of the Philippine

National Deployment and Vaccination Plan for COVID-19 Vaccines by the Philippine

Government. This was created to provide operational direction for the deployment and

vaccination program for COVID-19 vaccines. With the help of specialists from several

government agencies, the goal is to provide operational advice for the deployment and

immunization of the COVID-19 vaccine in the country at its core.

Healthcare Workers. Health professionals play a central and critical role in

improving access and quality health care for the population. They provide essential

services that promote health, prevent diseases and deliver health care services to

individuals, families and communities based on the primary health care approach.

Mechanisms for optimizing the strengths and skills of health professionals will be essential

to achieving the Millennium Development Goals. (World Health Organization, 2021).

In many places, health workers at the sub-national level are on the frontlines of

disseminating information about coronavirus (COVID-19) to communities. To ensure

communities are receiving timely and accurate information, it is vital health workers are

kept abreast of the most recent recommendations, and guidance. Understanding the

sources of information used by health workers can facilitate the transfer of relevant and

timely information, which in turn increases the use of such information by the people. (BMC

Health Services Research, 2021).

Healthcare workers must inform patients of the benefits they will receive from

getting vaccinated versus developing immunity from the natural disease. Emphasize that

prevention is always better than cure. (Department of Health, 2021).

 19

Global evidence shows that Community Healthcare Workers play an important role

in vaccine promotion and acceptance: whether through community dialogue and

engagement, education, trust-building, myth-busting, on- and offline social listening, or

facilitating community entry. (World Health Organization, 2021).

Moreover, still from the World Health Organization (2021), They said that the

Community Healthcare Workers are essential to engagement activities with community

leaders and decision-makers, driving community-level change by working within social

dynamics and institutional and social structures. The effectiveness of immunization

programmes, including COVID-19 vaccine delivery, relies on population uptake and

acceptance of vaccines, achieved through a range of strategies. It also requires trust,

which many CHWs have built in their communities.

Social Media. The nature of social interactions in the 21st century, transformed by

the change into a digital, connected, and globalized context, and concentrated in digital

media, has become a phenomenon which has transformed the organization and

representation of knowledge. Thus, aside from the traditional media, as the drivers of the

social communication thread in situations of crisis, to which they greatly contribute by

providing a truthful, informative story, other social agents have appeared. These new

agents are supported by social networks, and are massively and efficiently contributing to

the re-direction of the management of communication in a worldwide pandemic, along with

the social instability it has brought. Social networks have become platforms of constant

media flow that connect almost half of the world’s population, thereby becoming more

solidified and in direct competition with media and journalists as actors in the information–

communication process. (Escoda et al. 2020).

Early in the outbreak, Taiwan was predicted to have the second highest number

of COVID-19 cases due to the many people moving to and from Taiwan and China. For

information on COVID-19, timeliness and accuracy, although difficult to attain and

 20

measure—are foundational to mitigating and curing the disease for both the public and

the scientific community. Among the public, the internet is the most popular source of

information on the etiologies and intervention models of medical illnesses. Information has

been proliferating on traditional and social media since the COVID-19 outbreak. A recent

study of 21 countries found that the number of Google searches for “wash hands”

increased with the lower speed of the COVID-19 spread. Misinformation on COVID-19,

however, has also been proliferating on the internet, especially on social media. (Wang

et al, 2020).

According to Lancet Digital Health (2021), as a consequence of the pandemic,

social media has rapidly become a crucial communication tool for information generation,

dissemination, and consumption. It is becoming the platform of choice for public opinions,

perceptions, and attitudes towards various events or public health policies regarding

COVID-19. Social media has become a pivotal communication tool for governments,

organizations, and universities to disseminate crucial information to the public. Numerous

studies have already used social media data to help to identify and detect outbreaks of

infectious diseases and to interpret public attitudes, behaviors, and perceptions.

Going digital makes sense in a country that spends the greatest amount of time

online in the world (nearly 11 hours per day), particularly on social media (more than four

hours). Social media as a source of news have risen to 72% (+4pp) in our survey, with

TikTok even becoming a destination for news among Filipinos (6%) alongside Facebook

(73%), YouTube (53%), Facebook Messenger (36%), and Twitter (19%). Major revenue

drops arising from prolonged COVID-19 lockdowns have forced significant downsizing of

the Philippine media. The media environment has also been reshaped by the closure of a

major free-to-air TV network. The Philippines somewhat defies the trend in many countries

that has seen TV viewing surge as lockdowns grounded people at home. (Chua, 2021).
 21

The Department of Health started the #ChecktheFAQs campaign today to

underline the significance of correct information in the fight against the COVID-19

pandemic and to encourage the public to fact-check material they come across. The

campaign was established in collaboration with a number of tech companies including

Facebook, Google, TikTok, and Twitter, who all pledged their support for the initiative as

part of their individual missions to combat COVID-19 and vaccination disinformation on

the internet. Nacario stated that this is part of the Philippines' continuous pandemic

response strategy of linking more people to reliable information. This includes removing

harmful and misleading content across all products, providing authoritative information on

Search and YouTube, offering ad grants, and promoting quality vaccination news reporting

(DOH, 2021).

Since the beginning of the COVID-19 pandemic, there has been an abundance of

information, with nearly every media channel covering the latest developments.

Information channels, both traditional and social media, are sharing vaccine information

and may be very influential in swaying public opinion as to whether or not members of the

public want to be vaccinated. Past research has found that online forums, blogs, and social

media have contributed to the spread of vaccine hesitancy. Several authors have

examined how social media platforms contribute to vaccine hesitancy such as by

promoting personal narratives over empirical data and connecting anti-vaccination themes

to broader belief systems of freedom of choice and parental rights. Social media has

continued to be a vehicle for the spread of COVID-19 misinformation. The content and

spread of misinformation online can influence risk perception and vaccine hesitancy.

Exposure to websites and social media posts discouraging immunizations, even when

brief, can increase perception of vaccination risk while decreasing the perception of

benefits. Viewing such content can reduce viewers’ vaccination intentions. Buller and

colleagues (2019) describe how Facebook users appeared disproportionately swayed

 22

towards vaccine hesitancy due to narratives and emotional stories. Nadler, Crain and

Donovan (2018) describe this advantage of poor- quality information over good as a direct

and predictable consequence of the digital media ecosystem in combination with practices

and technologies of consumer monitoring, audience customization, and the automation of

influence campaigns. (Loeb et al, 2021).

In addition, still from Loeb et al (2021) Individuals tend to receive information from

multiple information channels during a pandemic. Channels of information are relied upon

by risk communicators to push out a message, and the public who pulls on that information

and pushes it to their own network. Bennet, Manheim and others, suggests that patterns

of homogenization, polarization, and targeted marketing have created a “one-step flow” of

persuasion even in legacy media, in which interpersonal social influence recedes as

targeted media increasingly exercises direct influence over individual opinion. Further,

media consumption patterns are often habitual, preceding a given event or information

topic. There is much discussion and research on social media as a vehicle for

misinformation and vaccine skepticism, and less on the role that traditional media, such

as TV, newspapers, and radio can play in misinformation. An individual’s perception of a

given channel can impact how that person acts upon that information. Perceptions of

credibility, authoritativeness, and persuasiveness vary by information source.

Facebook is one of the most popular social networking platforms. Prior to COVID-

19, Facebook had already been well-recognized for sharing all kinds of information

including personal, political, professional, health , and crisis-related information. In

extreme events (e.g. Japan tsunami, Katrina hurricane, terrorist attacks in Paris, and Arab

Spring), Facebook and other social networking sites (SNSs) have shown great potential

for improvising, transmitting, and disseminating information more easily, speedily, and

broadly than mainstream media. Although concerns about the quality of information have

been raised and discussed in the literature, social media offer potential opportunities for
 23

rumor refuting, identifying misinformation, and spotting fake news. The COVID-19 health

crisis highlights the particular strengths of this media as a powerful tool for social

interaction, and for seeking and sharing accurate as well as fake information about the

disease (i.e. symptoms, transmission patterns, and medical interventions). Despite the

fact that it is heavily used for sharing information during the COVID-19 pandemic, there is

little understanding of how and why people share information on Facebook during this

crisis. (Malik et. al, 2021)

Mass Media. The World Health Organization (WHO), on January 30, 2020,

declared the novel coronavirus a public health emergency of international concern. During

the 1st week of February, mass media focused on China’s tally and screening at airports.

Meanwhile, mass media started promoting hand hygiene and other preventive measures.

The WHO declared COVID-19 a global pandemic on March 11, 2020. From this day, the

media started constant reporting on COVID which created anxiety among the public,

leading to impulsive buying of hand sanitizers, face masks, and daily need products.

Simultaneously, the media started covering the shortage of personal protective equipment

(PPE) for health care workers. This coverage helped in putting masks and sanitizers under

the essential commodities act. (Indian Journal of medical Sciences, 2020).

Mass media became the major source of information about the novel coronavirus.

Media coverage of coronavirus news during geographical lockdowns, extended

quarantines, and financial and social hardships induced fear and caused psychological

stress. Domestic and elderly abuse upsurge. The unscientific cures and unverified

medicines endorsed by the politicians and fake doctors proved harmful. The media played

a worldwide role in coronavirus disease tracking and updates through live updates

dashboard. The media allowed for timely interventions by the Center For Disease Control

And Prevention (CDC) and the World Health Organization (WHO), enabling a rapid and
 24

widespread reach of public health communications. There was an upward trend for the

promotion of health and hygiene practices worldwide by adoption of safe health practices

such as increased hand washing, use of face coverings, and social distancing. Media

reinforced illness-preventing guidelines daily, and people were encouraged to use

telehealth to meet their healthcare needs. Mass media has an imperative role in today’s

world and it can provide a unified platform for all public health communications,

comprehensive healthcare education guidelines, and robust social distancing strategies

while still maintaining social connections. It can enable equal access to healthcare, end

discrimination, and social stigmatization. The role of media and public health

communications must be understood and explored further as they will be an essential tool

for combating COVID-19 and future outbreaks. (US National Library of Medicine, 2020).

Many big television networks have taken to rebranding or reformatting

programmes in a bid to engage consumers. Manila Broadcasting Company replaced

DZRH Network News with MBC Network News, which now simulcasts three times a day

on its flagship and provincial radio and television stations. TV5 converted its primetime

newscast Aksyon to Frontline Pilipinas and fielded more anchors. Last February, GMA

Network rebranded GMA News TV, its second free-to-air channel, as GTV (Good TV),

adding more sports, entertainment, and lifestyle programmes to its existing line-up of news

and current affairs programmes. The newspaper industry has been hit particularly hard as

COVID-19 curtailed distribution. The Philippine Daily Inquirer (PDI), one of the biggest

dailies, offered early retirement to employees, let go of several columnists, shut down its

Metro section, and shrank the number of its pages. Earlier, it closed its free paper Inquirer

Libre and tabloid Bandera, keeping the latter only online. In March, PDI launched a digital

subscription package where its Inquirer Plus mobile app combines access to one of eight

local newspaper partners. It says this strategy will help local journalism remain sustainable

and is in keeping with the growing subscription model worldwide. (Chua, 2021)
 25

Today, with the growth of technology, a lot of news channels and online news sites

have come up. They keep updating the news every minute which the newspapers cannot.

Newspapers face a tough competition from them. They appear to be a slow mode of

circulation of news. People get news quickly through the Internet, instant messages or

mobile applications. (Career Ride, 2016)

The newer online services are also helped by the fact that their material is

permanently searchable and therefore more comprehensively available to would-be

patrons in ways that traditional newspapers and broadcasts are not. Those who turn to

the newspaper are more likely to be 40 or older and more likely to be longtime residents

of the community. (Pew Research Center, 2021).

Components of the MMSU COVID-19 vaccination program

Registration. The registration area is where the vaccinee’s information and

documents are checked and submitted. Each vaccination team will have their respective

areas in the registration area. Personnel from the Human Resource Management Division

will be assigned at the registration area. At the registration area, the vaccinee will present

his/her PHC ID and immunization card for verification and scanning. Vaccination form will

be given to each vaccine. They remind the vaccinee to follow the minimum health

standards within the vicinity and provide the vaccination form and leaflet. Then directs the

vaccinee to the health education and final consent area. (Philippine Heart Center Incident

Command Post, 2021).

The information gathered on the health declaration form will be used to determine

if the person is infected with COVID-19. Furthermore, contact tracing is the process of

identifying, assessing, and managing people who have been exposed to someone who

has been infected with the COVID-19 virus. Contact tracing and quarantine of contacts

identified through contact tracing interrupt transmission between people and are essential
 26

public health tools for controlling the virus. Contact tracing can also help people who are

at a higher risk of developing severe disease know earlier that they have been exposed

so that they can get medical care quicker if they go on to develop symptoms. (World

Health Organization, 2021).

In the registration the personal information of the vaccinee is being asked by filling

up forms. The profile of the vaccinee shall be retrieved in the computer system and the

vaccinee’s identity shall be verified by presenting his/her government ID (eg. driver’s

license, PRC license, PhilHealth ID, Passport, etc). Other relevant documents shall be

presented at the registration. (Department of Health, 2021).

Furthermore, Philhealth MDR forms are required for different purposes, including pre-

employment requirements, updating membership records, verification, and availing

benefits due to hospitalization and confinement. (Dungo, 2021).

Counseling. In the easy read fact sheet made by the Australian Government

(2021), it states that when an individual goes for their COVID-19 vaccination, they will ask

for a consent. When individuals give their consent it means that it is okay for someone to

do something. The healthcare provider will tell why you should get the vaccine, why it’s

safe, and what will happen if you will have it. They might give an information sheet to read

and they can answer any questions and clarifications. They have to do this so one can

decide if they want to have the COVID-19 vaccination. They also want to make sure one

feels ok and choose to have the vaccination.

In this phase the vaccinee shall then be directed to the Health Education Area

where health educators shall present materials containing vaccine information and answer

any question the vaccinee may have regarding the COVID-19 vaccine. Once all questions

are answered, the vaccinee shall be asked to sign the Final Consent form in order to

proceed. (Department of Health, 2021).

 27

In addition, Philippine Heart Center Incident Command Post (2020) stated in their

guidelines that materials, such as leaflets and brochures will be made available together

with a projector and screen for additional health education information. And the health

education will be catered per batch of vaccinees. Instructions for post vaccination care will

also be provided. After signing the Final Consent Form, they will be directed to the

screening area.

Benefits of the COVID-19 Vaccine. Both the Pfizer and AstraZeneca vaccines

are known to be effective in protecting individuals from severe disease and risk of death

due to COVID-19 in adults of all ages. In the case of AstraZeneca, there have been reports

of a serious, but very rare, side effect of blood clotting. To date, this condition has occurred

in fewer than 10 people out of every million people that have received this vaccine. It is

important for people and health workers to understand that this risk exists and to be alert

to report and provide immediate medical care when these occur. However, it is also

important to remember that the benefits of vaccination far outweigh the risks of these

serious adverse events. This is why WHO continues to recommend vaccination against

COVID-19, especially for priority groups such as health workers, older persons and those

with underlying health conditions. The COVID-19 vaccination helps keep everyone from

getting the virus. COVID-19 vaccines were evaluated in clinical trials and have been

approved because those studies show that the vaccine significantly reduces the

probability of contracting the virus. Based on what has been proven about vaccines for

other diseases, the COVID-19 vaccine may help keep people from getting seriously ill,

even if one does get the virus. Getting vaccinated also may protect people around

particularly those at greater risk for severe illness from COVID-19. (World Health

Organization, 2021)
 28

Viruses are constantly changing, including the virus that causes COVID-19. These

changes occur over time and can lead to the emergence of variants that may have new

characteristics. Vaccines continue to reduce a person's risk of contracting the virus that

causes COVID-19. Vaccines are highly effective against severe illness. (Centers for

Disease Control and Prevention, 2022).

COVID-19 vaccination is a safer way to help build immunity. Getting COVID-19

may offer some natural protection, known as immunity. COVID-19 can have serious, life-

threatening complications, and there is no way to know how COVID-19 will affect you. The

vaccine eliminates nearly all chances of life-threatening COVID-19 reactions including

death. A growing body of evidence suggests that fully vaccinated people are less likely to

be infected without showing symptoms (called an asymptomatic infection) and potentially

less likely to spread the virus that causes COVID-19 to others. (County of Sonoma, 2020).

Wearing masks and social distancing help reduce the chance of being exposed to

the virus or spreading it to others, but these measures are not enough. Vaccines work with

the immune system, so it will be ready to fight the virus if people are exposed. The

combination of getting vaccinated and following CDC recommendations to protect oneself

and others provides the best protection from COVID-19. Ending the COVID-19 pandemic

will halt the growing negative impacts the virus is having on education, the economy,

health care and countless other activities of a functioning society. COVID-19 can bring

upon serious, life-threatening complications, as hospitals are seeing hundreds of patients

daily who need hospitalized care. Even though it affects certain groups less seriously than

others based on age, health and other factors, it is still not possible to predict how COVID-

19 will affect any individual. Getting COVID-19 offers some natural protection, known as

immunity. But experts do not know how long that immunity lasts, and the risk of severe

illness and death from COVID-19 far outweighs any benefits of natural immunity. Getting

vaccinated creates an antibody response, so that people are protected without having to
 29

experience the illness. Both natural immunity and immunity produced by a vaccine are

important aspects of COVID-19 that experts are investigating. Health care officials and

agencies plan to keep the public informed about new developments. (Koplon, 2021).

Vaccines contain weakened or inactive parts of a particular organism (antigen) that

triggers an immune response within the body. Newer vaccines contain the blueprint for

producing antigens rather than the antigen itself. Regardless of whether the vaccine is

made up of the antigen itself or the blueprint so that the body will produce the antigen, this

weakened version will not cause the disease in the person receiving the vaccine, but it will

prompt their immune system to respond much as it would have on its first reaction to the

actual pathogen. When someone is vaccinated, they are very likely to be protected against

the targeted disease. But not everyone can be vaccinated. People with underlying health

conditions that weaken their immune systems (such as cancer or HIV) or who have severe

allergies to some vaccine components may not be able to get vaccinated with certain

vaccines. These people can still be protected if they live in and amongst others who are

vaccinated. When a lot of people in a community are vaccinated the pathogen has a hard

time circulating because most of the people it encounters are immune. So the more that

others are vaccinated, the less likely people who are unable to be protected by vaccines

are at risk of even being exposed to the harmful pathogens. This is called herd immunity.

This is especially important for those people who not only can’t be vaccinated but may be

more susceptible to the diseases we vaccinate against. No single vaccine provides 100%

protection, and herd immunity does not provide full protection to those who cannot safely

be vaccinated. But with herd immunity, these people will have substantial protection,

thanks to those around them being vaccinated. Vaccinating not only protects yourself, but

also protects those in the community who are unable to be vaccinated. If you are able to,

get vaccinated. (World Health Organization, 2020).

 30

As of February 27, 2022, around 63.09 million people were already fully vaccinated

from the COVID-19 virus in the Philippines. This includes those who received single-dose

vaccines. In contrast, roughly 62.25 million people were still waiting for their second dose

of the vaccine. Meanwhile, about 10.14 million already received a booster shot. (Statista

Research Department, 2022)

Dr Rabindra Abeyasinghe, WHO Representative to the Philippines, said lessons

from the vaccination drive would help refine guidance WHO and partners were finalizing

to help vaccines reach everyone everywhere. “Vaccines are a critical tool in the fight

against COVID-19. They are highly effective for reducing severe disease and

hospitalization, and saving lives. We must keep fighting for equitable distribution of

vaccines,” said Dr Abeyasinghe. Dr Natividad said the goal was to reach

everyone. “Solidarity during this time of pandemic is important. We can’t just talk about

our own vaccination; we must ensure that others are vaccinated as well. Our own

protection relies on other people’s protection.” (World Health Organization Philippines,

2021).

Side effects of the COVID-19 vaccine. All medicines, including vaccines, have

potential side effects. In most cases, side effects from COVID-19 vaccines are mild.

Severe adverse events are extremely rare, and when they do occur, it needs to be closely

monitored and carefully investigated. That is why countries need to have strong systems

and mechanisms in place to identify adverse events following immunization, and to be

able to clearly and effectively communicate risks (World Health Organization, 2021).

It is normal to have certain reactions after a vaccination. There may be redness,

swelling or pain around the injection site. Fatigue, fever, headache and aching limbs are

also not uncommon in the first three days after vaccination. These normal vaccine

reactions are usually mild and subside after a few days. They show that the vaccine is
 31

working because it stimulates the immune system and the body forms antibodies against

the infection that is only feigned by the vaccination. Vaccines have been found safe and

approved by health authorities in many countries. At the same time, many people are

ambivalent because while they want to protect themselves against infection, they also fear

possible side effects from vaccination. They have doubts as to whether the vaccines are

actually safe, given the rapid pace of development, and whether possible side effects have

been adequately studied. Serious side effects that could cause a long-term health problem

are extremely unlikely following any vaccination, including COVID-19 vaccination. Vaccine

monitoring has historically shown that side effects generally happen within six weeks of

receiving a vaccine dose. For this reason, the FDA required each of the authorized

COVID-19 vaccines to be studied for at least two months (eight weeks) after the final dose.

(Freund, 2021).

Management of the Side effects. Going to bed early post-shot, and taking a day

off of work as much as possible are some of the interventions after getting vaccinated. If

someone has a fever, headache, or chills, try to drink fluids and wear lightweight clothing.

Take a cool shower or put a cool compress on the forehead for fever. As for the sore arm,

put an ice pack, heating pad, or cool cloth on the area to soothe it, to help numb the pain.

(Longman, 2021)

The CDC does not recommend taking pain relievers such as ibuprofen, aspirin, or

acetaminophen before the vaccine to try to prevent side effects. There’s some evidence

that these over-the-counter drugs could blunt the body’s immune response to the vaccine

because of their anti-inflammatory effects. For someone who is feeling really terrible after

the vaccine, they can take these medications, so long as they don’t have other conditions

that would prevent them from taking them normally, the CDC says. (Centers for Disease

Control and Prevention, 2021).

 32

In managing COVID 19 vaccine side effects, as a safety measure, after a person

receives a shot at the vaccination site, they are to wait seated in an observation area for

15 to 30 minutes. That is to make sure they do not have an immediate reaction to the

vaccine. Side effects typically last from 24 to 48 hours before completely disappearing. If

people are tired from the vaccine, it is perfectly fine to sleep to regain energy. Also, be

sure to drink plenty of fluids after the vaccination to hydrate one's system. If people

experience pain or swelling, they can take an over-the-counter pain reliever to help reduce

them. However, one must not take anything before the shot for the purpose of preventing

the side effects. Some drugs for pain relievers includes; Ibuprofen and Acetaminophen.

Furthermore, they also included for those people who have mild side effects such as

having pain or swelling in the injection site, managements can include continuous moving

of the hand particularly the one vaccinated, taking antihistamine to reduce swelling, and

applying a clean washcloth dampened with cool water over the injection site. (Mercy

Health, 2021).

The combination of getting vaccinated and following CDC recommendations to

protect oneself and others provides the best protection from COVID-19. Ending the

COVID-19 pandemic will halt the growing negative impacts the virus is having on

education, the economy, health care and countless other activities of a functioning society.

COVID-19 can bring upon serious, life-threatening complications, as hospitals are seeing

hundreds of patients daily who need hospitalized care. Even though it affects certain

groups less seriously than others based on age, health and other factors, it is still not

possible to predict how COVID-19 will affect any individual. (Koplon, 2021).

Screening. Screening patients for contraindications and precautions before a

vaccine is administered should be done always, even if the same vaccine was

administered previously. A patient’s health status or the recommendations for

 33

contraindications and precautions may have changed since the last dose was given.

Screening helps prevent adverse reactions of a vaccine such as anaphylaxis. (Centers for

Disease Control and Prevention, 2019).

Moreover, at the screening area, there are personnel assigned who shall scan the

patient’s QR code and conduct history taking and physical examination to ensure the

eligibility of the vaccinee. Using both the CEIR and screening form hard copy, the health

worker shall update the vaccinee’s profile and determine whether or not he/she is qualified

to receive the vaccination. (Department of Health, 2021). They added that during the

screening, they will conduct history-taking and will focus on the present history (past

history and co-morbidities are gathered during pre-registration and profiling) if the

vaccinee is currently experiencing the following symptoms or have experienced the

following in the past 14 days like fever, headache, cough, colds, sore throat, shortness of

breath or difficulty in breathing, chest pain and any other symptoms. They will also ask if

the vaccinee is taking any blood thinner or any medication that affects the immune system,

if the vaccinee received any vaccination in the past 4 weeks and experienced any serious

reaction after receiving a vaccine. And for women, they will ask if the vaccinee is

pregnant/breastfeeding or is there a chance she could become pregnant during the next

month.

Still according to the Department of Health (2021), After history taking, they

conduct Physical Examination wherein they take the vaccinee’s vital signs including heart

rate, respiratory rate, blood pressure and oxygen saturation. They will also perform

cardiovascular examination checking normal rate and rhythm, murmurs, irregular heart

rate and rhythm, and perform respiratory examination to check clear lung fields and

adventitious breath sounds. The personnel assigned for screening and assessment will

provide clearance for the vaccinee to be vaccinated. Those deferred for vaccination shall

be coordinated with the social mobilization team for follow-up and shall be provided with
 34

a possible vaccination schedule. Even though there is no evidence that acute illness

reduces vaccine efficacy or increases vaccine adverse events, as a precaution with

moderate or severe acute illness, all vaccines should be delayed until the illness has

improved. Mild illnesses (e.g., upper respiratory infections, diarrhea) are not

contraindications to vaccination. It is not needed to withhold vaccination if a person is

taking antibiotics. (Immunize.org, 2020).

As stated by the Philippine Heart Association & Philippine Society of Hypertension

(2021), they recognized that significant vaccination deferrals and delay were observed

due to blood pressure elevations that to date have not resulted in any serious nor life

threatening events established to be related to COVID-19 vaccines. They recommended

that there is no need to take vital signs (blood pressure, respiratory rate, heart rate) during

screening unless the vaccinee is in distress which warrants further evaluation. If

warranted, blood pressure (BP) must be taken accurately. Individuals with BP elevations

not classified as Hypertensive Emergency, may be vaccinated, but must be observed for

30 to 60 minutes post vaccination, monitoring for evolving signs or symptoms of

hypertensive emergency, as well as hypotension which may be a manifestation of

anaphylaxis.

Vaccination. After screening, the vaccinee shall then be directed to the

Vaccination Area where the vaccine shall be administered. Prior to administration, the

vaccine is being prepared. The COVID-19 vaccine is removed from the freezer or

refrigerator then allowed to come to room temperature. Ensure also that the vaccinator is

following aseptic technique. Perform hand hygiene before vaccine preparation, between

patients, when changing gloves (if worn), and any time that the hands are soiled. After

the vaccine preparation, it is then administered via intramuscular injection in the deltoid

muscle. Once vaccinated, the QR code shall be scanned and the vaccination details (e.g.
 35

date of vaccination, vaccine manufacturer, batch number, lot number, name of vaccinator

and signature) shall be recorded in the CEIR and immunization card. The vaccinee is then

directed to the Post-vaccination Monitoring Area for further observation (Department of

Health, 2021).

Before injecting the vaccine, part of the healthcare providers is to communicate to

the patient or parents/guardian the information regarding the vaccine. Before

administering each dose of particular vaccines, it is required by law to provide a copy of

the most current Vaccine Information Statement (VIS) to either the adult being vaccinated

or to the child’s parent/legal representative (CDC, 2019). During the vaccine

administration, it is also important to follow infection control procedures such as hand

hygiene and healthcare providers to prepare the vaccines properly to maintain integrity of

the vaccine. They strictly follow aseptic technique Use a designated, clean medication

area that is not adjacent to areas where potentially contaminated items are placed (CDC,

2021). Additionally, the vaccines should be administered intramuscularly to optimize

immunogenicity and minimize local adverse reactions because of cutaneous side effects

which bring attention to clinical implications. Compared with muscle tissue, subcutaneous

fat is less vascularized, which may harm the processing and presentation of antigens. In

addition, superficial administration of vaccines more likely causes local side effects

(Gyldenlove et al, 2021).

Post-vaccination monitoring. After vaccination, the vaccine shall be observed

for adverse reactions for 30 minutes to one hour at the post-vaccination monitoring area.

The post-vaccination monitoring area must be closely linked with an identified referral

health facility. After an hour, once cleared, the vaccines shall be provided with instructions

about the possible adverse reaction that the vaccine might experience, and the location

of facilities where he/she can proceed should he/she experience adverse reactions. After
 36

monitoring and observing the vaccine for any adverse reaction in the 1st hour after

vaccination. If the vaccine has any adverse reactions, provide immediate

intervention/treatment. Refer vaccine/s with adverse reaction/s to appropriate AEFI/AESI

referral health facilities in a timely manner. Provide the vaccine with information on what

signs and symptoms he/she should watch for at home and where he/she should proceed

to for treatment. Since the observation of vaccines post-vaccination will take 30 minutes

to one hour, it is expected that there might be pooling or crowding of vaccines in this area.

Thus, this area must be spacious enough to accommodate all vaccines and to allow

observance of physical distancing measures. In addition, equipment needed for AEFI

response must be available and accessible. (Department of Health Philippines, 2021).

Moreover, the Philippine Heart Center Incident Command Post (2020) stated that

after vaccination, meeting rooms A and B of ETRS Complex are the designated Post-

Vaccination Monitoring Area. Observation of vaccinees post-vaccination will be 30

minutes to one hour. Fellows, and Nurses will be assigned at the DAPA Hall and ETRS

Training Rooms A & B. 6.1 One (1) Hour - Persons with history of an immediate allergic

reaction of any severity to a vaccine or injectable therapy and persons with history of

anaphylaxis due to any cause. 6.2 Thirty (30) Minutes – all other persons. First, monitors

and records patient’s vital signs every 15 minutes for 30 minutes to 1-hour post

vaccination. Instructs the vaccinee on possible adverse reactions and when, how, and

where to report if he/she manifest signs and symptoms. Provide information on post-

marketing surveillance.

Observing the patient and watch out for any symptoms of shortness of breath,

syncope and anaphylactic reaction, or any reaction as stipulated by the manufacturer.

Respond and give first aid to vaccinee for possible AEFI and refer vaccinee to Emergency

Room AEFI Desk for further management if needed. In designing local mechanisms of

monitoring, LVOCs shall follow the minimum frequency of prompts or follow-up from the
 37

vaccine: one (1) week, two (2) weeks, one (1) month, three (3) months, six (6) months,

and twelve (12) months after the date of vaccination. LVOCs may use more frequent

intervals of monitoring depending on their capacity and agreements with the vaccination

sites. (Department of Health Philippines, 2021).

The Vaccine Adverse Event Reporting System (VAERS) is a national early warning

system in the United States for potential safety issues with licensed vaccines. The Centers

for Disease Control and Prevention (CDC) and the US Food and Drug Administration

(FDA) jointly oversee VAERS (FDA). Reports of vaccine-related adverse events (potential

side effects) are accepted and evaluated by VAERS. Anyone can submit a report to

VAERS. Even if it is unclear if the vaccine caused the adverse event, patients, parents,

caregiver, and healthcare providers (HCP) are recommended to report it to VAERS. HCPs

are also required to record some adverse occurrences following vaccination. One of the

major drawbacks of VAERS data is that it cannot tell if the vaccine is to blame for the

reported adverse event. This constraint has produced some ambiguity in the publicly

available VAERS data, particularly in terms of the number of reported fatalities. There

have been cases where reports of deaths following immunization have been

misunderstood as deaths caused by the vaccines. This has caused immense irreparable

damage to the campaign to increase vaccinations and return to any sense of normalcy re-

opening businesses, schools, concerts, and many other gatherings. (Chau, 2021).

In addition, the centre's direction to state governments to have one adverse event

management centre in each block is an important preparatory step in the anti-COVID

vaccination drive. Adverse events following vaccination are known to happen following

vaccination. This could, in turn, induce paranoia and vaccine resistance and hinder our

efforts towards herd immunity through vaccination. The block level adverse event

management center can counter this phenomenon by quickly offering medical care to the

patient and disseminating accurate information on the patient’s condition. This could, in
 38

turn, induce paranoia and vaccine resistance and hinder our efforts towards herd immunity

through vaccination. The block level adverse event management centre can counter this

phenomenon by quickly offering medical care to the patient and disseminating accurate

information on the patient’s condition. Already, a couple of adverse events during phase-

3 trials have created quite a public stir while the non-events among several hundred

volunteers does not elicit the same attention. (TOI Quick Edits, 2020).

Related Studies

This section provides a discussion of the related studies focused on COVID-19

vaccination program and socio-demographic profile as indicator of COVID-19 vaccination

program awareness.

Vaccination plays an important role in combating against the COVID-19 as

supported by the study of Aw et al (2021) entitled “COVID-19 Vaccine Hesitancy—A

Scoping Review of Literature in High-Income Countries”, Vaccination forms a critical pillar

in the road to recovery from the COVID-19. Notably, vaccine candidates with promising

results received expeditious emergency use authorization by drug authorities. Despite

quick and concerted vaccination programs implemented by governments globally, such

efforts have been hampered by vaccine hesitancy. Vaccine hesitancy was identified by

the World Health Organization (WHO) as one of the 10 threats to global health in 2019. It

is defined as the “delay in acceptance or refusal of vaccination despite availability of

vaccination services” by the Strategic Advisory Group of Experts on immunization and

involves a complex interaction of time, place, context, and vaccine specific factors.
 39

In a study by El-Elimat et al (2021) titled “Acceptance and attitudes toward COVID-

19 vaccines: A cross-sectional study from Jordan”, it revealed that half of the participants

were concerned about the vaccine's safety after it became accessible, as seen by their

worries about adverse effects. This is in line with the findings of Pogue and colleagues,

who found that the majority of participants in the United States were concerned about the

COVID-19 vaccinations' negative effects. In addition, the majority of the participants in the

present study agreed that obtaining the vaccination is critical for protecting against

COVID-19. However, nearly half of them thought that the vaccination would be refused by

the majority of individuals. This disparity may be attributable to their worries about the

vaccine's negative effects.

The global drive to vaccinate against severe acute respiratory syndrome-

coronavirus-2 (SARS-CoV-2) began in December 2020 with countries in Europe, Middle

East, and North America leading the roll out of a mass vaccination program. A systematic

review by Hasan et al (2021) titled “The Implementation of Mass-Vaccination against

SARS-CoV-2: A Systematic Review of Existing Strategies and Guidelines” synthesized all

available English-language guidelines and research regarding mass-vaccination for

COVID-19 until 1 March 2021 the first three months of the global mass-vaccination effort.

Data were extracted from national websites, PubMed, Embase, Medline and medRxiv,

including peer and non-peer review research findings. A total of 15 national policy

documents were included. Policies were summarized according to the World Health

Organization (WHO) framework for mass vaccination. All included policies prioritized front-

line health care workers and the elderly. Limited information was available regarding

staffing, cold chain, communication strategies and infrastructure requirements for effective

vaccine delivery. A total of 26 research studies were identified, reporting roll-out strategies,

vaccine uptake and reasons for refusal, adverse effects, and real-life estimates of efficacy.
 40

Early data showed a reduction in SARS-CoV-2 cases, hospitalization and deaths in

settings with good coverage. Very low rates of vaccine-related serious adverse events

were observed. These findings provide an overview of current practice and early outcomes

of COVID-19 mass-vaccination, guiding countries where roll-out is yet to commence.

Furthermore, three psychological factors of university students were used in the

study of Biswas, B. et al. in 2021, entitled “Students’ Perception towards COVID-19

Vaccination Program in Bangladesh: A Study on University Students” which aimed to

understand the perception towards the COVID-19 vaccination program in Bangladesh and

the targeted subjects are the university students so they surveyed 322 students from the

different universities in Bangladesh to understand their perception regarding vaccines. In

response to knowledge-related questions, only 16.8% of university students expressed

that vaccines are effective, while 21.1% of respondents expressed their faith in the

ineffectiveness of vaccines and the rest didn’t respond clearly. Moreover, around sixty

percent (65.8%) of university students showed their confusion about the vaccine which

may create long-term physical problems, while 17.4% expressed a positive response in

this case. On the other hand, almost two-thirds of all respondents (65.8%) said that the

COVID-19 vaccine has the potential for some side effects, while only 2.5% believed that

the vaccine has no potential for side effects, and 31.7% of respondents had no sense

about the issue. In a matter related to perception towards COVID-19 vaccination program,

34.8% of university students agreed that they were satisfied with the government policy

towards the vaccination program, while 46.0% respondents were neutral and 19.3%

disagreed with the policy taken by the government for this case. When asked the

respondents about their thoughts or perceptions of the COVID-19 vaccine's safety and

effectiveness, 20.5% agreed that the vaccine is safe and effective, while 57.8% of

respondents kept themselves neutral and 21.7% disagreed. More than one-third of the
 41

total respondents (36.0%) were interested in taking the vaccine as soon as possible, while

31.7% were neutral and 32.3% showed an unwillingness to take the vaccine. Around forty

percent (39.8%) respondents claimed that they could take part to raise awareness and

motivate people towards the vaccine, while more than half of all respondents (52.2%) were

neutral in this matter and the rest disagreed on raising awareness and motivating other

people for the vaccine. Furthermore, 36.0% of university students believed that

vaccination will help to stop spreading the virus, while 41.6% kept themselves neutral in

this case and 22.4% of respondents didn’t think vaccination will help to halt spreading

COVID-19. Moreover, most of the students doubt the effectiveness of the vaccine which

interrupts them from taking the vaccine willingly. The results of this study can be used as

a basis of the concerned authorities as they should take note of necessary arrangements

for raising awareness about the COVID-19 vaccination program among the mass of

people so that they may feel safe at the time of being vaccinated. The study revealed that

the lack of proper knowledge and awareness creates a barrier in the mindset of students

to participate in vaccination. The findings indicate that policymakers and health workers

need to rethink the vaccination strategy and pay more effort to pertinent information

dissemination. In line with the study, this is used as a basis for the study since the aim of

both studies are similar as to increasing the knowledge of students as to the vaccination

program.

In addition, most medical clerkship students at Soebandi General Hospital who are

the respondents in the study of Supangat et al in 2021, titled “COVID-19 Vaccines

Programs: adverse events following immunization (AEFI) among medical Clerkship

Student in Jember, Indonesia” accepted vaccinations. The probable reason is information

and knowledge of the subject. They are medical clerkship students that have already

known about how dangerous Sars-Cov-2 infection is while they should continue their
 42

study. They distinguished the adverse event following immunization (AEFI) symptoms as

systemic symptoms and localized symptoms. The most common AEFI of COVID-19

vaccinations was localized pain in the injection site then followed by malaise, a systemic

symptom. The study revealed the relationship of being knowledgeable increases the

acceptance to vaccination and the AEFI from the vaccination. The findings of this study

served as a basis for researchers for their study since the side effects of COVID-19

vaccine is a variable in the study.

A study from Siu et al (2022) entitled “Perceptions of and hesitancy toward COVID-

19 vaccination in older Chinese adults in Hong Kong: a qualitative study” stated that the

decision to acquire a COVID-19 immunization is complicated for older persons, especially

those with low income results showed that some of the participants thought that they were

unsuitable for vaccination due to their age. They are uncertain whether to get vaccinated

because they want to see how others respond first with the vaccines since these vaccines

are still new. The participants' perceptions of and hesitancy toward vaccination were

influenced by a confluence of factors at the individual (trust, confidence, and social support

networks), microsocial (stigma toward health care workers), intermediate-social

(government), and macrosocial (cultural stereotypes, civic and collective responsibility,

and economic considerations) levels.

Vaccination non intent differed by sociodemographic characteristics and

decreased across most socioeconomic groups from September to December in the study

of Nguyen et al. in 2021 titled, “COVID-19 Vaccination Intent, Perceptions, and Reasons

for Not Vaccinating among Groups Prioritized for Early Vaccination”. Nonintent decreased

by 10.3 percentage points among adults aged 50–64 years and by 11.1 percentage points

among adults aged ≥65 years. Although nonintent was higher among women, nonintent

among both women and men decreased by 6.0 percentage points. Nonintent was higher
 43

among adults with lower educational attainment but decreased across most education:

among adults with a high school diploma or less, nonintent decreased 7.9 percentage

points. Among adults in the December surveys who did not intend to get vaccinated, the

main reasons most frequently cited were concerns about side effects and safety of the

COVID-19 vaccine (29.8%), planning to wait to see if the vaccine is safe and consider

receiving it later (14.5%), lack of trust in the government (12.5%), and concern that

COVID-19 vaccines were developed too quickly (10.4%). A larger percentage of the

December survey participants than September participants reported safety concerns as a

main reason (29.8% versus 23.4%), and a smaller percentage reported concern that

vaccines were developed too quickly (10.4% versus 21.6%).

The only demographic predictor of having a definite intention of COVID-19

vaccination was sex. They have found out in the study that males demonstrated higher

intention to take the COVID-19 vaccine than do females (Wang et al. 2020). Furthermore,

Wang et al. (2020) agrees that male were more confident to accept COVID-19 vaccination

as soon as possible than women and this is based from their study entitled “Acceptance

of COVID-19 Vaccination during the COVID-19 Pandemic in China”.

In a study of Mustapha et al. (2021), it was revealed that the prevalence of COVID-

19 vaccine acceptance among the students of the healthcare profession in Northwest

Nigeria was low. It was interesting that contrary to the assertion that health sciences

students should have a high rate of accepting the vaccine, given their predisposed medical

knowledge and prospect as healthcare professionals, they instead had fewer students

accepting to take the vaccines. Higher level students have been shown to accept the

vaccines as they more likely have come across and recognize COVID-19 patients during

clinical postings and are more knowledgeable on the virus and its pathogenicity.
 44

High knowledge scores associated with higher education background, higher-

income category and living with who is at higher risk of getting severe COVID-19 that is

according to the online survey conducted by Mohamed et al (2021). The online

survey was conducted for two weeks in December 2020 which used a bilingual, semi-

structured questionnaire. A total of 1406 respondents participated and sixty two percent

of respondents had poor knowledge about COVID-19 vaccine (mean knowledge score

4.65; SD = 2.32) and 64.5% were willing to get a COVID-19 vaccine.

People with higher level of education were found to have more knowledge about

COVID-19 vaccinations, which is supported by previous research. Similar scenarios were

found in other earlier studies in Bangladesh, illustrating that individuals with a higher

educational background showed more knowledge regarding COVID-19. It may be the

case that more educated people are more knowledgeable and concerned about their

health and well-being, through access to more information sources, and become more

engaged in life events that could impact them, such as COVID-19 vaccinations. (Islam et

al, 2021)

A study of Pham, L. et al. (2021) entitled “The intention to get a COVID-19 vaccine

among the students of health science in Vietnam” determines the factors related to the

intention to vaccinate against COVID-19 for health science students in Ho Chi Minh City

(HCMC). A cross-sectional survey was done through a questionnaire to all health sciences

students of the University of Medicine and Pharmacy in Ho Chi Minh City (UMP), Vietnam.

A total of 854 students completed the survey, whose vaccination acceptance was 77.1%.

The study assessed the students’ intention toward COVID-19 vaccine and related factors

to notify the university administrators and policymakers. The findings showed the

acceptability of vaccines had differences within the education year of students, besides,

knowledge, perception of benefits, cues to action, behavioral control, and attitudes toward
 45

the vaccine were positive predictive factors. The majority of students received information

toward COVID-19 via social media (88.5%). Social media are the major platforms that

people could seek information and discuss COVID-19. In accordance with the Luo S’

results, increasing social media exposures and peer discussions could enhance students’

perceived information sufficiency, which leads to a rise in their vaccination intention.

However, social media was recorded as the major source of negative information about

vaccination. The spread of mis- and disinformation through the social media platforms,

such as conspiracy theories, exaggerated side effects, and down-graded vaccine efficacy

may increase vaccine hesitancy. The primary reasons for hesitancy included being afraid

of the side effects (73.0%), vaccine safety (65.3%), and the process of new vaccine

development (53.6%).

It was found that the most significant behavioral and attitude barriers to acquiring

a COVID-19 vaccination include widespread mistrust regarding vaccine benefits and

safety, as well as worries about unforeseen effects. It is from the study of Paul et al. (2021)

titled, “Attitudes towards vaccines and intention to vaccinate against COVID-19:

Implications for public health communications”. In the most-trusted information sources

about COVID-19 vaccines, health care providers topped the list, followed by

pharmaceutical companies reports, and the national Jordanian government. The least-

trusted information sources were social media and family members, respectively. The

findings of this study served as a basis for researchers for the conduct of their study since

information source/s is a variable of the study .

A web-based cross sectional survey study was conducted using a “Google Form”

to obtain responses from medical and allied health science students during February and

March 2020. Out of 730 participants that filled out the web based survey, 715 participants

have given their consent of voluntary participation and completed the questionnaire with
 46

a response rate of 97.95%. The mean age of the study participants was 21.81 ± 2.6 years.

The majority of students were from the pharmacy (n = 327, 45.73%) and medical (n = 161,

22.52%) fields, followed by physiotherapy, nursing, dental, and other allied health science

backgrounds. Current global pandemic situation demands substantial awareness about

the clinical presentation, spread, preventive measures and management of COVID-19.

We discovered that the students from different institutions are having adequate awareness

about COVID-19. Also, it has been observed that the majority of participants acquired the

information from social media which is an unauthentic resource of obtaining evidence

about diseases. Students should be informed about the authentic sources of information

as provided by global health authorities and health ministry of respective countries. Our

study finding also highlights the specific aspects of knowledge and perception where the

partial or incorrect responses were noted and these areas should be addressed in future

through webinars, leaflets and educational campaigns to improve understanding and to

correct the myths about COVID-19. (Science Direct, 2021),

Relationship between the profile of the respondents and the awareness on

COVID-19 vaccination

High levels of knowledge, positive attitudes, and confidence in vaccines were

positively associated with age, higher level of study, being a medical student, a recent

vaccination experience, and not knowing trusted persons who did not believe in

vaccines. Students of medicine scored significantly higher compared to non-medical

students as to knowledge on vaccination. These findings are from the study titled, “The

intent of students to vaccinate is influenced by cultural factors, peer network, and

knowledge about vaccines” of Ilogu, L. et al. of 2021.

 47

Theoretical Framework

Nola J. Pender, one of the well-known nursing theorists in nursing, proposed or

introduced the Health Promotion Model in nursing which explains preventative health

measures and describes nurses’ critical function in helping patients prevent illness by self-

care and bold alternatives. The model notes that each person has unique personal

characteristics and experiences that affect subsequent actions. The theory is developed

to incorporate behaviors for improving health and applies across the life span. It centers

into health promoting behaviors which boost the health and wellness of an individual.

Pender’s model focuses on three areas: individual characteristics and experiences,

behavior-specific cognitions and affect, and behavioral outcomes.

Indicated in Pender’s model include health promotion which is defined as a

behavior, motivated by the desire to increase well-being and actualize human health

potential. It enables people to increase control over and to improve their health. The other

one is health protection or illness prevention which is described as a behavior motivated

by a desire to actively avoid illness, detect it early, or maintain functioning within illness

constraints. The protection of individuals, groups and populations through expert advice

and effective collaboration to prevent and mitigate the impact of disease.

Aside from the 2 concepts which the model indicated, there are also three major

areas that are under the model, these include individual characteristics and experiences,

behavior-specific cognitions and affect, and lastly the behavioral outcomes. These

concepts are expected and believed to provide an influence in the awareness of

Coronavirus Disease (COVID-19) Vaccination Program among health sciences learners.

Maintaining awareness and vigilance is crucial as the number of outbreak cases reported

in our nation grows. As responsible members of the community, everyone must take
 48

precaution for our safety and other people. Staying informed is critical for preventing the

spread of the illness.

Health information can be extremely useful, empowering a person to make

important health decisions (Mekonnen, 2021). However, health information also can be

confusing and overwhelming. Given the wealth of information available through the

internet, journals, and other sources, it is important to be able to assess its quality. Being

informed with proper and accurate information regarding the COVID-19 vaccination

program and the vaccines makes a person’s health behavior improved in a positive

manner and later improves health. By this, health sciences learners can be resource

persons for questions particularly all about the vaccine such as the benefits, side effects

and its management for health promotion in the individuals utilizing health information that

has been learned which is within the range of individual characteristics and experiences.

Other health sciences learners will manage the side effects of the vaccine according to

their experiences from being vaccinated of flu shots and also with the first dosage of

COVID-19 vaccine. Also with behavioral-specific cognitions and affect particularly in

interpersonal influences in giving advice or ways in managing side effects which must be

accurate most especially in people who have decreased knowledge in health for positive

health outcomes.

Applying the nursing paradigm of the theory, the MMSU health sciences learners

are the Person because they are the primary focus of the study and they are the ones who

are responsible to create healthy choices for their own human health potential and they

are the ones who must be able to reflect on their behaviors. The environment is the

COVID-19 pandemic, which now creates changes to the health of the patients and is the

stressor to the environment which is the reason why vaccination is implemented. It creates

a change in the perception of the people on the vaccine itself as it affects their perception
 49

or not. Health relating to the study is the health of the patient and health sciences learners

which is dynamic, and can change anytime for instance their belief or compliance in getting

vaccinated when properly educated about the vaccine and vaccination program and its

components as to registration, counseling, screening, vaccination and post-vaccination.

The health sciences learners have been affected by the COVID-19 pandemic and virus

as a change in their health status, creating the biggest disruption in their everyday lived

experiences. Hence, the health promotion model is primarily used in this study to

determine proper actions to take in health promotion and disease prevention. The actions

of the implementers of the COVID-19 vaccination program serve as the Nursing because

they are providing health education to the health sciences learners about the components

of the vaccination program including the advantages of vaccines, side effects and

management of side effects. This will enhance their perception, thus, increasing their

awareness of the vaccination program and the vaccine itself.

 50

Conceptual Framework

Figure 1 shows the profile of the respondents and the level of awareness of the

respondents on COVID-19 vaccine. The box at the left part represents the independent

variable which is the profile of the respondents as to the age, sex, program, year level,

and source of information in availing the vaccine while the boxes at the right part

represents the dependent variables which is the level of awareness of the respondents on

the components of the MMSU vaccination program COVID-19 as to registration,

counseling, screening, vaccination, and post monitoring. The arrow signifies the

relationship between the profile of the respondents and the level of awareness of

respondents on the components of the MMSU vaccination program COVID-19.

Thus, the profile of the respondents and its relationship with the level of

awareness of respondents on the components of the MMSU vaccination program COVID-

19 are being described in this study.

 51

Profile of the respondents Awareness of the respondents on

the components of the MMSU
1. age
vaccination program on COVID-
2. sex
19:
3. program
4. year level 1. Registration
5. source of information in 2. Counseling
availing the vaccine 3. Screening
4. Vaccination
5. Post-vaccination
monitoring

Figure 1. Research Paradigm

 52

Hypothesis

1. There is no significant relationship between the respondent’s profile and level of

awareness on the components of the MMSU vaccination program on COVID-19.

 CHAPTER III

METHODOLOGY

This chapter presents and discusses the research design which was used in the

study, locale of the study, data gathering instrument, the procedure in gathering data and

the statistical tools applied to analyze the data.

Research Design

This study utilized descriptive-correlational research design. It is descriptive

because it involves analysis and interpretation of the profile of the respondents and the

level of awareness. Furthermore, it also involves correlation to determine the relationship

between the profile of the respondents and the components of MMSU COVID-19

vaccination among health sciences learners. Thus, the descriptive-correlational design

was deemed appropriate.

Research Locale

The study was conducted in Mariano Marcos State University (MMSU), College of

Health Sciences (CHS) at Brgy. #16 Quiling Sur Batac, Ilocos Norte. The City of Batac is

situated in the southwestern portion of the Province of Ilocos Norte. Quiling Sur was

chosen with the purpose that it is where the College of Health Sciences was located,

wherein the learners from the said college were the respondents for the study; the learners

from the Departments of Nursing, Pharmacy and Physical Therapy from first to fourth level

for the academic year 2021-2022 were included. According to TOPUNIVERSITIES (2020),

MMSU is a university which has a 3 Quacquarelli Symonds (QS) Star rating and it is

classified as a Level 4 University (SUC Level IV) in a 5-level classification system of the
 54

Philippine State Universities, and one of the 19 out of the 111 Universities with level 4

status. In 2014, MMSU was granted Institutional Accreditation by the Accrediting Agency

of Chartered Colleges and Universities in the Philippines (AACCUP), becoming the first

State University to be accredited using the agency's Outcomes-Based Evaluation

Instrument. Recently, the MMSU has been ISO 9001:2015 certified.

The Mariano Marcos State University ranked number 3 in the Highest number of

Level III Accredited Programs in 2019, Top 3 in the Most Improved Internal Quality

Assurance Unit in 2019, Top 4 in the Higher Percentages of Accredited Programs over

the Total Accredited Programs ad Top 5 in the Highest number of Level III Accredited

Programs in 2020.

For the College of Health Sciences, just recently the Mariano Marcos State

University received certificates of authority from the Commission on Higher Education-

Region 1 to conduct limited face-to-face laboratory classes and internship for the BS in

Nursing and BS in Physical Therapy programs. The Department of Nursing was awarded

as Top 9 Performing School in the November 2019 Nurse Licensure Examination.

Meanwhile, the Department of Pharmacy was awarded number 11 Best school in the

Philippines in 2019, TOP 3 Performing School in the June 2021 Pharmacist Licensure

Examination and just recently, they were awarded as TOP 5 Performing School in the

November 2021 Pharmacist Licensure Examination regulated by the PRC. Additionally,

the Department of Physical Therapy was awarded as Number 5 Best school in the

Philippines 2019 and TOP 3 Performing School in the February 2019 Physical Therapy

Licensure Examination.

Population and Sampling

The target population of this study were the MMSU health sciences learners which

comprised those who were officially enrolled in the school year 2021-2022 of BS in
 55

Nursing, BS in Physical Therapy and BS in Pharmacy programs from levels 1 to 4, for they

are one of the priorities being vaccinated in MMSU, who are having limited face-to-face,

and they are the future health care professionals and frontliners exposed to patients.

The researchers determined the sample size of the study using the Slovin’s

formula with 0.05 margin of error. Out of 1250 health sciences learners, the respondents

of the study were 303. After computing for the total sample, stratified random sampling

was used to determine the samples from each program. The computed values of

respondents were 167 from BSN, 65 from BSPT and 71 from BSPH totalling to 303

respondents. This method was used because it enabled the researchers to obtain a

sample population that best represents the entire population being studied, making sure

that each subgroup of interest was represented.

Research Instruments

Electronic survey questionnaires (Google Forms) were used as a primary tool in

gathering the data. The questionnaires were prepared by the researcher containing the

questions aligned with the objectives of this study.

There were two portions of the questionnaire which were used to collect data. The

first section determined the profile of the respondents as to age, sex, program, year level,

and source of information in availing the vaccine while the second section contained

questions about the respondents' level of awareness on the components of the MMSU

COVID-19 vaccination program in terms of registration, counseling (benefits, side

effects and management of side effects), screening, vaccination and post-vaccination

monitoring. The questionnaire was answered using Likert scale. For the awareness of the

respondents on the components of the MMSU COVID-19 vaccination program, a 5-point

rating scale was utilized with the following descriptions: 1-unaware/not aware, 2-slightly

aware, 3-somewhat aware, 4-moderately aware, 5-extremely aware.

 56

The researchers had a pilot testing for the questionnaire to the ten (10) Health

Sciences Learners from MMSU before the actual data gathering. Their suggestions and

comments were presented to the research adviser for incorporation of the suggestions for

the final research instrument used. To assess the consistency, reliability and accuracy of

the questionnaire, the researchers used Cronbach's Alpha, which is a measure of internal

consistency, that is, how closely related a set of items are as a group, and is considered

to be a measure of scale reliability (UCLA, 2021). Twenty (20) respondents were used to

compute the internal consistency and validity of the questionnaire. The obtained score of

Cronbach's Alpha is 0.94, which is interpreted as excellent. This means that the contents

of the instrument were consistent and reliable in terms of internal consistency.

Ethical Considerations

Ethical considerations were implemented in the data collection. Ethical approval

was sought from the MMSU Research Ethics Review Board (URERB). The rights of the

respondents were maintained or upheld throughout the conduct of this study. The consent

was sought first from the respondents which are the health sciences learners via Google

Forms before answering the questions given to them.

The study was explained to the respondents including the benefits they could get

from it. This study will benefit health sciences learners by raising awareness and fostering

a better knowledge of the COVID-19 vaccination program, which they may use to reduce

their risk of contracting the infection and spreading it to their families and to others. It

was emphasized that their participation was based on their willingness or volition to take

part in the study. They were not forced to participate because they had the choice whether

to participate or not. The researchers guaranteed minimal risks, inconveniences, or

discomforts as the researchers gathered all the data needed via Google Forms. Conflict

of schedule among learners are the inconveniences in the conduct of this research. The
 57

researchers gathered data through Google Forms, hence, there was no physical contact

with the respondents. If there were any inconveniences such as an intermittent internet

connection, the researchers assisted in managing difficulties.

With the use of the Google Forms, the respondents participated in the data

gathering, through giving their consent by clicking the agree button, then proceeded to the

questionnaire and started answering. Otherwise the respondents who didn’t want to

participate clicked the disagree button and they no longer have any access to the

questionnaire.

They were given freedom to choose whether they wanted to participate in the data

gathering or not. They were given the chance and respect to exercise their freedom of

choice and right to withdraw from the data gathering and if such events occur they had to

contact the principal researcher to be informed.

The identity of the respondents were kept private together with their answers to

observe confidentiality. The respondents' anonymity were guaranteed by the researchers

because their names were optional and their identities were not revealed during data

collection, analysis, or presenting of the findings. Respondents were assured that the data

that was gathered from them were utilized for academic purposes only and were only

confined within the knowledge of the researchers, adviser, and the panel. Data and

materials were kept privately by the principal researcher and together with a flash drive

that were utilized for a digital copy and backup data were deleted permanently six months

after the study was completed and defended.

DATA GATHERING PROCEDURE

The researchers presented the research proposal together with the research

questionnaire to the panelist for approval and revisions. After which, it was reviewed by

the advisory committee that was forwarded to the University Research Ethics Review
 58

Board (URERB) for ethics review. Upon the approval of the URERB, the researchers

requested permission from the OIC Dean of the College of Health Sciences through the

Department chair of the Department of Nursing to conduct the study with their research

adviser.

After permission was secured, respondents were then identified and informed of

the purpose of the study; the researchers requested permission from the health sciences

learners and informed consent for each of the respondents was obtained.

Before the data gathering was conducted, the researchers conducted a pre-testing

of the research instrument with ten (10) respondents who were not included in the final list

of respondents. The comments and suggestions were presented to the research adviser

and panel then incorporated into the research instrument.

Due to the present situation we are in, the questionnaires were administered

through Google Forms and were answered by the respondents to obtain substantial data

regarding the COVID-19 vaccination program among health sciences learners of MMSU.

The respondents were given approximately 3-5 days that was good for 25-30 minutes to

answer the given questionnaire.

STATISTICAL ANALYSIS

In analyzing the gathered data to attain the objective of this study, frequency count

and percentage, mean rating, and Spearman rho correlation analysis was utilized.

Frequency counts the number of times that each variable occurs and percentage

frequency distribution specifies the percentage of observations that exist for each data

point or grouping of data points which is calculated by taking the frequency in the category

divided by the total number of participants and multiplying by 100%. The frequency count
 59

and percentage were utilized in analyzing the profile of the respondents as the data are

nominal.

The measures of central tendency were used as this provided numeric information

about the trait or characteristic being measured in the awareness of COVID-19 vaccination

program among health sciences learners.

The mean rating is referred to as the arithmetic mean or average mean (X) that

describes the given criteria or variables' central tendency. The mean was computed by

adding all the scores and dividing the sum by the total number of scores.

The mean rating was utilized to interpret the questions regarding the respondents'

awareness of the components of the MMSU COVID-19 vaccination program including its

registration, counseling, screening, vaccination, and post monitoring (side effects and how

to manage them) because the data are ordinal. The following scale was utilized:

Level of Awareness on the Components of the MMSU Vaccination Program on

COVID-19

Range of Means Descriptive Interpretation

4.20-5.00 Extremely Aware

3.40-4.19 Moderately Aware

2.60-3.39 Somewhat Aware

1.80-2.59 Slightly Aware

1.00-1.79 Unaware/Not Aware

Correlation analysis was used to describe the relationship or association between

variables. The Spearman rho correlation was utilized as the statistical tool to measure the

degree of association between the profile of the respondents and their level of awareness

on the COVID-19 vaccination because the Spearman rho correlation was applicable as

the variables of interest were measured on an ordinal scale.

 CHAPTER IV

PRESENTATION, ANALYSIS, AND INTERPRETATION OF DATA

This chapter presents the results, analysis, and interpretation of the data gathered.

It discusses the level of awareness among health sciences learners on the vaccination

program of the university.

Profile of Respondents

Table 1 discusses the profile of the respondents as to age, sex, program, year

level, and source of information in availing the vaccine.

Table 1. Profile of the Respondents

f %
Age
17 0 0
18 20 6.61
19 73 24.1
20 78 25.75
21 60 19.81
22 69 22.78
23 3 1
303 100.00
Sex
Male 105 34.66
Female 198 65.35
303 100.00
Program
Nursing 167 55.12
Pharmacy 71 23.44
Physical Therapy 65 21.46
303 100.00
Year Level
1 85 28.06
2 71 23.44
3 72 23.77
4 75 24.76
303 100.00
 61

Source of Information in
Availing the Vaccine
School Administrators 165 54.46
Faculty 190 62.71
Healthcare workers 223 73.6
Social Media: Facebook 268 88.45
Social Media: Twitter 158 52.15
Social Media: Messenger 239 78.88
Mass Media: Television 191 63.04
Mass Media: Radio 81 26.74
Mass Media: Newspaper 38 12.55

Age. The age of the respondents are ranged from 17-23 years old. Twenty-year-

old learners comprise one fourth of the total population of respondents (25.75) and no

respondents are under the age of seventeen while only one percent (1.0) are twenty-three

years old. In the old education system of the Philippines, the higher education bachelor

degrees are taken for four years in which students are usually from 17-20 years old.

However, with the implementation of the K-12 program in 2012, another two years is

added to basic education before a student proceeds to college (Quality Assurance Agency

for Higher Education, 2018). The Chronicle of Higher Education (2019) also states that

nearly 60 percent of undergraduates were ages 21 and under and only 16 percent were

older. The results imply that the big majority belongs to the 19-22 age group because

these are the learners who had undergone the K-12 program before entering college.

Sex of Respondents. Table 1 shows that 198 (65.35%) of the respondents are

female while 105 (34.66%) are male. This reflects the statistics that female health sciences

learners outnumber the males health sciences learners. Based on the College of Health

Sciences population records for the academic year 2021-2022, there are 965 female

health sciences learners and 285 male health sciences learners. According to the

Philippine Statistics Authority (2018), the health profession is dominated by women (75%).
 62

Moreover, Nursing and allied health professions in the UK are typically dominated by

women. More than 90% of adult nursing students in England are female. Men are also

under-represented in most allied health professions. (Research Works Limited, 2020).

Furthermore, according to the International Labour Organization (2020), the most female-

dominated occupations are personal care workers, such as health care assistants and

home-based personal workers. In fact, health care dominates the occupations that are

mostly filled by women. Around three-quarters of health associate professionals’

assistants in areas such as pathology, imaging and pharmacy are women, and 69% of

health professionals such as general medical doctors and nurses are women. The findings

implied that female learners are more dominant than male due to a higher female

population than male.

Program of Respondents. Table 1 displays that the respondents from the nursing

department are 167 (55.12%) learners. Followed by pharmacy with 71 (23.44%) and lastly

physical therapy with 65 (21.46%). Based on the College of Health Sciences population

records for the academic year 2021-2022, the overall number of students for nursing from

all levels is 689, pharmacy having 294, and physical therapy having 267 students. The

findings implies that the majority of the respondents came from the nursing program

because of having the largest population compared to the other programs.

Year Level. Table 1 reveals that 85 or 28.06% of the respondents belong to the

year level I while the year level II is (71 or 23.44%), with a 0.33 difference lower from that

of the year level III (72 or 23.77%). Based on the College of Health Sciences population

records for the academic year 2021-2022, year level I learners from all departments are

350 while 292 learners for year level II, 296 learners for year level III, and year level IV

have a total of 312 learners. This implies that year level I outnumbers the higher year
 63

levels because they have the highest number of populations among the year levels

enrolled.

Source of Information. The data presented in Table 1 shows that most of the

respondents’ source of information is social media, specifically Facebook (268 or 88.45%)

while (38 or 12.55%) is mass media, specifically newspaper.

This reflects the study of Wang et al. (2020) that among the public, the internet is

the most popular source of information on the etiologies and intervention models of

medical illnesses and offers a platform where all individuals can freely access medical

information. The result implies that social media is the most used source of information

because it disseminates information more easily and speedily. Moreover, Facebook and

other social networking sites have shown great potential for improvising, transmitting, and

disseminating information more easily and broadly than mainstream media.

Awareness of the Respondents on the Components

of the MMSU COVID-19 Vaccination Program

Table 2 discusses the data on the awareness of the respondents on the

components of the MMSU COVID-19 vaccination program as to registration, counseling,

screening, vaccination, and post-vaccination monitoring.

Table 2. Awareness on the Components of the MMSU COVID-19 Vaccination

Program
Mean Descriptive
Rating
Registration
A pre-registration was conducted among individuals who 4.74 EA
are willing to be vaccinated.
A health declaration form was filled out. 4.85 EA
Documents needed were submitted such as Form 5, ID, 4.65 EA
MDR of PhilHealth and a copy of schedule for the
vaccination.
4.74 EA
 64

Counseling
Information about the COVID-19 vaccine were provided as
to:
Benefits of the COVID-19 vaccine such as:
Protection against severe COVID-19 4.87 EA
Reduce the chance of getting the virus 4.84 EA
Protects people around and those at 4.89 EA
greater risk
Creates antibody against COVID-19 4.87 EA
Side effects of COVID-19 vaccine such as:
Chills 4.40 EA
Redness around the injection site 4.26 EA
Pain around the injection site 4.78 EA
Fatigue 4.5 EA
Fever 4.66 EA
Aching limbs 4.47 EA
Headache 4.53 EA
Management of side effects such as:
Getting a lot of rest 4.86 EA
Going to bed early 4.67 EA
Take over-the-counter pain reliever 4.64 EA
medicines
Drinking a lot of water 4.86 EA
Having a tepid sponge bath 4.09 MA
Taking a cool shower 4.16 MA
Ice pack on the painful arm 3.93 MA
Heating pad on the painful arm 3.84 MA
Queries regarding the COVID-19 vaccine were answered. 4.58 EA
Consent form was signed before the screening. 2.41 SA
4.43 EA
Screening
Undergone history taking that includes the following:
Fever 4.71 EA
Cough 4.69 EA
Colds 4.68 EA
Headache 4.72 EA
Sore throat 4.62 EA
Loss of taste 4.61 EA
Loss of smell 4.60 EA
Loss of appetite 4.51 EA
Any medication taken 4.59 EA
Vaccination received during the past 4.55 EA
4 weeks
Presence of allergy 4.62 EA
Pregnant 4.39 EA
 65

Breastfeeding 4.30 EA
Undergone physical examination that includes the vital
signs such as:
Blood pressure 4.89 EA
Heart rate 4.84 EA
Respiratory rate 4.81 EA
Oxygen saturation 4.69 EA
A form was filled out and clearance was provided before 4.89 EA
vaccination.
4.65 EA
Vaccination
The brand of the vaccine was informed before 4.84 EA
administration.
Vaccine was administered via intramuscular injection 4.93 EA
observing aseptic technique.
Vaccination card was provided and properly signed by the 4.90 EA
vaccinator.
4.89 EA
Post-vaccination Monitoring
Monitored for shortness of breath, syncope, and 4.75 EA
anaphylactic reaction for thirty (30) minutes.
Information was provided regarding medical intervention 4.83 EA
on any adverse effects.
After thirty (30) minutes to one (1) hour of monitoring and 4.69 EA
once cleared, a medication was provided with instructions
about the possible side effects of the vaccine.
4.75 EA

Legend:

Range of Means Descriptive Interpretation

4.20-5.00 Extremely Aware (EA)
3.40-4.19 Moderately Aware (MA)
2.60-3.39 Somewhat Aware (S)
1.80-2.59 Slightly Aware (SA)
1.00-1.79 Unaware/Not Aware (UA)

Registration Phase. As shown in table 2, the composite mean for the registration

phase is 4.74, extremely aware. In the registration phase, “A health declaration form was

filled out” garnered the highest mean of 4.85 described as extremely aware. Meanwhile,

the statement “Documents needed were submitted such as Form 5, ID, MDR of PhilHealth

and a copy of schedule for the vaccination”, got the lowest mean of 4.63.
 66

According to the Philippine Medical Association (2021), the information gathered

on the health declaration form will be used to determine if the person is infected with

COVID-19. Furthermore, Dungo (2021), stated that PhilHealth MDR forms are required

for different purposes, including pre-employment requirements, updating membership

records, verification, and availing benefits due to hospitalization and confinement. This

implies that respondents are extremely aware as to the overall process of the registration

phase of the MMSU vaccination program on COVID-19.

Counseling Phase. It is shown in Table 2 that generally, it has a composite mean

of 4.43, described as extremely aware.

Under the benefits of COVID-19 vaccine, the statement “Protects people around

and those at greater risk” obtained the highest mean (4.89) described as extremely aware

while the statement “Reduces the chance of getting the virus” garnered the lowest mean

(4.84) but is still described as extremely aware. Based on the article of World Health

Organization (2021), the COVID-19 vaccination helps keep everyone from getting the

virus. It is proven to significantly reduce the probability of contracting the virus and it may

also protect people around, particularly those at greater risk for severe illness from

COVID-19. Furthermore, Koplon (2021) stated that getting vaccinated creates an antibody

response so that people are protected without having to experience the illness. Both

natural immunity and immunity produced by a vaccine are important aspects of COVID-

19 that experts are investigating.

For the side effects of COVID-19 vaccine, “Pain around the injection site” garnered

the highest mean (4.78) described as extremely aware and the statement “Redness

around the injection site” has the lowest mean (4.26) but is still described as extremely

aware. According to Freund (2021), it is normal to have certain reactions after a

vaccination in which there may be redness, swelling, or pain around the injection site.
 67

Furthermore, he stated that reactions are usually mild and subside after a few days. They

show that the vaccine is working because it stimulates the immune system and the body

forms antibodies against the infection that is only feigned by the vaccination.

In the management of side effects, the management which obtained the highest

mean (4.86) described as extremely aware include “Getting a lot of rest” and “Drinking a

lot of water”. On the other hand, the management of “Heating pad on the painful area” got

the lowest mean (3.84) and is described as moderately aware. Longman (2021) stated

that going to bed early post-shot and taking a day off of work as much as possible are

some of the interventions after getting vaccinated. If someone has a fever, headache, or

chills, try to drink more fluids. In addition, Mercy Health (2021) added that if people are

tired from the vaccine, it is perfectly fine to sleep and regain energy. Also, ensure to drink

plenty of fluids after the vaccination to hydrate one's system.

The statement “Queries regarding the COVID-19 vaccine were answered”

garnered the highest mean (4.58) described as extremely aware while the statement

“Consent form was signed before the screening” got the lowest mean (2.41) and is

described as slightly aware. In the easy read fact sheet made by the Australian

Government (2021), The healthcare provider will tell why you should get the vaccine, why

it’s safe, and what will happen if you will have it. They might give an information sheet to

read and they can answer any questions and clarifications. Moreover, the Department of

Health (2021), stated that vaccinees will be directed to the Health Education Area where

health educators shall present materials containing vaccine information and answer any

question the vaccinee may have regarding the COVID-19 vaccine.

This implies that the respondents are extremely aware of the things done in the

counseling phase together with the benefits of the vaccine, the side effects and their

management.
 68

Screening Phase. As shown in the table, the composite mean for the screening

phase is 4.65 which is interpreted as extremely aware.

History Taking. Under 2.3.1, the highest mean is headache (4.72) and it implies

that respondents are extremely aware. Meanwhile, breastfeeding has the lowest mean

with 4.30. However, it still means that respondents are extremely aware. Overall, they

are aware that undergoing history taking is important to check for eligibility for vaccination

and according to Immunize.org (2020), even though there is no evidence that acute illness

reduces vaccine efficacy or increases vaccine adverse events, as a precaution with

moderate or severe acute illness, all vaccines should be delayed until the illness has

improved, if signs and symptoms are present in the history taking.

Physical Examination. As shown in the table above, respondents are extremely

aware of the physical examination in the screening phase as blood pressure has the

highest mean with 4.89 and oxygen saturation as the lowest with 4.69. This explains that

respondents are aware of the vital signs taking that is usually done prior to vaccination.

However, just recently, from the joint statement of the Philippine Heart Association and

the Philippine Society of Hypertension last April 2021, they recommended that there is no

need to take vital signs (blood pressure, respiratory rate, heart rate) during screening

unless the vaccinee is in distress which warrants further evaluation as they recognized

that significant vaccination deferrals and delay were observed due to blood pressure

elevations that to date have not resulted to any serious nor life threatening events

established to be related to COVID-19 vaccines.

Under 2.3.3 where form will be filled and clearance will be provided, the mean is

4.89 which reveals that respondents are extremely aware. As stated by the Centers for

Disease Control and Prevention (2019), screening helps prevent adverse reactions of the

vaccine to be administered. The findings imply that respondents have the greatest
 69

awareness as to the overall process of the screening. They know that passing the

screening phase is important and a clearance is needed to be allowed for vaccination.

Vaccination Phase. Table 2.4 presents the vaccination phase of the program.

Vaccines being administered intramuscularly and observing aseptic techniques have the

highest mean (4.93) , which is interpreted as extremely aware. Meanwhile, informing the

brand of the vaccine before administration has the lowest mean (4.84) which is still

described as extremely aware. Overall, the respondents are extremely aware of this

component, with a composite mean of 4.89.

For COVID-19 vaccines, it should be administered intramuscularly to optimize

immunogenicity and minimize local adverse reactions (Gyldenlove et al, 2021). Deviation

from the suggested route may reduce vaccine efficacy or increase local adverse reactions.

Moreover, healthcare providers always use aseptic techniques to prevent microbial

contamination and infection (CDC, 2021). It is also equally important to provide the

patients or parents/guardians with information about vaccines and immunization. Before

administering each dose of certain vaccines, healthcare providers should provide a copy

of the most current Vaccine Information Statement (VIS) to them (CDC, 2019). This

implies that this component of the program is executed properly hence, the respondents

are very much aware of these procedures under this phase.

Post-Vaccination Phase. With regards to the post-vaccination phase, it is evident

in table 2 that the respondents are extremely aware regarding the post-vaccination

monitoring with a composite mean of 4.75. Majority of the respondents are extremely

aware of the item “Information was provided regarding medical intervention on any

adverse effect” which has the highest mean of 4.83 which is interpreted as extremely

aware. Meanwhile, “after thirty (30) minutes to one (1) hour of monitoring and once

cleared, a medication was provided with instructions about the possible side effects of the
 70

vaccine” has the lowest mean of 4.69 which is still described as extremely aware. In the

study of Chau (2021), there have been cases where reports of deaths following

immunization have been misunderstood as deaths caused by the vaccines. This has

caused immense irreparable damage to the campaign to increase vaccinations and return

to any sense of normalcy re-opening businesses, schools, concerts, and many other

gatherings. In addition, the centre's direction to state governments is to have one adverse

event management centre in each block as an important preparatory step in the anti-

COVID vaccination drive. Adverse events following vaccination are known to happen

following vaccination. This could, in turn, induce paranoia and vaccine resistance and

hinder our efforts towards herd immunity through vaccination. The block level adverse

event management center can counter this phenomenon by quickly offering medical care

to the patient and disseminating accurate information on the patient’s condition. (TOI

Quick Edits, 2020). This implies that the respondents are extremely aware of the elements

under post-vaccination phase and that disseminating accurate information and offering or

providing medical care after vaccination is vital.

Correlation Between the Profile of the Respondents

And the Level of Awareness on the Components of the

MMSU Vaccination Program on COVID-19.

Table 3 presents the relationship between the profile of the respondents and the

level of awareness on the components of the MMSU vaccination program on covid-19.

Table 3. Correlation between the profile of the respondents and the level of
awareness
Profile of the Components of the MMSU vaccination program on COVID-19
respondents
Registration Counseling Screening Vaccination Post- Overall
vaccination
Age 0.182* 0.152* 0.155* 0.218* 0.197* 0.192*
 71

Sex 0.042 0.218* 0.149* 0.184* 0.206* 0.148*

Program -0.091 -0.101 0.168* 0.170* 0.173* 0.150*
Year Level 0.178* 0.169* 0.205* 0.252* 0.239* 0.225*
Source of 0.029 -0.021 0.009 0.387* 0.293* 0.182*
Information in
Availing the
Vaccine
Legend: *Correlation is significant at the 0.05 level

The table above presents the relationship between the profile of the respondents

and the components of the MMSU vaccination program. As indicated, the age and year

level showed a significant relationship to all the components of the program. Meanwhile,

sex is significant to all except on the registration phase. For the program, it is significant

to the last three phases (screening, vaccination, post-vaccination). Finally, the source of

information is only significant to the vaccination and post-vaccination phase of the

program. Overall, the profile of the respondents have significant relationship to the

components of the vaccination program, hence the hypothesis is rejected.

Age. On the column of age, there is a significant relationship of age to the

awareness of all of the phases of the vaccination program. As indicated, the correlation

coefficient to registration is at (0.182), counseling is at (0.152), screening (0.15),

vaccination at (0.18), and post-vaccination at (0.197). The overall correlation coefficient is

0.192 which means that the correlation is significant at 0.05 level. The majority of the

respondents belong to the age group 19-22. One study conducted in Northwest Nigeria

displayed that the baseline prevalence of accepting COVID-19 vaccines among students

of health sciences is low despite their predisposed medical knowledge. However, other

studies also revealed that increasing age has been shown to accept the vaccines because

they are more likely to have come across and recognize COVID-19 patients during clinical

postings and are believed to be more knowledgeable on the virus and its pathogenicity

(Mustapha et al, 2021). Findings imply that older individuals are more aware and more
 72

likely to get vaccinated because they are knowledgeable regarding the vaccination

program.

Sex. As shown in the table above, there is a significant relationship between sex

and the level of awareness of the respondents on the components of the MMSU

vaccination program on COVID-19 with an overall correlation coefficient of (0.148).

Correlation coefficient of counseling is (0.218), screening (0.149), vaccination (0.184), and

post-vaccination (0.206) which are significant at .05 level of significance. This contradicts

the study of Wang et al. (2020) in which, the only demographic predictor of having a

definite intention of COVID-19 vaccination was sex. They have found out in their study

that males demonstrated higher intention to take the COVID-19 vaccine than females. It

also agrees that male were more confident to accept COVID-19 vaccination as soon as

possible than women. Furthermore, Bellon, M. (2020) stated that women are more likely

to express a desire to delay or reject the COVID-19 vaccine, to state that the vaccine was

too new, that they were fearful of side effects, and that they had a medical contraindication

to the vaccine than men. With this, it is implied that sex is a predictor of the level of

awareness on the vaccination program because female are more likely to recieve

vaccination.

Program. As shown on the table above, on the column of program, there is a

significant relationship between the program of the respondents and the level of

awareness on the components of the MMSU vaccination program on COVID-19

particularly on the three phases namely; Screening, Vaccination, and Post Vaccination

phase as indicated by correlation coefficient of Screening (0.168), Vaccination (0.170),

Post-Vaccination (0.173), which is significant at .05 level of significance. The overall

correlation coefficient is 0.150 which means that the correlation is significant at 0.05 level.

As stated by Science Direct (2021), though the students from medical and allied health
 73

sciences are not directly involved in managing COVID-19 patients, they can serve as an

information provider. They can sensitize community people about maintaining personal

hygiene, symptoms of COVID-19, and how to prevent its spread. It is implied that the

program of the student is a demographic predictor of the level of awareness of the

vaccination program because they can be key informants and help spread awareness

regarding the components of COVID-19 vaccination program.

Year Level. As shown in the table above, year level is significant to the awareness

of respondents on all phases or components of the MMSU vaccination program. Therein

presented, the year level’s significance to registration is at (0.178) correlation coefficient,

counseling at (0.169), screening (0.205), vaccination at (0.252), and post-vaccination at

(0.239). Overall, the correlation coefficient is (0.225) which is interpreted as significant. In

the study of Mustapha et al. (2021), in relation to the age’s significance to the vaccination

program, higher level students have been shown to accept the vaccines as they more

likely have come across and recognize COVID-19 patients during clinical postings and are

more knowledgeable on the virus and its pathogenicity. The University of Massachusetts

Global (2019) also stated that the higher the year level or attainment of a person, the more

aware and knowledgeable a person is when it comes to health. Higher level of education

certainly exposes people to a wealth of information that might prompt them to make

healthier choices such as getting vaccinated. It can be implied that year level is a predictor

of the awareness on the vaccination program because vaccine acceptance has been seen

among higher level students.

Source of Information. Based on the table, the respondents’ source of

information has a significant relationship with their level of awareness on the components

of the MMSU vaccination program on COVID-19 as indicated by a correlation coefficient

of vaccination (0.387) and post-vaccination (0.293) with an overall correlation coefficient

 74

of of (0.182) which are significant at .05 level of significance According to Loeb et al.

(2021), since the beginning of the COVID-19 pandemic, there has been an abundance of

information, with nearly every media channel covering the latest developments.

Information channels, both traditional and social media, are sharing vaccine information

and may be very influential in swaying public opinion as to whether or not members of the

public want to be vaccinated. An individual’s perception of a given channel can impact

how that person acts upon that information. Perceptions of credibility, authoritativeness,

and persuasiveness vary by information source. The content and spread of misinformation

online can influence risk perception and vaccine hesitancy. Exposure to websites and

social media posts discouraging immunizations, even when brief, can increase perception

of vaccination risk while decreasing the perception of benefits. This implies that source of

information is a significant factor on the respondents’ level of awareness on the

components of the MMSU vaccination program on COVID-19 because it has a big

influence on public opinion and how people react to information.

 CHAPTER V

SUMMARY OF FINDINGS, CONCLUSIONS AND RECOMMENDATIONS

This chapter presents the summary of the research undertaken, the conclusions

drawn from the findings, and the recommendations offered.

Summary of Findings

As to the profile of the respondents, under age, findings show that respondents

who are 20 years old garnered the highest mean (25.75%) which comprises one fourth of

the total population while no respondent is 17 years old. As for sex, female respondents

(198 or 65.35%) outnumber the males (105 or 34.66%). Under the program, the highest

portion (167 or 55.12%) is Nursing while Physical Therapy (65 or 21.46%). Moving on, 85

or 28.06% of the respondents belong to the year level I (85 or 28.06%) while the least is

under the year level II (71 or 23.44%). Lastly, most of the respondents use social media

as their main source of information, specifically Facebook (268 or 88.45%) while (38 or

12.55%) uses mass media, particularly newspapers.

Regarding their awareness as to the components of the COVID-19 vaccination

program, results revealed that under the registration phase, filling out of a health

declaration form got the highest mean (4.72) while submitting documents needed such as

Form 5, ID, MDR of PhilHealth and a copy of schedule for the vaccination has the lowest

mean (4.63). Overall, the respondents are extremely aware of these elements under this

phase with a composite mean of 4.74. In the counseling phase, generally, it has a

composite mean of (4.43), described as extremely aware. Under the benefits, the COVID-

19 vaccine protects people around and those at greater risk obtained the highest mean

(4.89); on the other hand, reducing the chance of getting the virus garnered the lowest
 76

mean (4.84). For the side effects of COVID-19 vaccine, experiencing pain around the

injection site garnered the highest mean (4.78); meanwhile, having redness around the

injection site got the lowest mean (4.26). In the management of side effects, getting a lot

of rest and drinking a lot of water obtained the highest mean (4.86) while the applying

heating pad on the painful area got the lowest mean (3.84). Respondents are extremely

aware of having their queries regarding the COVID-19 vaccine answered which results to

have a mean of 4.58 described as extremely aware. Going further, findings in the

screening phase suggest that the respondents are extremely aware with a mean of

(4.65). Having a headache got the highest mean (4.72) under history taking while

breastfeeding had the lowest mean (4.30). In the physical examination, taking blood

pressure has the highest mean (4.89) while oxygen saturation taking is the least (4.69).

Finally, the respondents are extremely aware that a form is being filled and clearance is

provided which gives the mean of (4.89). As to the vaccination phase, it has a composite

mean of (4.89), described as extremely aware. Vaccines being administered

intramuscularly and observing aseptic technique have the highest mean (4.93) while

informing the brand of the vaccine before administration has the lowest mean (4.84). And

lastly, with regards to the post-vaccination phase, the respondents are extremely aware

(4.75) in general. Information provided regarding medical intervention on any adverse

effect has the highest mean (4.83); meanwhile, providing medication with instruction

regarding the possible side effects of the vaccine after thirty (30) minutes to one (1) hour

of monitoring and is being cleared has the lowest mean (4.69).

As to the relationship between the profile of the respondents and their level

of awareness, age has a significant relationship to all the components of the vaccination

program. The correlation coefficients on the registration, counseling, screening,

vaccination, and post-vaccination are (0.182), (0.152), (0.155), (0.218), (0.197)

respectively with an overall correlation coefficient of (0.192). Under sex, it shows

 77

significance in the counseling phase (0.218), screening (0.149), vaccination (0.184), and

post-vaccination (0.206) with an overall correlation coefficient of (0.148). For the program,

it is only significant to the screening with (0.168) correlation coefficient, vaccination with

(0.170), and post-vaccination with (0.173) and an overall correlation coefficient (0.150). It

is also been found that there is significant relationship of the year level in all of the

components of the vaccination program— registration, counseling, screening, vaccination,

and post-vaccination with correlation coefficient of (0.178), (0.169), (0.205), (0.252), and

(0.239), and an overall correlation coefficient of (0.225) respectively. For the source of

information, significant relationships are found only in the phases of vaccination (0.387)

and post-vaccination phase (0.293) with an overall correlation coefficient of (0.182).

 78

Conclusions

In view of the aforementioned findings, the following conclusions were drawn:

1. The higher representations of the respondents are at age 20, female, learners of

the nursing program, year level I, and also, the majority of the respondents’ source

of information on the vaccination program is social media, particularly Facebook.

2. The respondents have extreme awareness on all components of the COVID-19

vaccination program except some points in the management of side effects under

the counseling phase.

3. Significant relationships are noted between the profile of the respondents to the

awareness on all of the components of the vaccination program. Specifically, age

and year level are significant predictors on their awareness on all components of

the program while sex is significant to all components except the registration

phase. Moreover, the program is significant to the phases of screening,

vaccination, and post-vaccination; meanwhile, source of information is significant

only to the phases of vaccination and post-vaccination.

4. The Health Promotion Model of Nola Pender is acceptable and a valid anchor in

the study as it provided assistance to the study’s path. The study claims that the

Health Promotion model is applicable to explore awareness on the components of

the MMSU COVID-19 vaccination program through its constructs. The

incorporation of the Health Promotion Model concepts was a success and as an

outcome, the researchers have come up with accurate and dependable findings

and conclusions.
 79

Recommendations

In light of the findings and conclusions of the study, the following recommendations

are hereunder presented:

1. The health sciences learners can utilize the result of the study as a guide to

augment their knowledge as to the MMSU COVID-19 vaccination program and

the vaccine itself.

2. The Department of Health vaccination implementers can utilize the results of

the study to help them formulate and recalibrate their strategies and plans in

the implementation of the vaccination program to further strengthen the said

program.

3. The health sciences faculty can take the results of the study as a guide in ruling

out ideas to formulate measures for the enhancement of the awareness of the

learners in the vaccines and the vaccination program itself while keeping their

commitment to the learners to share relevant information.

4. The result of the study is recommended to the parents of the learners to

enhance their understanding as to how their children perceive the vaccination

program and the vaccine itself. This can be used to further clarify the extent of

the COVID-19 vaccination program toward their children in health sciences

courses.

5. The future researchers who would want to conduct researches in the same

field of endeavor can make use of the results of the study as supplementary

reference material and a springboard to explore further knowledge.

Furthermore, it is recommended to conduct a study with wider scope for more

results and to validate the result of the study.

 80

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