| Abstract|| |
Aim: To assess knowledge, attitudes, and beliefs among dental students and faculty members regarding COVID-19 vaccines in dental colleges in Haryana, India. Objectives: To assess knowledge level, attitudes, and beliefs differences among BDS, MDS students and faculty members and find association between knowledge and COVID-19 vaccine inoculation among study participants. Materials and Methods: A cross-sectional study was carried out among students and faculty members of dental colleges in Haryana, India. Data collection was done via an online questionnaire based on questions to assess the knowledge, attitude and beliefs regarding COVID-19 vaccines. Results: The present study comprised of 270 study participants, where majority, i.e., 81.5% have reported COVID-19 vaccine inoculation. The mean knowledge score of the participants was reported to be 5.54 ± 2.19. A significant difference was found in the mean knowledge score of faculty members (7.81 ± 1.69), MDS (6.72 ± 1.49), and BDS (4.39 ± 1.68) students. COVID-19 vaccine inoculation was found to be significantly associated with average knowledge score of participants (OR = 6.1, P < 0.01). Conclusion: Dental professionals have an adequate degree of knowledge and attitude level regarding COVID-19 vaccines and are generally optimistic about resolving the pandemic situation with the immunization.
Keywords: Attitude, COVID-19 vaccines, dentists, immunisation, knowledge, pandemic
|How to cite this article:|
Chauhan N, Manjunath B C, Kumar JS, Yadav V, Sabbarwal B, Kumar A. Knowledge, attitudes, and beliefs among dental students and faculty members regarding COVID-19 Vaccines in Dental Colleges of Haryana, India - A cross-sectional study. Indian J Dent Res 2022;33:230-4
|How to cite this URL:|
Chauhan N, Manjunath B C, Kumar JS, Yadav V, Sabbarwal B, Kumar A. Knowledge, attitudes, and beliefs among dental students and faculty members regarding COVID-19 Vaccines in Dental Colleges of Haryana, India - A cross-sectional study. Indian J Dent Res [serial online] 2022 [cited 2023 Feb 5];33:230-4. Available from: https://www.ijdr.in/text.asp?2022/33/3/230/367876
| Introduction|| |
The COVID-19 pandemic is an ongoing global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Prevention, early diagnosis, medical management efforts, and campaigns are being led by the World Health Organization (WHO), as well as a number of research groups with clinical professionals from all over the world. Nonpharmaceutical Interventions (NPIs), such as physical distancing and masking, were the only effective approaches for preventing the spread of SARS-CoV-2 until recently. Adherence to these NPIs is inconsistent and difficult to maintain. Thus, developing an efficient vaccine is the effective method for controlling and gradually eradicating this pandemic.
The genetic sequence of the virus was published in the beginning of 2020 and vaccine development has been accelerated owing to unprecedented collaboration between governments and global pharmaceutical companies., Approximately 123 COVID-19 vaccine candidates are undergoing clinical trials and 194 are in preclinical development.,
The rapid development of the vaccines has led to doubts regarding their safety and efficacy., Several studies have reported concerns regarding the vaccine's efficacy or safety, the vaccine's manufacturing country, antivaccine movements, and the belief in rushed vaccine research and production, rumors and misinformation as factors in COVID-19 vaccination reluctance.,,,
Beginning in early 2021 India had administered approximately 939 million doses in total as of October 9, 2021, including first and second doses of currently approved vaccines. With vaccine distribution underway, it's critical to assess communities' acceptance of COVID-19 vaccination.,
Studies to assess the knowledge, attitude, practices and acceptance regarding COVID-19 vaccine has been done among healthcare workers, general population,, among different countries population with difference in income level and trust of public in government.,
Immunization of dentists is important due to possibility of exposure to COVID-19 patients. Given that limited research has addressed COVID-19 vaccine knowledge, attitudes and beliefs among dental professionals, the current study was formulated to assess knowledge, attitude, beliefs among dental professionals regarding COVID-19 vaccines in dental colleges of Haryana, India.
| Material and Methods|| |
A cross-sectional study was conducted for one month in three dental colleges of Haryana, India through an online questionnaire. The target population was BDS, MDS students and Faculty members in the dental colleges. The study protocol was reviewed by Institutional Ethics Review Board and ethical clearance was granted (PGIDS/IEC/39).
A pilot study was done among 30 participants, 7% difference was observed in total correct answers percentage between BDS and MDS students. On the basis of this sample size was calculated with 80% power and 95% confidence interval. Total sample size was calculated to be 270. Students and faculty from three randomly selected dental colleges were included in the study.
A self- structured Questionnaire was developed in English language, and converted into an online questionnaire using Google forms. It was reviewed by a committee comprising of experts from Public Health Dentistry. Prior to being finalized, the questionnaire was pilot-tested on a group of 30 participants to ensure clarity, feasibility, validity and to know baseline data for sample size calculation and necessary modifications were made, its internal consistency was assessed by calculating the Cronbach's alpha as 0.79. Most of the questions were assigned to be mandatory answered items to avoid incompleteness and missing data. The final questionnaire was then administered using Google through E-mail, WhatsApp, and Facebook. The answer procedures, the voluntary nature of participation, and anonymity declaration within the explanation of informed consent were presented on the questionnaire's top page. Responders answered the questionnaire via their internet surroundings.
The questionnaire was divided into 3 sections: the first section consisted of demographic details such as gender, age, college, academic year and professional status. The second section consisted of 10 questions to assess knowledge regarding COVID-19 vaccines and 10 questions to assess attitudes regarding COVID-19 vaccine. The third section consisted of eight questions.
For knowledge items incorrect responses were given a score of zero, and correct answers were assigned a score of one. The total score for knowledge ranged from zero to ten, and an individual score ≤4, 5–7, and 8–10 was considered poor, average, and good knowledge respectively. In the section on attitudes, scores were calculated based on the respondents' answers to attitudinal statement, 1 = strongly disagree, 2 = disagree, 3 = neither agree nor disagree, 4 = agree, and 5 = strongly agree. Scores were calculated by averaging respondents' answers to the ten statements. Total scores ranged from 1–5, and an individual score 1–3, 3.1–4, and 4.1–5 was considered poor, fair, and good attitude, respectively.
Data were extracted from the Google form to Excel sheet and statistically analyzed using IBM SPSS software version 26. Qualitative data were presented as frequencies and percentages and a chi-square test was used for analysis. Quantitative variables were presented as mean and standard deviation, and ANOVA was used for analysis. Bivariate logistic regression was applied to predict association between knowledge and vaccine acceptance among respondents. The adopted significance level was P < 0.05.
| Results|| |
The present study comprised of 270 study participants, where 162 (60.0%) were BDS students, 54 (20.0%) were MDS students and 54 (20.0%) were faculty members. A majority of the participants i.e., (81.5%) belonged to 18–29 years age group followed by 30–49 (18.5%) years age groups. Majority of study participants, i.e., 220 (81.5%) had COVID-19 vaccine inoculation done. Majority of the faculty members i.e., 90.7% had taken COVID-19 vaccine as compared to 83.3% MDS students and 77.8% BDS students. Majority of the study participants i.e., 48 (88.9%) faculty members, 135 (83.3%) BDS students and 42 (77.8%) MDS students had taken it to protect from COVID-19. Majority of the study participants i.e., 9 (5.6%) BDS students, 5 (9.3%) MDS students and 2 (3.7%) faculty members had not taken COVID-19 vaccine as they did not trust vaccine's efficacy. Majority of the study participants i.e., 46 (85.2%) faculty members, 114 (70.4%) BDS students and 44 (84.6%) MDS students believed that vaccination will reduce severe infection which requires hospitalization [Table 1].
|Table 1: Demographic characteristics and distribution of study participants according to belief regarding COVID-19 vaccine inoculation|
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Among participants higher mean correct response i.e., 0.90 ± 0.29 had reported regarding the side effects of COVID-19 vaccine. Among participants less mean correct response i.e., 0.16 ± 0.36 had reported regarding the approaches in designing of vaccines.
In the present study mean knowledge score reported was 5.54 ± 2.19. Mean knowledge score was found significantly more among faculty members (7.81 ± 1.69) as compared to MDS students (6.72 ± 1.49) and BDS students (4.39 ± 1.68) (p value <0.001) [Figure 1]. Statistically significant difference among mean knowledge score of faculty members and BDS students, faculty members and MDS students, BDS and MDS students was reported. The overall mean attitude score reported was 4.4 ± 0.69. Mean attitude score of faculty members was 4.5 ± 0.79, MDS students was 4.5 ± 0.69 and 4.4 ± 0.69 was of BDS students. The difference between mean attitude score of faculty members, MDS students and BDS students was not significantly reported (P value = 0.69) [Table 2].
|Figure 1: Distribution of Study Participants according to difference in mean knowledge score regarding COVID-19 vaccine|
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|Table 2: Distribution of study participants according to mean knowledge and attitude score regarding COVID-19 vaccine|
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The odds of study participants getting vaccinated significantly reported 6.1 times more with knowledge score of 5–7 as compared to participants with knowledge score of ≤4 [Table 3].
|Table 3: Association between COVID-19 vaccination inoculation and knowledge of study participants|
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| Discussion|| |
The present study comprised of 270 study participants, where 60.0% were BDS students, 20.0% were MDS students and 20.0% were faculty members. A majority of the participants belonged to 18–29-year age group followed by 30–49-year age groups. In the present study COVID-19 vaccine uptake had observed higher i.e., 81.5% among dental professionals. Similarly, COVID-19 vaccine willingness in general population was also reported higher i.e., 71.9% in a study conducted by Bhartiya S et al. No statistically significant difference was seen regarding inoculation of COVID-19 vaccine. Similarly, in another study, approximately more than half of the study population were willing to receive the COVID-19 vaccine with no statistically significant difference among the general population, medical students, medical doctors, and paramedics. In the present study, majority of the study participants had their vaccination done to get protection from COVID-19 disease. Similarly, study done by Saied MS et al. found out that motivating factors for receiving COVID-19 vaccine was fear of getting infection of themselves for 35.1%, fear of family members especially parents getting infected for 77.7% participants and belief on safety of COVID-19 vaccines for 14.1%.
In a study done by Elhadi M et al. regarding the vaccine trust and safety, similar findings were reported where majority of participants believed that the COVID-19 vaccine will effectively control the disease and less number of participants were concerned that unforeseen problems can be caused by COVID-19 vaccine in the future.
Overall study participants had reported adequate knowledge regarding the COVID-19 vaccines. Majority of the participants had knowledge about the type of COVAXIN and COVISHIELD vaccines. Similarly, knowledge regarding the route of administration of COVID-19 vaccine and side effects of COVID-19 vaccines had been observed among majority of dental professionals. The present study revealed significantly high mean knowledge score among faculty members regarding COVID-19 vaccines as compared to MDS and BDS students. As from the beginning of COVID-19 vaccination campaigns in India, to vaccinate all health workers including students, faculty members and support staff for their benefit and well-being, time to time vaccination drives have been held in medical and dental colleges of Haryana under the supervision of faculty members.,, A majority of faculty members have reported higher knowledge regarding COVID-19 vaccines.
In the present study no significant difference reported in the mean attitude score of study participants. Majority had reported significantly good attitude towards COVID-19 vaccines, implying a general willingness to take the vaccination.
In the present study COVID-19 vaccine uptake was found to be significantly associated with average knowledge of participants regarding COVID-19 vaccines (OR = 6.1, P < 0.01). This study is in line with a study done by Riad A et al. where the perceived level of vaccine knowledge and effectiveness was a significant determinant of COVID-19 vaccine uptake among dental students across the globe. In their study, they concluded that the perceived knowledge level was found to be associated with increased awareness about the risk/benefit ratio of COVID-19 vaccination, a higher level of readiness to take new vaccines, and a lower level of misconception about immunization.
In our study, despite understanding the need of the COVID-19 vaccine and agreeing to take COVID-19 vaccination, the major reason for not taking the vaccine among study participants was lack of knowledge and concerns regarding safety and effectiveness of COVID-19 vaccines. In previous studies also healthcare workers and general population concerns regarding vaccine effectiveness, safety, and adverse effects was reported.,
Evidence suggests that focusing on creating trust in COVID-19 vaccinations is critical. This includes managing the COVID-19 information paradigm with trusted messengers and developing vaccine confidence through openness and expectation management. Communities should be involved early on in order to hear what they have to say. Concerns, inquiries, and misinformation should all be addressed.,
Several strengths and limitations of this study should be acknowledged. Strength of this study is that there is a dearth of studies about COVID-19 vaccines among healthcare workers and most probably, this is one of the earliest studies carried out among dental professionals regarding COVID-19 vaccines. Our findings provide valuable information about the knowledge, attitudes and beliefs of an important group of frontline workers during this development period of COVID-19 vaccine to fight against ongoing pandemic. The questionnaire had neutrally worded questions, not leading questions and answers and anonymity, to avoid response (extreme) bias. Limitations of this study is that it was conducted only in dental colleges of Haryana state of North India, so there is limited generalizability.
| Conclusion|| |
Dental professionals have an adequate degree of knowledge and attitude level about COVID-19 vaccines and are optimistic about resolving the pandemic situation with the immunization. The rapid development of COVID-19 vaccine might have contributed to the emergence of concerns among the dental professionals, as the most prevalent reason for not having COVID-19 vaccination, was the disbelief regarding the efficacy of COVID-19 vaccines. Interventional educational campaigns regarding COVID-19 vaccines among healthcare workers are essential to increase vaccination percentage. Additional studies to address barriers to vaccine acceptance are required especially among high-risk population such as medical and dental professionals.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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Dr. Neha Chauhan
Post Graduate Institute of Dental Sciences, Rohtak - 124 001, Haryana
Source of Support: None, Conflict of Interest: None
[Table 1], [Table 2], [Table 3]