Impact of Coronavirus Infectious Disease (COVID-19) pandemic on willingness of immunization—A community-based questionnaire study

The pandemic coronavirus infectious disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged from Wuhan, China, in December 2019 and has spread widely across the world. Taiwan is geographically near mainland China and was presumed to have high numbers of COVID-19 cases [1]. However, the disease was not prevalent in Taiwan due to the contributions of brisk responses by the government to disease control and cooperation from the general population of Taiwan [2]. Information about the disease entity, the route of transmission and the preventive guidelines were updated soon after the COVID-19 outbreak [35]. The Taiwan Centers for Disease Control (Taiwan CDC) updated the population regarding the confirmed cases and quarantine policies daily and educated the public to ensure they had access to correct information about self-hygiene and disease prevention from the very beginning [6]. Citizens with mobile devices can easily link to resources and obtain recent and correct information. In addition, COVID-19 confirmed case number updating, policy renewals, such as the required duration for quarantine, and disease prevention guidelines, such as social distancing and hand washing, were also announced on these social media platforms. Thus, citizens could instantly capture first-hand and transparency data from the Taiwan CDC [7]. In comparison with the worldwide COVID-19 pandemic, which reached 77.5 million people infected with a mortality of approximately 1.7 million, there were 770 cumulative confirmed cases, mostly imported, and 7 deaths reported in Taiwan as of December 22nd, 2020 [89].

Similar to COVID-19, influenza is a contagious and easily mutated RNA virus that needs to be protected against by vaccination annually but still causes seasonal epidemics. The World Health Organization (WHO) encourages countries to conduct routine influenza surveillance [1012]. The Taiwanese government-funded annual program of seasonal influenza immunization initially supplied vaccines for high-risk groups, including those aged 65 and above or aged 50–64 with comorbidities. After expanding vaccine coverage, a government-funded influenza vaccine has been available for the healthy population aged 50–64 since 2016 [1314]. However, the immunization rates have been relatively low at 18.1% and 51.3% for those aged 50–64 and aged 65 and above, respectively [15]. Consequently, the incidence rate of severe influenza infection-related morbidities has been reported to range from 0.4 to 1.8 per 100,000 people annually in Taiwan in the past 5 years [16]. According to previously published studies, the COVID-19 pandemic caused medical preference changes in reproductive and colon cancer screening issues [1718]. Similarly, people in Taiwan showed great cooperation with the government for disease prevention, which resulted in personal, social and behavioral modifications during this period. Although vaccines designed to protect against COVID-19 have also been urgently investigated worldwide and are under human clinical trials [1921], little is known about what variables might influence the willingness to receive vaccinations. 

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