Introduction: The COVID-19 pandemic has demonstrated its capacity for rapid global transmission, leading to an unprecedented public health crisis with profound social, economic, and political repercussions. DM is one of the most common comorbidities in individuals with COVID-19 and is associated with increased risk of severe disease, intensive care unit admissions, and higher mortality. Given the high vulnerability of diabetic patients to adverse outcomes from COVID-19, primary prevention through vaccination remains the cornerstone strategy for reducing the risk of infection and its complications in this population. The aim of this study was to assess the rate of COVID-19 vaccine uptake among individuals with diabetes and to identify factors influencing vaccine acceptance. Methods: This was a cross-sectional study conducted in randomly selected eligible adult DM patients visiting endocrine clinic in TASH from September 1 to October 30, 2022 using structured questionnaire. Data was entered into SPSS Version 25 and descriptive statistics was done to summarize the data. Then binary logistic regression analysis using bivariate and multivariate analysis was done. Results: A total of 305 patients participated in the study, of whom 201 (66%) had received at least one dose of the COVID-19 vaccine. Of the vaccinated individuals, 102(50.7%) were administered two doses and 60(29.9%) received three doses. Factors associated with an increased likelihood of vaccine uptake included male sex (adjusted odds ratio [AOR] = 1.8, 95% confidence interval [CI] = 1.46–3.45), age groups of 31–40 years, 41–50 years, 51–60 years, 61–69 years, and >70 years (AOR = 3.9, 95% CI = 1.21–12.78; AOR = 9.9, 95% CI = 2.67–36.98; AOR = 8.9, 95% CI = 2.56–30.85; AOR = 7.9, 95% CI = 1.89–33.06, respectively). Additionally, higher educational attainment was associated with greater vaccine uptake, with secondary education (AOR = 3.1, 95% CI = 1.19–8.11) and tertiary education (AOR = 7.8, 95% CI = 2.54–23.87) showing significant associations. Perceived severity of COVID-19 infection was also a predictor of vaccine uptake (AOR = 2.4, 95% CI = 1.88–6.60). Beliefs about the benefits of vaccination, such as the perception that vaccination reduces the risk of transmission (AOR = 4.7, 95% CI = 1.21–18.29), the belief that vaccination is the best way to prevent complications (AOR = 12.1, 95% CI = 3.89–37.55), and the belief in the efficacy of vaccination in reducing the risk of infection when recommended by a healthcare provider (AOR = 6.1, 95% CI = 1.98–19.02), were also positively associated with vaccine uptake. Conclusion: COVID-19 vaccine uptake among DM patients at TASH was low. Thus, different strategies should be applied to promote COVID-19 vaccine uptake in DM patients.
| [1] | COVID C. Global Cases by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). JHU COVID-19 Resource Center. Johns Hopkins Coronavirus Resource Center. 2020. |
| [2] | Worldometer report COVID-19 cases in Ethiopia. 2020. Available from: https: // www.worldometers.info/ coronavirus/ country/ Ethiopia. Accessed, July 11 2022. |
| [3] | Figueiredo A, Larson HJ. Exploratory study of the global intent to accept COVID-19 vaccinations. Commun Med 2021; 1(1).View Article PubMed |
| [4] | Reid JA, Mabhala MA. Ethnic and minority group differences in engagement with COVID-19 vaccination programmes – at pandemic pace: When vaccine confidence in mass roll out meets local vaccine hesitancy. Isr J Health Policy Res 2021; 10(1): 1–9.View Article PubMed |
| [5] | IDF Diabetes Atlas 10th Edition 2021. China Diabetes Report 2000–2045. Available online: https:// diabetesatlas.org/ data/en/ country/42/cn.html (accessed on 13 December 2021). |
| [6] | Wang, J.; Yuan, B.; Lu, X.; Liu, X.; Li, L.; Geng, S.; Zhang, H.; Lai, X.; Lyu, Y.; Feng, H.Willingness to accept COVID-19 vaccine among the elderly and the chronic disease population in China. Hum. Vaccines Immunother. 2021.View Article PubMed |
| [7] | Vaccines and immunization. Available online at: https:// www.who.int/healthtopics/ vaccines-and-immunization? (accessed JULY 11 ,2022). |
| [8] | Omer SB, et al. Vaccine refusal, mandatory immunization, and the risks of vaccine-preventable diseases. N Engl J Med.2009; 360(19): 1981.View Article PubMed |
| [9] | Fisher KA, et al. Attitudes toward a potential SARS-CoV-2 vaccine: a survey of US adults. Ann Intern med.2020; 173(12): 964–73.View Article PubMed |
| [10] | Organization WH. COVID-19 vaccines 2021. Available from: https:// www.who.int/ emergencies/ diseases/ novelcoronavirus-2019/ covid-19-vaccines. |
| [11] | Sallam M. COVID-19 vaccine hesitancy worldwide: a concise systematic review of vaccine acceptance rates. Vaccines (Basel) 2021; 9: 160.View Article PubMed |
| [12] | Nm,Baden, L.R.; El Sahly, H.M.; Essink, B.; Kotloff, K.; Frey, S.; Novak, R.; Diemert, D.; Spector, S.A.; Rouphael, N.; Creech, C.B. Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine. N. Engl. J. Med. 2021, 384, 403–416.View Article PubMed |
| [13] | WHO. Interim Recommendations for Use of the ChAdOx1-S [Recombinant] Vaccine against COVID-19 (AstraZeneca COVID-19 Vaccine AZD1222 Vaxzevria™, SII COVISHIELD™): Interim Guidance, First Issued 10 February 2021, https:// apps.who.int/iris/handle/10665/343388. |
| [14] | Palamenghi L, Barello S, Boccia S, GJEjoe Graffigna. Mistrust in biomedicalresearch and vaccine hesitancy: the forefront challenge in the battle against COVID-19 in Italy 2020; 35: 785e8.View Article PubMed |
| [15] | Sherman SM, Smith LE, Sim J, Amlˆot R, Cutts M, et al. COVID-19 vaccination intention in the UK: Results from the COVID-19 vaccination acceptability study (CoVAccS), a nationally representative cross-sectional survey. Hum Vaccines Immunother 2020: 1–10.View Article |
| [16] | McKee C, Bohannon K. Exploring the reasons behind parental refusal of vaccines. J Pediatr Pharmacol Ther. (2018) 21: 104–9.View Article PubMed |
| [17] | Reuben RC, Danladi MM, Saleh DA, Ejembi PE. Knowledge, attitudes and practices towards COVID-19: an epidemiological survey in North-Central Nigeria. Journal of community health. 2020: 1-14.View Article PubMed |
| [18] | "Addis Ababa | national capital, Ethiopia". Encyclopædia Britannica. Retrieved 14 November 2022. |
| [19] | Kotrlik, J. W. K. J. W., & Higgins, C. C. H. C. C. Organizational research: Determining appropriate sample size in survey research. Information technology, learning and performance journal. 2001; 19(1): 46-47. |
| [20] | Israel GD. Determining sample size. University of Florida IFAS Extension. 1992: 3. |
| [21] | Xu, J.; Chen, S.;Wang, Y.;Duan, L.; Li, J.; Shan, Y.; Lan, X.;Song, M.; Yang, J.;Wang, Z.Prevalence and Determinants of COVID-19 Vaccination Uptake Were Different between Chinese Diabetic Inpatients with and without Chronic Complications: A Cross-Sectional Survey. Vaccines 2022, 10, 994.View Article PubMed |
| [22] | Omar, S.M.; Khalil, R.; Adam, I.; Al-Wutayd, O. The Concern of COVID-19 Vaccine Safety Is behind Its Low Uptake among Patients with Diabetes Mellitus in Sudan. Vaccines 2022, 10, 527.View Article PubMed |
| [23] | Harrison JA, Mullen PD, Green LW. A meta-analysis of studies of the health belief model with adults. Health Educ Res. 1992; 7: 107–116.View Article PubMed |
| [24] | Nega Dagnew Baye et al. COVID-19 vaccine uptake and its determinants among residents of South Gondar Zone, Northwest Ethiopia: a cross-sectional study. PAMJ - One Health. 2022; 8: 14.View Article |
| [25] | Nachimuthu, S.; Viswanathan, V. Trend in COVID-19 vaccination among people with diabetes: A short study from India. Diabetes Metab. Syndr. 2021, 15, 102190.View Article PubMed |
| [26] | Duan, L.; Wang, Y.; Dong, H.; Song, C.; Zheng, J.; Li, J.; Li, M.; Wang, J.; Yang, J.; Xu, J. The COVID-19 Vaccination Behavior and Correlates in Diabetic Patients: A Health Belief Model Theory-Based Cross-Sectional Study in China, 2021. Vaccines 2022, 10, 659.View Article PubMed |
| [27] | Tourkmani, A.M.; Bin Rsheed, A.M.; AlEissa, M.S.; Alqahtani, S.M.; AlOtaibi, A.F.; Almujil, M.S.; Alkhashan, I.H.; Alnassar,T.N.; Alotaibi, M.N.; Alrasheedy, A.A. Prevalence of COVID-19 Infection among Patients with Diabetes and Their Vaccination Coverage Status in Saudi Arabia: A Cross-Sectional Analysis from a Hospital-Based Diabetes Registry. Vaccines 2022, 10, 310.View Article PubMed |
| [28] | Adane et al. Knowledge, attitudes, and perceptions of COVID-19 vaccine and refusal to receiveCOVID-19 vaccine among healthcare workers in northeastern Ethiopia. (2022) 22: 128.View Article PubMed |
| [29] | Haimanot Abebe et al. Understanding of COVID-19 Vaccine Knowledge, Attitude, Acceptance, and Determinates of COVID-19 Vaccine Acceptance Among Adult Population in Ethiopia. 2021: 14.View Article PubMed |
| [30] | Potdar, M.; Potdar, S.; Potdar, M. A study of gender disparities towards COVID-19 vaccination drive in Maharashtra State, India.Diabetes Metab. Syndr. Clin. Res. Rev. 2021, 15, 102297.View Article PubMed |
| [31] | Taye BT, Amogne FK, Demisse TL, et al. Coronavirus disease 2019 vaccine acceptance and perceived barriers among university students in northeast Ethiopia: a cross-sectional study Clinical Epidemiology and Global Health. Elsevier; 2021.View Article PubMed |
| [32] | Zewude B, Habtegiorgis T, Hizkea A, Dela T, Siraw G. Perceptions and experiences of COVID-19 vaccine side-effects among healthcare workers in Southern Ethiopia: a cross-sectional study. Pragmatic Observ Res. 2021; 12: 131–145.View Article PubMed |
| [33] | Stolow, J.A.; Moses, L.M.; Lederer, A.M.; Carter, R. How Fear Appeal Approaches in COVID-19 Health Communication May Be Harming the Global Community. Health Educ. Behav. 2020, 47, 531–535.View Article PubMed |