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      COVID-19 vaccine hesitancy in Malaysia: Exploring factors and identifying highly vulnerable groups

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          Abstract

          Vaccine hesitancy is a global health challenge in controlling the virulence of pandemics. The prevalence of vaccine hesitancy will put highly vulnerable groups, such as the elderly or groups with pre-existing health conditions, at a higher risk, as seen with the outbreak of the pandemic Covid-19. Based on the trends of vaccine hesitancy in the state of Sabah, located in East Malaysia, this study seeks to identify several variables that contribute to vaccine hesitancy. In addition to this, this study also determines which groups are affected by vaccine hesitancy based on their demographics. This study is based on a sampling of 1,024 Sabahan population aged 18 and above through an online and face-to-face questionnaire. The raw data was analysed using the K-Means Clustering Analysis, Principal Component Analysis (PCA), Mann-Whitney U Test, Kruskal-Wallis Test, and frequency. The K-Means Clustering found that more than half of the total number of respondents (Cluster 2 = 51.9%) tend to demonstrate vaccine hesitancy. Based on the PCA analysis, six main factors were found to cause vaccine hesitancy in Sabah: confidence (var(X) = 21.6%), the influence of local authority (var(X) = 12.1%), ineffectiveness of mainstream media (var(X) = 8.4%), complacency (var(X) = 7.4%), social media (var(X) = 6.4%), and convenience issues (var(X) = 5.8%). Findings from both Mann-Whitney U and Kruskal-Wallis tests demonstrate that several factors of group demographics, such as employment status, level of education, religion, gender, and marital status, may explain the indicator of vaccine hesitancy. In particular, specific groups tend to become vaccine hesitancy such as, unemployed, self-employed, students, male, single, level of education, and Muslim. Findings from this empirical study are crucial to inform the relevant local authorities on the level of vulnerability among certain groups in facing the hazards of COVID-19. The main contribution of this study is that it seeks to analyse the factors behind vaccine hesitancy and identifies which groups more likely hesitant toward vaccines based on their demographics.

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          Vaccine hesitancy: Definition, scope and determinants.

          The SAGE Working Group on Vaccine Hesitancy concluded that vaccine hesitancy refers to delay in acceptance or refusal of vaccination despite availability of vaccination services. Vaccine hesitancy is complex and context specific, varying across time, place and vaccines. It is influenced by factors such as complacency, convenience and confidence. The Working Group retained the term 'vaccine' rather than 'vaccination' hesitancy, although the latter more correctly implies the broader range of immunization concerns, as vaccine hesitancy is the more commonly used term. While high levels of hesitancy lead to low vaccine demand, low levels of hesitancy do not necessarily mean high vaccine demand. The Vaccine Hesitancy Determinants Matrix displays the factors influencing the behavioral decision to accept, delay or reject some or all vaccines under three categories: contextual, individual and group, and vaccine/vaccination-specific influences.
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            Multivariate Data Analysis

            For over 30 years, this text has provided students with the information they need to understand and apply multivariate data analysis. This text provides an applications-oriented introduction to multivariate analysis for the non-statistician. By reducing heavy statistical research into fundamental concepts, the text explains to students how to understand and make use of the results of specific statistical techniques. In this revision, the organization of the chapters has been greatly simplified. New chapters have been added on structural equations modeling, and all sections have been updated to reflect advances in technology, capability, and mathematical techniques. :Pearson New International Edition.
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              Silhouettes: A graphical aid to the interpretation and validation of cluster analysis

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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: InvestigationRole: MethodologyRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: InvestigationRole: MethodologyRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: InvestigationRole: MethodologyRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: Project administrationRole: ResourcesRole: VisualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: Project administrationRole: ResourcesRole: VisualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: Project administrationRole: ResourcesRole: VisualizationRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                8 July 2022
                2022
                8 July 2022
                : 17
                : 7
                : e0270868
                Affiliations
                [1 ] Faculty of Social Sciences and Humanities, Geography Programme, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
                [2 ] Faculty of Social Sciences and Humanities, International Relations Programme, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
                [3 ] Asian Institute of International Affairs and Diplomacy, Universiti Utara Malaysia, Sintok, Kedah, Malaysia
                [4 ] Faculty of Social Sciences and Humanities, History Programme, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
                Satyawati College (Eve.), University of Delhi, INDIA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0001-8683-8848
                Article
                PONE-D-22-04772
                10.1371/journal.pone.0270868
                9269452
                35802652
                05bc19cd-6a61-4c27-8b59-e81284c27885
                © 2022 Jafar et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 16 February 2022
                : 17 June 2022
                Page count
                Figures: 4, Tables: 9, Pages: 20
                Funding
                The author(s) received no specific funding for this work.
                Categories
                Research Article
                Medicine and Health Sciences
                Medical Conditions
                Infectious Diseases
                Infectious Disease Control
                Vaccines
                Medicine and Health Sciences
                Medical Conditions
                Infectious Diseases
                Viral Diseases
                Covid 19
                People and Places
                Geographical Locations
                Asia
                Malaysia
                Biology and Life Sciences
                Immunology
                Vaccination and Immunization
                Medicine and Health Sciences
                Immunology
                Vaccination and Immunization
                Medicine and Health Sciences
                Public and Occupational Health
                Preventive Medicine
                Vaccination and Immunization
                Social Sciences
                Sociology
                Communications
                Social Communication
                Social Media
                Computer and Information Sciences
                Network Analysis
                Social Networks
                Social Media
                Social Sciences
                Sociology
                Social Networks
                Social Media
                Medicine and Health Sciences
                Medical Conditions
                Infectious Diseases
                Infectious Disease Control
                Vaccines
                Viral Vaccines
                Biology and Life Sciences
                Microbiology
                Virology
                Viral Vaccines
                Medicine and Health Sciences
                Epidemiology
                Medical Risk Factors
                Research and Analysis Methods
                Mathematical and Statistical Techniques
                Statistical Methods
                Multivariate Analysis
                Principal Component Analysis
                Physical Sciences
                Mathematics
                Statistics
                Statistical Methods
                Multivariate Analysis
                Principal Component Analysis
                Custom metadata
                All relevant data are within the paper and its Supporting Information files.
                COVID-19

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