Demographic and KAP determinants of COVID-19 vaccine hesitancy and vaccine refusal: a cross-sectional study in Indian population

Meghna Gupta, Rohit Goyal, Shruti Aggarwal, Mansunderbir Singh, Vitull K. Gupta, Nikita Garg


Background: Recent rise in vaccine non-acceptance is a threat to global health, especially with the ongoing   COVID-19 pandemic. Examining the intentions of the Indian population towards the COVID-19 vaccine and the determinants of vaccine hesitancy and vaccine refusal is of utmost importance.

Methods: We conducted a cross-sectional web-based anonymous survey, using pre-validated questionnaires. Demographic and knowledge, attitude, and practice characteristics were collected, and a binary logistic regression was applied to analyse the association between these characteristics and the participants’ intention to for the COVID-19 vaccine. Reasons for vaccine non-acceptance were then determined using a pre-validated vaccine hesitancy questionnaire.

Results: Out of the 1172 non-vaccinated participants, 190 (16.2%) refused vaccination, and 219 (18.6%) were hesitant. Adequate knowledge about the COVID-19 disease, made people less likely to be hesitant for vaccination (OR=0.39; 95% CI=0.27-0.57), and less likely to refuse it (OR=0.41; 95% CI=0.27-0.61). Females had a higher tendency to refuse the vaccination (OR=1.47; 95% CI=1.02-2.14), or to be hesitant for it (OR=1.80; 95% CI=1.29-2.52). Social media played an important role in decreasing vaccination refusal (OR=0.40; 95% CI=0.22-0.73), when compared to evidence-based literature.

Conclusions: Knowledge about the COVID-19 disease can help people make a more informed decision towards vaccination, and social media can be utilised as a medium to address the gaps in knowledge of the Indian population.


COVID-19, KAP, India, Survey, Vaccine hesitancy, Vaccine refusal

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