Published: 2022-01-28

Attitude and practice towards COVID-19 vaccination among healthcare workers in Kerala

Enid Elizabeth Thomas, Jayasree Anandabhavan Kumaran


Background: COVID-19 is a major public health challenge for the whole world. The introduction of vaccines in such a short span of time is a great achievement, but this has also received mistrust and hesitance among the public as well as Healthcare workers (HCW).

Methods: This was a descriptive study done during the period of April 2021-May 2021 to assess the attitude and practice towards COVID-19 vaccination among HCW in Kerala. Data was collected using a semi structured questionnaire and the data was analyzed using Epi info software.

Results: The study was done among 126 HCW whose mean age was 31.60±7.8 SD years. Majority (91.3%) agreed that COVID-19 vaccine is necessary to control the pandemic and 81.7% had already taken and 11.1% were planning to take soon. Duration of protection (61.1%), protection against new strains (57.1%), inadequate studies on long term effects (47.6%) and inadequate clinical trials (26.9%) were the most common concerns. 79.6% had experienced adverse effects following vaccination. Fever (51.4%), injection site pain (45.6%) and myalgia (41.7%) were the most common adverse effects experienced.

Conclusions: Most of the HCW had positive attitude and practice towards COVID-19 vaccination. Only minor adverse effects were reported. But there were still concerns regarding the same which should be addressed.


Attitude, Practice, COVID-19 vaccination, Health care workers

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WHO. Coronavirus disease 2019 (COVID-19) Situation Report-94 highlights, 2020. Available at: Accessed on 20 November 2021.

WHO. WHO Coronavirus Disease (COVID-19) Dashboard, 2021. Available at: https://covid19. Accessed on 20 November 2021.

Government of Kerala. Dashboard Official Kerala COVID-19 Statistics, 2021. Available at: Accessed on 20 November 2021.

WHO. Responding to COVID-19 - Learnings from Kerala, 2020. Available at: india/news/featurestories/detail/responding-to-c-learnings-from-kerala. Accessed on 20 November 2021.

Mongabay. After early success, Kerala stumbles in containing the COVID-19 pandemic, 2020. Available at: Accessed on 20 November 2021.

WHO. Summary WHO SAGE conclusions and recommendations on Vaccine Hesitancy-Guide-to-Tailoring-Immunization-Programmes-TIP, 2015. Available at: sage/meetings/2014/october/2_SAGE_Appendicies_Background_final.pdf?ua=12 Accessed on 20 November 2021.

Ipsos. Global attitudes on a COVID-19 vaccine, 2020. Available at: global-attitudes-covid-19-vaccine-december-2020. Accessed on 20 November 2021.

MoHFW. Information Regarding COVID-19 Vaccine, 2021. Available at: https://www.mohfw. Accessed on 20 November 2021.

Shekhar R, Sheikh AB, Upadhyay S, Singh M, Kottewar S, Mir H, et al. COVID-19 Vaccine Acceptance among Health Care Workers in the United States. Vaccines (Basel). 2021;9(2):119.

Dzieciolowska S, Hamel D, Gadio S, Dionne M, Gagnon D, Robitaille L, et al. Covid-19 vaccine acceptance, hesitancy, and refusal among Canadian healthcare workers: A multicenter survey. Am J Infect Control. 2021;49(9):1152-7.

Fares S, Elmnyer MM, Mohamed SS, Elsayed R. COVID-19 Vaccination Perception and Attitude among Healthcare Workers in Egypt. J Prim Care Community Health. 2021;12:21501327211013303.

Elhadi M, Alsoufi A, Alhadi A, Hmeida A, Alshareea E, Dokali M, et al. Knowledge, attitude, and acceptance of healthcare workers and the public regarding the COVID-19 vaccine: a cross-sectional study. BMC Public Health. 2021;21(1):955.

Hajure M, Tariku M, Bekele F, Abdu Z, Dule A, Mohammedhussein M, et al. Attitude Towards COVID-19 Vaccination Among Healthcare Workers: A Systematic Review. Infect Drug Resist. 2021;14:3883-97.

Biswas N, Mustapha T, Khubchandani J, Price JH. The Nature and Extent of COVID-19 Vaccination Hesitancy in Healthcare Workers. J Community Health. 2021;46(6):1244-51.

Jain J, Saurabh S, Kumar P, Verma MK, Goel AD, Gupta MK, et al. COVID-19 vaccine hesitancy among medical students in India. Epidemiol Infect. 2021;149:132.

Kabamba NM, Kabamba NL, Ngoie MG, Banza NDB, Mbidi MJ, Luhata LC, et al. Acceptability of Vaccination Against COVID-19 Among Healthcare Workers in the Democratic Republic of the Congo. Pragmat Obs Res. 2020;11:103-9.

Li M, Luo Y, Watson R, Zheng Y, Ren J, Tang J, Chen Y. Healthcare workers' (HCWs) attitudes and related factors towards COVID-19 vaccination: a rapid systematic review. Postgrad Med J. 2021;140195.

Joshi A, Sridhar M, Tenneti VJD, Devi V, Nallaperumal AB. COVID-19 Vaccine Hesitancy in Healthcare Workers Amidst the Second Wave of the Pandemic in India: A Single Centre Study. Cureus. 2021;13(8):17370.

Metwali BZ, Jumaili AA, Alag ZA, Sorofman B. Exploring the acceptance of COVID-19 vaccine among healthcare workers and general population using health belief model. J Eval Clin Pract. 2021;27(5):1112-2.

Singhania N, Kathiravan S, Pannu AK. Acceptance of coronavirus disease 2019 vaccine among health-care personnel in India: a cross-sectional survey during the initial phase of vaccination. Clin Microbiol Infect. 2021;27(7):1064-6.

Malik AA, Fadden SM, Elharake J, Omer SB. Determinants of COVID-19 vaccine acceptance in the US. E Clin Med. 2020;26:100495.

Gennaro F, Murri R, Segala FV, Cerruti L, Abdulle A, Saracino A, et al. Attitudes towards Anti-SARS-CoV2 Vaccination among Healthcare Workers: Results from a National Survey in Italy. Viruses. 2021;13(3):371.

MOHFW. Common Side Effects (AEFI) of COVID-19 Vaccine, 2019. Available at: Accessed on 20 November 2021.

Riad A, Pokorná A, Attia S, Klugarová J, Koščík M, Klugar M. Prevalence of COVID-19 Vaccine Side Effects among Healthcare Workers in the Czech Republic. J Clin Med. 2021;10(7):1428.

Pokharel K, Dawadi BR, Karki A. Side Effects after Second Dose of Covishield Vaccine among Health Care Workers: A Descriptive Cross Sectional Study. JNMA J Nepal Med Assoc. 2021;59(238):577-9.

Sultana A, Shahriar S, Tahsin MR, Mim SR, Fatema KR, Saha A, et al. A Retrospective Cross-Sectional Study Assessing Self-Reported Adverse Events following Immunization (AEFI) of the COVID-19 Vaccine in Bangladesh. Vaccines (Basel). 2021;9(10):1090.