Determinant Factors of COVID-19 Vaccine Hesitancy Among Adult and Elderly Population in Central Java, Indonesia

PURPOSE: The Coronavirus disease (COVID-19) vaccination program has been rolled out to address the pandemic. However, the COVID-19 vaccination coverage rate in Indonesia, especially in Central Java, is low. The study aimed to identify COVID-19 vaccine acceptance and to determine the factors associated with COVID-19 vaccine hesitancy. PARTICIPANTS AND METHODS: A cross-sectional study was conducted from September to October 2021. A self-reported questionnaire was distributed to participants aged ≥ 18 years and living permanently in the area of study by the multistage sampling technique. Bivariate and multivariate analyses were performed to determine the association. All statistical tests were significantly considered if the p-value <0.05 at 95% confidence interval (CI). RESULTS: A total of 500 participants were eligible, with the age ranging from 18 to 76 years old. COVID-19 vaccine acceptance rate was 93.6%. In the multivariate logistic regression analysis, we found that the elderly (aOR=5.231; 95% CI=1.891–14.468), having comorbidity (aOR=4.808; 95% CI=1.975–11.706), not being exposed to information (aOR=7.039; 95% CI=2.072–23.908), not believing in the vaccine halalness (OR=3.802; 95% CI=1.272–11.364), not believing that vaccines could prevent the COVID-19 infection (OR=4.964; 95% CI=1.970–12.507), and having vaccination-related mild-moderate anxiety (OR=14.169; 95% CI=2.405–83.474) were more likely to have vaccine hesitancy (p<0.05). Place of residence, education level, belief that the vaccine could prevent the severe symptoms of COVID-19, and knowledge were significantly related to the vaccine acceptance in the bivariate analysis (p<0.05), but they were no longer significant in the multivariate (p>0.05). CONCLUSION: A high acceptance rate of the COVID-19 vaccine was found in this study. However, vaccine hesitancy is a major public health concern for attaining herd immunity and reducing the risk of case mortality. These findings could be the strategic focus for the government to improve COVID-19 vaccination coverage.