COVID-19 vaccination hesitancy in rural setting of Western India: A cross-sectional study

Background and Aim: The low acceptance rate of the vaccine in rural India has been acting as a hurdle to achieving herd immunity against multiple active variants of coronavirus. A large section of the rural population is prone to COVID-19 infection due to their negative perception of vaccination and their inability to access it. Therefore, this study aims to evaluate acceptance rate of the vaccine along with the major factors determining the non-receptivity of the COVID-19 vaccine among rural people. Methods: A hospital-based cross-sectional study was conducted in rural Rajasthan from August to November 2021. Out of 138 participants, 110 rural adults from different villages who were not yet vaccinated were interviewed using a semi-structured schedule. The characteristics of participants and factors determining COVID-19 vaccination hesitancy were assessed using MS Excel 2021 and STATA 13.1. Results: The side effects of the COVID-19 vaccine were the major reason for hesitancy among respondents (71%). Many respondents (51%) reported that the vaccine portal was not user-friendly and not working properly; in addition, the volatility of the network makes slot booking more difficult. Due to the shortage of vaccines and the absence or low numbers of medical staff, some respondents (>40%) attributed the inefficacy of health care centers as a cause for not getting vaccinated. Fifty-three percentage of respondents rejected the vaccine due to political orientation, and ~40% believed that the vaccine was being tested first on poor rural people. Lack of awareness and ignorance led to half of the population postponing it. Thirty-five percentage of them argued that the vaccine does not cure COVID-19, and 37% feared that the vaccine could lead to death. Many women (56%) were dependent on men or elders for access to health care centers and considered it necessary for men only. Conclusion: The findings of this study highlight the major hurdles to ensuring the equitable coverage of vaccination in rural India, which reflect the urgent need for awareness campaigns and door-to-door vaccination to prevent community transmission among the rural population of India.