Introduction
Materials and methods
Study design and setting
Study population and sample size calculation
Study instrument
Independent variables – regimens of COVID-19 vaccine and demographic characteristics
Dependent variable – behavioural change post-vaccination
Pre-vaccination questions | Post-vaccination questions |
---|---|
How often did you wear a mask when going outside one month before getting vaccinated? | How often do you wear a mask when going outside one month after being fully vaccinated for two weeks? |
How often did you wash your hands after touching things in public one month before getting vaccinated? | How often do you wash your hands after touching things in public one month after being fully vaccinated for two weeks? |
How often did you keep a physical distance of 1–2 m one month before getting vaccinated? | How often did you keep a physical distance of 1–2 m one month after being fully vaccinated for two weeks? |
How often did you avoid social activity one month before getting vaccinated? | How often do you avoid social activity one month after being fully vaccinated for two weeks? |
Statistical analysis
Ethical considerations
Results
Participant characteristics
Socio-demographics data | n | Percentage (%) |
---|---|---|
Gender (n = 469) | ||
Female | 316 | 67.4 |
Male | 153 | 32.6 |
Marital status (n = 469) | ||
Single | 269 | 57.4 |
Married | 172 | 36.7 |
Divorced | 13 | 2.8 |
Widowed | 10 | 2.1 |
Other | 5 | 1.0 |
Age (years) (n = 447) | ||
18–24 | 127 | 28.4 |
25–44 | 142 | 31.8 |
45–59 | 128 | 28.6 |
≥ 60 | 50 | 11.2 |
Education (n = 468) | ||
Uneducated/Primary/Elementary school | 4 | 0.8 |
Secondary/High school or Vocational Certificate | 60 | 12.8 |
High Vocational Certificate | 30 | 6.4 |
Bachelor's Degree or higher | 374 | 80.0 |
Healthcare worker (n = 467) | ||
Non-healthcare worker | 324 | 69.4 |
Healthcare worker | 143 | 30.6 |
Residence area (n = 469) | ||
Urban | 315 | 67.2 |
Suburb | 99 | 21.1 |
Rural | 55 | 11.7 |
COVID-19 vaccine regimens (n = 469) | ||
Two-dose regimens | ||
1stAZD1222 / 2ndAZD1222 | 82 | 17.5 |
1stCoronaVac / 2ndAZD1222 | 66 | 14.0 |
1stBBIBP-CorV / 2ndBBIBP-CorV | 29 | 6.2 |
1stBNT162b2 / 2ndBNT162b2 | 24 | 5.1 |
1stCoronaVac / 2ndCoronaVac | 15 | 3.2 |
1stAZD1222 / 2ndBNT162b2 | 13 | 2.8 |
Three-dose regimens | ||
1stCoronaVac / 2ndCoronaVac / 3rdBNT162b2 | 69 | 14.7 |
1stCoronaVac / 2ndCoronaVac / 3rdAZD1222 | 38 | 8.1 |
1stAZD1222 / 2ndAZD1222 / 3rdBNT162b2 | 19 | 4.1 |
1stBBIBP-CorV / 2ndBBIBP-CorV / 3rdBNT162b2 | 15 | 3.2 |
Others | ||
Other regimens | 99 | 21.1 |
Protective behavioural change after COVID-19 vaccination
Protective behaviour | Score from 1 to 5, median (IQR) |
P-value | |
---|---|---|---|
Pre-vaccination behaviour | Post-vaccination behaviour | ||
Wearing mask when going outside | 5.0 (5.0, 5.0) | 5.0 (5.0, 5.0) | 0.096 |
Hand washing after touching | 5.0 (4.0, 5.0) | 5.0 (4.0, 5.0) | < 0.001 |
Physical distancing of 1–2 m | 4.0 (4.0, 5.0) | 5.0 (4.0, 5.0) | 0.019 |
Avoiding social activity | 4.0 (4.0, 5.0) | 5.0 (4.0, 5.0) | 0.010 |
Factor | Wearing mask when go outside (%) | Hand washing after touching (%) | Physical distancing 1–2 m (%) | Avoiding social activity (%) | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Unimproved | Improved |
P-value | Unimproved | Improved |
P-value | Unimproved | Improved |
P-value | Unimproved | Improved |
P-value | |||||
Unchanged | Decrease | Increase | Unchanged | Decrease | Increase | Unchanged | Decrease | Increase | Unchanged | Decrease | Increase | |||||
Total (
n
= 469)
| 92.1 | 5.5 | 2.4 | 79.5 | 7.8 | 12.7 | 82.9 | 3.2 | 13.9 | 71.7 | 10.9 | 17.4 | ||||
Gender
| ||||||||||||||||
Male (n = 153) | 84.3 | 10.5 | 3.3 | 0.567 | 80.4 | 6.5 | 13.1 | 1.000 | 81.0 | 3.9 | 14.4 | 0.909 | 64.7 | 11.8 | 22.9 |
0.036*
|
Female (n = 316) | 92.1 | 2.8 | 1.9 | 77.2 | 8.2 | 12.3 | 81.6 | 2.8 | 13.3 | 72.8 | 10.1 | 14.2 | ||||
Status
| ||||||||||||||||
Single (n = 269) | 88.5 | 5.2 | 3.0 | 0.485 | 76.2 | 8.9 | 13.4 | 0.850 | 80.7 | 2.2 | 14.9 | 0.252 | 68.0 | 13.4 | 16.7 | 0.257 |
Married (n = 172) | 90.7 | 5.8 | 1.7 | 80.8 | 5.8 | 11.6 | 80.8 | 5.2 | 13.4 | 72.1 | 5.8 | 19.2 | ||||
Others (Divorced, Widowed, Others) (n = 28) | 92.9 | 3.6 | 0.0 | 82.1 | 7.1 | 10.7 | 92.9 | 0.0 | 3.6 | 78.6 | 14.3 | 7.1 | ||||
Age group
| ||||||||||||||||
Early adult 18–24 (n = 127) | 85.0 | 7.1 | 3.1 | 0.361 | 68.5 | 13.4 | 15.7 | 0.234 | 74.8 | 3.9 | 18.1 | 0.295 | 64.6 | 15.0 | 18.1 | 0.191 |
Middle adult 25–44 (n = 142) | 93.0 | 2.8 | 1.4 | 83.1 | 7.0 | 8.5 | 83.1 | 0.7 | 14.8 | 72.5 | 12.7 | 13.4 | ||||
Late adult 45–59 (n = 128) | 90.6 | 4.7 | 3.1 | 78.9 | 5.5 | 15.6 | 87.5 | 2.3 | 10.2 | 77.3 | 5.5 | 16.4 | ||||
Elderly ≥ 60 (n = 50) | 88.0 | 8.0 | 0.0 | 80.0 | 4.0 | 12.0 | 76.0 | 6.0 | 14.0 | 60.0 | 10.0 | 26.0 | ||||
Education
| ||||||||||||||||
Vocational Certificate or below (n = 64) | 84.4 | 6.3 | 3.1 | 0.964 | 71.9 | 12.5 | 12.5 | 1.000 | 75.0 | 3.1 | 18.8 | 0.257 | 68.8 | 6.3 | 20.3 | 0.504 |
High Vocational Certificate or higher (n = 404) | 90.3 | 5.2 | 2.2 | 79.2 | 6.9 | 12.6 | 82.4 | 3.2 | 12.9 | 70.3 | 11.4 | 16.6 | ||||
Healthcare worker
| ||||||||||||||||
Non-healthcare worker (n = 324) | 88.9 | 5.6 | 2.8 | 0.566 | 80.2 | 6.2 | 11.7 | 0.490 | 79.0 | 3.4 | 15.7 | 0.072 | 69.4 | 8.3 | 19.8 |
0.029*
|
Healthcare worker (n = 143) | 90.9 | 4.9 | 1.4 | 73.4 | 11.2 | 14.7 | 86.7 | 2.8 | 9.1 | 71.3 | 16.1 | 11.2 | ||||
Accommodation
| ||||||||||||||||
Urban (n = 315) | 88.9 | 5.1 | 2.9 | 0.540 | 77.1 | 8.3 | 12.4 | 0.907 | 81.6 | 3.2 | 13.3 | 0.651 | 67.3 | 11.7 | 18.7 | 0.110 |
Suburb (n = 99) | 92.9 | 4.0 | 1.0 | 80.8 | 7.1 | 12.1 | 80.8 | 2.0 | 16.2 | 71.7 | 9.1 | 17.2 | ||||
Rural (n = 55) | 87.3 | 9.1 | 1.8 | 80.0 | 5.5 | 14.5 | 81.8 | 5.5 | 10.9 | 83.6 | 7.3 | 7.3 | ||||
Vaccine regimens
| ||||||||||||||||
2 doses
| 0.945 | 0.839 | 0.348 | 0.742 | ||||||||||||
1stAZD1222 / 2ndAZD1222 (n = 82) | 91.3 | 6.3 | 2.5 | 86.3 | 3.8 | 10.0 | 80.0 | 5.0 | 15.0 | 66.7 | 12.3 | 21.0 | ||||
1stCoronaVac / 2ndAZD1222 (n = 66) | 93.7 | 4.8 | 1.6 | 80.0 | 3.1 | 16.9 | 87.7 | 1.5 | 10.8 | 78.1 | 4.7 | 17.2 | ||||
1stBBIBP-CorV / 2ndBBIBP-CorV (n = 29) | 93.3 | 3.3 | 3.3 | 82.8 | 6.9 | 10.3 | 79.3 | 6.9 | 13.8 | 86.2 | 6.9 | 6.9 | ||||
1stBNT162b2 / 2ndBNT162b2 (n = 24) | 83.3 | 8.3 | 8.3 | 69.6 | 17.4 | 13.0 | 77.3 | 4.5 | 18.2 | 59.1 | 18.2 | 22.7 | ||||
1stCoronaVac / 2ndCoronaVac (n = 15) | 100.0 | 0.0 | 0.0 | 73.3 | 6.7 | 20.0 | 73.3 | 0.0 | 26.7 | 66.7 | 13.3 | 20.0 | ||||
1stAZD1222 / 2ndBNT162b2 (n = 13) | 73.3 | 13.3 | 13.3 | 84.6 | 7.7 | 7.7 | 92.3 | 0.0 | 7.7 | 84.6 | 7.7 | 7.7 | ||||
3 doses
| ||||||||||||||||
1stCoronaVac / 2ndCoronaVac / 3rdBNT162b2 (n = 69) | 88.1 | 6.0 | 6.0 | 74.6 | 10.4 | 14.9 | 79.1 | 1.5 | 19.4 | 74.6 | 10.4 | 14.9 | ||||
1stCoronaVac / 2ndCoronaVac / 3rdAZD1222 (n = 38) | 94.7 | 2.6 | 2.6 | 76.3 | 5.3 | 18.4 | 92.1 | 2.6 | 5.3 | 78.9 | 5.3 | 15.8 | ||||
1stAZD1222 / 2ndAZD1222 / 3rdBNT162b2 (n = 19) | 100.0 | 0.0 | 0.0 | 84.2 | 10.5 | 5.3 | 68.4 | 5.3 | 26.3 | 84.2 | 5.3 | 10.5 | ||||
1stBBIBP-CorV / 2ndBBIBP-CorV / 3rdBNT162b2 (n = 15) | 100.0 | 0.0 | 0.0 | 85.7 | 0.0 | 14.3 | 85.7 | 0.0 | 14.3 | 57.1 | 14.3 | 28.6 | ||||
Others
| ||||||||||||||||
Others (n = 99) | 90.7 | 7.2 | 2.1 | 77.8 | 12.1 | 10.1 | 85.9 | 4.0 | 10.1 | 63.9 | 16.5 | 19.6 |
Predicting factors of improved protective behaviours after COVID-19 vaccination
Factor | Adjusted OR (95% CI) | |||
---|---|---|---|---|
Wearing mask when go outside
|
Hand washing after touching
|
Physical distancing 1–2 m
|
Avoiding social activity
| |
Gender (ref. = female)
| ||||
Male | 2.13 (0.54–8.44) | 1.17 (0.63–2.19) | 0.89 (0.47–1.68) | 1.58 (0.90–2.76) |
Marital status (ref. = single)
| ||||
Married | 0.71 (0.11–4.61) | 1.44 (0.63–3.31) | 1.00 (0.45–2.25) | 1.12 (0.53–2.37) |
Other | < 0.01 (0.00-inf) | < 0.01 (0.00-inf) | 0.89 (0.20–3.39) | 2.81 (0.05–1.44) |
Age group (ref. = middle adult, 25–44 years)
| ||||
Early adult (18–24 years) | 2.43 (0.22–27.48) | 1.29 (0.45–3.74) |
3.93 (1.26–12.27)*
| 2.36 (0.84–6.60) |
Late adult (45–59 years) | 2.53 (0.37–17.18) | 0.59 (0.26–1.38) | 1.99 (0.86–4.65) | 1.33 (0.61–2.90) |
Elderly (≥ 60 years) | < 0.01 (0-inf) | 4.09 (0.10–1.62) | 2.17 (0.58–8.09) | 2.9 (0.97–8.67) |
Education (ref. = high vocational certificate or higher)
| ||||
Vocational certificate or lower | 2.71 (0.36–20.64) | 1.57 (0.66–3.88) | 0.81 (0.29–2.23) | 2.10 (0.90,4.91) |
Healthcare worker (ref. = healthcare worker)
| ||||
Non-healthcare worker | 2.81 (0.45–17.54) |
4.31 (1.72–10.94)*
| 0.88 (0.41–1.90) |
2.45 (1.13–5.33)*
|
Accommodation (ref. = rural)
| ||||
Urban | 4.29 (0.32–57.21) | 1.42 (0.49–4.12) | 0.89 (0.34–2.32 |
3.60 (1.11–11.64)*
|
Suburb | 0.72 (0.03–16.37) | 1.52 (0.48–4.84) | 1.19 (0.41–3.50) | 2.63 (0.75–0.92) |
Vaccine regimens (ref. = 1
st
AZD1222 / 2
nd
AZD1222)
| ||||
2 doses
| ||||
1stCoronaVac / 2ndAZD1222 | 0.3 (0.01–6.32) | 0.67 (0.22–2.13) | 3.07 (0.98–9.58) | 0.99 (0.49–3.75) |
1stBBIBP-CorV / 2ndBBIBP-CorV | < 0.01 (0.00-inf) | 1.19 (0.29–4.67) | 1.39 (0.30–6.53) | 0.50 (0.09–2.76) |
1stBNT162b2 / 2ndBNT162b2 | 2.69 (0.13–56.65) | 1.45 (0.29–7.12) | 2.30 (0.46–11.41) | 1.30 (0.27–6.22) |
1stCoronaVac / 2ndCoronaVac | 3.1 (0.22–44.62) | 2.71 (0.68,11.73) | 2.63 (0.54–12.80) | 1.81 (0.41–8.01) |
1stAZD1222 / 2ndBNT162b2 | < 0.01 (0.00-inf) | 0.9 (0.09–8.43) | 0.85 (0.09–8.20) | 0.57 (0.06–5.31) |
3 doses
| ||||
1stCoronaVac / 2ndCoronaVac / 3rdBNT162b2 | 1.3 (0.14–11.99) | 2.61 (0.88–7.63) | 1.42 (0.42–4.78) | 1.50 (0.52–4.31) |
1stCoronaVac / 2ndCoronaVac / 3rdAZD1222 | 0.73 (0.06–9.60) | 0.48 (0.10–2.48) | 1.85 (0.54–6.40) | 0.99 (0.30–3.27) |
1stAZD1222 / 2ndAZD1222 / 3rdBNT162b2 | 1.08 (0.46–256.53) | 2.02 (0.42–10.02) | 0.57 (0.06–5.28) | 0.21 (0.02–1.91) |
1stBBIBP-CorV / 2ndBBIBP-CorV / 3rdBNT162b2 | < 0.01 (0.00-inf) | 0.93 (0.15–5.76) | 0.86 (0.09–8.48) | 0.29 (0.65–12.69) |
Other regimens
| ||||
Others | 1.09 (0.13–8.96) | 0.84 (0.30–2.31) | 0.82 (0.27–2.52) | 1.67 (0.71–3.95) |