Empowering Education: Addressing Vaccination Hesitancy in The Covid-19 Era

Abstract

The COVID-19 pandemic started in 2019 with the emergence of a new coronavirus and has greatly affected societies worldwide. It has led to an increase in mortality rates, disturbed pre-existing health conditions, disrupted educational systems, and reduced global workforce productivity and production. The scientific community has expedited vaccine development to combat the pandemic. However, the emergence of various vaccines has paradoxically resulted in a decline in public confidence, contributing to anti-vaccine sentiments. This study explores the pivotal role of education in fortifying vaccination rates and seeks to identify effective strategies to address hesitancy and strengthen public health measures. This research uses the two-stage least squares (2SLS) methodology to analyze the “Learning Loss Covid-19” cross-sectional dataset, which the World Bank published on January 4, 2023. The investigation focuses on the relationship between “Vaccination rate (per person)” and “Year of Education” across 41 countries. The empirical findings show that education has a significant impact on vaccination rates. An increase of one year in educational attainment leads to an approximate 14% increase in doses administered per person and a substantial 23% surge in the average dosage across nations. Therefore, education plays a crucial role in fortifying and elevating vaccination rates, demonstrating its significance as a potent tool in global public health endeavours.

Keywords

• Health Economics
• Education
• IV Estimators
• COVID-19
• Vaccination Hesitancy

Eğitimin Güçlendirilmesi: Covid-19 Döneminde Aşı Tereddüdünün Ele Alınması

Öz

2019 yılında yeni bir korona virüsün ortaya çıkmasıyla başlayan COVİD-19 salgını, dünya çapında toplumlar üzerinde derin etkiler yarattı. Bununla birlikte, çeşitli aşıların ortaya çıkması, paradoksal olarak halkın güveninin azalmasına yol açarak aşı karşıtlığının artmasına neden oldu. Bu çalışma, aşılama oranlarının artırılmasında, tereddütlerin gidermesinde ve halk sağlığı önlemlerini güçlendirmede eğitimin rolünü belirlemeyi amaçlıyor. Araştırmada, Dünya Bankası tarafından yayınlanan 41 ülkenin yer aldığı “Learning Loss Covid-19” yatay kesit veri setinden yararlanılmıştır. Ayrıca, “Aşılama oranı (kişi başına)” ile “Eğitim Yılı” arasındaki ilişkiyi analiz etmek için iki aşamalı en küçük kareler (2SLS) yöntemini kullanılmıştır. Ampirik bulgular, eğitim düzeyindeki bir yıllık artış, kişi başına uygulanan dozlarda yaklaşık %14'lük bir artışa ve ülkeler genelinde ortalama dozda %23'lük bir artışa yol açmaktadır. Bu nedenle eğitim, aşılama oranlarının güçlendirilmesinde ve artırılmasında önemli bir rol oynamakta ve küresel halk sağlığı çalışmalarında güçlü bir araç olarak önemini ortaya koymaktadır.

Anahtar Kelimeler

• Sağlık Ekonomisi
• Eğitim
• IV Tahmin Edicileri
• COVİD-19
• Aşı Tereddüdü

Kaynakça

1. Abdulah, D. M. (2021). Prevalence and Correlates of COVID‐19 Vaccine Hesitancy in The General Public in Iraqi Kurdistan: A Cross‐Sectional Study. Journal of Medical Virology, 93(12), 6722-6731.
2. Barello, S., Nania, T., Dellafiore, F., Graffigna, G., and Caruso, R. (2020). ‘Vaccine Hesitancy’ Among University Students in Italy During The COVID-19 Pandemic. European Journal of Epidemiology, 35, 781-783.
3. Basmann, R. L. (1957). A Generalized Classical Method of Linear Estimation of Coefficients in a Structural Equation. Econometrica, 25(1), 77–83.
4. Basmann, R. L. (1959). The Computation of Generalized Classical Estimates of Coefficients in A Structural Equation. Econometrica: Journal of The Econometric Society, 27(1), 72-81.
5. Basmann, R. L. (1960). On Finite Sample Distributions of Generalized Classical Linear Identifiability Test Statistics. Journal of The American Statistical Association, 55(292), 650-659.
6. Blume, S. (2006). Anti-Vaccination Movements and Their Interpretations. Social Science & Medicine, 62(3), 628-642.
7. Bobo, J. K., Gale, J. L., Thapa, P. B., and Wassilak, S. G. (1993). Risk Factors for Delayed Immunization in A Random Sample of 1163 Children from Oregon and Washington. Pediatrics, 91(2), 308-314.
8. Burroway, R., and Hargrove, A. (2018). Education Is the Antidote: Individual-And Community-Level Effects of Maternal Education On Child Immunizations in Nigeria. Social Science & Medicine, 213, 63-71.

9. Danis, K., Georgakopoulou, T., Stavrou, T., Laggas, D., and Panagiotopoulos, T. (2010). Socioeconomic Factors Play a More Important Role in Childhood Vaccination Coverage Than Parental Perceptions: A Cross-Sectional Study in Greece. Vaccine, 28(7), 1861-1869.
10. Detoc, M., Bruel, S., Frappe, P., Tardy, B., Botelho-Nevers, E., and Gagneux-Brunon, A. (2020). Intention to Participate in a COVID-19 Vaccine Clinical Trial and to Get Vaccinated Against COVID-19 In France During the Pandemic. Vaccine, 38(45), 7002-7006.
11. Dror, A. A., Eisenbach, N., Taiber, S., Morozov, N. G., Mizrachi, M., Zigron, A., ... and Sela, E. (2020). Vaccine Hesitancy: The Next Challenge in The Fight Against COVID-19. European Journal of Epidemiology, 35, 775-779.
12. Dubé, E., Laberge, C., Guay, M., Bramadat, P., Roy, R., & Bettinger, J. A. (2013). Vaccine Hesitancy: An Overview. Human Vaccines & Immunotherapeutics, 9(8), 1763-1773.
13. Durbin, J. (1954). Errors in Variables. Revue De l’Institut International De Statistique. Review of The International Statistical Institute, 22(1/3), 23–32.
14. Fine, P. E. (1993). Herd Immunity: History, Theory, Practice. Epidemiologic Reviews, 15(2), 265-302.
15. Fisher, K. A., Bloomstone, S. J., Walder, J., Crawford, S., Fouayzi, H., and Mazor, K. M. (2020). Attitudes Toward a Potential SARS-COV-2 Vaccine: A Survey of US Adults. Annals of Internal Medicine, 173(12), 964-973.
16. Graffigna, G., Palamenghi, L., Boccia, S., and Barello, S. (2020). Relationship Between Citizens’ Health Engagement and Intention to Take The COVID-19 Vaccine in Italy: A Mediation Analysis. Vaccines, 8(4), 576.
17. Hak, E., Schönbeck, Y., De Melker, H., Van Essen, G. A., and Sanders, E. A. (2005). Negative Attitude of Highly Educated Parents and Health Care Workers Towards Future Vaccinations in The Dutch Childhood Vaccination Program. Vaccine, 23(24), 3103-3107.
18. Hansen, L. P. (1982). Large Sample Properties of Generalized Method of Moments Estimators. Econometrica, 50(4), 1029–1054.
19. Hausman, J. A. (1978). Specification Tests in Econometrics. Econometrica: Journal of The Econometric Society, 46(6), 1251-1271.
20. Kaim, A., Siman-Tov, M., Jaffe, E., and Adini, B. (2021). Effect of A Concise Educational Program On COVID-19 Vaccination Attitudes. Frontiers in Public Health, 9, 767447.
21. Kreps, S., Prasad, S., Brownstein, J. S., Hswen, Y., Garibaldi, B. T., Zhang, B., and Kriner, D. L. (2020). Factors Associated with US Adults’ Likelihood of Accepting COVID-19 Vaccination. JAMA Network Open, 3(10), E2025594-E2025594.
22. Kricorian, K., Civen, R., and Equils, O. (2022). COVID-19 Vaccine Hesitancy: Misinformation and Perceptions of Vaccine Safety. Human Vaccines & Immunotherapeutics, 18(1), 1950504.
23. Lazarus, J. V., Wyka, K., Rauh, L., Rabin, K., Ratzan, S., Gostin, L. O., ... and El-Mohandes, A. (2020). Hesitant or Not? The Association of Age, Gender, And Education with Potential Acceptance of A COVID-19 Vaccine: A Country-Level Analysis. Journal of Health Communication, 25(10), 799-807.
24. Newbold, S. C., Finnoff, D., Thunström, L., Ashworth, M., and Shogren, J. F. (2020). Effects of Physical Distancing to Control COVID-19 On Public Health, The Economy, And The Environment. Environmental and Resource Economics, 76, 705-729.
25. Nuzhath, T., Tasnim, S., Sanjwal, R. K., Trisha, N. F., Rahman, M., Mahmud, S. F., ... and Hossain, M. M. (2020). COVID-19 Vaccination Hesitancy, Misinformation and Conspiracy Theories On Social Media: A Content Analysis of Twitter Data. Access address: https://osf.io/preprints/socarxiv/vc9jb
26. Olagoke, A. A., Olagoke, O. O., and Hughes, A. M. (2021). Intention to Vaccinate Against the Novel 2019 Coronavirus Disease: The Role of Health Locus of Control and Religiosity. Journal of Religion and Health, 60, 65-80.
27. Orenstein, W. A., and Ahmed, R. (2017). Simply Put: Vaccination Saves Lives. Proceedings of The National Academy of Sciences, 114(16), 4031-4033.
28. Palamenghi, L., Barello, S., Boccia, S., and Graffigna, G. (2020). Mistrust in Biomedical Research and Vaccine Hesitancy: The Forefront Challenge in The Battle Against COVID-19 In Italy. European Journal of Epidemiology, 35, 785-788.
29. Plotkin, S. L., and Plotkin, S. A. (2012). A Short History of Vaccination. Vaccines. Access address: https://www.sciencedirect.com/science/article/abs/pii/B9781455700905000173?via%3Dihub
30. Pogue, K., Jensen, J. L., Stancil, C. K., Ferguson, D. G., Hughes, S. J., Mello, E. J., ... and Poole, B. D. (2020). Influences On Attitudes Regarding Potential Covid-19 Vaccination in The United States. Vaccines, 8(4), 582.
31. Puri, N., Coomes, E. A., Haghbayan, H., and Gunaratne, K. (2020). Social Media and Vaccine Hesitancy: New Updates for The Era of Covid-19 And Globalized Infectious Diseases. Human Vaccines & Immunotherapeutics, 16(11), 2586-2593.
32. Salali, G. D., and Uysal, M. S. (2022). Covid-19 Vaccine Hesitancy Is Associated with Beliefs On the Origin of the Novel Coronavirus in The UK and Turkey. Psychological Medicine, 52(15), 3750-3752.
33. Salmon, D. A., Haber, M., Gangarosa, E. J., Phillips, L., Smith, N. J., and Chen, R. T. (1999). Health Consequences of Religious and Philosophical Exemptions from Immunization Laws: Individual and Societal Risk of Measles. Jama, 282(1), 47-53.
34. Sargan, J. D. (1958). The Estimation of Economic Relationships Using Instrumental Variables. Econometrica: Journal of The Econometric Society, 26(3), 393-415.
35. Stock, J. H., Wright, J. H., and Yogo, M. (2002). A Survey of Weak Instruments and Weak Identification in Generalized Method of Moments. Journal of Business & Economic Statistics, 20(4), 518-529.
36. Troiano, G., and Nardi, A. (2021). Vaccine Hesitancy in The Era of COVID-19. Public Health, 194, 245-251.
37. Zhang, S., Yin, Z., Suraratdecha, C., Liu, X., Li, Y., Hills, S., ... and Liang, X. (2011). Knowledge, Attitudes and Practices of Caregivers Regarding Japanese Encephalitis in Shaanxi Province, China. Public Health, 125(2), 79-83.
38. Wakefield, A. J., Murch, S. H., Anthony, A., Linnell, J., Casson, D. M., Malik, M., ... and Walker-Smith, J. A. (1998). Retracted: Ileal-Lymphoid-Nodular Hyperplasia, Non-Specific Colitis, And Pervasive Developmental Disorder in Children. The Lancet, 351(9103), 637-641.
39. Wei, F., Mullooly, J. P., Goodman, M., Mccarty, M. C., Hanson, A. M., Crane, B., and Nordin, J. D. (2009). Identification and Characteristics of Vaccine Refusers. Bmc Pediatrics, 9, 1-9.
40. Wilson, S. L., and Wiysonge, C. (2020). Social Media and Vaccine Hesitancy. Bmj Global Health, 5(10), E004206.
41. Wooldridge, J. M. (1995). Score Diagnostics for Linear Models Estimated by Two Stage Least Squares. Advances in Econometrics and Quantitative Economics: Essays in Honor of Professor Cr Rao, 66-87.
42. World Bank (2023). Learning Loss COVID-19 2020-2022. Access Address: Https://Doi.Org/10.48529/Wbnm-Cn45 World Health Organization. Immunization Agenda 2030: A Global Strategy to Leave No One Behind. Geneva: World Health Organization; 2020. Access Address: Https://Www.Immunizationagenda2030.Org/.
43. Wu, D. M. (1974). Alternative Tests of Independence Between Stochastic Regressors and Disturbances: Finite Sample Results. Econometrica: Journal of The Econometric Society, 42(3), 529-546.