Acceptance of COVID-19 Vaccination and Vaccine Hesitancy Among People with Chronic Diseases in Thailand: Role of Attitudes and Vaccine Literacy Towards Future Implications

Introduction: Vaccination is an important strategy to prevent or reduce hospitalizations and mortality caused by COVID-19 infection. However, some people with chronic diseases are hesitant to get the COVID-19 vaccination. Objective: This study aimed to assess the acceptance of COVID-19 vaccination and associated factors among people with chronic diseases. Methods: A cross-sectional online survey was conducted between May and August 2021. A sample of 457 Thai adults living with one or more chronic diseases was drawn from a larger online survey. Results: Participants were 19 to 89 years old. The three most commonly reported chronic diseases were hypertension, diabetes, and obesity. The acceptance rate of COVID-19 vaccination was 89.1%. Forty-six percent of respondents had received the COVID-19 vaccination, and 43.1% intended to get the vaccine. Reasons for vaccine hesitancy/refusal included concerns about adverse side effects from the vaccines including long-term effects that might complicate their disease condition. Multiple logistic regression analyses revealed that having a bachelor's degree or higher [aOR 4.40; 95% CI: 2.12-9.14], being employed [aOR 2.11; 95% CI: 1.03-4.39], and having positive attitudes [aOR 2.36; 95% CI: 1.69-3.29] and negative attitudes [aOR 0.38; 95% CI: 0.27-0.55] predicted acceptance of the COVID-19 vaccination. Vaccine literacy was significantly associated with acceptance of COVID-19 vaccination in binary logistic regression analyses, but it was not retained in the multiple logistic regression model. Conclusion: Vaccine literacy and attitudes influence acceptance of COVID-19 vaccination in people with chronic diseases.