FCHAPTER I

THE PROBLEM AND ITS SETTING

Introduction

COVID-19 has taken a heavy toll on rural livelihoods. Loss of income and

job opportunities were overarching challenges in poor communities in the

Philippines. The COVID-19 is potentially a severe acute respiratory infection

caused by SARS-CoV 2. It has made an impact both in terms of morbidity and

mortality across countries and continents; declared a Public Health Emergency of

International Concern (PHEIC) and later a pandemic.

In the last months, after the outbreak of a new coronavirus infection

(COVID-19) on 31 December 2019 among humans in Wuhan (China), an

increasing amount of information and concerns are impacting on global mental

health. Global media, local and international health organizations (including

World Health Organization), epidemiologists, virologists and opinion-makers put

out information, recommendations and minute-by-minute updates on COVID-19

spreading and lethality. Never-the less, the burden of this infection on the global

mental health is currently neglected even if it may challenge patients, general

population, as well as policy makers and health organizations and teams.

The city of Wuhan in China is in the spotlight since December 2019

because of the outbreak of a febrile respiratory syndrome due to a pneumonia

caused by a new unknown coronavirus (Li et al., 2020) possibly linked to a

wholesale seafood market in Huanan (Y. Chen, Liu, & Guo, 2020).

Chinese health authorities have employed rapid public health measures,

including intensive surveillance, epidemiological investigation and the closure of

the markets on January 1, 2020 (N. Chen, Zhou, et al., 2020). Severe acute

respiratory syndrome due to coronavirus (SARS-CoV), Middle Eastern

Respiratory Syndrome due to coronavirus (MERS-CoV), avian influenza and

other common respiratory viruses (Centers for Disease Control and Prevention,

2020) were rapidly ruled out.

The new coronavirus (SARS-CoV-2, initially named 2019-nCoV) has been

isolated from a patient in a short time on January 7, 2020, and the genome

sequencing of this virus has been performed (Lu et al., 2020). The genetic

sequence of SARS-CoV-2 has been officially recognized by World Health

Organization (WHO) on January 12, 2020, and this has led to the development of

specific polymerase chain reaction PCR-based diagnostic tests to detect the new

infection in different countries (Corman et al., 2020). SARS-CoV-2, previously

indicated as an unknown beta-coronavirus, is the seventh member of

coronaviruses’ family which infects humans, different from both MERS-CoV and

SARS-CoV, SARS-CoV-2 (Zhu et al., 2020). This outbreak is possibly related to

the sale of bush meat derived from wild or captive sources in the seafood market

(Cui et al., 2019).

Statement of the Problem

This study will determine the factors associated with vaccine confidence

and acceptance on COVID-19 of LGU at Tampakan, South Cotabato.

Specifically, this study will seek to answer the following questions:

1. What are the profiles of the respondents in terms of;

a. age;

b. gender;

c. civil status; and

d. position

e. years of service

2. What are the factors associated with vaccination confidence on COVID-19.

3. What are their level of acceptance?

4. Is there a significant relationship between the factors associated with vaccine

confidence and the level of acceptance of LGU at Tampakan South Cotabato?

Review of Related Literature

Even if the impact of this epidemic on global mental health is not

registered and measured, similar information may be derived by previous

experiences with coronavirus infections. During the Korean MERS-CoV outbreak

in 2015, patients were treated with hemodialysis in an isolated environment.

Patients reported decreased values in their hematocrit, calcium and phosphorus

levels after 2 weeks of isolation. Also, the levels of circulating cell-free genomic

DNA (ccf-gDNA) and circulating cell-free mitochondria DNA (ccf-mtDNA), which

are indicators of psychophysical stress in humans, have shown a significant

delay in their normalization during the hemodialysis among patients when

compared with controls’ group. This implies that medical isolation during the

Korean MERS outbreak has caused high level of stress in hemodialyzed patients

(Kim et al., 2019). This should be considered since the Chinese government is

undergoing one of the biggest lockdowns in public health history (Guerriero et al.,

2014) and security measures mostly consist of isolating large segments of the

population. Isolation may be protective in many circumstances such as terrorist

attacks, and previous experiences with an increase of mental distress during

these events have been described (Fagan et al., 2003). Also, a 3.4-fold increase

in incidence of functional neurological symptom disorder has been reported after

the city-wide lockdown following the Boston Marathon bombings (Guerriero et al.,

2014). Care providers must be aware of functional neurological symptom

disorders after stressful community events particularly in individuals with prior

psychiatric diagnoses (Jeong et al., 2016).

Mental health support and follow-up should be provided even 6 months

after the release from isolation for those individuals with prior vulnerable mental

health status. Support should include accurate information as well as appropriate

supplies for the subjects, including food, clothes and accommodation, if needed

(Lin et al., 2007).

 Also, health care providers may develop psychiatric disorders after coping

with stressful community events. In 2003, during the SARS-CoV outbreak in

Singapore, 27% of health care workers reported psychiatric symptoms (Lee et

al., 2018). Medical staff that performed MERS-related tasks showed post-

traumatic stress disorder symptoms after the Korean outbreak of 2015. As

described, the rate of symptoms increased even after the isolation (home

quarantine). Early and continuous psychiatric interventions were delivered by the

mental health team coping with the outbreak, as suggested in the occurrence of

high mortality infectious disease outbreaks (Shantanu & Kearsley, 2020).

Similarly, during the Ebola outbreaks in Sierra Leone in 2014 and in the

Democratic Republic of the Congo in 2018, medical staff reported high levels of

anxiety and the impact of stigma among those who were in direct contact with

infected patients (Park et al., 2018).

During the 2003 SARS-CoV outbreak in Taiwan, most of the staff in the

emergency department and in the psychiatric ward developed post-traumatic

stress disorder (PTSD). Also, emergency department staff have shown more

severe PTSD symptoms than staff in the psychiatric ward (Lee et al., 2018).

Emergency professional, in fact, reported the feeling of interpersonal isolation

and the fear that they would transmit the virus to their relatives. Medical staff also

stated that the use of heavy protective suits and N95 masks made

communication between staff members very difficult with related psychological

distress (Lee et al., 2018). Psychological adaptation was described among health

personnel who had access to well-equipped and structured environment. During

the 2015 Korean MERS-CoV outbreak, the influences of stigma and hardiness

had a direct impact on mental health of health personnel working on public

hospitals (Shigemura et al., 2020).

In the COVID-19 emergency, medical workers in Wuhan have been

dealing with high risk of infection and inadequate protection against

contamination, overwork, frustration, discrimination, isolation, patients with

negative emotions, a lack of contact with their families and exhaustion (Kang et

al., 2020). The current situation is causing mental health problems such as

stress, anxiety, depressive symptoms, insomnia, denial, anger and fear (Jones et

al., 2017). These mental health problems not only affect attention, understanding

and decision-making capacity of medical workers, which could hinder the fight

against COVID-19, but they could also have a lasting effect on their overall well-

being (Kang et al., 2020).

The prevalence in the general population of PTSD has been ranging from

4% to 41%; the prevalence of major depression increased by 7% after the

outbreak. There are some factors that may increase the risk of developing such

conditions as described: female sex, lower socioeconomic status, interpersonal

conflicts, frequent social media use and lower resilience and social support

(Heather Mowbray, 2020).

 During each community crisis, people often seek out event-related

information to stay informed on what is happening. However, when information

from official channels is lacking or is irregularly disseminated, people may be

exposed to some social and media misleading information. In a study conducted

on a university lockdown after a shooter incident in the United States, those

subjects receiving conflicting information about the lockdown reported much

higher levels of acute stress (Purgato et al., 2018). Those subjects who had

direct contact via phone text messages and used social media for critical updates

during the lockdown were exposed to more conflicting information and stress.

Also, higher acute stress was reported by heavy social media users in the study.

This report highlights the importance of releasing substantive official updates at

regular intervals during a crisis event and monitoring social media to reduce

exposure to misleading information and distress (Purgato et al., 2018). In fact,

fear of the unknown leads to higher anxiety level in both healthy people and

those with pre-existing mental health problems; unjustified public fear may lead

to discrimination, stigmatization and scapegoats (Mowbray, 2020).

First, people’s emotional responses are likely to include extreme fear and

uncertainty, and negative social behaviors will often be driven by fear and

distorted perceptions of risk. Second, special efforts should be directed to

vulnerable populations, including (1) infected and sick patients, their families and

colleagues, (2) individuals and their relationships with the community, (3)

individuals with preexisting medical conditions (both physical and/or mental), (4)

health care providers, especially nurses and doctors who work directly with sick
or quarantined people. Finally, the degree of psychological stress that health

professionals and others might face and the risks of vulnerable populations

should be considered in the decision-making of the crisis.

Although studies related to mental health in patients with COVID-19 are

scarce, several authors highlight that it is possible to predict more or less the

expected consequences in mental and physical health of the most vulnerable

parts of the population (Kang et al., 2020).

Community psychological interventions and support might have some

effects in reducing PTSD symptoms, depressive and anxiety symptoms in adults

during these stressful events. More evidence-based research is needed,

particularly on the impact of these interventions in children and adolescents over

longer periods of follow-up (Purgato et al., 2018)

.Hypothesis

This study will be formulated and tested the following hypothesis at a .05

level of significance.

1. There is no relationship between the fear of side effects and the level of

acceptance.

Theoretical Framework
 This study will use the following theories served as evidence and

justification to the study.

Social Control Theory

, Social control theory proposes that people's relationships, commitments,

values, norms, and beliefs encourage them not to break the law. Thus, if moral

codes are internalized and individuals are tied into and have a stake in their

wider community, they will voluntarily limit their propensity to commit deviant

acts. The theory seeks to understand how it is possible to reduce the likelihood of

criminality developing in individuals. It does not consider motivational issues,

simply stating that human beings may choose to engage in a wide range of

activities unless the range is limited by the processes of socialization and social

learning. The theory derives from a Hobbesian view of human nature as

represented in Leviathan, i.e. that all choices are constrained by implicit social

contracts, agreements, and arrangements among people. Thus, morality is

created in the construction of social order, assigning costs and consequences to

certain choices and defining some as evil, immoral, and/or illegal.

Around the globe, epidemiologists, statisticians, biologists, and health

officials are grappling with these questions. Though engineering perspectives are

uncommon in epidemiological modeling, we believe that in this case, public

officials could greatly benefit from one. Of course, the COVID-19 pandemic isn’t

an obvious or typical engineering problem. But in its basic behavior, it is an

unstable, open-loop system. Left alone, it grows exponentially, as we have all

been told repeatedly. However, there’s good news, too: Like many such systems,

it can be stabilized effectively and efficiently by applying the principles of control

theory, most notably the use of feedback.

Inspired by the important work of epidemiologists and others on the front

lines of this global crisis, we have explored how feedback can help stabilize and

diminish the rate of propagation of this deadly virus that now literally plagues us.

We’ve drawn on proven engineering principles to come up with an approach that

would offer policymakers concrete guidance, one that takes into account both

medical and socioeconomic considerations. We relied on feedback-based

mechanisms to devise a system that would bring the outbreak under control and

then adeptly manage the longer-term caseload.

Moreover, a Fellow of the IEEE, he has led the research, development,

and deployment of control and machine-learning technology in such applications

as microalgae cultivation, large-scale data centers, automotive power-train

control, and semiconductor fabrication. Guy A. Dumont is a professor of electrical

and computer engineering at the University of British Columbia in Vancouver and

a principal investigator at BC Children’s Hospital Research Institute. An IEEE

Fellow, he has 40 years of experience applying advanced control theory in the

process industries, in particular, pulp and paper and, for the last 20 years, in

biomedical applications such as automated drug delivery for closed-loop control

of anesthesia.

Evolutionary epidemiology theory of vaccination, vaccination aims to prevent or

limit the risk of pathogen infections for individual hosts but large vaccination
coverage often has dramatic epidemiological consequences at the scale of the

whole host population. This massive perturbation of the ecology and

transmission of the pathogen can also have important evolutionary effects. In

particular, vaccine-driven evolution may lead to the spread of new pathogen

variants that may erode the benefits of vaccination. This chapter presents a

theoretical framework for modeling the short- and long-term epidemiological and

evolutionary consequences of vaccination. This framework can be used to make

quantitative predictions about the speed of such evolutionary processes. This

work helps identify the relevant phenotypic traits that need to be measured in

specific parasite populations to evaluate the potential evolutionary consequences

of vaccination. In particular, this may help in the debate regarding the

involvement of evolution in the re-emergence of pertussis despite the high

coverage of vaccination.

Conceptual Framework

Based on the foregoing review of the theoretical background of this study,

the conceptual framework will be formulated. The schematic presentation of the

conceptual framework shown in Figure 1 will be based on the premise that

vaccine confidence could help attain the level of acceptance to achieve herd

immunity. The residents of the community will have different perceptions and

have encountered issues and concerns on the vaccine confidence.

 This conceptual framework was a guide in this study of the factors

associated with the vaccine confidence and acceptance on COVID 19 of LGU at

Tampakan South Cotabato.

INDEPENDENT VARIABLE DEPENDENT VARIABLE

Perceived factors associated

with vaccination confidence:
a. Fear of side effects;
b. Safety;
c. Effectiveness; Level of acceptance
d. Unnecessary;
e. Inadequate information;
and of the study
Significance
f. short duration of
immunity
This study will aim to find out the factors associated with the vaccine

confidence and acceptance on COVID 19 of LGU at Tampakan South Cotabato.

The result of the study will give significant benefits to the following:

LGU. This will help them to know what are the most factors associated

with their vaccine confidence, to give them an idea of why they have a different

perception of this vaccination. This will also test their skills on how they surpass

those factors that they’ve experienced before. This will equip the professional

practice of their profession.

Researchers. This research will give them more knowledge and

information about factors associated with the vaccine confidence and acceptance

on COVID 19 of PNP Personnel at Tampakan South Cotabato. This study will

help the researcher gain more knowledge and skills in solving various problems.

This will serve as a training ground for the researcher to have experience in
seeking solutions for the problem. This will enhance and develop also her critical

thinking perspective.

Future Researchers. This study will guide as their future reference if their

study will be related or similar to our study. This will serve as a guide for them on

conducting a study about factors associated with the vaccine confidence and

acceptance on COVID 19 of PNP Personnel at Tampakan South Cotabato. They

will also use this one as a basis for their research studies. Moreover, it will give

them some ideas to be used in seeking answers for their research.

Scope and Delimitation

This study was delimited to the Perceived factors Associated with Vaccine

Confidence and Acceptance On Covid 19 Of LGU, Tampakan South Cotabato.

The respondents of the study will be the PNP personnel at Tampakan South

Cotabato. This study started on November 2021 and if possible, it will end on

March 2022. In this duration the researcher gathered information to the

respondents by purposive sampling procedure and interpreted the data collected.

Definition of Terms

The following terms were defined operationally and conceptually for the

readers to clearly understand this study.

ACCEPTANCE-the action of consenting to receive or undertake something

offered.

CONFIDENCE-he feeling or belief that one can rely on someone or something;

firm trust.
COVID-19 - an acute respiratory illness in humans caused by a coronavirus,

capable of producing severe symptoms and in some cases death, especially in

older people and those with underlying health conditions. It was originally

identified in China in 2019 and became pandemic in 2020.

LGU AT TAMPAKAN, SOUTH COTABATO- Operationally, it refers to

respondents’ locale where they are currently living/residing.

PERCEIVED-become aware or conscious of (something); come to realize or

understand.

VACCINE -a substance used to stimulate the production of antibodies and

provide immunity against one or several diseases, prepared from the causative

agent of a disease, its products, or a synthetic substitute, treated to act as an

antigen without inducing the disease.

Chapter II

METHODOLOGY

This chapter presents the research design, Research Design, Research

Locale Population and Sample, Research Instrument, Data Collection, Statistical

Tools, and Ethical considerations.

Research Design

The researchers have chosen to conduct quantitative methods to collect

data. The quantitative approach measures the level of acceptance of COVID-19

of LGU in Tampakan, South Cotabato thru statistics. This study will use the
descriptive survey method that describes data and characteristics about the

population or phenomenon being studied. The purpose of this study is to know

perceived factors associated with vaccine confidence and acceptance of COVID-

19 of LGU in Tampakan, South Cotabato. According to Williams (2007)

descriptive research is a research method that can determine the situation in

current phenomenon. Nassaji (2015) also states that the goal of descriptive

research is drawing and classifying the phenomenon. In addition, Walliman

(2011) defines that descriptive research relates to an observation in collecting the

data.

Research Locale

Tampakan, officially the Municipality of Tampakan (Hiligaynon: Banwa

sang Tampakan; Cebuano: Lungsod sa Tampakan; Tagalog: Bayan ng

Tampakan), is a 2nd class municipality in the province of South

Cotabato, Cotabato, Philippines. According to the 2020 census, it has a

population of 41,018 people. Tampakan is a landlocked municipality in the

coastal province of South Cotabato. The municipality has a land area of 390.00

square kilometers or 150.58 square miles which constitutes 10.28% of South

Cotabato's total area. Its population as determined by the 2020 Census was

41,018. This represented 4.20% of the total population of South Cotabato

province or 0.84% of the overall population of the SOCCSKSARGEN region.

Based on these figures, the population density is computed at 105 inhabitants

per square kilometer or 272 inhabitants per square mile.

Population and Sample

The respondents of the study are 50 random LGU of Tampakan, South

Cotabato.

Research Instrument

The survey questionnaire is the major instrument the researcher will be

utilized in this study. The researcher will use a self-made questionnaire. It is a

survey questionnaire that aims to determine the perceived factors associated

with vaccine confidence and acceptance on COVID-19 of LGURa in Tampakan,

South Cotabato

Data Collection

The researchers will observe the following factors in the actual field to

gather the data needed:

The researcher will send a letter of permission to the Dean of the College

of Criminology asking permission to conduct a study. After the letter will be

approved, the researchers have to validate the instrument through expert

individuals. The researchers must write a letter of intent to the respondents then

administer the survey questionnaire to them. The researchers will retrieve the

survey questionnaire from the respondents. Lastly, the raw data obtained will be

tallied, tabulated, and later to be interpreted to give meaning to the data gathered

with the help of a statistician.

Statistical Tools
 The statistical treatment that will be utilized in analyzing and interpreting

the data on the perceived factors associated with vaccine confidence and

acceptance on COVID-19 of PNP personnel in Tampakan, South Cotabato, the

researchers will use a graph for interpretation of data.

Ethical Consideration

The responsibility of the researchers is, to be honest, and respectful to

individuals who are affected by this study. When the researchers conducted the

survey, they gave respect to the decision of the respondents in terms of privacy

and confidentiality. The researchers informed and asked first their permission

and explained carefully the purpose of this study. The researchers had the

consent of their program director or thesis adviser to start conducting the survey.

SURVEY QUESTIONNAIRES FOR THE RESPONDENTS

This questionnaire is intended to gather information and data from the

respondents of Tampakan, South Cotabato LGU relative to the vaccine and acceptance
The questionnaire is composed of three parts: first, the socio-economic and demographic
profiles of the respondents; second, the perceptions of the respondents toward vaccine
confidence; and third, the level of acceptance of vaccine
General Instruction: Please give the information asked for in this questionnaire by
writing your response or by put a check mark () in the space provided for. Rest assured
that all information gathered will remain confidential.

I. PROFILE OF THE RESPONDENTS

A. Age : 18-25 years old

26-30 years old
31-35 years old
36-40 years old
41-45 years old
46-50 years old
Above 50 years old

B. Sex :[ ] Male
[ ] Female

C. Marital Status :[ ] Single

[ ] Married
[ ] Widowed/er
[ ] Legally Separated/Annulled

D. Highest Educational Attainment:

[ ] Baccalaureate Degree
[ ] Earned units in Master’s Degree
[ ] Master’s Degree
[ ] Earned units in Doctoral Degree
[ ] Doctoral Degree

E. Length of Service ________________

F. Positions Handled and Term of Office

Position No. of Years in Office
_______________________________________ ___________________
_______________________________________ ___________________
_______________________________________ ___________________

II. PERCEPTIONS TOWARD VACCINE CONFIDENCE

Please rate the extent of your confidence on the different indicators relative to the
vaccine confidences. Encircle the number which corresponds to your response in each
indicator.
Please use the following in determining your response to each indicator:
 5 - Highly Confident
4 - Confident
3 - Uncertain
2 - Not Confident
1 - Highly Not Confident

Indicators

Indicators 5 4 3 2 1
A, Fear of Side Effects
1. My friends and relative have colds for several days after they
get vaccine.
2. My parents discourage me to be vaccinated due to occurrence
of side effect.
3. My co-worker discourages me to be vaccinated.
B. Safety
1. I feel safe from Corona virus once I get vaccinated.
2. I will not be infected with the Corona virus once vaccinated.
[Link] family is protected and safe from Corona virus.
C. Effectiveness
1. I choose only vaccine with high effectivity rate such Moderna
and Pfizer.
2. I don’t believe on President Duterte’s claim that all vaccines
are effective.
3. I don’t care
D. Unnecessary
1.I think vaccines are not needed in this pandemic times.
2. Vaccines add cost to the government spending.
3. Just like war, vaccine is a form of business esp. the rich
countries.
E. Inadequate Information
1. The vaccine program lacks adequate information on its safety
and protection.
2. Social media circulates fake news about vaccine effect on
human.
3. 3. People are confused on the news around them.
G. Short of Duration Immunity
1. I know that vaccine will last for less than 6 month and no
longer effective in your body.
2. It is a waste of time to get vaccinated with no assurance of its
immunity against Corona Virus.
3. It is useless to get vaccinated because you are prone to
infection against Corona virus.

III. PERCEPTIONS TOWARD VACCINE ACCEPTANCE

 Please rate the extent of your acceptance on the different indicators relative to the
vaccine confidences. Encircle the number which corresponds to your response in each
indicator.
Please use the following in determining your response to each indicator:
5 - Highly accepted
4 - Accepted
3 - Uncertain
2 - Not Accepted
1 - Highly Not Accepted

Indicators 5 4 3 2 1

1. I know the government tries its best effort to attain the

herd immunity to control the spread of Corona virus.
2. The government is very sincere in information
dissemination of the positive effect of vaccine.
3.I firmly believe that when herd immunity will be attained,
Corona virus will be eliminated.