KWAME NKRUMAH UNIVERSITY OF SCIENCE AND TECHNOLOGY, KUMASI

COLLEGE OF HEALTH SCIENCES

FACULTY OF ALLIED HEALTH SCIENCES
DEPARTMENT OF NURSING

KNOWLEDGE ATTITUDE AND PERCEPTION ON COVID-19 VACCINATION AMONG

5TH YEAR OPTOMETRY STUDENTS IN KNUST

A DISSERTATION SUBMITTED TO THE DEPARTMENT OF NURSING, KWAME

NKRUMAH UNIVERSITY OF SCIENCE AND TECHNOLOGY, KUMASI IN PARTIAL
FULFILMENT OF THE REQUIREMENT FOR THE AWARD OF BACHELOR OF SCIENCE
DEGREE (BSc) IN NURSING

BY
OSEI Sarpong Daniel
AWUAH Asamoah Richmond
ASIEDU Irene
ASIEDUAA Asare Anita

SUPERVISED BY:
DR. PHILEMON AMOOBA

JULY 2022

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 DECLARATION
We do hereby declare that the findings of this thesis are genuine information which has not been
presented by any person or group of persons elsewhere. Recognition has however been given to
authors whose works were cited.

OSEI SARPONG DANIEL

SIGNATURE…………….
(INDEX NUMBER: 3333818)
DATE……………………..

AWUAH ASAMOAH RICHMOND

SIGNATURE………………………
(INDEX NUMBER: 3337818)
DATE……………………………..

ASIEDU IRENE
SIGNATURE……………………
(INDEX NUMBER: 3335118)
DATE…………………………..

ASARE ASIEDUAA ANITA

SIGNATURE………………….
(INDEX NUMBER: 3337018)
DATE………………………….

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ABSTRACT
BACKGROUND: Vaccination is the most effective public health measure against the covid-19
pandemic. Joining the global community in fighting the covid-19 pandemic, Ghana rolled out her
first phase of vaccination on 1st March 2021. Factors such as knowledge. Attitude, and perception
influence the public’s acceptance of the vaccine, hence the need to understand and interpret them
in order to boost mass acceptance. This present study aimed to assess the knowledge, attitude and
perception of covid-19 vaccination among 5th optometry students in Kwame Nkrumah University
of Science and Technology.

METHOD: A cross-sectional study was conducted among 66 students (males – 68.2%; females –
31.8%; age range – 20 – 29). This study was conducted using structured questionnaire which had
informed consent, along with four sections (socio-demographics, knowledge, attitude and
perception)

RESULTS: 66 out of 69 5th year optometry students responded yielding a response rate of 95.7%.
74.2% had fair knowledge about Covid-19 vaccination; 62.1% had a good attitude toward the
Covid-19 vaccination, with 80.3% being vaccinated; 39.4% had a fair perception of the covid-19
vaccination. A significant asssociation was observed between good perception level and
vaccinlation status in a univariate logistics regression [ cOR = (0.143), 95% CI = 0.025 – 0.807,
p-value = (0.028)].

CONCLUSION: In conclusion, the knowledge, attitude, and perception of the 5th-year optometry
students towards the covid-19 vaccination were fair. The study showed more positive attitudes but
inadequate knowledge towards covid-19 vaccination. Therefore, there is the need to improve
health education programmes and accurate information distribution.

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TABLE OF CONTENTS
Chapter One (1)............................................................................................................................... 7

1.1 INTRODUCTION ........................................................................................................... 7

1.2 PROBLEM STATEMENT ............................................................................................. 8

1.3 RESEARCH OBJECTIVES ........................................................................................... 9

1.4 DEFINITION OF TERMS ........................................................................................... 10

Chapter Two (2) ............................................................................................................................ 11

2.1 LITERATURE REVIEW ............................................................................................. 11

2.2 KNOWLEDGE, ATTITUDE, AND PERCEPTION OF COVID-19

VACCINATION .................................................................................................................. 11

2.3 KNOWLEDGE .............................................................................................................. 11

2.4 ATTITUDE .................................................................................................................... 12

2.5 PERCEPTION ............................................................................................................... 13

Chapter Three (3) .......................................................................................................................... 15

3.1 STUDY AREA AND POPULATION .......................................................................... 15

3.2 INCLUSION CRITERIA.............................................................................................. 15

3.3 EXCLUSION CRITERIA ............................................................................................ 16

3.4 STUDY DESIGN ........................................................................................................... 16

3.5 SAMPLING TECHNIQUE .......................................................................................... 16

3.6 DATA COLLECTION TECHNIQUE ........................................................................ 16

3.7 DATA ANALYSIS METHOD ..................................................................................... 17

3.8 ETHICAL CONSIDERATION.................................................................................... 17

Chapter Four (4) ............................................................................................................................ 18

4.1 RESULTS ....................................................................................................................... 18

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 4.2 KNOWLEDGE LEVEL OF 5TH YEAR OPTOMETRY STUDENTS ON COVID-
19 VACCINATION ............................................................................................................. 19

4.2.1 Knowledge Level Distribution among Gender, Religion and Age Category of the
Study Participants ............................................................................................................... 20

4.3 ATTITUDE LEVEL OF 5TH YEAR OPTOMETRY STUDENTS ON COVID-19

VACCINE............................................................................................................................. 21

4.3.1 Attitude level among Gender, Religion and Age group of the study participants
................................................................................................Error! Bookmark not defined.

4.4 PERCEPTION LEVEL OF 5TH YEAR OPTOMETRY STUDENTS ....................... 24

4.4.1 Perception level among Gender, Religion and Age group of the study participants
................................................................................................Error! Bookmark not defined.

4.5 ASSOCIATION BETWEEN THE ATTITUDE, KNOWLEDGE, PERCEPTION,

AND PARTICIPANTS’ SOCIODEMOGRAPHIC AND READINESS TO TAKE
VACCINE............................................................................................................................. 26

Chapter Five (5) ............................................................................................................................ 29

5.1 DISCUSSION ................................................................................................................. 29

5.2 STRENGTHS ................................................................................................................. 30

5.3 LIMITATIONS.............................................................................................................. 30

5.4 DISSEMINATION OF RESULTS OF STUDY ......................................................... 31

5.5 CONCLUSION .............................................................................................................. 31

REFERENCES .................................................................................................................... 32

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LIST OF TABLES
Table 1 Socio-demographic characteristics of 5th year optometry students, KNUST, 2022. 18
Table 2 The knowledge level distribution among 5th Year Optometry students ................. 19
Table 3 Knowledge level among Gender, Religion and Age group of the study participants
....................................................................................................................................................... 20
Table 4 Overall attitude level of study participants ................................................................ 22
Table 5 Attitude level among Gender, Religion and Age group of the study participants .. 23
Table 6 Perception Level of the study participants ................................................................. 25
Table 7 Perception level among Gender, Religion and Age group of the study participants
....................................................................................................................................................... 25
Table 8 Association between Knowledge, Attitude and Perception Levels with Gender,
Religion and Age group of study participants .......................................................................... 26
Table 9 Association between Knowledge, Attitude and Perception levels and Vaccination
status............................................................................................................................................. 28

LIST OF FIGURES
Figure 1. Showing the knowledge level among gender, religion and age group of study
participants. .................................................................................................................................. 21
Figure 2 Attitude of 5th Year Optometry Students on Covid-19 Vaccination regarding whether
they had taken the vaccine. .......................................................................................................... 22
Figure 3 Showing the attitude levels among gender, religion and age group of study participants.
....................................................................................................................................................... 24

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 Chapter One (1)

1.1 INTRODUCTION
The novel infectious disease, Coronavirus disease (COVID-19), which continues to decimate lives
and ravage the world, was declared a global pandemic on 11th March, 2020 by the World Health
Organisation (WHO). It is a pneumonia-like (severe acute respiratory disease, SARS) caused by a
new variant coronavirus called SARS-CoV-2. The first case of the pandemic was detected in
Wuhan, China (Acheampong et al., 2021; Sonmezer et al., 2022). At the time of writing, the
COVID-19 statistics on the worldometer dashboard globally were 570,069,039 cases with
6,392,468 deaths and Africa recording 12,479,522 cases with 256,616 deaths. COVID-19 has
spread within a short time span throughout the globe since its onset, and has had significant impact
on healthcare services and workers, with unusual social and economic hardships. In light of this
burden, countries employed several strategies and methods as recommended by the World Health
Organization, to help mitigate the spread of the virus. This included social distancing, avoidance
of handshakes, restrictions on movement, and wearing of facemasks. Despite the hope the
implementation of these measures brought, it indirectly had some negative impacts on national
economies and individual health, which led to an increase in unhealthy behaviours and mental
disorders (Ciardi et al., 2021; Gall et al., 2021).

As these measures were practised by the general public, the scientific community was engaged in
research projects to understand the nature of the SARS-CoV-2 to help in the development of
vaccine candidates (Al-kafarna et al., 2022). Since the virus, SARS-CoV-2, has affected
populations globally due to its high contagion profile, vaccines are the most significant and
effective public health measure to protect the public from being infected with it (Islam et al., 2021).
The development of vaccines follows a slow, systematic and time consuming process, and has to
pass through a number of regulatory checks for its potency, safety and efficacy. However, the
development of the COVID-19 vaccines were sped up globally in response to the dire need to curb
the spread of the disease (Fan et al., 2021; Singh & Bono, 2021.). As at June 2021, 102 candipdate
vaccines were in clinical phase and 185 were in pre-clinical phase. Among these, the World Health

7
Organization, WHO, listed Janssen, Astrazeneca-SK Bio, Serum Institute of India, ,
Pfizer/BioNTech and Moderna vaccines for emergency use as at the said period (Id et al., 2022).

The willingness of the general public to accept the COVID-19 vaccines even before their
development was relatively positive as opposed to the reality now. Despite the fact that people
eagerly anticipated the vaccine development, vaccine hesitancy has been a top concern of late in
both developed and developing nations. The acceptance or hesitancy of the COVID-19 vaccines
is influenced by a number of factors such as knowledge and perception on the spread of the disease
as perceived by people, concerns on the safety of the vaccine, worries about the efficacy of the
vaccine, perceived risk, etc. in light of this, it is vital to understand and interpret people’s
knowledge, attitude, perceptions, practices, and concerns regarding COVID-19 vaccine to boost
mass acceptance of it (Id et al., 2022; Kumari et al., 2021).

1.2 PROBLEM STATEMENT

The first two cases of COVID-19 in Ghana were recorded on 12th March, 2020. 204 confirmed
cases, with 31 recoveries and 5 deaths were the COVID-19 statistics in Ghana as at 2nd April,
2020(Serwaa et al., 2020). A number of measures were put forth immediately – by the government
of Ghana together with her health and security agencies – to detect, contain and mitigate the spread
of the disease. These measures included, a ban on social gatherings, the suspension of schools,
churches and mosques, travelling and movement restrictions, and ultimately partial lockdowns in
the cities of Accra and Kumasi on 30th march, 2020. Other preventive measures were washing of
hands with soap and running water, the use of alcohol base sanitizers and the putting on of face
masks (Kenu et al., 2020). As at 14th January, 2022, the COVID-19 statistics on the dashboard of
the Ghan Health Service were 152,729 confirmed cases of the disease with 1,336 deaths. In efforts
to curb the spread of the virus, Ghana received her first consignment of COVID-19 vaccines
(AstraZeneca) from the United Nations-backed COVAX initiative on 24th February, 2021.
Following the guidelines from the Ghana Health Service, the vaccination was executed in four
phases, with the first phase targeting health workers, people with underlying health conditions, the
aged (60 years and above) and security personnel. The first phase was carried out on 1st March,

8
2021, with the President of the nation, Nana Akuffo Addo, being the first person to get vaccinated
(Adjei et al., 2022; Amo-Adjei et al., 2022).

A sector of the nation which got greatly affected is the educational system pertaining to the fact
that the country has large number of students who access educational facilities to acquire training.
The government had to direct the shutting down of schools momentary due to the rise in the
number of COVID-19 cases in the country everyday. This saw the shift of face-to-face academic
activities to online studies by most educational institutions. This however, came with its own
challenges and after sometime, most educational institutions had to resume face-to-face academic
activities with imposed governments restrictions on the safety protocols of COVID-19 (Ampofo
& Aidoo, 2022). Students were one group among others – teachers, executive, legislature and civil
servants, journalists and other essential service providers – featured in the deployment of the
second phase of the COVID-19 vaccination in Ghana (Adjei et al., 2022). In view of this, it is
imperative to know the understanding and state of mind of students in attempts to promote safe
and continuous academic life by assessing their knowledge, attitude and perception on COVID-19
vaccination (Ampofo & Aidoo, 2022). This study was planned to develop a validated, concise and
easy to administer questionnaire to assess the knowledge, attitude and perception of COVID-19
vaccination among the student population.

1.3 RESEARCH OBJECTIVES

1.3.1 GENERAL OBJECTIVE

The study has for its objective assessing the knowledge, attitude, and perception of Covid-19
vaccination among KNUST students.

1.3.2 SPECIFIC OBJECTIVES

The specific objectives of this study are to

1. Investigate the knowledge of 5th year optometry students in KNUST on COVID-19

vaccination
2. Explore the attitude of 5th year optometry students in KNUST on Covid-19 vaccination.
3. Assess the perception of 5th year optometry students in KNUST on Covid-19 vaccination

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1.4 DEFINITION OF TERMS
Knowledge means having an insight into Covid-19 and its vaccination
Attitude means the way people behave toward the Covid-19 vaccination
Perception means how someone understands Covid-19 vaccination

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 Chapter Two (2)

2.1 LITERATURE REVIEW

This chapter seeks to review the findings obtained from relevant studies done on the knowledge,
perception, and attitude towards COVID-19 vaccination.

2.2 KNOWLEDGE, ATTITUDE, AND PERCEPTION OF COVID-19 VACCINATION

This chapter seeks to review the findings obtained from relevant studies done on the knowledge,
perception, and attitude towards COVID-19 vaccination. Vaccination is one of the most effective
primary preventive interventions in public health (Amo-Adjei et al., 2022), and it is the most
effective preventive measure against COVID-19 spread (Addo et al., 2021). Vaccine is a
preparation used in the stimulation of the immune response of the body against disease or infection
(CDC). Vaccination is the introduction of this preparation into the body to stimulate immune
protection from a specific disease (CDC). COVID-19 vaccination is therefore the introduction of
a vaccine into the body to stimulate the body’s immune response against COVID-19 disease. The
knowledge, attitudes and practices (KAP) of the people towards the COVID-19 vaccine is pivotal
to understanding the dynamics in the epidemiology of controlling disease, its effectiveness,
compliance and success of the vaccination program (Singh & Bono, n.d.)

2.3 KNOWLEDGE
Knowledge is very important in the determination of people’s attitude towards things. On the other
hand, attitude has been used in the prediction of behavioural intentions in many fields of study
(Addo et al., 2021). A cross-sectional survey was done to assess the knowledge and attitudes
among adults to receive the COVID-19 vaccines in Ghana, it was found out that 51% of Ghanaians
over 15years (mostly urban adults) were likely to take the COVID-19 vaccine if made available to
the public; 28% were “undecided” about taking the vaccine, and 21% were “somewhat unlikely or
very unlikely” to take the vaccine. 59.9% of the ‘undecided’ group pointed out that, they had
inadequate information regarding the effects of the vaccine. 60.9% of the ‘somewhat unlikely or

11
very unlikely’ to take the vaccine group also pointed out having inadequate knowledge regarding
the effects of the COVID-19 vaccine (Acheampong et al., 2021).

The results of a study done to assess the knowledge and acceptance of COVID-19 vaccination
among Italian undergraduates showed a high acceptance level towards COVID-19 vaccination and
a good level of knowledge on the characteristics of the vaccines and the campaign to get them
immunized. Hence, good knowledge correlates with vaccine acceptance(Gall et al., 2021).
However, knowledge on COVID-19 vaccination is influenced by several variables. A survey done
in Bangladesh, 2021, on the knowledge, attitude and perceptions towards COVID-19 vaccinations
found the knowledge regarding COVID-19 vaccination low among more than half of the
population. More also, knowledge on COVID-19 vaccinations was strongly associated with
education, family type, previous vaccination experience and monthly wage of a family (Islam et
al., 2021). In an Italian study, greater knowledge on COVID-19 vaccination was associated with
older age, male gender, studying a life science course, being a health worker, higher educational
level of parents and COVID-19 vaccination acceptance (Gall et al., 2021). In a cross-sectional
study in Turkey, people with higher education showed more willingness to accept the vaccines
than those with low education, because, the former have better compression skills and easier access
to information than the latter (Sonmezer et al., 2022). A cross-sectional community survey in
Bangladesh, found the main source of knowledge on COVID-19 vaccine to be from the mass
media, social media and the internet(Islam et al., 2021).

2.4 ATTITUDE
Attitude has been used in the prediction of behavioural intentions in many fields of study (Addo
et al., 2021). It is influenced by several factors. In study conducted among healthcare workers in
north-eastern Ethiopia, negative attitudes and poor perception among healthcare workers were
found to be the most significant variables in the refusal to accept COVID-19 vaccines (Adane et
al., 2022). Having poor knowledge about the COVID-19 vaccine, young age group, working in
private clinics and healthcare centres were the variables which determined the unfavourable
attitudes towards the COVID-19 vaccine among healthcare workers in a western Ethiopian survey
(Id et al., 2022). Addo and team, conducted a research in 2021 to analyse the view of personal
health engagement and vaccine related attitude among Ghanaians and concluded that, the level of

12
personal health engagement showed a positive relation with the willingness to accept COVID-19
vaccination. Personal health engagement reduces delay and unwillingness to take the COVID-19
vaccination. When people receive right and timely medical literacy, they tend to understand the
values of immunization and take better control and responsibilities for their health (Addo et al.,
2021).

2.5 PERCEPTION
Perception deals with how something is regarded, understood, or interpreted. Thus, people may
have access to the right information at the right time about something, but how such information
is regarded or understood will determine their attitude toward it. How a thing is perceived
determines one’s level of trust for it. Trust is not just a feeling we perceive, but also a way of
perceiving (Bredlau, 2019). In view of this, a mixed-method study was done in Ghana, in 2021, to
assess the trust and willingness towards COVID-19 vaccine uptake. The study indicated that, 51%
of participants had moderate trust in the vaccine, about 34% had very much trust in the vaccine
and 14% had no trust in COVID-19 vaccine. 70% of the respondents stated willingness to get
vaccinated if made available to them; 20% will not accept and 10% were undecided (Amo-Adjei
et al., 2022).

A principal factor linked with attitude towards, and perception of COVID-19 vaccination is one’s
educational background. There is more positive perception among people with higher education
than those who completed just elementary school or below, as reported by a study in Turkey
(Sonmezer et al., 2022). Also, a study conducted in Ethiopia among healthcare workers showed
overall good knowledge (62.5%), good perception (60.5%) and positive attitudes (52.3%) about
COVID-19 vaccination (Adane et al., 2022). When people have good knowledge on something,
they in turn show good perception of it. How people regard and understand COVID-19, and for
that matter, COVID-19 vaccination determine their trust and in effect, their attitude towards taking
the vaccination.

This research seeks to investigate the knowledge, attitude, and perception of only optometry
students in 5th year in KNUST – Ghana, using only questionnaires to gather information from
respondents

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14
 Chapter Three (3)

3.1 STUDY AREA AND POPULATION

The study was conducted among 5th year Optometry students in Kwame Nkrumah University of
Science and Technology (KNUST). KNUST is the second largest public university in Ghana (after
University of Ghana, Legon), located in Kumasi, the capital of Ashanti Region. It is currently the
best university in Africa in terms of quality education (Times Higher Education, April 2022).
Administratively, the university has six (6) colleges. They include College of Health Sciences,
College of Science, College of Engineering, College of Arts and Built Environment, College of
Agriculture and Natural Resources and College of Humanities and Social Sciences. Each college
is headed by a Provost. The colleges are divided into schools and faculties, which are further
divided into departments headed by Heads of Department.

The Department of Optometry and Visual Science (DOVS) is home to preeminent leadership in
optometric education, patient care, and ophthalmic research in Ghana. The program seeks to
prepare enthusiastic individuals to be highly competent practitioners and optometric leaders
through education and research while advancing professional and ethical eye care, scholarship,
and service to humanity. As a premier Optometry school in Ghana, the department runs a six-year
undergraduate Doctor of Optometry program, leading to a Doctor of Optometry (OD) degree. It
has concurrently grown to include graduate Masters and Doctoral programs in Vision Science. The
department of Optometry and Visual Science was established at the department of Physics,
KNUST in 1992. It is currently under the college of Science and faculty of Biosciences, and head
by Dr Kwadwo Owusu Akuffo. 5th year Optometry class formed our population with 69 students.
Out of this population, 66 students responded to the questionnaires administered.

3.2 INCLUSION CRITERIA

All 5th year Optometry students present at the time of survey and willing to partake were included
in the study.

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3.3 EXCLUSION CRITERIA
Those who were absent (health reasons, had travelled, etc.) were excluded and not considered in
sampling procedure.

3.4 STUDY DESIGN

A cross-sectional study design was employed. The study was conducted within a period of one
week utilizing structured questionnaires as a tool for data collection. Descriptive design
(Quantitative) was used to measure the level of knowledge, the attitude and perception of Covid-
19 vaccination among 5th year Optometry students in KNUST. The association between the
Knowledge, Attitude and Perception of the 5th year optometry students and their uptake of the
Covid-19 vaccine was analysed quantitatively.

3.5 SAMPLING TECHNIQUE

A convenience sampling procedure was used. Sampling was carried out on the targeted population
based on their availability and willingness.

3.6 DATA COLLECTION TECHNIQUE

The data for this research was collected through structured questionnaire which was based on
suggestions by the team and literature review (Islam et al., 2021). Data was collected from
respondents after an informed consent. The questionnaire was closed-ended. Respondents were
guided to tick or circle. Enough time was given to respondents to go through and provide their
response to each question. Language for communication with respondents was mainly English,
but Twi was used for further explanation where necessary. The questionnaire covered questions
concerning; Demographics of respondents, vaccination status of students, knowledge on the types
of vaccines available and myths and misconceptions about Covid-19 vaccines.

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3.7 DATA ANALYSIS METHOD
Data was analysed using the Statistical Package for Social Sciences (SPSS) version 22.0 software.
Descriptive statistics of percentages, frequencies and cross tabulations was used to generate output
on all the variables. The results were presented as tables, graphs and charts.

3.8 ETHICAL CONSIDERATION

The rights of participants were safeguarded and protected from harm. Prior to data collection,
administrative permission was sought from the Head of Department(HOD) of Optometry and
Visual Science to carry the study. Ethical approval was obtained from the Ethics
Committee(CHPRE) after submission of proposal for review to ensure that participants rights were
not violated. Lastly, participants were informed and consented to the research to ensure
confidentiality and anonymity.

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 Chapter Four (4)

4.1 RESULTS

Out of 69 5th year optometry students, 66 students responded, of which 45 (68.2%) were males,
and 21 (31.8%) were females. 49 (74.2%) were between the ages of 20 – 24 years, and 17 (25.8%)
were between the ages of 25 – 29 years. A total of 63 (95.5%) respondents were Christians, and 3
(4.5%) were Muslims. All 66 (100%) respondents were single.

Table 1 Socio-demographic characteristics of 5th year optometry students, KNUST, 2022.

Variables Option Frequency Percent (%)

Gender Male 45 68.2
Females 21 31.8
Religion Christianity 63 95.5
Islam 3 4.5
Traditional 0 0
Age 15-19 0 0
20-24 49 74.2
25-29 17 25.8
>30 0 0
Marital status Single 66 100
Married 0 0
Divorce 0 0
Separated 0 0
Widow(er) 0 0

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 4.2 KNOWLEDGE LEVEL OF 5TH YEAR OPTOMETRY STUDENTS ON COVID-19
VACCINATION

Frequencies of participants’ answers to questions regarding the knowledge about the COVID-19
vaccine are presented in Table 4.2. A total of nine questions were asked with regards to knowledge
about Covid-19 vaccination. A score of nine out of nine was graded as Excellent. A score of seven
to eight out of nine was graded as Adequate. A score of four to six out of nine was graded as Fair,
and a score of one to three out of nine was graded as Inadequate. In all, 18.2% of the respondent
had adequate knowledge about Covid-19 vaccination. 74.2% had fair knowledge about Covid-19
vaccination, and 7.6% had inadequate knowledge about Covid-19 vaccination. Averagely,
respondents had a fair knowledge about the Covid-19 vaccination.

Table 2 The knowledge level distribution among 5th Year Optometry students

ITEM FREQUENCY PERCENTAGE (%) AVERAGE LEVEL

Knowledge Level (0-9) Fair (5.53)

Excellent (9) 0 0

Adequate (7-8) 12 18.2

Fair (4-6) 49 74.2

Inadequate (0-3) 5 7.6

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4.2.1 KNOWLEDGE LEVEL DISTRIBUTION AMONG GENDER, RELIGION
AND AGE CATEGORY OF THE STUDY PARTICIPANTS

Table 3 Knowledge level among Gender, Religion and Age group of the study participants

KNOWLEDGE LEVEL FREQUENCY

Gender
Male Female
Excellent 0(0) 0
Adequate 10(83.3) 2(16.7)
Fair 32(65) 17(34.7)
Inadequate 3(60) 2(40)

Religion
Christian Muslim
Excellent 0(0) 0
Adequate 12(100) 0(0)
Fair 47(95.9) 2(4.1)
Inadequate 4(80) 1(20)

Age group
20-24 25-29
Excellent 0(0) 0(0)
Adequate 10(83.3) 2(16.7)
Fair 36(73.5) 13(26.5)
Inadequate 3(60) 2(40)

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 Knowledge Level among Gender, Religion and Age group of study participants
50

40
Number of participants

30

Males
20 Female
Christian
Muslim
10
20-24
25-29

0
Excellent Adequate Fair Inadequate
Knowledge Level

Figure 1. Showing the knowledge level among gender, religion and age group of study
participants.

4.3 ATTITUDE LEVEL OF 5TH YEAR OPTOMETRY STUDENTS ON COVID-19

VACCINE

Respondents’ answers to the attitude toward the vaccination questions is reported in Table 4.3. A
total of three questions were used to grade the attitude of the respondents about Covid-19
vaccination. A score of three out of three was graded as Excellent. A score of two out of three was

21
graded as Good. A score of one out of three was graded as Fair, and a score of zero out of three
was graded as Poor. In all, 9.1% of the respondent had an excellent attitude toward Covid-19
vaccination. 62.1% had a good attitude toward the Covid-19 vaccination, 19.7% had a fair attitude
toward the Covid-19 vaccination, and 9.1% had a poor attitude toward the Covid-19 vaccination.
Averagely, respondents had a good attitude towards the Covid-19 vaccination.

Response to the question: have you taken the Covid-19

vaccine
60
53

50

40

30

20
13

10

0
0
Yes No Maybe

Figure 2 Attitude of 5th Year Optometry Students on Covid-19 Vaccination regarding

whether they had taken the vaccine.

Table 4 Overall attitude level of study participants

ITEM FREQUENCY PERCENTAGE (%) AVERAGE LEVEL

Attitude Level (0-3) Good (1.7)

Excellent (3) 6 9.1
Good (2) 41 62.1

22
 Fair (1) 13 19.7
Poor (0) 6 9.1

Table 5 Attitude level among Gender, Religion and Age group of the study participants

Attitude Level (0-3) FREQUENCY

Gender
Male Female
Excellent (3) 5(83.3) 1(16.7)
Good (2) 30(73.2) 11(26.8)
Fair (1) 9(69.2) 4(30.8)
Poor (0) 1(16.7) 5(83.3)
Religion
Christian Muslim
Excellent (3) 6(100) 0(0)
Good (2) 38(92.7) 3(7.3)
Fair (1) 13(100) 0(0)
Poor (0) 6(100) 0(0)
Age Group
20-24 25-29
Excellent (3) 5(83.3) 1(16.7)
Good (2) 30(73.2) 11(26.8)
Fair (1) 9(69.2) 4(30.8)
Poor (0) 5(83.3) 1(16.7)

23
 A bar graph showing the Attitude levels among Gender, Religion and Age group

40

30
Number of participants

20
25-29
20-24
Muslims
10 Christians
Females
Males

0
Excellent Good Fair Poor

Attitude Level

Figure 3 Showing the attitude levels among gender, religion and age group of study participants.

4.4 PERCEPTION LEVEL OF 5TH YEAR OPTOMETRY STUDENTS

The distribution of perception of Covid-19 vaccination is presented in Table 4.3. A total of nine
questions were used to grade the perception of the respondents about Covid-19 vaccination. A
score of nine out of nine was graded as Excellent. A score of six to seven out of nine was graded
as Good. A score of three to five out of nine was graded as Fair, and a score of zero to two out of
nine was graded as Poor. In all, 9.1% of the respondent had an excellent perception regarding
Covid-19 vaccination. 36.4% had a good perception of Covid-19 vaccination, 39.4% had a fair
perception of the Covid-19 vaccination, and 15.2% had a poor perception of Covid-19 vaccination.
On average, respondents had a fair perception of the Covid-19 vaccination.

24
Table 6 Perception Level of the study participants

ITEM FREQUENCY PERCENTAGE (%) AVERAGE LEVEL

Perception Level (0-9) Fair (4.9)

Excellent (9) 6 9.1
Good (6-7) 24 36.4
Fair (3-5) 26 39.4
Poor (0-2) 10 15.2

Table 7 Perception level among Gender, Religion and Age group of the study participants

PERCEPTION
LEVEL FREQUENCY

Gender
Male Female
Excellent (9) 6(100) 0(0)
Good (6-7) 19(79.2) 5(20.8)
Fair (3-5) 17(65.4) 9(34.6)
Poor (0-2) 3(30) 7(70)
Religion
Christian Muslim
Excellent (9) 6(100) 0(0)
Good (6-7) 23(95.8) 1(4.2)
Fair (3-5) 24(92.3) 2(7.7)
Poor (0-2) 10(100) 0(0)
Age Group
20-24 25-29

25
 Excellent (9) 3(50) 3(50)
Good (6-7) 6(25) 18(75)
Fair (3-5) 8(30.8) 18(69.2)
Poor (0-2) 10(100) 0(0)

4.5 ASSOCIATION BETWEEN THE ATTITUDE, KNOWLEDGE, PERCEPTION, AND

PARTICIPANTS’ SOCIODEMOGRAPHIC AND READINESS TO TAKE VACCINE
In a Chi-square analysis (Table 4.5), none of the sociodemographic of participants, showed a
significant association with knowledge levels. Gender (p-values = 0.038 and 0.012) however, was
shown to have significant associations with Attitude and perception levels.

Table 8 Association between Knowledge, Attitude and Perception Levels with Gender, Religion
and Age group of study participants

VARIABLE FREQUENCY P-VALUE

Knowledge Level

Excellent Adequate Fair Inadequate

Gender 0.447
Male 0(0) 10(83.3) 32(65.3) 3(60)
Female 0(0) 2(16.7) 17(34.7) 2(40)
Age Group 0.587
20-24 0(0) 10(83.3) 36(73.5) 3(60)
25-29 0(0) 2(16.7) 13(26.5) 2(40)
Religion 0.187
Christian 0(0) 12(100) 47(95.9) 4(80.0)
Muslim 0(0) 0(0) 2(4.1) 1(20.0)

Attitude Level

26
 Excellent Good Fair Poor
Gender 0.038
Male 5(83.3) 30(73.2) 9(69.2) 1(16.7)
Female 1(16.7) 11(26.8) 4(30.8) 5(83.3)
Age Group 0.87
20-24 5(83.3) 30(73.2) 9(69.2) 5(83.3)
25-29 1(16.7) 11(26.8) 4(30.8) 1(16.7)
Religion 0.59
Christian 6(100) 38(92.7) 13(100) 6(100)
Muslim 0(0) 3(7.3) 0(0) 0(0)

Perception Level
Excellent Good Fair Poor
Gender 0.012
Male 6(100) 19(79.2) 17(65.4) 3(30)
Female 0(0) 5(20.8) 9(34.6) 7(70)
Age Group 0.129
20-24 3(50.0) 18(75.0) 18(69.2) 10(100)
25-29 3(50.0) 6(25.0) 8(30.8) 0(0)
Religion 0.714
Christian 6(100) 23(95.8) 24(92.3) 10(100)
Muslim 0(0) 1(4.2) 2(7.7) 0(0)

Also, in a Chi-square analysis to determine the association between Vaccination status and
Knowledge, Attitude and Perception levels (Table 4.6), a significant association was seen between
vaccination status with Attitude level (p-value <0.001) and perception level (p-value = 0.045).
However, there were no significant association between Knowledge level and vaccination status.
In a univariate logistic regression to determine which attitude and perception levels are
independent predictors of vaccination status, a significant association was observed between good
perception level [ cOR = (0.143), 95% CI = 0.025-0.807, p-value = 0.028] which means those with

27
good perception on COVID-19 vaccines are more likely to be vaccinated. The other categories
showed no significant association.

Table 9 Association between Knowledge, Attitude and Perception levels and Vaccination status

VARIABLE FREQUENCY P-VALUE cOR P-VALUE

Vaccinated?
Yes No
Knowledge level 0.161
Excellent 0(0) 0(0)
Adequate 12(22.6) 0(0) Ref (1)
Fair 37(69.8) 12(92.3) inf 0.999
Inadequate 4(7.5) 1(7.7) inf 0.999
Attitude level <0.001

Excellent 6(11.3) 0(0) 0 0.999

Good 39(73.6) 2(15.4) 0 0.999
Fair 8(15.1) 5(38.5) 0 0.999
Poor 0(0) 6(46.2) Ref (1)
Perception level 0.045
Excellent 6(11.3) 0(0) 0 0.999
Good 21(39.6) 3(23.1) 0.143(0.025-0.807) 0.028
Fair 21(39.6) 5(38.5) 0.238(0.049-1.153) 0.075
Poor 5(9.5) 5(38.5) Ref (1)

28
 Chapter Five (5)

5.1 DISCUSSION
The Covid-19 pandemic has made healthcare agency over the world establish various infection
prevention and control measures (Id et al., 2022). In an attempt to stop the surge in the number of
covid-19 cases, covid-19 vaccines have been developed. Over 90 covid-19 vaccines are still
undergoing different phases of clinical trial (Islam et al., 2021). The vaccine is the most effective
strategy to halt further spread of the covid-19 pandemic. Many countries, since 2020 have rolled-
out the vaccines through emergency use authorization (EUA) (Id et al., 2022) *(Covid-19 vaccines
have been available in Ghana since March 2021 and has since been distributed in phases.) this
research present findings from a novel study conducted among 5th year optometry students in the
Kwame Nkrumah University of Science and Technology to assess their knowledge, attitude, and
perception towards the Covid-19 vaccination.
From our research, we found out that, more than half (74.2%) of our study participants belonged
to the age group (20 – 24), and more than two-thirds of the respondents were males. All
respondents except 3 were Christians.
Our study found out that, about three-quarters (74.2%) of our respondents had fair knowledge
about Covid-19 vaccination. More than half (62.1%) of our respondents had a good attitude toward
the Covid-19, with 53 respondents representing 80.39% already vaccinated.
Our study also highlighted that more than one-third (39.4%) of our respondents had a fair
perception regarding Covid-19 vaccination.

The knowledge regarding covid-19 vaccination was fair among the 5th-year optometry students.
The knowledge level showed no significant relationship with gender, age, and religion. However,
attitudes and perceptions were significantly associated with gender and not age groups or religion.
This finding is similar to a study in Bangladesh demonstrating a significant relation of attitude
toward covid-19 vaccination to gender (Islam et al., 2021). The study showed that more females
had a higher attitude score regarding covid-19 vaccination than males. However, the present study
indicated that more males had a higher attitude score with regards to covid-19 vaccination and had
been vaccinated. This discrepancy of attitude found in the current study on covid-19 vaccination

29
is possibly due to the higher number of male respondents (45) as compared to females (21). The
high attitude score observed among our respondents can also be attributed to their high education
background which is consistent with the Sub-Saharan Africa research, which postulates people
with high education background take the vaccine (Acheampong et al., 2021).
The knowledge on the covid-19 vaccination had no significant relationship with the covid-19
vaccine uptake. The knowledge was assessed by asking questions such as the source of
information, the purpose of the vaccine, vaccine eligibility, etc. this finding in our study is different
from a study in India on the development and validation of a questionnaire demonstrating a
significant relationship between knowledge and vaccine uptake (India). The fairly high knowledge
score among the 5th-year optometry students can be attributed to high education level – being
health students – and social media. This observation is in line with the study conducted among
undergraduate students from Central and Southern Italy, which reported that students studying a
life-science course, health workers and highly educated people have greater knowledge on covid-
19 vaccination (Gall et al., 2021).

The study found out that the 5th year optometry students have a fair perception of covid-19
vaccination. Perception regarding covid-19 vaccination showed a significant association with
readiness to take the vaccine. In the current study, 51.5% of the respondents assumed that the
vaccines are safe considering their course of development. Also, in the current study, 53% of the
respondents reported that they were willing to pay if the vaccines came at a cost. This is
inconsistent with the Bangladesh study where 99% of the participants reported that the vaccines
should be free (Islam et al., 2021).

5.2 STRENGTHS
The research study to the best of our knowledge is the first of its kind in the 5th year optometry
class hence, will serve as a reference for future research. The study design used (cross-sectional
study) allows for easy analysis of data to draw conclusion. It is also cheap and less time consuming.

5.3 LIMITATIONS
The research study has some limitations. First, knowledge, attitude, and perception could not be
explored extensively due to the need to avoid numerous questions. This could have concealed

30
necessary information regarding uncollected variables. Furthermore, the sample size was limited,
therefore, findings cannot be generalized. Moreover, the males outnumbered the females, hence
creating some degree of bias in the responses. Lastly, the study failed to provide a qualitative
viewpoint on attitude and perception toward the Covid-19 vaccination and its correlated factors,
which could have buttressed the quantitative findings.

5.4 DISSEMINATION OF RESULTS OF STUDY

A copy of the research findings in the form of an article will be pasted on the notice board at the
department of optometry and visual science and the nursing department. Project findings will be
published in local or international journals. Findings will be presented at workshops and research
conferences.

5.5 CONCLUSION
In conclusion, the knowledge, attitude, and perception of the 5th-year optometry students towards
the covid-19 vaccination were fair. The study showed more positive attitudes but inadequate
knowledge towards covid-19 vaccination. Therefore, there is the need to improve health education
programmes and accurate information distribution. Additionally, more future research should be
done to explore on the knowledge, attitude, and perception of health students towards covid-19
vaccine uptake and its influencing factors using qualitative data.

31
 REFERENCES

Acheampong, T., Akorsikumah, E. A., Osae-Kwapong, J., Khalid, M., Appiah, A., & Amuasi, J.
H. (2021). ExaminZing vaccine hesitancy in sub-saharan africa: A survey of the knowledge
and attitudes among adults to receive covid-19 vaccines in ghana. Vaccines, 9(8).
https://doi.org/10.3390/vaccines9080814
Adane, M., Ademas, A., & Kloos, H. (2022). Knowledge , attitudes , and perceptions of COVID-
19 vaccine and refusal to receive COVID-19 vaccine among healthcare workers in
northeastern Ethiopia. BMC Public Health, 1–14. https://doi.org/10.1186/s12889-021-12362-
8
Addo, P. C., Kulbo, N. B., Sagoe, K. A., Ohemeng, A. A., & Amuzu, E. (2021). Guarding against
COVID-19 vaccine hesitance in Ghana: analytic view of personal health engagement and
vaccine related attitude. Human Vaccines and Immunotherapeutics, 17(12), 5063–5068.
https://doi.org/10.1080/21645515.2021.2008729
Alhassan, R. K., Aberese-Ako, M., Doegah, P. T., Immurana, M., Dalaba, M. A., Manyeh, A. K.,
Klu, D., Acquah, E., Ansah, E. K., & Gyapong, M. (2021). COVID-19 vaccine hesitancy
among the adult population in Ghana: evidence from a pre-vaccination rollout survey.
Tropical Medicine and Health, 49(1). https://doi.org/10.1186/s41182-021-00357-5
Amo-Adjei, J., Nurzhynska, A., Essuman, R., & Lohiniva, A.-L. (2022). Trust and willingness
towards COVID-19 vaccine uptake: a mixed-method study in Ghana, 2021. Archives of
Public Health, 80(1), 1–12. https://doi.org/10.1186/s13690-022-00827-0
COVID-19 Situation Dashboard | Ghana. (n.d.). Retrieved June 21, 2022, from
https://www.ghs.gov.gh/covid19/dashboardm.php
Gall, F., Sabella, E. A., Roma, P., Giglio, O. De, Caggiano, G., Tafuri, S., Molin, G. Da, Ferracuti,
S., Montagna, M. T., Liguori, G., Orsi, G. B., & Napoli, C. (2021). Knowledge and
Acceptance of COVID-19 Vaccination among Undergraduate Students from Central and
Southern Italy. 1–13.
How do vaccines work? (n.d.).
Id, T. T., Wakuma, B., Turi, E., Mulisa, D., Ayala, D., Fetensa, G., Mengist, B., Abera, G.,

32
 Atomssa, E. M., Seyoum, D., Shibiru, T., & Getahun, A. (2022). Attitude of health
professionals towards COVID-19 vaccination and associated factors among health
professionals , Western Ethiopia : A cross-sectional survey. 1–14.
https://doi.org/10.1371/journal.pone.0265061
Islam, S., Siddique, A. B., Akter, R., Tasnim, R., Sujan, S. H., Ward, P. R., & Sikder, T. (2021).
Knowledge , attitudes and perceptions towards COVID-19 vaccinations : a cross- sectional
community survey in Bangladesh. 1–11.
Kenu, E., Frimpong, J. A., & Koram, K. A. (2020). Responding to the COVID-19 pandemic in
Ghana. Ghana Medical Journal, 54(2), 72. https://doi.org/10.4314/GMJ.V54I2.1
Latinne, A., Hu, B., Olival, K. J., Zhu, G., Zhang, L., Li, H., Chmura, A. A., Field, H. E.,
Zambrana-Torrelio, C., Epstein, J. H., Li, B., Zhang, W., Wang, L. F., Shi, Z. L., & Daszak,
P. (2020). Origin and cross-species transmission of bat coronaviruses in China. Nature
Communications, 11(1), 4235. https://doi.org/10.1038/s41467-020-17687-3
Preventing the spread of the coronavirus - Harvard Health. (n.d.).
Rzymski, P., Zeyland, J., Poniedziałek, B., Małecka, I., & Wysocki, J. (2021). The perception and
attitudes toward covid-19 vaccines: A cross-sectional study in poland. Vaccines, 9(4), 1–13.
https://doi.org/10.3390/vaccines9040382
Shen, K., Yang, Y., Wang, T., Zhao, D., Jiang, Y., Jin, R., Zheng, Y., Xu, B., Xie, Z., Lin, L.,
Shang, Y., Lu, X., Shu, S., Bai, Y., Deng, J., Lu, M., Ye, L., Wang, X., Wang, Y., & Gao, L.
(2020). Diagnosis, treatment, and prevention of 2019 novel coronavirus infection in children:
experts’ consensus statement. World Journal of Pediatrics, 16(3), 223–231.
https://doi.org/10.1007/S12519-020-00343-7
Singh, T., & Bono, S. (n.d.). Knowledge , attitude and practice towards COVID-19 vaccination
acceptance in West India.
Sonmezer, M. C., Sahin, T. K., Erul, E., & Ceylan, F. S. (2022). Knowledge , Attitudes , and
Perception towards COVID-19 Vaccination among the Adult Population : A Cross-Sectional
Study in Turkey. 2019(January), 1–12.
Acheampong, T., Akorsikumah, E. A., Osae-Kwapong, J., Khalid, M., Appiah, A., & Amuasi, J.
H. (2021). Examining vaccine hesitancy in sub-saharan africa: A survey of the knowledge
and attitudes among adults to receive covid-19 vaccines in ghana. Vaccines, 9(8).
https://doi.org/10.3390/vaccines9080814

33
Adane, M., Ademas, A., & Kloos, H. (2022). Knowledge , attitudes , and perceptions of COVID-
19 vaccine and refusal to receive COVID-19 vaccine among healthcare workers in
northeastern Ethiopia. BMC Public Health, 1–14. https://doi.org/10.1186/s12889-021-12362-
8
Addo, P. C., Kulbo, N. B., Sagoe, K. A., Ohemeng, A. A., & Amuzu, E. (2021). Guarding against
COVID-19 vaccine hesitance in Ghana: analytic view of personal health engagement and
vaccine related attitude. Human Vaccines and Immunotherapeutics, 17(12), 5063–5068.
https://doi.org/10.1080/21645515.2021.2008729
Alhassan, R. K., Aberese-Ako, M., Doegah, P. T., Immurana, M., Dalaba, M. A., Manyeh, A. K.,
Klu, D., Acquah, E., Ansah, E. K., & Gyapong, M. (2021). COVID-19 vaccine hesitancy
among the adult population in Ghana: evidence from a pre-vaccination rollout survey.
Tropical Medicine and Health, 49(1). https://doi.org/10.1186/s41182-021-00357-5
Amo-Adjei, J., Nurzhynska, A., Essuman, R., & Lohiniva, A.-L. (2022). Trust and willingness
towards COVID-19 vaccine uptake: a mixed-method study in Ghana, 2021. Archives of
Public Health, 80(1), 1–12. https://doi.org/10.1186/s13690-022-00827-0
COVID-19 Situation Dashboard | Ghana. (n.d.). Retrieved June 21, 2022, from
https://www.ghs.gov.gh/covid19/dashboardm.php
Gall, F., Sabella, E. A., Roma, P., Giglio, O. De, Caggiano, G., Tafuri, S., Molin, G. Da, Ferracuti,
S., Montagna, M. T., Liguori, G., Orsi, G. B., & Napoli, C. (2021). Knowledge and
Acceptance of COVID-19 Vaccination among Undergraduate Students from Central and
Southern Italy. 1–13.
How do vaccines work? (n.d.).
Id, T. T., Wakuma, B., Turi, E., Mulisa, D., Ayala, D., Fetensa, G., Mengist, B., Abera, G.,
Atomssa, E. M., Seyoum, D., Shibiru, T., & Getahun, A. (2022). Attitude of health
professionals towards COVID-19 vaccination and associated factors among health
professionals , Western Ethiopia : A cross-sectional survey. 1–14.
https://doi.org/10.1371/journal.pone.0265061
Islam, S., Siddique, A. B., Akter, R., Tasnim, R., Sujan, S. H., Ward, P. R., & Sikder, T. (2021).
Knowledge , attitudes and perceptions towards COVID-19 vaccinations : a cross- sectional
community survey in Bangladesh. 1–11.
Kenu, E., Frimpong, J. A., & Koram, K. A. (2020). Responding to the COVID-19 pandemic in

34
 Ghana. Ghana Medical Journal, 54(2), 72. https://doi.org/10.4314/GMJ.V54I2.1
Latinne, A., Hu, B., Olival, K. J., Zhu, G., Zhang, L., Li, H., Chmura, A. A., Field, H. E.,
Zambrana-Torrelio, C., Epstein, J. H., Li, B., Zhang, W., Wang, L. F., Shi, Z. L., & Daszak,
P. (2020). Origin and cross-species transmission of bat coronaviruses in China. Nature
Communications, 11(1), 4235. https://doi.org/10.1038/s41467-020-17687-3
Preventing the spread of the coronavirus - Harvard Health. (n.d.).
Rzymski, P., Zeyland, J., Poniedziałek, B., Małecka, I., & Wysocki, J. (2021). The perception and
attitudes toward covid-19 vaccines: A cross-sectional study in poland. Vaccines, 9(4), 1–13.
https://doi.org/10.3390/vaccines9040382
Shen, K., Yang, Y., Wang, T., Zhao, D., Jiang, Y., Jin, R., Zheng, Y., Xu, B., Xie, Z., Lin, L.,
Shang, Y., Lu, X., Shu, S., Bai, Y., Deng, J., Lu, M., Ye, L., Wang, X., Wang, Y., & Gao, L.
(2020). Diagnosis, treatment, and prevention of 2019 novel coronavirus infection in children:
experts’ consensus statement. World Journal of Pediatrics, 16(3), 223–231.
https://doi.org/10.1007/S12519-020-00343-7
Singh, T., & Bono, S. (n.d.). Knowledge , attitude and practice towards COVID-19 vaccination
acceptance in West India.
Sonmezer, M. C., Sahin, T. K., Erul, E., & Ceylan, F. S. (2022). Knowledge , Attitudes , and
Perception towards COVID-19 Vaccination among the Adult Population : A Cross-Sectional
Study in Turkey. 2019(January), 1–12.

35