Acceptance and accessibility to the early phase COVID-19 vaccination among the healthcare workers and hill tribe population in Thailand

Abstract

Coronavirus disease 2019 (COVID-19) is a serious emerging disease and an extreme threat to human life. This study aimed to understand the perceptions of hill tribe people living in the border areas of Thailand-Myanmar and health workers regarding the acceptability and accessibility of the COVID-19 vaccine and health workers' perceptions of the readiness to implement the vaccination program during the early period of national COVID-19 vaccination. A qualitative method was applied to elicit information from key informants who lived in hill tribe villages and the health professionals who served them. The study was conducted in seven hill tribe villages located along the Thailand-Myanmar borders in Mae Fah Luang District, Chiang Rai Province, Thailand. The participants were hill tribe villagers aged 20 years and over; public health care professionals working in village health centers who had primary roles in implementing disease prevention and control measures; and public health care professionals working in districts and provincial public health offices who had primary roles in policy development and implementation. A total of 63 participants (26 men and 37 women) from seven hill tribe villages provided information. Three acceptance choices regarding receiving the COVID-19 vaccine were found among the hill tribes: definite acceptance, likely acceptance, and no preference. Two factors related to obtaining access to the new COVID-19 vaccine were found: Thai citizenship and the level of literacy related to the vaccine. There was no process or protocol in place for implementing the new vaccine among health professionals working at the district, subdistrict, or community levels, but the national expanded immunization program (EPI) system was clearly demonstrated to extend throughout the health service chain in Thailand. During the early period of national COVID-19 vaccine implantation in Thailand, not all members of the hill tribes accepted the vaccine; participant acceptance depended on several factors, including a participant's previous experience with vaccination, whether he or she required more information before making a decision, etc. While acceptance of the vaccine depended on the individual's background, not everyone had an equal opportunity to access the vaccine. The new COVID-19 vaccine should be available at the village level, including in hill tribe villages, to reduce the systemic threat to the country.

Figure 1

Map of the study hill tribe villages in Mae Fah Luang District, Ching Rai Province, Thailand.