Unity University

Faculty of Health Science

Department of Nursing
KNOWLEDGE, ATTITUDE AND ACCEPTANCE OF COVID-19 AMONG HIGHER
EDUCATION STUDENTS IN ADDIS ABABA, ETHIOPIA 2022
GROUPMEMBERS
1. Beariyam Sisay UUSCHS 033
2. Bezawit Tassew UUSCHS 037
3. Eden Melese UUSCHS 169
4. Habiba Mohammed surur UUSCHS 147
5. Mieraj Sultan UUSCHS 050
6. Selam Ekubazgi UUSCHS 054
7. Tihitina Diribssa UUSCHS 125
8. Zinash Dendir UUSCHS 132

The proposal is submitted to Unity University, college of health sciences, department of

nursing for partial fulfillment of requirement of undergraduate degree.

30 May 2022G.C
Addis Abeba Ethiopia
ACKNOWLEDGMENT
First and for most we would like to thank our God for helping us accomplish this paper and
secondly we would like to express our sincere gratitude to our advisor Mr. Tewodros Tesfaye for
his help, dedication and also for his constructive comments and assistance.
ABBREVATIONS AND ACRONYMS
BioNTech- Biology and Technology
CT- computerized tomography
COVID-19- coronavirus disease
MoH- Ministry of health
SARS- Severe acute respiratory syndrome
SARSC0V-2- Severe acute respiratory syndrome coronavirus 2
WHO- World Health Organization
ETB- Ethiopian birr
CI- Confidence interval
BSc- Bachelor of science
SPSS- statistical package for social science
Table of Contents

Contents
List of Figures................................................................................................................................................4
List of Table...................................................................................................................................................4
ACKNOWLEDGMENT .................................................................................................................................... 4
ABBREVATIONS AND ACRONYMS ................................................................................................................. 5
Summary.......................................................................................................................................................6
Backgrounds ......................................................................................................................................... 8
Problem of statement.............................................................................................................................10
Significance of study ............................................................................................................................... 12
1.4. LITERATURE REVIEW ........................................................................................................................ 12
1.4.1. Socio-demographic characteristics ........................................................................................... 12
1.4.4. Knowledge of Covid-19 vaccination..........................................................................................12
1.4.5. Attitude towards the COVID-19 vaccine ................................................................................... 12
1.4.6. Acceptance of Covid-19 vaccine ............................................................................................... 12
OBJECTIVE...................................................................................................................................................12
General objectives .................................................................................................................................. 12
Specific objectives .................................................................................................................................. 12
Methodology .............................................................................................................................................. 12
Study area and period ............................................................................................................................ 12
Study design ........................................................................................................................................... 12
Study Population and source .................................................................................................................. 12
Eligibility criteria ..................................................................................................................................... 12
Inclusion Criteria ................................................................................................................................. 12
Exclusion Criteria ................................................................................................................................ 12
Variables of study ................................................................................................................................... 12
Dependent variable ............................................................................................................................ 12
Sample size and sampling procedure ..................................................................................................... 12
Sampling Technique and Procedure ....................................................................................................... 12
Operational definition ............................................................................................................................ 12
Data collection tool and procedure ........................................................................................................ 12
 Pretest .................................................................................................................................................... 12
Data quality assurance ........................................................................................................................... 12
Data processing and analysis .................................................................................................................. 12
Ethical consideration .............................................................................................................................. 12
Dissemination of the result .................................................................................................................... 12
Work plan ................................................................................................................................................... 12
Budget .................................................................................................................................................... 12
Annex I Greeting ......................................................................................................................................... 12
Annex II; Consent form ............................................................................................................................... 12
Annex III-English version of questionnaire Assessment of knowledge, attitude and acceptance of
COVID-19 vaccine. ...................................................................................................................................... 12
List of Figure
Figure 1: Schematic presentation of sampling procedures ............................................................ 24

List of Table
Table 1: plan of activities for a study on the knowledge, attitude, and acceptance toward
covid-19 vaccination among students in selected higher education Addis Ababa Ethiopia 2022 27
Table 2: Budget summary..............................................................................................................29
Table 3: Socio-demographic characteristics among university students 2022G.C ....................... 36
Table 4: Questions on Vaccination status among study participants. ........................................... 38
Table 5: Assessment on general knowledge of covid-19 vaccination among higher education
students. ......................................................................................................................................... 39
Table 6: Assessment of Knowledge about covid-19 transmission and symptoms among higher
education students..........................................................................................................................40
Table 7: Questions on Attitude about COVID-19 Vaccination on higher education students. ..... 43
Table 8: Factors affecting acceptance of covid-19 vaccination.....................................................44
Summary
BACKGROUND: Coronavirus disease (COVID-19) is a deadly disease which continues to
affect many countries in the world. This is caused by the new coronavirus strain severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2) which has become a serious public health
concern worldwide. The best way to protect the community from this highly contagious virus
aside from using preventive measures is introducing vaccines. Vaccines are effective
interventions that can reduce the high burden of diseases globally.
OBJECTIVES: To evaluate the knowledge, attitude and acceptance of the COVID 19 vaccines
and related factors among unity university students in Addis Ababa, Ethiopia
METHOD: An Institutional based cross-sectional survey was conducted in St.Mary's
university,St. Lideta Health science and Business collage and Rift Valley University, Addis
Ababa, Ethiopia. Data collection will be done via self-administrated questionnaire.
CONCLUSION: Acceptance of the COVID-19 vaccine is an essential determinant of vaccine
uptake and the likelihood of controlling the COVID-19 pandemic. Developing strategies to
decrease public hesitation and increase trust is vital for implementing vaccination programs.

KEY WORDS: Knowledge, Attitude, Acceptance, University students, COVID-19

 INTRODUCTION
1.1. Backgrounds
COVID-19 is a new strain of coronavirus that has not been previously identified. The COVID-19
is the cause of an outbreak of respiratory illness first detected in Wuhan, Hubei province, China.
Since December 2019, cases have been identified in a growing number in countries.[1]
People with COVID-19 have had a wide range of symptoms reported – ranging from mild
symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. Anyone
can have mild to severe symptoms. People with these symptoms may have COVID-19: fever or
chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches,
headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting,
diarrhea [2]

Diagnostics can play an important role in the containment of COVID-19, enabling the rapid
implementation of control measures that limit the spread through case identification, isolation,
and contact tracing (i.e., identifying people that may have come in contact with an infected
patient). [3] Regarding the transmission, current evidence suggests that the virus spreads mainly
between people who are in close contact with each other, for example at a conversational
distance. The virus can spread from an infected person’s mouth or nose in small liquid particles
when they cough, sneeze, speak, sing or breathe. Another person can then contract the virus
when infectious particles that pass through the air are inhaled at short range (this is often called
short-range aerosol or short-range airborne transmission) or if infectious particles come into
direct contact with the eyes, nose, or mouth (droplet transmission).
The virus can also spread in poorly ventilated and/or crowded indoor settings, where people tend
to spend longer periods of time. People may also become infected when touching their eyes, nose
or mouth after touching surfaces or objects that have been contaminated by the virus. [4]
The best way to protect the community from this highly contagious virus aside from using
preventive measures is introducing vaccines. Vaccines train your immune system using a
harmless form of the virus, SARS-CoV-2, which causes COVID-19. Vaccines stimulate an
immune response without causing illness. Each type of vaccine for COVID-19 works differently
to introduce antigens, which are unique features of the SARS-CoV-2 virus, to your body. The
antigen triggers a specific immune response and this response builds immune memory, so your
body can fight off SARS-CoV-2 in future. [5] . Currently used five vaccines approved by the
EMA are: Pfizer–BioNTech, Johnsen-Johnsen, Novavax, Moderna and Oxford–AstraZeneca.

Low- and middle-income countries are at risk of vaccination delays due to several reasons: lack
of public trust, shortage of resources, and scarcity of vaccination supply as many high-income
countries secure a large amount of the new vaccines, without prioritizing other countries.[6]

Based on the latest COVID-19 vaccination dataset 65.2% of the world population has received at
least one dose of a COVID-19 vaccine. 11.56 billion doses have been administered globally, and
11.7 million are now administered each day. Only 15.3% of people in low-income countries have
received at least one dose.[7]
As for Ethiopia, On March 13, 2020, the first COVID-19 was identified. Since then, the number
of new cases in the country has been rapidly increasing. As of March 10, 2021, the country had
168,335 COVID-19 positive cases and 2451 deaths domestically. As a result, Ethiopia became
one of the five African countries with the largest COVID-19 case burden. Ethiopia’s
government, on the other hand, has been working hard to disseminate information about
COVID-19 prevention measures through television, radio, and social media, and had declared a
state of emergency.[8]
In Ethiopia, from 3 January 2020 to 28 April 2022, there have been 470,492 confirmed cases of
COVID-19 with 7,510 deaths, reported to WHO. As of 10 April 2022, only 21% (a total of
29,411,822 vaccine doses have been administered).[9]

Therefore, we chose university students for this initial study as a number of these people will
become influential in the future. Hence it is critical to evaluate university students intentions
regarding the COVID-19 vaccination, leading to more widespread knowledge distribution.
1.2. Problem of statement
Coronavirus disease (COVID-19) is a deadly disease which continues to affect many countries in
the world. This is caused by the new coronavirus strain severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2) which has become a serious public health concern worldwide [10].
The virus that causes COVID-19 is mainly transmitted through droplets generated when an
infected person coughs, sneezes, or exhales [11,12]. Countries within Africa and Asia that
introduced preventative measures early appeared to have lower prevalence and morbidity rates
than countries than introduced such measures later on such as Western European countries
certainly during the early stages of the pandemic. [13-15]
The pandemic’s impact on the global economy combined with disruptions it causes in Ethiopia
represents a large, unprecedented shock to the country’s economy. Although the country took
early swift measures, our assessment of the partial lockdown measures suggests that they were
not as strict as those observed in other Africa countries. Accordingly, our estimates of the
economic costs of COVID-19 on Ethiopia are significantly lower than those reported for other
countries on the continent. We estimate that during the lockdown period Ethiopia’s GDP
suffered a 14 percent loss (43.5 billion Birr or 1.9 billion USD) compared to a no-COVID case
over the same period. Nearly two-thirds of the losses were in the services sector.. The broader
agri-food system also was affected considerably because of its linkages with the rest of the
economy. In terms of the welfare of Ethiopians, we estimate that the economic impacts during
the lockdown caused 10.1 million additional people to fall below the poverty line [16]
Healthcare professionals also suffered from insomnia, loneliness, sleep disorder, and mental
depression as a result of the workload and related stress [17]. They were experiencing anxiety
attacks as well as frustration due to a lack of knowledge, environmental changes, and fear of
infection both by themselves and by their family members [18]. The world has implemented
different COVID-19 prevention measures, like quarantine, restricted movement, nationwide
lockdowns, [19] hand washing with water and soap, keep respiratory hygiene, and use facemask
[20,21]. Despite the implementation of these measures across the world, the burden of the
pandemic is not significantly reduced [22].. The health and economic burden of the pandemic
prompted the need for timely and effective vaccine development [23]. Hence, vaccination was
considered as the best strategy for controlling the transmission of the disease [22]
Globally, 12 March 2022 there have been 452,201,564 confirmed cases of COVID-19, including
6,029,852 deaths, reported to WHO. In Africa 8,481,781 Confirmed case [20]. In Ethiopia, from
3 January 2020 to 12 March 2022, there have been 469,134 confirmed cases of COVID-19 with
7,484 deaths, reported to WHO[24]. 63.5% of the world population has received at least one
dose of a COVID-19 vaccine. 10.86 billion Doses have been administered globally, and 18.29
million are now administered each day [25].
Based on the latest COVID-19 vaccination dataset 65.2% of the world population has received at
least one dose of a COVID-19 vaccine. 11.56 billion doses have been administered globally, and
11.7 million are now administered each day. Only 15.3% of people in low-income countries have
received at least one dose.[7]
Vaccine hesitancy is complex and is influenced by multiple factors. Some of factors associated
with COVID-19 vaccine hesitancy are lack of confidence in the vaccine itself, the possible
justification might be social media such as face book and telegram might distribute
misinformation and conspiracies theories regarding the COVID-19 vaccine might cause
menstrual disturbance and infertility and lack of adequate information about the COVID-19
vaccine. The major cited reasons for COVID-19 vaccine hesitancy were due to side effects,
concerned about efficacy and might be those were found ≤ 23 year old might consider
themselves as healthy, young and have immunity that could protect them from severe COVID-19
complications. Therefore, building the public confidence in vaccines is an important starting
point towards acceptance and sufficient uptake of safe COVID-19 vaccines [26]. In this regard,
identifying and addressing possible gaps and COVID-19 vaccine related misconceptions in the
public is a key element to be taken into consideration [27].
Universities are considering high risk area for COVID-19 outbreak given the crowded
environment of campuses with the high mobility and limited space. Extensive vaccination of
college students is important in the context of vaccination safety assessment and improving
vaccination coverage and control of disease [18]. Therefore the objective of this study is to
determine the level knowledge, attitude and acceptance of COVID 19 vaccine among higher
education students.
1.3. Significance of study
University students play a critical role in all societies. They are regarded as wise, influential,
receptive, informed, and responsive to public health challenges. To ensure herd immunity and
develop effective COVID-19 vaccination programs, it is crucial to identify the factors that
influence the intention and behavior of the specialized group with possible reluctance or
hesitancy about COVID-19 vaccines. Furthermore, the majority of university students lives in
residential halls and shared housing.
Hence, it is critical to evaluate university students’ intentions regarding the COVID-19
vaccination, leading to more widespread knowledge distribution. The transmission of COVID-19
is very high among University students due to the presence of different contributing factors.
They are very active both on social media and in the community. They make an opportunity to
make judgments by their own. Furthermore, they may participate in different activities like sport
clubs, and part-time work which makes good opportunity to contract COVID-19 pandemic.

For health professionals

The result of this study will help for health professional to go out for or undertake proactive
campaigns to universities and know they will be able to know the level of knowledge and
attitude of the students.
This study will also help them to work on how they (the health professions) provide explanation
and advocate the students’ knowledge and attitude.
For other health care stakeholders
The result of this study would assist policymakers to undertake proactive campaigns and
well-designed strategies and to provide vaccine.
For other researchers
This study will be useful for other investigators as a baseline data for further research in the
study area.
1.4. LITERATURE REVIEW
1.4.1. Socio-demographic characteristics
In a cross-sectional survey conducted on students from three universities in China., the male to
female ratio was approximately 1:1.6, and most participants were aged 18–21 years old (84.7%).
Most students were of Han nationality (98.5%). The proportion of students majoring in Science
and Engineering, Humanities and Social Science, Medicine, and Natural Science was
approximately 1:2.8:1.7:1.2. More than half of students had a science background (58.5%),
which is consistent with the proportion of existing majors in China. Most of the students’
families lived in rural areas (47.9%) and new urban communities (39.5%). A majority of students
were from medium-income families (75.8%) and most spent approximately 800–1,500 yuan per
month (66.4%). Nearly all students had no underlying health conditions (98%) and had not
visited high and medium-risk COVID-19 areas in the past 6 months (99.2%). Most students had
not yet received the COVID-19 vaccine (81.6%). Nearly half of students’ family members had
received vaccines (41.4%). [28]
And In a population-based cross-sectional explanatory e-survey conducted in Ethiopia, a total
of 425 participants in the study were included. The average age of participants was 29.2
years (SD=9.8). Approximately half were male 216 (50.8%) and 195 (45.8%) had college
and above followed by secondary school 180 (42.4%). Most were single/divorced/widowed
309 (72.5%). [29]

1.4.4. Knowledge of COVID-19 vaccination

A study in Nigeria indicates that majority of the respondents are knowledgeable about the
approved COVID-19 vaccines such as Johnson & Johnson’s(70.8), Moderna (61.4),
AstraZeneca–Oxford (57.2), and Pfizer–BioNTech (51.8). However, only a few were able to
correctly identify that some vaccines are not meant for COVID-19, such as K-BCG (44.9) and
K-Anthrax (42.0). The study also revealed that majority of respondents were aware that
COVID-19 vaccination could protect them from getting sick with COVID-19 (77.4), and after
getting a COVID-19 vaccine, they can still test positive for COVID-19 on a viral test (58.0).
Meanwhile, a smaller percentage of students believed that the COVID-19 vaccine could alter
their DNA (29.0), they do not need to get vaccinated if they already had COVID-19 (36.7), and
the vaccine can make them sick with COVID-19 (31.1). [30]
And from the total study participants taken in a research in Northwest Ethiopia , 46.8% (95% CI:
43.3, 50.6) had good knowledge about COVID-19 vaccinations). The mean score of knowledge
was 5.48 with the standard deviation (SD) of 3.05. Five hundred thirty-six (85.6%) study
participants have ever heard about COVID-19 vaccine. Nearly two-thirds (64.9%) of participants
didn't know COVID-19 vaccine effectiveness. Also, approximately one-third (34.2%) of
participants did not know current availability of COVID-19 vaccines[31]

1.4.5. Attitude towards the COVID-19 vaccine

The mean score of attitudes was significantly higher among participants who reported being
female and having previous history of receiving all the necessary vaccines. Adjusted multiple
regression, using only variables that were statistically significant in bivariate analysis, retained
being female and having previous history of receiving all the necessary vaccines as factors
significantly associated with attitudes .Of particular interest is that only about a quarter of
participants(26%)regard the current COVID-19 vaccine In Bangladesh, almost 60%would have
the vaccine without hesitation and two thirds would encourage family or friends to have the
vaccination (66%).Therefore, public health work is required to positively impact on attitudes to
the COVID-19 vaccination. [32]
Binary logistic regression analysis is done in a study conducted among Chinese college students.
It revealed that students living in urban and those with health-related course were positively
associated with acceptance of future COVID-19 vaccination. In addition, college students who
worried about being infected with COVID-19, who heard about the COVID-19 vaccines
previously, who thought that vaccines are safe, who thought that vaccines could protect people
from being infected with COVID-19, and who encouraged their family and friends to have the
vaccine (all p values<0.05) were more likely to accept future COVID-19 vaccination.[33]
1.4.6. Acceptance of COVID-19 vaccine
Factors involved in determining vaccine acceptance revealed that female students seemed to be
prone to vaccine defiance and hesitancy. Alongside, students of lower-income families were
more likely to be hesitant toward the vaccine. Interestingly, the likelihood of vaccine resistance
and vaccine hesitancy prevailed among students with no COVID-19 infection history. Putting it
simply, a pre-infection history raised the vaccine acceptance rate among the studied population.
Moreover, students with inadequate vaccine knowledge, negative perceptions, and negative
attitudes toward the vaccine were more likely to refuse or equivocate a COVID-19 vaccine. [34]
2. OBJECTIVE
2.1. General objectives
To evaluate the knowledge, attitude and acceptance of the COVID-19 vaccines among higher
education students in Addis Ababa, Ethiopia.
2.2. Specific objectives
 To assess knowledge of student towards COVID-19 vaccine.
 To determine attitude of student towards COVID-19vaccine.
 To assess acceptance of student towards COVID-19 vaccine.
 3. Methodology
3.1. Study area and period
An institutional-based cross-sectional study design will be conducted among students in
Ethiopian higher education institutions from June 15 to 30, 2020. In Ethiopia, there are about 45
public and 83 higher private institutions. The study will be conducted at higher private
institutions by which lottery method was used to pick out. Among them are St.Mary's
University, St.Lideta Health science and Business collage and Rift Valley University.
3.2. Study design
An Institutional based cross-sectional survey will be conducted on St.Mary's university, St.
Lideta Health science and Business collage and Rift Valley University.
3.3. Study Population and source
All study population found in higher education institution, in Addis Ababa studying in St. Mary
university, Rift valley university, and St.Lideta university during the study period. The study
population will be all students studying in St. Mary University: Computer Science, Accounting
and finance, Management, Marketing management, and Tourism departments. In Rift Valley
University: Marketing management, Business management, and Computer science and
accounting & finance departments. In St.Lideta university: Accounting & finance, and Business
management departments.
3.4. Eligibility criteria
3.4.1. Inclusion Criteria
Students studying in computer science, Accounting and finance, management, marketing
management, Economics, and business management departments
3.4.2. Exclusion Criteria
Those that will not be existing at a time of data collection. Students who study at health science
departments and extension students.

Variables of study
Dependent variable
Attitude, Knowledge and Acceptance level of other than health students toward COVID-19
vaccine.
 Independent variable
Socio-demographic characteristics gender, age, marital status, educational status, social media,
residence area and chronic medical illness.
3.5. Sample size and sampling procedure
A single population proportion formula is used to calculate the sample size. we use 50% of
prevalence was used to get the maximum sample size by considering 95% confidence interval,
marginal error (d) of 5% and 10% non-response rate.
2 2
Z ×P(1-P) 1.96 ×0.5(1-0.5)
n= = = 384.16 ≈384
2 2
D 0.05

We use adjust the formula because the total population is less than 10,000
na= nr = 384 = 314.75≈315 add 10% non-respond rate the total sample size will be
1+ (nr-1) 1+(384-1)
N 1715

346.5≈347
3.6. Sampling Technique and Procedure
Simple random sampling or lottery method will be used to select higher educational institutes
and the total sample size of the study will be allocated to each institution based on the number of
students in each institution the study participants or samples will be selected by the day the data
will be collected.
Proportional for each selected institutions based on the department
Proportionate sample (n) = total sample size (nt) ×population of individual institutions(N)
total population(Nt)

Proportionate sample of St. Marry University= 315 ×1563 = 287

1715

Proportionate sample of Rift valley university= 315 ×92 = 16.89 ≈ 17

1715

Proportionate sample of St. Lideta university= 315×50 = 9.18 ≈ 9

1715
Schematic presentation of sampling procedures

All private higher institutions

Lottery method is used to select ----- institutions

Rift Valley St. Mary St. Lideta

University University University

N1 = 92 N2= 1563 N3= 50

Proportionate to size sample

Total sample size (nt) = n1+n2+n3=347

Figure 2: Schematic presentation of sampling procedures

3.7. Operational definition
Good knowledge: - participants who scored the mean value and above the mean on knowledge
questions.
Poor knowledge: - participant who scored below the mean value on knowledge questions.
Positive attitude: - when study participants respond the mean value or more of attitude questions
Negative attitude: - when study participants respond to less than mean value of attitude questions
Good acceptance: - when study participants respond the mean value or more of acceptance
questions
Poor acceptance: - when study participants respond to less than mean value of acceptance
questions
3.8. Data collection tool and procedure
Data will be collected using self-administered questionnaire using close ended questions. The
questionnaire will not be translated into any of the other official languages as the language used
in both institutions is English. The questionnaire will be adapted and modified from previously
published studies.[35][36][37][28] The questionnaire will be structured into four distinctive
parts; socio- demographic (13 questions), knowledge (26 questions), attitude (11 question),
acceptance (6 questions). During data collection three teams namely data collectors and
supervisors will be involved and the data collectors and supervisors will be eight BSC graduating
nurses. Training will be given for data collectors and supervisors by advisor for one day
regarding the purpose, objective of the study, the contents of questionnaires, the method of data
collection and how to keep confidentiality and privacy. Data collection will be during day time in
free time or lunch time started after submitting of the proposal and getting acceptance of the
proposal by the Unity University faculty of health science department of nursing in order to
obtain permission and approval letter for data collection then permission will be obtained from
higher education institution, Rift valley University, ST. Mary university college, ST. Lideta
health science college, to collect the data. Verbal Consent will be obtained from the participants
and confidentiality and privacy of information will be told for study participants.
3.9. Pretest
Pretest will be conducted before data collection on 5% of sample other than study area at Alkan
medical and Business college to assess clarity of the questions, if there any ambiguity regarding
the tool will be reword /or rephrasing again or if any changes must be done to be applied.
3.10. Data quality assurance
One day training will be given for data collectors and supervisors by advisor regarding the
purpose of the study, how to collect the data, how to keep confidentiality and privacy. Before the
data collection Pretest will be done to maintain quality of questionnaires and after data collection
the completeness of the data will be checked by the principal investigator and supervisor in
addition any problem during data collection encountered will be discussed among the team and
will be solved immediately.
All questionnaires will be evaluated for missing or duplicate answers. Unanswered questions and
questions marked with two response alternatives will be scored as incorrect responses.
Descriptive statistics (means, standard deviation, frequencies and percentages) will be calculated
for all questionnaire items.
3.11. Data processing and analysis
The collected data will be entered in to Epi data 7.0 and exported to SPSS version 24 statistical
packages for further analysis and will be cleaned, edited and analyzed. Frequencies and
Percentage will be used to summarize descriptive statistics, mean, and standard deviation will be
used while tables and charts will be used for data presentation.

3.12. Ethical consideration

This study will be carried out after getting approval from the Ethical Review Committee of unity
University and the copy of approval letter given for St. Mary’s university, Rift Valley university,
St.lideta university and Alkan medical and business collage research group. Then data will be
collected after getting a written consent from research group. Informed verbal consent also will
be obtained from each study participants. All participants will be informed about the purpose of
the study, the importance of their participation, maintenances of privacy and confidentiality prior
to data collection. Participants’ involvement in the study is on voluntary basis; participants who
are unwilling to participate in the study and those who wish to quit their participation will be
informed to do so without any restriction. Privacy and confidentiality of information given by
each study participants will be maintained by omitting their names in the questionnaire.
3.13. Dissemination of the result
The result of this study will be presented and submitted in the form of soft and hard copy to unity
university faculty of health science and department of nursing as partial fulfillment of the
requirement for degree in clinical nursing.
4. Work plan

Table 1: plan of activities for a study on the knowledge, attitude, and acceptance toward covid-19
vaccination among students in selected higher education Addis Ababa Ethiopia 2022
Sr.no Activity Responsib Jan Feb Mar Apr May June July Aug
le unit
1. Topic selection RER
and approval committee
2. Finalizing the Advisor,
topics of the and RER
research committee
3. Submission of RER
draft proposal to committee
RER committee and
advisors
4. Facilitating Students
student research
work to submit at
least every 2
weeks to
respective adviser
5. Training of data Students
collectors and and
pretest advisors
6. Data collection Students
and data entry
and
7. Data analysis Students
8. Reporting finding Students
9. submission of first RER
draft and research committee
 defense and
advisors
10. Research project Students
writing up and
finalization
11. Defense of the RER
research project committee
and
advisors
4.1. Budget
Table 2: Budget summary
Items Cost
Transportation 500 ETB
Stationary (pen pencil) 100 ETB
Paper printing and duplicating ink 3500 ETB
Flash disk and CD 250 ETB
Card 500 ETB
Total 4850 ETB
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Annex I Greeting
Hello, I am____________. I am a student at Unity University, faculty of Health Science. I would
like to ask you few questions about knowledge, attitude and acceptance on covid-19 vaccination.
Your name will not be written in this form and will never be used in connection with any
information you tell us. All information given by you will be kept strictly confidential. Your
participation is voluntary and you are not obliged to answer any question you do not wish to
answer. If you feel discomfort with the interview please feel free to drop it any time you want.
But, your willingness to answer all of the questions would be appreciated. Your correct answer
to the questions can make the study achieve the goals. Therefore, you are kindly requested to
respond genuinely and voluntarily with patience.
Do I have your permission to continue? 1. Yes 2. No If yes, continue to the next page. If no, skip
to the next participant by writing reasons for his/ her refusal
Name and Signature of the data collector __________________________________ Date of
interview ____________Time started ___________Time completed________ Checked by
Supervisor: Name _______________signature ________ Date_______
Result of interview:
1. Completed
2. Respondent not available.
3. Refused
4. Partially completed.
Annex II; Consent form
The questionnaire must be completed at the school address. If a respondent refuses to co-operate,
make a note for the researcher. Please hand the respondent your letter of introduction or read it
out if necessary. Confirm to the respondent (owner) that the information supplied will be treated
strictly confidential. Obtain signed/verbal Consent.
Follow the instruction to the interviewers carefully to ensure that the questions are asked
according to sequence. Indicate the response by means of a tick or circle in the blocks provided
for closed ended questions or write down the exact response where applicable.
Do not try to influence respondents. Should the respondents give you wrong answers
deliberately, make a note of this next to the relevant question. Check the completed questionnaire
thoroughly to ensure that no question has been skipped and all the questions have responses.
Complete the Observation Checklist. Upon completion of the Questionnaire, thank the
respondent for agreeing to participate and remind them that they will receive feedback.
Annex III-English version of questionnaire Assessment of knowledge, attitude and acceptance of
COVID-19 vaccine.
Table 3: Socio-demographic characteristics among university students 2022G.C
Variable Category
Sex 1.Male
2.Female
Age 1.20–24
2.25–29
3.≥30
Religion 1.Orthodox
2.Muslim
3.Protestant
4.Others
Marital status 1.Single
2.Married
3.Divorced
4.Widowed
Residence 1.Urban
 2.Rural
Year of university level education 1.2nd
2.3rd
3.4th
4.Above
Educational status of mother 1.Cannot read and write
2.Can read and write
3.Primary (grades 1–8)
4.Secondary (grades 9–12)
5.College or above
Educational status of father 1.Cannot read and write
2.Can read and write
3.Primary (grades 1–8)
4.Secondary (grades 9–12)
5.College or above

History of chronic medical illness 1.Yes

2.No
Received training about COVID-19 1.Yes
2.No
Use social media 1.Yes
2.No
Peer is a source of 1.Yes
information about 2.No
COVID-19
Use TV, radio and Newspaper as a source of 1.Yes
COVID-19 information 2.No

Table 4: Questions on Vaccination status among study participants.

Variable Category
Have you vaccinated against COVID-19 virus? 1.Yes
 2.No
What kind of vaccines you were vaccinated 1.AstraZeneca vaccine2.Sinopharm vaccine
3.Pfizer vaccine
4.Johnson & Johnson Vaccine
5.Do not know
It is important to take the vaccine to protect the 1.Yes
people from COVID-19 2.No

Table 5: Assessment on general knowledge of covid-19 vaccination among higher education

students.
Variable Category
There is an effective medicine available for 1.Yes
treating COVID-19 2.No
3.I don't know
There are ways to help slow the spread of 1.Yes
COVID-19 2.No
3.I don't know
Currently there is no vaccine to protect against 1.Yes
COVID-19 2.No
3.I don't know
The ordinary flu vaccine will protect me from 1.yes
COVID-19 2.No
3.I don't know
Antibiotics are an effective treatment for 1.yes
COVID-19 2.No
3.I dont know
Taking vitamin C or other vitamins will protect 1.Yes
you from the COVID-19 2.No
3.I don't know
There is no evidence that vaccines against 1.Yes
pneumonia will protect you against the 2.No
COVID-19 3.I don't know
Regularly rinsing your nose with saline will 1.Yes
protect you against the COVID-19 2.No
3.I don't know
There is no evidence that eating garlic will 1.Yes
protect you against the COVID 2.No
3.I don't know
The health effects of COVID-19 appear to be 1.Yes
more severe for people who already have a 2.No
serious medical condition 3.I don't know

Symptoms of COVID 19 1. Fever

2. Headache
3. Shortness of breath
4. Cough
5. No symptoms

Table 7: Questions on Attitude about COVID-19 Vaccination on higher education students.

Variable Category
Perceived Susceptibility 1.Yes
Are you worried about catching coronavirus? 2.No
Do you believe you are immune to the 1.yes
Coronavirus? 2.No
Perceived Severity 1.Yes
Do you believe that the Coronavirus disease 2.No
would be a mild illness for you
Do you think too much fuss is being made 1.yes
about the risk of the Coronavirus? 2.no

Did the Coronavirus pandemic have a big 1.Yes

impact on your life? 2.No
Perceived Benefits Do you think vaccination 1.Yes
should be made mandatory for everyone? 2.No
Do you think people, who are at risk of serious 1.Yes
illness from the Coronavirus, need to be 2.No
vaccinated on priority basis?
Do you think vaccines will work against 1.Yes
COVID-19 2.no
Perceived Barriers Are you afraid/concerned 1.Yes
about the safety/side effects of the COVID-19 2.No
vaccine?
Cues to Action Do you think we are all 1.Yes
responsible for reducing the spread of the 2.No
Coronavirus?
Do you agree to take the COVID-19 vaccine if 1.Yes
it is not free? 2.No

Table 8: Questions on Acceptance about COVID -19 vaccination on higher education

students
Would you like to receive the
1. Yes
COVID-19 vaccine? 2. No
Would you be willing to
1. Yes
receive the COVID-19
2. No
vaccine if you are charged for
3. I don’t know
it in the future?
STATEMENT OF DECLARATION

By our signature below, we declare and affirm that this proposal is our own work. We have
followed all ethical principles of scholarship in the preparation of this proposal. All scholarly
matter that is included in the proposal has been given recognition through citation. We affirm
that we have cited and referenced all sources used in this document. Every effort has been made
to avoid plagiarism in the preparation of this proposal.
This proposal is submitted in partial fulfillment of the requirement for a graduate degree from
Unity University. We solemnly declare that this proposal has not been submitted to any other
institution anywhere for the award of any academic degree, diploma or certificate.

STUDENT
Name: Signature: Date:
________________________________ _________ ____________
________________________________ _________ ____________
________________________________ _________ ____________
________________________________ _________ ____________
________________________________ _________ ____________
________________________________ _________ ____________
______________________________ _________ ____________
________________________________ _________ ____________

RESEARCH ADVISORS:

NAME_______________________ RANK ________ SIGNITURE _____________

DATE ____________