Ads511-Factors Influencing Attitudes Towards Vaccination Programme in Sungai Petani

Faculty of Administrative Science & Policy Studies
Universiti Teknologi MARA
Bachelor of Administrative Science (Hons)
Title of Proposal:
Factors influencing attitudes towards

vaccination programme in Sungai Petani.
Name of Students Matric No.
1. NUR HIDAYAH BINTI ABU BAKAR 2021393485

2. NUR HIDAYATI BINTI HARUN 2021340769
MARCH 2022 - FEBRUARY 2023

Acknowledgement
In the name of Allah, the Most Gracious and Most Merciful, the omnipotent creator who has
granted us the opportunity to develop and the eagerness to learn a great deal. Without His favor,
we would be unable to accomplish our mission. Sincere appreciation to the Holy Prophet
Muhammad (Peace be upon him), whose manner of life has consistently guided us.
In addition, we would like to express our gratitude to Professor Madya Dr. Zaherawati Zakaria
for her oversight and unwavering assistance with this particular project. Her support, the good
words and recommendations has contributed a lot to the success of this project. Without her
assistance, we would not be able to properly complete these chapters of the research paper.
Additionally, we would like to thank our parents and relatives for their support as we pursued
knowledge.
Universiti Teknologi Mara (UiTM) deserves credit for providing us with the opportunity to
study here. Without the provided opportunities, we would not have the chance to experience
and acquire information on the subject of research methodology.
Declaration
We hereby declare that the work contained in this research proposal is our own except those
which have been duly identified and acknowledged. If we are later found to have plagiarized
or to have committed other forms of academic dishonesty, action can be taken against me
under the Academic Regulations of UiTM’s.
Signed:
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NAME: NUR HIDAYAH BINTI ABU BAKAR
MATRIC NO.: 2021393485
Signed
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NAME: NUR HIDAYATI BINTI HARUN
MATRIC NO.: 2021340769

TABLE OF CONTENTS
CHAPTER 1:
INTRODUCTION.................................................................................................................... 1
1.1 Introduction ..................................................................................................................... 3
1.2 Background of Study ...................................................................................................... 3
1.3 Problem Statement .......................................................................................................... 6
1.4 Research Question ........................................................................................................ 10
1.5 Research Objective ....................................................................................................... 10
1.6 Scope of Study .............................................................................................................. 11
1.7 Significance of Study .................................................................................................... 12
1.8 `Definition of Key Term ............................................................................................... 13
1.8.1 COVID-19 ............................................................................................................. 13
1.8.2 Vaccination program ............................................................................................. 13
1.8.3 Religious belief ...................................................................................................... 14
1.8.4 Confidence level .................................................................................................... 14
1.8.5 Family Persuasion.................................................................................................. 15
1.8.6 Health conditions ................................................................................................... 15
1.8.7 Sungai Petani ......................................................................................................... 15
1.9 Conclusion .................................................................................................................... 16
CHAPTER 2:
LITERATURE REVIEW & CONCEPTUAL FRAMEWORK ....................................... 17
2.1 Introduction ................................................................................................................... 18
2.2 Factors towards attitudes in COVID -19 vaccination programme: An Overview ........ 18
2.3 Variables related to vaccination programme ................................................................ 21

2.3.2 Confidence level .................................................................................................... 24
2.3.4 Health conditions ................................................................................................... 29
2.4 Conceptual framework .................................................................................................. 32
2.4.1 Definition ............................................................................................................... 33
2.4.3 Confidence Level ................................................................................................... 33
2.4.5 Health Conditions .................................................................................................. 34
2.5 Hypothesis..................................................................................................................... 34
2.6 Summary ....................................................................................................................... 35
CHAPTER 3:
RESEARCH METHODOLOGY ......................................................................................... 36
3.1 Introduction ................................................................................................................... 37
3.2 Research Design............................................................................................................ 37
3.3 Unit of Analysis ............................................................................................................ 37
3.4 Population and Sampling .............................................................................................. 39
3.4.1 Sample ................................................................................................................... 39
3.4.2 Sample Framework ................................................................................................ 40
3.4.3 Sample Size ........................................................................................................... 40
3.4.4 Sample Technique ................................................................................................. 41
3.5 Measurement / Instrument ............................................................................................ 42
3.5.1 Nominal Scale........................................................................................................ 43
3.5.2 Ordinal Scale ......................................................................................................... 43
3.5.3 Interval Scale ......................................................................................................... 44
3.6 Data Collection ............................................................................................................. 49

3.7 Data Analysis ................................................................................................................ 50
3.7.1 Descriptive Statistics ............................................................................................. 50
3.7.2 Correlation ............................................................................................................. 50
3.7.3 Multiple Regression Analysis ................................................................................ 51
3.8 Pilot Study..................................................................................................................... 52
3.9 Conclusion .................................................................................................................... 53
REFERENCES ........................................................................................................................ 54
LIST OF FIGURES
Figure 1. 1 Khairy Warns Anti-Vaxxers: We Will Make Life “Difficult” For You................... 8
Figure 1. 2 Vaccination Progress by State ................................................................................ 8
Figure 2. 1 Conceptual Structure of Independent Variables and Dependent Variables......... 32
LIST OF TABLES
Table 3. 1 Attitudes toward COVID-19 Vaccine and influencing factors............................... 42
Table 3. 2 Table of Interval Scale ........................................................................................... 44
Table 3. 3 Correlation Strength based on Guilford Rules of Thumb ...................................... 51
Table 3. 4 Cronbach's Alpha Formula .................................................................................... 52
Table 3. 5 The scale Cronbach’s Alpha .................................................................................. 52

CHAPTER 1:
INTRODUCTION
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ABSTRACT
Vaccination programme is an initiative by the government of Malaysia as one of the ways to

curb spread of the COVID-19 virus through the restriction orders, stay at home campaign,
closures of tourism spots and more. Vaccines are useful strategies that help alleviate the world's
illness load. With the accessibility of COVID-19 vaccines, nothing is known about the
acceptance and views of the Malaysian people about these vaccines. This study aimed to
determine the attitudes towards vaccination programmes in Sungai Petani as well as the factors.
The methodology is founded on a quantitative method. Respondents that were intended to be
presented in this research study are the respondents of residents in Sungai Petani. A total of
150 respondents are scheduled to be used in this research study. This research study was
significantly focusing on the various kinds of attitudes of respondents in Sungai Petani towards
vaccination programs carried out on them.
Keywords: Covid-19 Vaccines, Covid-19, Attitudes, Vaccination Programme, and

Government
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CHAPTER 1
INTRODUCTION
1.1 Introduction
This study focuses on the factors influencing attitudes towards vaccination programmes in
Sungai Petani. The chapter begins by discussing the study’s background that highlights the
advantages of the vaccination program as well as the problems statement that leads study to
be conducted. This chapter will also include a research question and research objective. By
the end of this chapter, the researchers will explain the significance of the study, the scope of
the study, as well as the key terms related to definition and concept throughout the research.
1.2 Background of Study
Following the Covid-19 outbreak, since December 12th, 2019, a continuous occurrence of an
unknown acute respiratory tract infection has been reported in Wuhan City, Hubei Province,
China, originating from the Hunan South China Seafood Market (Elengoe, 2020). The virus
has spread widely throughout the world including Malaysia. The Ministry of Health (MOH)
in Malaysia reported 5,251 COVID-19 cases, including 86 deaths and 2,967 cases of recovery
as of April 17, 2020 (MOH, 2020). Selangor, in Malaysia, had the greatest number of
confirmed COVID-19 cases to date (1,338). The first incidence of COVID-19 was found in
Malaysia on January 25, 2020, and traced to three Chinese nationals who had intimate contact
with an infected individual in Singapore. They arrived in Malaysia on January 24, 2020
through Singapore (MOH, 2020).
Due to this shocking outbreak, Malaysia has strictly found another alternative to stop this
virus from spreading worse throughout the country. This is accomplished by a vaccination
campaign. In February 2021, a special committee known as Jawatankuasa Khas Jaminan
Akses Bekalan Vaksin COVID-19 (JKJAV) launched the Malaysian National COVID-19
Immunization Program (NIP), which aimed to "operate smoothly, safely, effectively, and in
an organised manner in the effort to curb and end the COVID-19 pandemic." It is divided into
three stages: Phase 1 prioritises frontline workers in public and private healthcare, essential
services, defence, and security; Phase 2 prioritises senior citizens (those aged 60 and older),
high-risk groups with chronic diseases such as heart disease, obesity, diabetes, and high blood
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pressure, and people with disabilities; and Phase 3 (the current phase, set to end in February
2022) prioritises adults aged 18 and older. According to Chan et al., 2022, the Malaysian
Ministry of Health has approved five vaccines: Pfizer-BioNTech BNT162b2, Oxford-
Astrazeneca AZD1222, Sinovac CoronaVac, CansinoBio Ad5-nCoV, and Sputnik V Gam-
COVID (Chan et al., 2022).
The success of any vaccination programme aimed at achieving herd immunity is dependent
on vaccine acceptance and uptake. The issue of vaccine hesitancy must be addressed in order
to achieve herd immunity. The Malaysian Ministry of Health has increased vaccine promotion
programmes, particularly through social media and mass media. More dialogues and forums
involving experts from the ministry and universities, for example, have been broadcast on
television and Facebook Live.
To achieve herd immunity, vaccination programs do not necessitate a large percentage of the
population being infected. However, vaccination of a large enough percentage of the
population is necessary to achieve such immunity. However, vaccinations have been shown
to be an effective way to reduce the burden of COVID-19, but their effectiveness is dependent
on the population's desire to be vaccinated. Only a high rate of vaccine acceptance makes
immunization programs effective.
According to data from other nations, the acceptability of the COVID-19 vaccine is
influenced by numerous factors. Perception of disease risk, safety of the vaccine, the
efficiency of the vaccine and the general attitudes of the people are a few of these things to
keep in mind when thinking about vaccination. It is imperative that the public be educated on
the importance of vaccines and that governments, health authorities, and civil rights groups
be prepared to dispel myths and misconceptions about vaccinations in order to get public
acceptance for immunization when it is necessary.
According to research, Portugal, Singapore, and the United Arab Emirates have some of the
highest vaccination rates in the world (Felter, 2020). However, several other countries,
primarily in Africa, have only vaccinated small portions of their people. The Malaysian
government similarly reacted quickly by implementing the countrywide COVID-19
vaccination programme in three phases, frontline workers, prioritising senior citizens and
high-risk groups with chronic diseases. Meanwhile, more than 90 percent of males and
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females in Sungai Petani have fully immunized their children, demonstrating a positive
attitude towards vaccination (Aziz, 2019).
Hence, this research study will be conducted using the title “Factors influencing attitudes
towards vaccination programme in Sungai Petani” which will explore the problems, opinions
and concerns of the community about the vaccination program. The main purpose of this
study is also to examine the attitudes of reactions towards the vaccination program in
Malaysia.
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1.3 Problem Statement
The COVID-19 vaccination program is an ongoing global effort to immunize large numbers of
individuals against COVID-19 in order to provide protection against the disease where Covid-
19 vaccination is essential for everyone to take as it will give acceptance to the people from
getting the Covid-19 (Ayenigbara, Adegboro, Ayenigbara, Adeleke, & Olofintuyi, 2021).
However this study investigates the residents to be vaccinated based on their attitude that
affects their beliefs to be vaccinated or not (Serpa-Barrientos, Leonardo, Jesus, & Alberto,
2021). Researchers have found that the COVID-19 vaccination program occurred to have a
different attitude due to several factors which are religion belief, confidence level, educational
level, health conditions and perceptions. Vaccine hesitancy, on the other hand, is on the rise
around the world, and the WHO considers it one of the top ten global health problems (Greyling
& Rossouw, 2022). Besides that, this study also involves four perspectives of Covid-19
vaccination attitudes that influence them involving age, gender, income level and education.
This is particularly relevant where it can be seen that Covid-19 vaccination program is directly
affected through it.
According to the World Health Organization (WHO) there are 6,293,414 confirmed deaths all
around the world through the Covid-19 disease (“WHO Coronavirus (COVID-19) Dashboard,”
2022). Although the United States and United Kingdom are among the counties that are able
to produce lots of vaccination It indicates that the vaccination program is quite slow as there
were no initiatives from the people to take the vaccination. It can be seen in America where
their vaccination rates are quite slow and make people are not easy-to-reach, particularly those
who live outside the cities (The Economist, 2021). The supply of vaccination is not the main
problem but people resist vaccine uptake which occurred to be lowest in the US. The
government in the US is able to produce more than three million doses a day, but the daily
average has decreased to approximately 650,000 from President Joe Biden at that time.
Moreover, among some healthy young people in the United States, there is a lack of urgency
to get vaccinated, which has raised some concern about their vaccine safety (Horton, 2021).
Another problem happens where in recent months, countries like France, Italy, and Spain have
overtaken the United Kingdom in terms of the percentage of people who are fully vaccinated
in Europe. A spoke spoken from the government of the UK reported that there have been no
reports of vaccine supply shortages but it shows that it is simply taking longer to reach the final
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adults in the country who have not yet accepted the vaccine offer. The result shows that in late
March and early April, the quantity of daily vaccinations dropped substantially from 750,000
first doses provided in one day to less than 50,000. The government claims it is collaborating
with celebrities, social media platforms, and dating apps to spread the word about the
advantages of vaccinations among younger age groups (Worrall, 2021). Thus, countries such
as China also is one of the countries where vaccination is slow where at first the government
has announced the lockdown but after a few months people in China are free from Covid-19
disease and not taking any measures that make the Covid-19 disease happen again. Moreover,
local media stories and social media concerns demonstrate the difficulties of obtaining an
appointment elsewhere (WU, 2021). Looking at the problems, China has yet not China has not
authorized the use of Pfizer and only depends on the lockdown.
According to Minister of Science, Technology and Innovation Khairy Jamaluddin, as the

AstraZeneca Covid-19 vaccine would not be ready until the second quarter of 2021, it is
uncertain whether the government will include rural Sabah and Sarawak's frontline workers,
senior residents, and individuals with chronic diseases in the initial dosage of the Pfizer
vaccine. Even if the government decides to provide Pfizer doses to Sabah and Sarawak's rural
areas, the delivery process will be far more complicated. Vaccines will be repackaged at these
distribution centres and supplied through ground transport to outlying areas in both states
within 48 hours. Based on Alvin Chua, president of the Federation of Malaysian Freight
Forwarders (FMFF), stated that the Pfizer and modern vaccines are unsuitable for East
Malaysian states due to storage and delivery difficulties of Pfizer Biotech’s vaccine requires
storage at -70°C, whereas the modern Covid-19 vaccine is stored frozen between -25°C and -
15°C. Further, it would be prohibitively expensive for the government to acquire cold storage
freezers for each hospital in East Malaysia. Given that each cold storage freezer is projected to
cost RM80,000, the total cost of installing cold storage freezers in 24 government hospitals in
Sabah and 21 government hospitals in Sarawak would be around RM3.6 million (theSun,
2021).
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Figure 1. 1
Khairy Warns Anti-Vaxxers: We Will Make Life “Difficult” For You.
Source: Mail, 2021. Adopted form Malay Mail websites
Based on the statement above by Datuk Khairy Jamaludin, he indicates that Anti-vaccinex is
also one of the problems people avoid to take a vaccine and the problems for their vaccination
programs. The restriction starts where "The Public Service Department has instructed federal
servants to receive the vaccine or face disciplinary action. MINDEF (the Ministry of Defence)
has issued a directive stating that anyone (military personnel) who does not take the vaccine
will be considered to be in violation of MINDEF's regulation, implying that it is required "He
added that harsh measures should be used against anti-vaccination groups. The issue is where
anti-vax reject all the statements from the minister and make people believe it as it was to
prevent them from taking the vaccination and follow the program that has been taken by the
government (Ram, 2021).
Figure 1. 2
Vaccination Progress by State
Source: Ministry of Health Malaysia, 2021. Adopted from COVIDNOW website
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Based on the graph above according to the Ministry of Health, 2022, it shows that Kelantan,
Sabah, Kedah and Pahang are the main states that resist the Covid-19 vaccination program at
the beginning of the program. The issue shows that it proves that the vaccination program is
quite low in four states.
Based on the survey collected among respondents found that there were differences in results
depending on different countries. Concurringly, with the earlier research, the groups most
vulnerable to vaccination acceptance are the same groups with the mistrust of vaccination
programmed according to Paul, Steptoe, & Fancourt, 2020. It can be seen where the data that
has been surveyed revealed that the most significant behavioral and attitude barriers in
receiving a COVID-19 vaccine are a general disbelief in the advantages and safety of vaccines,
as well as apprehensions regarding their unanticipated side effects. This is consistent with prior
research indicating that low vaccine confidence and concerns regarding the novelty and safety
of the COVID-19 vaccine are significant hurdles to vaccination acceptance. Thus, this behavior
may be a result of a significance of the COVID-19 impact outbreak had on the public's daily
life, including the inability to return to work and school, tight travel restrictions, and enormous
economic losses (Chen et al., 2021).
Through this, does any scenario happen from overseas and Malaysia that will directly affect
the vaccination program in Sungai Petani? Are there any factors that contribute to this
phenomenon as well in Sungai Petani among the residents?
Hence, this study tries to reveal the Covid-19 vaccination program in Sungai Petani by looking
at this scenario between the countries.
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1.4 Research Question
The following research questions were formulated to gain a deeper knowledge of the elements
impacting Sungai Petani residents’ perceptions toward the vaccination program:
i. What is the extent of the vaccination programme among the public in Sungai Petani?
ii. What is the relationship between religious beliefs and vaccination programmes among
the public in Sungai Petani?
iii. What is the relationship between the confidence levels in the vaccination programme
among the public in Sungai Petani?
iv. What is the relationship between family persuasions towards the vaccination
programme among the public in Sungai Petani?
v. What is the correlation between health conditions towards vaccination programmes

among residents in Sungai Petani?
1.5 Research Objective
The following research objective was developed for a better understanding of the factor
influencing attitudes towards vaccination programmes in Sungai Petani.
i. To know the extent of the vaccination program among the public in Sungai Petani.
ii. To identify the relationship on religious beliefs and vaccination programmes among the
public in Sungai Petani.
iii. To identify relationships on confidence levels in the vaccination programme among the
public in Sungai Petani.
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iv. To examine the relationship based on family persuasion towards vaccination
programmes among the public in Sungai Petani.
v. To identify the correlation between health conditions towards vaccination programmes

among residents in Sungai Petani.
1.6 Scope of Study
This research has been studied to explore the factors that influence attitudes towards
vaccination programmes in Sungai Petani. In this examination, the studies are able to obtain
knowledge and information regarding the residents from all over the countries on their
perspective towards vaccination programs and their attitude. Based on this, the researcher is
able to help the student with better understanding and is able to educate for the future researcher
within UiTM students. Thus, these findings will result in how to understand more the attitude
of residents all around the world towards vaccination programs.
The results of this study were expected to present the attitude on vaccination programs by
conducting this study. As we want to know more regarding the impact towards the resident’s
attitude that directly will influence in Sungai Petani, Kedah. Besides that, resident attitudes
towards vaccination programs are the factors for them to be willing to accept or not. It is a
general problem where the resident has their own reason based on the factors that influence
them such as health issues and side effects that prevent them from getting the vaccine.
Therefore, it is important to increase the knowledge among the residents towards Covid-19
vaccination program.
Furthermore, through the vaccination program people's acceptance is important for their
uptake. Thus, the government plays an important role in participating in vaccination programs
as it will influence the people's attitude through these programs. It shows that vaccination
programs had proven to have numerous advantages and functions given from the government
as an effective alternative for their acceptance. Based on this acceptance, people will become
more confident which influences their attitude towards acceptance. Based on the result, this
will rsluting on effectiveness of vaccination programs all around the world.
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1.7 Significance of Study
This research intended to examine the factors influencing vaccination program attitudes in
Sungai Petani. As a consequence of these studies, the researchers will have a better
understanding of the factors that influence attitudes towards vaccination programs in Sungai
Petani. This research help researchers to learn about what attitudes shown by the respondents
among Sungai Petani residents towards vaccination programs in Sungai Petani. This research
has the potential to assist and educate residents, future researchers, and government officials,
as the vaccination program has been a hot debate since the spread of the Covivirus-19 virus.
This contributes significantly to the question of whether respondents accept the vaccination
program, and their attitudes toward vaccination can be investigated.
Using quantitative research, the researchers can also assess the data collected from the
respondents. This study also examines the level of immunization program participation among
respondents based on their attitudes. It also allows respondents to express their ideas and
perceptions regarding the proposed government vaccination program. As people generally
know, governments proposed vaccination programmes to curb the spreading of Covid-19 virus
among people. This research study is very important to get to know the perceptions and
attitudes of respondents towards the vaccination programme and the factors affected.
In addition, by completing this research, the researchers can determine other aspects of the
vaccination program, such as religion, disease, and several other factors. The researcher can
also assess the efficacy of vaccination and infectious disease act laws and regulations.
Identifying these factors is particularly useful for gathering information and determining the
attitudes of respondents regarding the immunization campaign. This study's findings and
outcomes may also assist future researchers gain a deeper understanding of the Covid-19 virus
and vaccination program.
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1.8 `Definition of Key Term
This section defines the terminologies used in this research to ensure that key concepts and
terminology are understood consistently.
1.8.1 COVID-19
COVID-19 is an infectious disease caused by the coronavirus SARS-CoV-2. The majority of

infected individuals will experience mild to moderate respiratory illness and recover without
additional therapy. However, some will become critically ill and require medical attention.
People who are older or who have underlying conditions like cardiovascular disease, diabetes,
chronic lung disease, or cancer are more prone to get a serious illness. Anyone can get COVID-
19 and become critically ill or die at any age. The COVID-19 pandemic in Malaysia is part of
the ongoing global coronavirus disease pandemic of 2019. (COVID-19). As of 20 March 2022,
the country ranks third in Southeast Asia for the number of COVID-19 cases, after Vietnam
and Indonesia, and fourth for the number of COVID-19 deaths, after Indonesia, the Philippines,
and Vietnam (World, 2020). When an infected individual coughs, sneezes, speaks, sings, or
breathes, small liquid particles can be transferred from their lips and nose. The size of these
particles varies from respiratory droplets to aerosols. It is essential to practise respiratory
etiquette, such as coughing into a flexed elbow, and to isolate yourself at home until you feel
better.
1.8.2 Vaccination program
The immunisation campaign is among the measures adopted by the Malaysian government to
prevent the spread of COVID-19 infections in the country. Vaccination is an achievement for
world health and development, annually saving millions of lives. Vaccines lessen the likelihood
of contracting a disease by bolstering the body's natural defences. When people acquire a
vaccine, our immune system responds. The National COVID-19 Immunisation Programme
(Malay: Program Imunisasi COVID-19 Kebangsaan), shortened as NIP or PICK, is a national
vaccination campaign that is presently being applied by the Malaysian government as a strategy
to control the dispersion of coronavirus disease 2019 (COVID-19) and to end the COVID-19
pandemic in Malaysia by achieving the highest immunisation rate among its citizens and non-
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citizen. Therefore, this research is conducted with the intention to also know the rate of
acceptance of vaccination programmes and respondents' attitude toward it.
1.8.3 Religious belief
Religious belief refers to the acceptance of a religion's essential tenets; for instance, in Islam,
Allah is the only God in the entire universe and beyond. It also refers to beliefs that exist within
every religion. Religion is the totality of a group's real and sacred ideas, values, and rituals.
The religious beliefs of a group explain where its members adjust to the world and how they
should act to each creature on Earth and to God. In human groups, religious beliefs provide a
social function by creating a common identity. Religion also plays an influence in vaccination
decisions, and parents frequently use religious study as an argument to avoid vaccinating their
children. While according to other perspectives on religious reasons to get vaccinated, there is
also an argument that states that vaccination is allowed as the vaccine introduced in Malaysia
is halal certificated (Wati, 2021). Therefore, religious belief became one of the factors which
explain different attitudes toward the vaccination programme.
1.8.4 Confidence level
Confidence is called the sentiment or confidence that one can rely on something or someone.
Confidence level literal meaning is when the confidence is measured with something that is
too high or low confidence that something can be trusted or not. Allocation, administration,
and patient experience in vaccination programmes are crucial to achieving herd immunity, as
problems with the vaccination program might undermine motivation and confidence in the
vaccines. Building public confidence in the COVID-19 vaccines thus engaging with the
community about the vaccination program is not simple, since some people are confident that
the vaccine is beneficial for them, while others are confident that it is harmful. Discussing this,
it determines that confidence level is one of the factors of attitudes in the vaccination
programme.
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1.8.5 Family Persuasion
For many aspects of life, family is an important role in the decision-making of a person. The
family usually rules everything in the concept of persuasion as they know each other better
than outsiders. The influence of family persuasion in one’s life is very huge as it also triggered
one’s decision in the COVID-19 vaccine undertaking. In every family, there will be many kinds
of perceptions towards vaccines as they were determined whether good or bad. Family
persuasion in vaccination shapes the attitude of a person towards the vaccination programme.
It contributes to the factor of different attitudes of a person toward vaccination. Hence, family
persuasion is among the factors of attitudes towards the vaccination programme.
1.8.6 Health conditions
The health condition of a person indicates whether they are able to experience many things or
not as their health condition might hinder someone from not being able to receive a vaccine.
Because of age, health issues, or other circumstances, some people may not get certain
immunizations or should pending their willingness to get vaccinated. The health condition that
one shall be vaccinated is must at a good condition. Someone that is allergic to medicinal drugs
or a medical condition such chronic diseases like cancer, chronic kidney or liver disease, or
others that might cause them to get very sick from the vaccine. Thus, health conditions are one
of the factors of attitudes toward the vaccination programme.
1.8.7 Sungai Petani
Sungai Petani is a town in Kuala Muda District, Kedah, Malaysia. Sungai Petani, the largest
city in Kedah, is located around 55 kilometres south of the state capital, Alor Setar, and 33
kilometres northeast of George Town, the capital of the neighbouring state, Penang. The name
"Sungai" signifies a river in the Malay language, whereas "Petani" means farmer. Due to the
vast number of paddy fields and farmers in this state, Sungai Petani's full name translates to
"Farmer's River." The previous spelling of Sungai Petani was "Sungai Petani" since "Petani"
might also refer to Pattania, a city in modern-day Thailand to which the river once flowed. The
main street of Sungai Petani is Jalan Ibrahim. The clock tower, a notable landmark in Sungai
Petani, was constructed in 1936 and stands 12.1 meters tall. It is topped by a golden structure
in the shape of a dome. Jubli Perak, a renowned public park in Sungai Petani, was formerly a
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bird park. Due to its proximity to University Technology Mara, the researchers' place of study,
Sungai Petani is selected as the location of choice.
1.9 Conclusion
This study provides a variety of studies and a deeper understanding on the problem, concern,
and opinion form the community about the vaccination program towards their attitude. Through
this, it shows that this study is very beneficial for the full-time and part-time students in getting
the information. Thus, through this significance of the study, the research questions, and
research purpose all have a role in determining the value of the variables. This study applies
gender, age, educational level, and income status as independent variables through this chapter.
The definition of each word and term is clarified in the section containing definitions of
essential terms as it involves a worldwide investigation. Moreover, researchers will know how
these variables will affect the attitude towards vaccination programs in Sungai Petani, Kedah.
Perhaps, with the assistance from the previous researcher, it will guide the researcher to discuss
more regarding independent variables in the following chapter.
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CHAPTER 2:
LITERATURE REVIEW
& CONCEPTUAL
FRAMEWORK
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2.1 Introduction
The purpose of this chapter is to examine prior empirical literature based on the variables
provided in Chapter 1. This chapter includes an introduction, a literature review, the conceptual
framework of the investigation, and a section on the hypotheses. The study selected four
independent variables which were believed to be a major contributor to the dependent variable
which is a factor influencing attitudes towards vaccination programmes in Sungai Petani. As
the independent variables consist of religious belief, confidence level, family persuasion, and
health conditions. Following the review of relevant literature, the researcher also will construct
the hypothesis to investigate if there is a relationship between the dependent and independent
variables of this study.
2.2 Factors towards attitudes in COVID -19 vaccination programme: An Overview
More than 175 million cases have resulted from the current COVID-19 epidemic worldwide,
which is a significant problem (OECD, 2021). Therefore, the government of Malaysia worked
hard in implementing the initiative to impose the COVID-19 vaccination programme to curb
the worst cases, especially death cases resulting from the virus of COVID-19. However, due to
the unexpected situation of pandemic Malaysian and worldwide are experiencing right now,
the undertaking of a vaccine that was strongly suggested by the ministry of health Malaysia
was highly accepted but also at the same time highly doubted and rejected by some sections of
society. These two types of groups bring to the discussion of attitudes toward the COVID-19
vaccination programme and what were the factors causing different attitudes produced by
netizens. Therefore this section of research particularly will be discussing the overview of
factors towards attitudes in the COVID-19 vaccination programme.
As a result, the significance of COVID-19 vaccinations in supplementing individual preventive

actions against the pandemic has become crucial, and vaccination coverage is viewed as
essential for sustaining the efficacy of public health interventions. Since the availability of
COVID-19 vaccines, governments throughout the world have exerted enormous efforts to
eradicate the disease. Individuals can benefit from efficient procurement and immunization
programs. Nonetheless, with the beginning of immunization campaigns at the national level,
numerous vaccine-related issues. Effectiveness, trustworthiness, and safety are now the
primary concerns of the community. Consequently, expected and estimated vaccination
18
acceptance rates differ between individuals. Since the early 1950s, the National Vaccination
Program in Malaysia has distributed vaccines to protect its inhabitants from vaccine-
preventable diseases.
However, society has debated the permissibility of immunizations in general. In some

situations, it contributes to vaccine reluctance. Malaysia has boosted the immunization
coverage rate observing the current COVID-19 pandemic situation, to the extent that 62% of
the population is fully immunized as of 1st October 2021 (Elnaem et al.). The countrywide
COVID-19 vaccination is however considered essential for social protection and economic
recuperation planning. According to prior international research, the acceptability of vaccines
differs on a variety of cultural, societal, and awareness factors that influence reluctance. As a
result, health care practitioners have established a number of vaccination advocacy programs.
Initiatives to improve community understanding of the vital role immunizations play in
preventing disease combat the COVID-19 epidemic pandemic.
Based on the research, dependent variables are known as vaccination programmes while
independent variables were identified as four factors, which are religious belief, confidence
level, family persuasion, and health condition. These factors were among the strongest factors
of different attitudes given by the citizens of Malaysia including the target of researchers’
participants which were the residents of Sungai Petani, Kedah, Malaysia.
Being the independent variable identified religious belief as to the factor of attitudes toward
vaccination, it can be explained that some believers of many religion trusts that their religion
allows them to get an injection of vaccine for COVID-19 to prevent the spread of infectious
disease which allow themselves to receive and open to the vaccination programme without any
problem while some others conclude that the ancients of past believers did not receive such
things and that they should not allow themselves to be open to vaccination programme too,
following the past behaviour of their ancients of the particular religion. Indeed, it is common
knowledge that a person's religious beliefs affect his or her immunization behaviour and
decisions.
Other than that, confidence level. Looking at the element, one’s confidence level can be
different according to maybe their own research, their readings, their knowledge, the
information they obtained, and many more others. According to their research, their confidence
toward vaccination programmes whether they strongly support the vaccination programme or
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strongly deceived by the vaccination programme campaign. Their knowledge about the vaccine
or vaccination programme will determine their later confidence level of whether they should
believe in the vaccination programme in the effort to reduce the spread of the virus or if their
confidence level says otherwise which they confident the vaccination programme is bad for
them and that the injection people be receiving contained dangerous ingredient that may affect
their life in the future. Indeed, it is common knowledge that a person's confidence level affects
his or her immunization behaviour and decisions.
Next thing is family persuasion. It was well discussed in Chapter 1 of this research that family
persuasion contains a heavy influence on someone’s decision to not or to support the
vaccination programme by the willingness of getting vaccinated or not. Family persuasion is
also a strong factor in the attitudes toward the vaccination programme of a person. It was the
family persuasion factor that mostly brought a person to be injected with the COVID-19
vaccine or not. Some families strongly agree and give their support towards the vaccination
programme no matter how many injections they have to receive. They also will persuade the
rest of their family members to together receive the injection and give full support towards the
vaccination programme so that their family can be immune from the virus COVID-19. Some
other families, on the other hand, have a hard time adjusting to the vaccination programme
because they trust that foreign medicine will be ruining them in the future. They also will
strongly disagree if any of their close family members decided to take the injection of the
COVID-19 vaccine. Hence, it is common knowledge that a person's family persuasion affects
his or her immunization behaviour and decisions.
Besides, health conditions. It is normal to understand and know that when a person is in great
condition of health, they can do and achieve many things in their life without many problems.
It was a different case when it comes to a person with many health problems. This also applies
to the factor of a person’s attitudes toward the vaccination programme. A person can have the
willingness to be vaccinated if there is no problem or issue with their health condition while a
person with chronic disease in which being vaccinated will make their disease worse, their
attitude is pushed towards their inability to receive COVID-19 vaccine and that they could not
support the vaccination programme. With one’s health condition, determine the attitudes
positive or negative while receiving or not, the said COVID-19 vaccination program.
Therefore, it is common knowledge that a person's health condition affects his or her
immunization behaviour and decisions.
20
To be concluded this overview of factors towards attitudes in the COVID-19 vaccination
programme outline the overall view of the topic. Therefore, it is important to take into account
what is the factors that differentiate one’s attitudes toward the COVID-19 vaccination
programme implemented by the government
2.3 Variables related to vaccination programme
Religion has frequently been used as a justification for refusing vaccinations. Religion law also
being the cited source of the credential of vaccine status that is being received by many in the
vaccination program. The Ministry of Health has said that the halal status of vaccinations is the
most frequently cited cause for vaccine refusal for most parents (Kusnin, 2017). A study
reported that 76% of individuals who refused immunization stated doubts about the halal status
of the vaccine (Chan et al., 2018). While Mohammad Diah (2019) found that the possibility of
the presence of haram ingredients in vaccines is the largest factor influencing parents' refusal
of vaccines. In reality, the halal status of a vaccine is the most important aspect in determining
whether to embrace immunization or not throughout the Muslim world (Ahmed et al., 2018).
Even though the Minister of Islamic Religious Affairs Malaysia has issued fatwas or edicts
regarding the necessity of vaccines for the preservation of life, mistrust in religious authorities
and health professionals regarding the halal status of vaccines has contributed to individuals'
reluctance to be vaccinated and support vaccination programmes. In the Malay or Muslim
ethnic group, where reservations about the halal status of vaccines led parents to resort to
homoeopathy, the religious focus of parents in their choice of homoeopathy as an alternative
medicine is evident (Lim et al., 2016; Chan et al., 2018). Homeopathy is frequently paired with
Islamic medical practises such as cupping and the usage of holy foods and fruits in Islam, such
as dates, honey, olives, and pomegranates (Wan Taib et al., 2017).
However, not all citizens of Malaysia were in doubt about the halal status of vaccines as they
strictly obey and follow the guidance as to the fatwa that has been issued by religious authorities
in Malaysia. When there were responsible religious authorities that were entrusted by many
such as YB Senator Dato’ Seri Dr. Zulkifli Mohamad Al Bakri issued the status of the foreign
vaccine that was obviously not familiar among the citizens, there should be no doubt as the
issued status of the vaccine has gone through study and checking with Islamic law such as from
21
the sources of Al-Quran and As-Sunnah. The religious influence of the fact that the majority
of states with high vaccine refusal rates are predominantly Malay or Muslim and come from
the states of Kedah, Kelantan, and Terengganu must be investigated further. Concerning the
permissibility of vaccination usage and halal status, Muslim parents' suspicion in religious
authorities and health professionals must be addressed with care. For example, the
Government's claim that it would create a halal vaccine plant in the country backfired since it
led to confusion regarding the halal status of current vaccines (Mustapha, 2019; Rumetta et al.,
2019).
Taking the example of the country Indonesia, a neighboring country with a mainly Muslim
population, has similarly struggled with issues regarding the halal status of vaccines, which has
contributed to a decline in measles vaccination rates among children (Harapan et al., 2021).
The Indonesian Ulama Council declared that the Sinovac vaccine is halal days before the
country began widespread immunization using the COVID-19 vaccine. Additionally, the
Indonesian government has collaborated with one of the country's largest Islamic
organizations, Nahdlatul Ulama, to expedite COVID-19 vaccination (Tempo, 2021). In this
sense, the Ministry of Health may follow a similar path by cooperating with significant Muslim
organizations in Malaysia, rather than confining representation to government-affiliated
religious authority.
To pull this religious belief matter further, there is a study representing a research of attitude,
familiarity and religious beliefs regarding vaccination among health science and non-health
science students in Universiti Teknologi Mara (UiTM)—Puncak Alam Campus (Selangor,
Malaysia) where the researchers took in the participants of the study research dated March to
June 2019 asking them in a questionnaire several questions regarding demographic questions
in terms of religious beliefs toward vaccination. These questions asked the participants
questions about their religious belief before taking the vaccine. Among the intreseting
questions were; “I receive vaccinations to maintain my health, as my body is an Amanah from
Allah that I must protect”, “the necessity of vaccination in Islam parallels the legislation
protecting life and the concept of preventing harm (izalat aldharar)”, “I take the vaccine
despite the fact that it is derived from porcine-based, but with maqsid syariah rationale”, “a
vaccination may induce adverse consequences in some individuals'' and more (M. Elkalmi et
al., 2021). The findings show that mostly, respondents show more than half results for every
question associated with religious belief. It is interesting to know that respondents of this
22
research think thoroughly about the religious belief that they had that must be associated with
vaccination. Most of the respondents’ answer responds towards the support of vaccination
programs if it was observed only for the religious belief aspects in showing the different attitude
factors toward vaccination programmes. From the observation of the research study made,
parental knowledge and attitudes were believed to be influenced by religious views, as many
religion-based groups were found to be unvaccinated or under-vaccinated. In the study also,
the researchers discovered a difference in religious beliefs based on study disciplines in which
medical participants had more favorable religious attitudes about vaccination. This may be
explained by a shift in the mentality of medical professionals, who now argue that interventions
such as vaccination should be evaluated based on their total potential benefits while
recognizing that no intervention is risk-free. Moreover, the findings support gender-based
disparities in the vaccination opinions of participants.
Looking at the research question, many other research studies regarding vaccintion for COVID-
19 were seen to include religious belief in their demographic questions to be asked upon their
respondents. Observing that, religious belief really holds to the strong factor of attitudes toward
the vaccination program of COVID-19. Moreover, Malaysia were known to be the country of
its citizens were of many kinds of religion such as Islam, Buddhism, Christianity, Hinduism
and other religion with many of the citizen is Muslim. Usually, vaccination concern from the
religious factor in attitudes toward vaccination programme coming from followers of Islam of
this country as Muslim people really take a heavy concern with its relating to the status of
undertaking products consumed or eaten. Fatwa which only came from Islamic religion, also
needs to be produced to convince the public that vaccines are necessary for the sake of universal
safety and health. Nonetheless, back to the original discussion, religious belief does stand a
strong factor towards the attitudes in vaccines undertaken in Malaysia.
Discussing this brings the realization of the difference in attitudes towards vaccination
programmes that mostly come from mistrust of a person towards their religious authorities. But
in the other perspective, the acceptance of vaccines also comes from another person in the same
religious party whose faith was strong to behave positively towards the vaccination programme
following their reference and trust to the religious authorities that be leading them in their
confusion in slowly accepting the foreign medicine or vaccine into the country which will be
induced into their bodies throughout the vaccination programme to prevent COVID-19 from
spreading.
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2.3.2 Confidence level
According to the Asadi Faezi et al., 2021, confidence refers to faith in the safety and efficacy
of vaccines and the competency of health care institutions. Vaccines must be easily accessible,
cost-effective, and delivered in a comfortable spot to be considered convenient. It was believed
that countries with greater confidence in the validity of side effect reports are more likely to
vaccinate their populations. The empirical results of this study show that a confidence level
towards factors influencing attitudes vaccination programs in Sungai Petani have the greatest
impact on it. The study measures attitudes regarding vaccination intentions against COVID-19
in Australia. The vaccine confidence index (VCI) consists of four questions to assess an
individual's perceptions regarding the safety, significance, effectiveness, and or compatibility
of vaccines with religious beliefs.
The Vaccine Confidence Index (VCI) was developed after the identification of major
determinants that influence public confidence in vaccines. In the earliest stages of the COVID-
19 pandemic in March/April 2020, 14 percent to 24 percent of respondents were uncertain or
unwilling to use a SARS-CoV-2 vaccine if it were available, according to data. The structural
results also indicate that this study analyses the characteristics of Australians who expect to
receive the vaccine in March 2021 and those who do not, supporting the hypotheses that attitude
vaccination programs have positive and significant impact for the acceptance towards
vaccination programs. Thus, according to Bai et al., 2021, the researcher suggested that attitude
towards vaccination programs for future vaccination tactics and immunisation efforts against
the COVID-19 pandemic, it is essential to allay these fears and boost public confidence in
COVID-19 vaccinations.
Moreover, the low level of confidence in a COVID-19 vaccination is likely due to many reasons
reported to influence confidence in previous vaccines, including faith in the vaccine's efficacy,
fear of adverse effects, and trust in the government and those making and administering the
vaccines. It can be seen where this study demonstrates that the vaccination hesitancy model is
prevalent even among adolescents, with adolescents' intentions being substantially correlated
with their confidence in the vaccine. According to the Wong et al., 2022, it has classified the
factors into three key categories: confidence (lack of belief in the safety and effectiveness of a
vaccination), complacency (low disease risk perception), and convenience (access including
availability and affordability) towards the attitude on vaccination programs. This study
suggests the Policymakers should prioritise enhancing confidence in COVID-19 vaccinations.
24
They might spread information about the vaccine more openly, in simple words, whilst also
acknowledging people's anxieties, anger, and other unpleasant feelings. They might highlight
the rigorous safety and efficacy requirements of the COVID-19 vaccine development process,
thus generating confidence in the vaccine. All of these may enhance confidence in vaccines.
This study takes samples from the Northern and Southern hemispheres where it shows that
confidence levels get 95 percent of which increase their levels of vaccines. For example,
through this the United States has set an example for other countries by introducing mobile
immunisation clinics to reach people in rural locations, so countries can follow suit for their
increasing confidence level between their countries. It can be seen that, the majority of the
respondents throughout the world get a measure between 97.9 percent according to the Elnaem
et al., 2021 where it can be indicated having high to very high confidence in the effectiveness
of vaccines. However, approximately one-fifth did not believe they gained adequate and
accurate information about COVID-19 vaccines.
This can be seen where confidence is also influenced by the manufacturer's ability to produce
safe and effective products where the researcher also measures the relationship between the
independent variables and intention to vaccinate after adjusting the other significant variables
was discovered using logistic regression with an adjusted odds ratio through the 95%
confidence interval. A p-value of less than 0.05 was significant through this study by Wong et
al., 2022.
While based on the Greyling & Rossouw, 2022, suggested that from the confidence level of a
vaccination program, these results give policymakers the required knowledge to promote
favourable perceptions towards the COVID-19 vaccination. Policymakers should strive on
improving faith in the COVID-19 vaccinations where they might more publicly share
information regarding the vaccine, do it in layman’s words, and acknowledge people’s
anxieties, rage, and other unpleasant feelings. They might underline the stringent safety and
efficacy criteria of the COVID-19 vaccine development process, therefore encouraging faith in
the vaccine. Through this, it may enhance vaccine confidence level more effectively.
From the researcher Elnaem et al., 2021, he investigates that different countries' acceptance
rates of confidence level for the COVID-19 vaccine have been recorded. It can be seen where,
Ecuador has recorded about (97.0%), Indonesia (93.3%), and China (91.3%) had the highest
acceptance rates, Malaysia (94.3 percent) had the lowest (23.6%), followed by Jordan (28.1%),
25
Italy (53.7), Russia (54.9 percent), Poland (56.3 percent), and the United States (56.9 percent),
where Malaysia was among the highest (94.3 percent). Surveys done in Hong Kong and China
found that the COVID-19 acceptance rate was 10% lower in the third wave than in the first
wave due to increased vaccine safety concerns and increased compliance with personal
protective behaviours in Hong Kong and China. Based on this researcher, The level of
confidence in the importance of vaccinations in combating this pandemic was high. However,
there were disparities in the occurrence and number of adverse effects experienced by
vaccinated individuals, which were explained by demographic and vaccine type data.
Thus, the confidence level has A strong link between vaccination intentions and respondents'
level of confidence in the vaccine. Parents who have been vaccinated are more likely to have
adolescents who are planning on getting vaccinated, and many of them have been vaccinated
in the past as well which they gain more trust based on that. So, for the overall results it showed
that this study had a response rate of 89.3 percent, with 1,057 adolescents participating in the
research. More than three-quarters (95.59) of the adolescent participants said they would be
open to receiving the COVID-19 vaccine in the future, with a confidence interval (CI) of
73.000-78.18% according to the Cai et al., 2021. It shows that, through this research, to ensure
the effectiveness of vaccination campaigns, it is critical to build public confidence and
awareness about the safety and efficacy of COVID-19 vaccinations.
According to El-Elimat, AbuAlSamen, Almomani, Al-Sawalha, & Alali, 2020, family

persuasion involving family where more people become vaccinated and resume which was
before activities, parents and carers must make difficult decisions about how to protect their
families. If the family includes both vaccinated and unvaccinated people, it may be confused
about how to keep everyone safe. In a study conducted in France, vaccination behaviours and
acceptance of the MMR and HBV vaccines were higher when parents reported receiving
information from their healthcare practitioners as opposed to the internet or relatives. Thus,
based on the findings concurred according to Mertens et al., who observed that higher levels
of fear during the COVID-19 pandemic were associated with diseased or deceased family
members. The self-concern is centred on preventing the disease from spreading to family
members, particularly the elderly, who have been recognised as having a poor outlook from
26
COVID-19. Moreover, research examining the correlation between vaccination willingness
and disease fear revealed that individuals who fear the disease are more likely to be vaccinated.
A research conducted by El-Elimat, AbuAlSamen, Almomani, Al-Sawalha, & Alali, 2020,

indicated that attitude towards vaccination program get the the majority of participants (73.1%)
were more concerned about family members becoming infected with COVID-19 than they
were about themselves becoming infected (27.3 percent). Thus, this research showed a strong
correlation between attitude vaccination programs and family persuasion.
Moreover, even though its function remained arguably in previous research of the family
members' attitude towards vaccination programs. It found that according to the Yılmaz &
Sahin, 2021, parents have the right to choose whether or not to vaccinate their children.
Consequently, it is essential to comprehend parents' willingness to get their children vaccinated
against COVID19, as well as the obstacles to and facilitators of COVID19 vaccination.
Numerous factors, such as worry regarding COVID19, children's illnesses and vaccination
status, and parents' educational level, have been shown to influence parents' readiness to allow
their children to receive the COVID19 vaccine in prior research. The safety and efficacy of the
vaccine is cited most frequently by parents as a reason for not vaccinating against COVID19.
The purpose of this study is to evaluate the attitudes and willingness of Turkish parents toward
the COVID19 vaccine.
Thus, it shows that family persuasion has the strongest determinant from mothers and their
sentiments toward immunizations were substantially more positive than those of fathers. For
example, Babicki, Pokorna-Kałwak, Doniec, & Mastalerz-Migas, 2021, indicates that 44% of
parents want to vaccinate their children as soon as feasible, whilst 14% do not want to vaccinate
their children at all. Concerns that the vaccine composition has not been adequately examined
and that it is ineffective, as well as the lack of information regarding potential future
consequences, are the key concerns regarding immunizations. This study suggests that there is
a need for ongoing monitoring of the safety of administering COVID-19 vaccinations to
children, as well as for evaluating their efficacy and benefits in reducing the individual risk of
severe course of COVID-19 and complications following this disease, and for evaluating the
population benefits of vaccines in children.
27
From the author of Popa, Muntean, Muntean, & Popa, 2020, they have a survey that the
majority of respondents indicated that they consulted multiple sources for vaccine-related
information. However, approximately one-third (32%) of respondents reported receiving
information on vaccine effectiveness from a specific source. In all instances, the family
physician (76%) was the most important source of knowledge, followed by the Internet (45%),
family (31%), friends (28%), literature (25%) and other sources (12 percent). It shows that
family persuasion also plays an important role in determining their children or siblings in
acceptance of vaccination programs.
In addition, based on the Al-Jayyousi et al., 2021, it said that from the medical perspective it
looked to be reliable sources of knowledge. They play an essential role in influencing people's
attitudes and behaviours toward vaccination, as do their recommendations and the
encouragement of friends and family. People's attitudes and behaviours have been shown to be
influenced by significant others, according to research. Advocacy from family members was
linked to more positive views and increased vaccine uptake through this article.
Following the reliability of the Patient Health Questionnaire according to the Bai et al., 2021,
the question will be asked such as “Will you advise your family to get vaccinated against
COVID-19? (No/Yes)” where the total score ranges from 0 to 21 that indicates the higher score
of the acceptance of the vaccination program through family persuasion. This shows that, since
both they and their family members seem confident about vaccinations, based on the research,
the researcher can assume that they will seek out immunizations against additional contagious
diseases in the future (Wong et al., 2022). Furthermore, the perception of the risk of COVID-
19 is the overarching theme underlying the reasons for intending to get vaccinated, with the
majority of students indicating that their concerns about themselves or their family members
contracting COVID-19 was a reason for intending to get vaccinated. This sense of the risk
posed by COVID-19 is the primary theme underlying the reasons for vaccination intent.
As stated by Cordina, Lauri, & Lauri, 2021, in “Attitudes towards COVID-19 vaccination,
vaccine hesitancy and intention to take vaccine. There was also a strong association between
willingness to take the vaccine and appreciating family opinions, as measured by Pearson's
correlation coefficient r for the relationship between willingness to take the vaccine and
respecting the family's opinion. Thus, it has been measured and investigated that respondents
had a generally favourable attitude toward the COVID-19 vaccination, and clear determinants
28
of respondents' desire to receive the vaccine have been established. There was a positive
correlation between the opinions of significant persons within the family and a willingness to
get vaccinated.
Through this, the researcher concluded that, because there is a positive correlation between the
opinions of significant others and the uptake of vaccines, it is expected that vaccination
programmes that are focused at groups of persons, such as family members persuasion will be
more effective.
2.3.4 Health conditions
The World Health Organization defines vaccine hesitation as "a delay in acceptance or rejection
of vaccines notwithstanding the availability of immunization services." Vaccine reluctance
exists across all social groupings on the planet. In the context of COVID-19, early research has
identified certain populations at risk for vaccine reluctance, but no studies have systematically
analysed COVID-19 vaccine reluctance across social or demographic groups.
Discussing this, the health condition of a person became a vital factor in a person being able or
not being able to receive a vaccine throughout the vaccination programme implemented.
Certain medical disorders, including lung disease, heart disease, diabetes, renal disease, liver
disease, and cancer, significantly enhance the risk of severe COVID-19 illness, including
hospitalization, intensive care unit admission, intubation or mechanical ventilation, and death.
Nearly ninety percent of hospitalized COVID-19 patients have an underlying medical problem,
according to studies. The risk of hospitalization due to COVID-19 increases as the number of
medical illnesses increases.
Following a population-based survey in Hong Kong, based on the health belief model, the
survey on the acceptance of the COVID-19 vaccination was carried out. Previously, a group of
epidemiologists, psychologists, and clinicians designed and developed the HBM
(Supplementary Document) in which in this study, acceptance was defined as consenting to
receive or administer the COVID-19 vaccine. It was determined by the responses to the
question, "would you receive a free COVID19 vaccine from the government during the next
12 months?" including the response alternatives "yes", "no", and "not sure". Among the
variables of the questionnaire were the sociodemographic details such as age, gender, marital
29
status, educational level, employment status, household income, and use of social security
allowance, and self-reported health status that was measured from a case of chronic conditions
and the consciousness health-related quality of life. This questionnaire is made to observe and
measure the acceptance of the vaccination programme.
From the result, it was stated that the presence of self-reported health status with a less chronic
disease that did not highly anticipate death as they received the vaccine was related to the
greater acceptability of the COVID-19 vaccination as they were the priority of vaccine
recipients. Respondents who assessed greater susceptibility to COVID-19 infection, greater
severity of COVID-19 to their own health, better benefits of vaccination, and prompts to action
were much more likely to suggest vaccine acceptance. Participants were less likely to declare
approval if they anticipated larger access barriers to acquiring the vaccine and greater damage
from the immunization.
Another research study is from U.S. whereas, National Immunization Survey-Adult COVID
Module (NIS-ACM) data gathered between August 1, 2021 and September 25, 2021 were
analysed in 2022 to evaluate the COVID-19 vaccination status, intent, vaccine confidence, and
behaviour of adults with specified medical problems. The COVID-19 immunization coverage
was evaluated by type of high-risk medical condition. The result later then shows that 81.8%
of people with known medical problems received at least one dose of the COVID-19 vaccine.
Those with a provider referral had much more coverage (86.5%) than those without (Lu et al.,
2022). Adults with high-risk medical problems but will not cause death because of vaccines
were more likely to indicate vaccination. From the research also, 18% of persons with
documented medical issues were unvaccinated (Lu et al., 2022). Receiving a medical reference
was substantially related to vaccination, indicating that provider recommendations are an
essential strategy for boosting vaccine coverage.
From the research input, researchers were able to point out that a person with chronic health
conditions such as chronic kidney disease, chronic lung disease, cancer, and others was unable
to receive vaccination as the undertaken the injection of vaccine more prone to become severely
ill with COVID-19 vaccine probably sourcing from the ingredient from the vaccine that is not
suitable for a severely sick person. These people became the exceptions from the vaccination
programme as they are exempted from the requirement to obtain a vaccine. They need to focus
on fighting chronic diseases and not have to undergo a vaccination process that is highly
30
discouraged for them. While a person with a light health condition such as a cold were able to
take a vaccine, moreover, people in excellent health are strongly encouraged to be vaccinated.
Concurringly, from this research, it is discovered that those with chronic conditions have much
lower acceptance rates than healthy individuals. Compared to COVID-19 individuals without
these comorbidities, patients with cardiovascular disease, hypertension, diabetes, congestive
heart failure, chronic renal disease, and cancer have a higher chance of mortality (Mohamed,
2021). More information should be provided to this community regarding the risk of severe
COVID-19 and the benefits of vaccination for individuals with a low risk of developing a minor
health issue.
The COVID-19 immunization rate among people with documented high-risk medical
conditions remains unsatisfactory and varies widely by a medical condition. Higher COVID-
19 vaccine coverage among those with reported high-risk medical conditions may be
attributable to the ACIP's prioritization and identification of the elevated risk of severe COVID-
19 among those who reported these medical conditions.
The health condition of a person was not intentionally obtained whether good or not and it
describes the suitability and condition of whether they are able to take the vaccine or not. Most
of the questionnaires on the survey carried out by other researchers include the question of the
participants’ ability to take vaccines based on their current health condition. Health conditions
became one of the strongest factors of a person's attitudes towards vaccination programmes as
their availability to support the vaccination programme depending on their health rate before
taking the vaccine.
Moreover, a person with a tendency to mortality due to their chronic health condition plus if
their decision to get vaccinated will make them more likely close to death, they should be the
group of people that the government should also pay attention to. People with chronic health
conditions could be hospitalized already. Having been infected by the COVID-19 virus will
make it worse. Chronic disease patients infected with the COVID-19 virus will be significantly
more susceptible to mortality. Therefore, the government should protect those who are
generally not permitted to take this vaccine more carefully so that no one is affected by the
COVID-19 virus.
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2.4 Conceptual framework
This conceptual framework will provide a greater comprehension of the amount to which
independent variables have a significant association with cyberbullying in order to identify and
further appreciate the components that lead to attitudes toward vaccination programmes among
Sungai Petani residents. The researcher chooses four independent variables, including religious
belief, confidence level, family persuasion, and health conditions, based on an overall
assessment. The vaccination programme is the dependent variable. The conceptual structure of
the study is depicted below:
Figure 2. 1
Conceptual Structure of Independent Variables and Dependent Variables
32
2.4.1 Definition
The above conceptual framework specifies four independent variables that influence the
vaccination programs. In this study, the dependent variable is the vaccination program. The
purpose of this study is to identify the elements that influence the attitudes of Sungai Petani
inhabitants toward immunization programs.
Religious belief, confidence level, family persuasion, and health situations are the independent
variables that will influence vaccination program acceptance among Sungai Petani locals. The
positive or negative effect is exerted by the independent variable on the dependent variable.
Religious belief refers to the acceptance of a religion's essential tenets. Parents in Malaysia use
religious study as an argument to avoid vaccinating their children. There is also an argument
that vaccination is allowed as the vaccine introduced in Malaysia is halal (Wati, 2021).
2.4.3 Confidence Level
Confidence is called the sentiment or confidence that one can rely on something or someone.
Allocation, administration, and patient experience in vaccination programmes are crucial to
achieving herd immunity. Some people are confident that the vaccine is beneficial for them,
while others are confident it is harmful.
The influence of family persuasion in one's life is very huge as it also triggered one's decision
in the COVID-19 vaccine undertaking. In every family, there will be many kinds of perceptions
towards vaccines as they were determined whether good or bad. Family persuasion is among
the factors of attitudes towards the vaccination programme.
33
2.4.5 Health Conditions
The health condition of a person indicates whether they are able to experience many things or
not as their health condition might hinder someone from not being able to receive a vaccine.
Because of age, health issues, or other circumstances, some people may not get certain
immunizations or should pending their willingness to get vaccinated.
2.5 Hypothesis
This study intends to investigate the effect of immunisation programmes on the attitudes of
Sungai Petani residents. A review of the pertinent literature revealed that there are a variety of
perspectives and studies pertaining to attitudes about vaccination programmes that seek to
comprehend what individuals need to get vaccinated. There are two types of hypothesis, which
are alternate hypothesis (Ha) and null hypothesis (Ho). The alternate hypothesis states that
there is a relationship between the variables whereas the null hypothesis states that there is no
relationship between two variables. These research hypotheses are:
H1: The relationship between religious belief and vaccination programmes among the
public in Sungai Petani, Kedah.
Ho: There is no significant relationship between religious belief and vaccination

Ha: There is a significant relationship between religious belief and vaccination

H2: The relationship between confidence level and vaccination programmes among
the public in Sungai Petani.
Ho: There is no significant relationship between confidence level and vaccination

34
Ha: There is a significant relationship between confidence level and vaccination
H3: The relationship between family persuasion and vaccination programmes among
the public in Sungai Petani, Kedah.
Ho: There is no significant relationship between family persuasion and vaccination

programmes among the public in Sungai Petani, Kedah.
Ha: There is a significant relationship between family persuasion and vaccination

programmes among the public in Sungai Petani, Kedah.
H4: The relationship between health conditions and vaccination programmes among
the public in Sungai Petani.
Ho: There is no significant relationship between health conditions and vaccination

Ha: There is a significant relationship between health conditions and vaccination

2.6 Summary
Primarily, chapter 2 reviewed the literature study collected by previous researchers, which
focuses on the component that contributes to the issue of attitudes towards vaccination
programmes. This study examines the relationship between attitudes, vaccination programmes,
and factors that contribute to attitudes. Additionally, this chapter covered independent variables
and dependent variables.
On the basis of the literature reviews, a conceptual framework was created. Also studied is the
association between these factors of attitudes and vaccination programmes. Perhaps it will
assist the researchers in Chapter 3 Research Methodology writing. In Chapter 3, we will go
deeper into the research technique.
35
CHAPTER 3:
RESEARCH
METHODOLOGY
36
3.1 Introduction
In this section, we will describe how this study will be conducted. To achieve the research
objectives, the researcher described the methods used to acquire the required data for analysis.
This chapter contains several sections. Separating the sections were research design, unit
analysis, sampling, data collecting, and data analysis. The first section will discuss research
design, whereas the second section addresses unit analysis and measurement. The third section
described sampling, which may be further subdivided into sample frame, sampling size, and
sampling techniques. In addition, the fourth section discusses research measurement, followed
by the fifth part on data gathering. The sixth will be on data analysis, in which the researcher
discusses the statistical tests used to evaluate the hypotheses linked through this study.
3.2 Research Design
A research design, according to Sekaran and Bougie (2016), is a structure that a researcher
employs to collect, analyse, and evaluate data in order to answer research questions.
Quantitative, qualitative, and mixed methodologies research are the most widely utilized
approaches for conducting research. Quantitative study was illustrated based on numbers and
graphs. It was used to test theories and assumptions or confirm them. This type of research is
useful for establishing facts that can be generalised about a topic. While qualitative research is
described through use of words. It is used to analyse concepts, ideas, and emotions. This type
of research enables academics to understand more about unfamiliar topics. Mixed method is
the mixing of quantitative and qualitative research techniques in a single study (Raimo
Streefkerk, 2019). In this study, the researcher conducted a quantitative survey to evaluate the
hypotheses developed to determine the importance of the relationship between the factors
influencing attitudes towards vaccination programmes.
3.3 Unit of Analysis
37
Unit of analysis is what to be said about at research's finish, and it's referred to as a focus of a
study. The unit of analysis refers to the most examined parameter of the research endeavour.
Individuals and groups are examples of the numerous forms of unit analysis that may be
employed in a project. A unit of analysis is also a unit of observation, which is something that
is observed, measured, or collected in order to gain knowledge about the researcher's unit of
analysis. Unit analysis necessitates the application of partial multiplication and reduction
techniques to problems involving multiple units. Because the unit type is determined based on
real data analysis performed in the project or study, the unit of analysis is termed as such. For
example, if a data of medical records collected from patients at two different medical
institutions, consequently, the unit of analysis is the individual patient's data, as each patient's
medical records score is associated with them. In this study, data were collected from each
Sungai Petani resident, and each respondent's response was analysed separately. Thus,
individuals will be the unit of analysis in this study, and data will be collected from them.
Residents of Sungai Petani will be selected as respondents in order to analyse the factors that
influence the attitudes of Sungai Petani residents towards vaccination programme.
38
3.4 Population and Sampling
Populations were recognized as separate groups of people, whether a nation or a collection of

individuals who share a characteristic. A population is the group of individuals from which a
quantitative inquiry sample is taken. A population is a total group from which researchers wish
to draw conclusions from. A population does not always refer to persons in the study. It can
refer to any collection of elements to be studied, including objects, events, organizations,
countries, species, animals, and more. Consequently, any collection of individuals grouped by
a shared characteristic might be considered a population.
On the other hand, sampling is not the same as the total population; rather, it is a statistically
significant subset of a population. It was a precise group from whom data will be collected.
The sample size is always smaller than the total population size. The type of sample being
collected and the focus of the investigation both play important roles in determining the
methodology that will be utilised for the sampling process. Both the accuracy of the sample
that was selected for the study and the validity of the generalisations drawn from the research
will be based on the sampling technique that was used.
3.4.1 Sample
As has been said, a sample can be defined as a group of significantly smaller numbers of people
taken from a population for research reasons (Alvi, 2016). The sample is determined by which
participants act as the people who make up the sample, which is why they are referred to as
"the folks who make up the sample". In order to successfully collect data from all of the
different components that make up a population, researchers in the fields of social science and
education face an almost enormous barrier. It is often more practicable to take a sample from
the population, which enables data to be gathered more quickly and at a lower cost, as compared
to making an effort to communicate with each and every member of the community.
Nevertheless, the sample will later be used to make conclusions about the population, so it is
essential to understand how the data first appeared in the database in order to evaluate it and
draw conclusions based on it. In a simpler way to understand a sample, a sample is a subgroup
that contains the characteristics of a bigger population. A sample is taken as a representative of
a whole population of Kedahan in this case of research study. Thus, the sample of the study
here is the residents of Sungai Petani only.
39
3.4.2 Sample Framework
Sample framework is defined by Sekaran and Bougie (2016) as a physical description of all the
components that can be used to extract a sample. It is crucial to have a comprehensive
understanding of the sample framework. As this study investigates the factors influencing
attitudes towards vaccination programmes, therefore the sample of frameworks will be
investigated based on the attitude of people in Sungai Petani. Based on this sample, a total of
150 respondents will be used to measure the attitude towards the vaccination program. Thus,
despite the small sample size, these results are likely to be representative. Whether the
respondent accepted the vaccination program or not.
3.4.3 Sample Size
The most important phase in the research process is determining the appropriate size of the
sample. The act of deciding how many observers to include in a statistical sample is known as
a sample size selection. There are several circumstances in which the increase in precision that
comes with bigger sample size is either negligible or even non-existent. The accuracy of the
final estimations is used as a standard to evaluate the size of the samples used. The assessment
of the appropriate sample size for descriptive studies is distinct from that of experimental
investigations. The selection of appropriate sample size is an important step in conducting high-
quality evidence-based research. The assessment of the optimal sample size is necessary for a
few different reasons. First, in order to facilitate the suitable analysis; second, so as to deliver
the acceptable level of accuracy; and third, so as to enable the validity and significance test
(Kaur, 2021). The sample size for most studies should be greater than 30 and less than 500
(Roscoe, 1975). The scholar indicated that this range is sufficient. As a result, the researcher
intends to select approximately 150 respondents for this study's implementation. 150
respondents were expected due to the attitudes of whether positive or negative, the total
respondents expected number were actually divisible numbers. This meant that the outcome of
later-discovered attitudes may be neutral and balanced. The other reason was because it was a
population standard deviation of a research.
40
3.4.4 Sample Technique
Sampling is the process of selecting the proper number of components from a population.
Probability and non-probability sampling techniques are the two classifications of sampling
operations. Every member of the population has an equal chance of being chosen for the test
using a probability sampling technique. Sampling helps acquire reliable estimates of the
features of a population. Consequently, the sample result seems more representative of the
entire population.
Probability sampling includes simple random sampling, systematic sampling, stratified random
sampling, and cluster sampling. Non-probability sampling, on the other hand, does not rely on
random selection methods but rather on the researcher's own discretion. Non-probability
samples may yield accurate estimates of population characteristics, but they do not permit
objective samples to be evaluated accurately. Convenience sampling, snowball sampling,
judgement sampling, and quota sampling are non-probability sampling methods. (Negida,
2022). A stratified random sample formed by dividing a population into subgroups or strata
based on a certain sampling attribute. It permits researchers to collect a sample population that
correctly represents the entire population. In this study, the researcher employed stratified
random sampling to determine the actual sample size, as this sampling method demands a
smaller sample size, hence reducing costs and saving time. By allowing the researcher to decide
which subgroups were included in the sample, this strategy effectively helped the researcher
achieve a more comprehensive population coverage.
In this study, the recommended sampling method is probability sampling since each element
of the population has some chance of being chosen as a sample subject. There are seven types
of probability sampling which are simple random sampling systematic that will be used to see
the sample of religious belief, confidence level, family persuasion and health condition through
this IV.
41
Table 3. 1
Attitudes toward COVID-19 Vaccine and influencing factors
1. I would take the Covid-19 vaccine when it becomes available
2. How much would you say that you know about COVID-19?
3. How much news and information have you seen and heard about COVID-19
4. I engage in preventive behaviour (wearing mask/visor, social distancing, frequent hand

washing, sanitiser use)
5. I believe that the COVID-19 vaccine will help protect the people who take it
6. The opinion of family and friends is important in my decision to take COVID-19

vaccine
7. I value the advice of health professionals regarding the effectiveness of the COVID-19
vaccine
*All items were measured with a 5-point Likert scale (5=strongly agree, 4=agree, 3=neutral,
2=disagree, 1=strongly disagree), with questions about hesitancy and concerns regarding
COVID-19 vaccines.
3.5 Measurement / Instrument
After the study topic has been nailed down, the next step is to develop the research measure. A
variable's actual numerical values, which can be categorised in accordance with the level of
measurement, are also considered to be measurements of that variable. To ensure the validity
and dependability of the measurement, the measurement itself must be precise and consistent
with the subject being measured. The activity of making observations and keeping a record of
the observations are also part of the efforts made by the researchers to collect all of the relevant
42
information regarding the respondent's answer later. Based on the dependent variable,
vaccination programme and independent variable which are religious belief, confidence level,
family persuasion and health condition, all the variables will be taken into account while doing
the measurement scale in this research project. As a result, the researcher utilised three different
types of measurement for the purpose of this study, where they are three types of scales:
nominal scale, ordinal scale, and interval scale.
3.5.1 Nominal Scale
Nominal scales are defined as variables, categories, or alternatives that do not have a regular
order or ranking that is applicable everywhere (Ndukwu, 2020). The nominal scale is a
straightforward classification system that groups things like people, events, and perceptions
according to some common quality. Although males and females make up separate groupings,
neither can be definitively ranked higher than the other in every situation. In the field of study,
nominal data can be given a numerical value, but those values do not have any real-world
significance. The nominal scale is simple as it only needs to reveal whether the object is from
any category and no other information is needed. It was just whether people take the vaccine
or not, whether people trust the vaccine or not, and other more simple questions that need a
simple answer. For example, to code a nominal scale data, variable of residents into vaccine
undertaking of whether yes or no can be placed.
Using vaccination programme as dependent variable, it will be seen as the main topic of matters
in questionnaire while looking at the question regarding its independent variable; religious
belief (the religion types: Islam, Christianity, Buddhism, Hindusim and others), confidence
level (not confident, mix feeling and very confidence), family persuasion (no support, natural
and very supportive) and health condition (very healthy, mild condition and person with
chronic diseases).
3.5.2 Ordinal Scale
Ordinal represents order. Ordinal data are quantitative data with naturally occurring orders
between which the difference is unknown. It can be labelled, categorised, and ranked. The
ordinal scale is the second level of measurement, and it is used to represent the ranking of data
without explicitly establishing the degree to which the data differ from one another. A popular
43
advantage of using the ordinal scale is that the simplicity of comparing variables, and after
arranging the variables, grouping them is incredibly practical. The ordinal scale measurement
data are typically utilized in virtually all aspects of research that include the generation of
categorical data. Following that, the ordinal degree of evaluation is utilized in the vast majority
of the questionnaires that are frequently asked about vaccine undertaking satisfaction. The most
fundamental form of an ordinal scale is a ranking. For example, not satisfied, neutral, and very
satisfied.
Using vaccination program as dependent variable, it would be seen as the major topic of affairs
in questionnaire when looking at the question about its independent variable; religious belief
(number of times religion law referred to from scale 1 to 5), confidence level (not confident,
somewhat not confident, neutral, somewhat confident and very confident), family persuasion
(weak support, likely weak, neutral, likely strong and very strong) and health condition (bad,
not really, good and very good).
3.5.3 Interval Scale
Using an interval scale, the researcher could compare differences between different things. On
the data collected from respondents, specific arithmetic operations were conducted. The
interval scale allows researchers to estimate the distance between any two points on the scale.
The interval scale was used to determine the degree of preference variation among respondents.
(Sekaran and Bougie, 2016). In this study, the researcher examined the extent of the dependent
and independent variables using a Likert scale ranging from 1 to 5 with responses of 1 -
"Strongly Disagree," 2 - "Disagree," 3 - "Neutral," and 4 - "Agree," and 5 - "Strongly Agree."
Table 3. 2
Table of Interval Scale
Name of Concept Definition Operational Level of

Definition measurement
Independent According to the 1. The

variable:
Ansari et al., 2020 as Agreement
Religion belief cited by PMC (2021) towards
44
religious belief vaccination Interval Scale
describes where it program by (Likert Scale)
shows that a minority the

1. Strongly Disagree
of parents believe government. 2. Disagree
3. Uncertain
that vaccination
4. Agree
should not be 2. Vaccine 5. Strongly Agree
suggested owing to administratio
halal concerns, n in infants
teaching them that and children
vaccines are safe and is important.
halal. 3. Vaccines are
more
beneficial
than harmful
to the
children.
4. All vaccines
are safe for
children.
Independent According to Maria

variable: 1. Is confident Interval Scale
Cordina, Lauri, &
(Likert Scale)
Confidence level Lauri, 2021 as cited that those
by PMC (2021) who receive 1. Strongly Disagree
2. Disagree
confidence level the COVID-
3. Uncertain
refer to the 19 vaccine 4. Agree
will benefit 5. Strongly Agree
respondent being
more likely to be and from it in
not to take the terms of their
vaccine where it can overall
be negative and health.
positive.
45
2. Be open-
minded to the
medical
community's
assessment of
the COVID-
19 vaccine's
effectiveness.
3. Possibility of
promoting
vaccination
against
COVID-19
amongst
elderly
parents
4. Affirmative
on providing
children with
the COVID-
19 vaccine.
Independent According to the El- 1. Knowledge Interval Scale

variable: (Likert Scale)
Elimat, about
Educational level AbuAlSamen, COVID-19 1. Strongly Disagree
Almomani, Al- 2. Disagree
3. Uncertain
Sawalha, & Alali, 2. COVID-19 4. Agree
2021 as cited by has become 5. Strongly Agree
PMC (2021), the subject of

educational level recent media
refers to the attention.
46
education where it 3. In order to
did not affect prevent the
whether or not people spread of
were willing to get COVID-19,
the vaccine, those people need
with a tertiary to get
education were more vaccinated.
likely to think that
the vaccine will 4. Vaccines
protect those who get against
it. COVID-19
will be
developed by
pharmaceutic
al companies
in a safe and
effective
manner.
Independent According to the 1. Any plan on Interval Scale

Babicki, Pokorna- vaccinate
Health conditions Kałwak, Doniec, & your child
Mastalerz-Migas, against 2. Disagree
2021 as cited by Ger COVID-19 3. Uncertain
4. Agree
Rijkers (2021) health
5. Strongly Agree
conditions refer to 2. The
the threat to the life mandatory
and health of the vaccinations
public which seems among
to be congruent with children
current medical
knowledge. 3. The
mandatory
47
vaccinations
among adults
4. The vaccines
can provide a
preventive/
safety for the
children
Independent According to the 1. The opinion Interval Scale

Sinuraya, Kusuma, of my family
Family persuasion Pardoel, Postma, & is important
Suwantika, 2022 as in my 2. Disagree
cited by PMC (2022) decision to 3. Uncertain
4. Agree
family persuasion take the
5. Strongly Agree
refers to the opinion COVID-19
from the family in vaccine
order to make a
decision to take the 2. Elderly
vaccine. parents
should be
encouraged
to get the
COVID-19
vaccine.
3. Referrals to
the COVID-
19 vaccine
for the
benefit of
friends and
relatives who
48
may not
otherwise
receive it.
4. Believe that
COVID-19
vaccines will
help protect
the family
from
COVID-19
3.6 Data Collection
Data collection, according to Abdullah and Ahmad (2016), is a method used to answer concerns
about how a researcher gathered information from individuals, businesses, or activities in order
to further their research. Researchers in this study used a survey method known as a "cross-
sectional survey," which is quantitative in nature. According to Sekaran and Bougie (2016),
for instance, the term "cross-sectional" refers to a study that collects data only once to address
research questions. The researchers applied a set of questionnaires that were sent to respondents
who resided in Sungai Petani, Kedah. Google Forms were used to distribute the questionnaire
via an online survey. Malay and English were used as the languages of communication for the
questionnaire. The questionnaire was used by the researcher because it is more cost-effective
and time-efficient than other methods. Respondents were given a link to the questionnaire via
WhatsApp, Telegram, and Facebook. It was necessary to perform questionnaire pre-testing in
order to confirm and clarify the accuracy of each of the survey's questions.
49
3.7 Data Analysis
Statistical Package for the Social Science (SPSS) version 26 was used to analyse the data
obtained by the researcher in order to transform meaningless raw data into a form that provided
insight into the study. This strategy was chosen by the researcher since it is the most appropriate
software to utilise given the quantitative nature of the data obtained. This study employs three
statistical methods: descriptive statistics, correlation, and multiple regressions.
3.7.1 Descriptive Statistics
According to Bluman (2012), descriptive statistics is the process of collecting, organising,

summarising, and displaying data using visual methods such as charts, graphs, tables, or
statistical forms (averages and percentages), and then extracting information from it so that the
data set can be easily analysed. In research, the most often used descriptive statistics were the
mean, median, mode, standard deviation, variance, minimum and maximum variables. This
study utilized descriptive statistics to investigate the scope of attitudes towards vaccination
programmes in Sungai Petani.
3.7.2 Correlation
Researchers use the term correlation to characterise the strength of a linear relationship, which
can be positive or negative, between two variables. According to Sekaran and Bougie (2016),
the correlation coefficient (r) was utilised to determine the relationship between the variables
X and Y. in this study, the researcher use correlation to determine the strength of relationship
the between religious belief, confidence level, educational level, health conditions and family
persuasion towards vaccination programme in Sungai Petani.
50
Table 3. 3
Correlation Strength based on Guilford Rules of Thumb
Correlation Coefficient Interpretation
0.10 < r < 0.29 Weak
0.30 < r < 0.49 Moderate
0.50 < r < 1.00 Strong
Source: Adopted from Guilford (1973)
3.7.3 Multiple Regression Analysis
The statistical method known as multiple regression is a tool that may be applied in the
investigation of the connection that exists between a single dependent variable and a number
of independent variables. The purpose of doing a multiple regression analysis is to predict the
value of a single dependent variable by making use of multiple independent variables whose
values have already been determined. The multiple regression analysis is going to be used by
the researcher to analyse the relationship between one or more independent variables and a
dependent variable. It allows researchers to determine the variable that contributes the most to
all correlations. This technique will be utilized to identify the most significant elements in this
investigation that contribute to the factors of attitudes toward vaccination programmes among
residents of Sungai Petani.
51
3.8 Pilot Study
A pilot study is the first phase in a research technique and is essentially a single study that aids
in the planning and modification of the primary study. Through the pilot study, researchers
become acquainted with the methods entailed in the main study, which facilitates the selection
of the most suitable research method for addressing the research issue in the final evaluation.
Either an impartial external pilot study will be carried out in addition to the primary
investigation, or an internal pilot study will be carried out and incorporated into the research
strategy for the primary investigation. A pilot research will be carried out in order to determine
whether or not the questionnaire can be relied upon. For the purpose of the pilot project, the
questionnaire will need to be distributed to the approximately 150 residents of the Sungai Petani
area who are expected to take part in the study. After that, the information will be derived solely
from the people who filled out the questionnaire. Cronbach's alpha will be used to analyse the
questionnaire, and responses will be collected shortly. The alpha of Cronbach will be
determined using the following formula:
Table 3. 4
Cronbach's Alpha Formula
Cronbach’s Alpha = rk / [1 + (k – 1) r]
Where k = number of items considered
r = the mean of the inter-item correlations
Source: Matkar, n.d (2022). Adopted from Statistics How To website

Table 3. 5
The scale Cronbach’s Alpha
> 0.90 Excellent
0.80 < r < 0.89 Good
0.70 < r < 0.79 Acceptable
0.60 < r < 0.69 Questionable
0.50 < r < 0.59 Poor
< 0.50 Unacceptable
52
3.9 Conclusion
To be concluded, this chapter three which discussed the research methodology has divided its
debate through various subtopics which consists of the research chapters include research
design, unit of analysis, population and sampling, measurement, data collecting, data analysis,
and finally a pilot study. All of these different research approaches are being utilised in order
to uncover the factors that contribute to the attitudes that residents of Sungai Petani have
towards vaccination programmes. The next chapter of four and five will unveil the actual
implementation of this research and will be covered in greater depth throughout the next
semester.
53
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Ads511-Factors Influencing Attitudes Towards Vaccination Programme in Sungai Petani

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Faculty of Administrative Science & Policy Studies

Universiti Teknologi MARA

Bachelor of Administrative Science (Hons)

Factors influencing attitudes towards

Name of Students Matric No.

1. NUR HIDAYAH BINTI ABU BAKAR 2021393485

MARCH 2022 - FEBRUARY 2023

MATRIC NO.: 2021393485

MATRIC NO.: 2021340769

1.1 Introduction ..................................................................................................................... 3

1.2 Background of Study ...................................................................................................... 3

1.3 Problem Statement .......................................................................................................... 6

1.4 Research Question ........................................................................................................ 10

1.5 Research Objective ....................................................................................................... 10

1.6 Scope of Study .............................................................................................................. 11

1.7 Significance of Study .................................................................................................... 12

1.8 `Definition of Key Term ............................................................................................... 13

1.8.1 COVID-19 ............................................................................................................. 13

1.8.2 Vaccination program ............................................................................................. 13

1.8.3 Religious belief ...................................................................................................... 14

1.8.4 Confidence level .................................................................................................... 14

1.8.5 Family Persuasion.................................................................................................. 15

1.8.6 Health conditions ................................................................................................... 15

1.8.7 Sungai Petani ......................................................................................................... 15

1.9 Conclusion .................................................................................................................... 16

LITERATURE REVIEW & CONCEPTUAL FRAMEWORK ....................................... 17

2.1 Introduction ................................................................................................................... 18

2.3 Variables related to vaccination programme ................................................................ 21

2.3.1 Religious belief ...................................................................................................... 21

2.3.3 Family Persuasion.................................................................................................. 26

2.3.4 Health conditions ................................................................................................... 29

2.4 Conceptual framework .................................................................................................. 32

2.4.1 Definition ............................................................................................................... 33

2.4.2 Religious belief ...................................................................................................... 33

2.4.3 Confidence Level ................................................................................................... 33

2.4.4 Family Persuasion.................................................................................................. 33

2.4.5 Health Conditions .................................................................................................. 34

2.6 Summary ....................................................................................................................... 35

RESEARCH METHODOLOGY ......................................................................................... 36

3.1 Introduction ................................................................................................................... 37

3.2 Research Design............................................................................................................ 37

3.3 Unit of Analysis ............................................................................................................ 37

3.4 Population and Sampling .............................................................................................. 39

3.4.1 Sample ................................................................................................................... 39

3.4.2 Sample Framework ................................................................................................ 40

3.4.3 Sample Size ........................................................................................................... 40

3.4.4 Sample Technique ................................................................................................. 41

3.5 Measurement / Instrument ............................................................................................ 42

3.5.1 Nominal Scale........................................................................................................ 43

3.5.2 Ordinal Scale ......................................................................................................... 43

3.5.3 Interval Scale ......................................................................................................... 44

3.6 Data Collection ............................................................................................................. 49

3.7.1 Descriptive Statistics ............................................................................................. 50

3.7.2 Correlation ............................................................................................................. 50

3.7.3 Multiple Regression Analysis ................................................................................ 51

3.8 Pilot Study..................................................................................................................... 52

3.9 Conclusion .................................................................................................................... 53

Figure 1. 2 Vaccination Progress by State ................................................................................ 8

Figure 2. 1 Conceptual Structure of Independent Variables and Dependent Variables......... 32

Table 3. 2 Table of Interval Scale ........................................................................................... 44

Table 3. 3 Correlation Strength based on Guilford Rules of Thumb ...................................... 51

Table 3. 4 Cronbach's Alpha Formula .................................................................................... 52