INTRODUCTION

The World Health Organization (WHO) confirmed COVID-19 as a pandemic on March 11, 2020, which has generated a global economic and social crisis, generating chaos and uncertainty in all aspects of daily social performance, the forced changes that the world had to make show a difference with what we lived before, which had repercussions on the development of the daily activities of the citizens, of the health, economic, political, educational, cultural systems, among others¹.

Situation that has caused high medical costs related to post-infection care or the worsening of other diseases due to the postponement of preventive care and timely diagnosis, productivity losses due to work absenteeism and premature mortality, or the decrease in economic activity².

During September 14, 2021, globally 225,244,735 people were contaminated with COVID-19, 4,639,280 deaths and 5,719,029,358 doses of vaccines administered. However, the United States presented 41,213,908 confirmed cases, 662,016 deaths and according to reports until August 24, 2021, they had 54% of the population vaccinated. At the level of Latin America, Brazil is after four countries in the world with 21,006,424 cases, 587,066 deaths and 34.49% of the population vaccinated. Peru followed after nine countries with 2,161,358 cases, 198,799 deaths and 27.07% of population vaccinated. While in La Libertad 87,341 cases are reported, 10,131 deaths and as of September 17 of this year, 32.8% of the vaccinated population. However, it is good to emphasize that the Chilean nation leads the ranking of fully vaccinated population at 73.36%.^3-5.

Despite the results found, it was possible to develop a vaccine that, after several tests on volunteers in several countries, showed high percentages of efficacy, which allowed its application to begin to be authorized worldwide and thus reduce the rates of hospitalizations and deaths related to COVID-19. With these results, it is expected that the promotion and distribution will be equitable so that economic, labor, social and family activities can gradually return.⁶.

However, there are various elements that affect the process of acceptance of vaccination, since the pandemic unfolds in a context of distrust in the safety and efficacy in the absorption of the vaccine, as well as possible adverse effects. This has triggered negative attitudes in people, due to ignorance and "misleading or incorrect information with false messages made on social networks by users and/or groups in order to create a certain state of opinion" or also called an infodemic, hindering the measures to contain the outbreak, promoting fear, generates unnecessary chaos as well as division at a time when it is necessary to be empathetic and help save lives and thus defeat this health crisis⁷.

In this perspective, YouTube is the second most visited platform worldwide, showing anti-vaccine videos that indicate, as a consequence, diseases such as autism, sudden death, or that microchips are placed through vaccines to alter the genetics of people or that one of the first volunteers died from complications caused by the Oxford Vaccines Group vaccine, the same ones that have been rejected by the World Health Organization (WHO), because they are attributed as pseudoscientific knowledge, which needs verification of specialists, a situation that leads to mistrust by part of the population towards vaccination against COVID-19⁸.

Events that have led to the reluctance to be vaccinated by a group of people, which does not yet allow reaching 50% of the vaccinated population, and at the same time the lack of vaccines in some countries, which constitutes a challenge to take care of the planet, put the good of others and equity in all countries first, so that everyone has access to this benefit of saving lives, reducing the severity of the disease, controlling the transmission of the virus and slowing down the spread of the pandemic. In such a way, that vaccines currently constitute one of the most efficient and effective actions of public health that will contribute to the reduction of morbidity and mortality⁹.

The previous approach leads to the reflection that the domain of the pandemic is not only based on the efficacy of the vaccine against COVID-19, but also on the real and objective information that must reach the population and the vaccination strategies of each country. , as well as in the spiritual adoption of each human being, moved by deep respect for creation and not indiscriminate usufruct for the sake of progress, seeking the care and conservation of the planet, which will be reflected in attitudes of a new planetary consciousness, based on reason and not on personal particularities, which will translate into sustaining compliance with security measures in their entirety, as well as promoting and raising awareness of information pertinent to the role and relevance of vaccines against COVID-19¹⁰.

From all the above, the research problem arises: Is there a relationship between knowledge and attitudes about the COVID-19 vaccine, in the inhabitants of the province of Trujillo - Peru?

With the purpose of contributing to changes in attitudes and achieving 85% of the population vaccinated to maintain community or "herd" immunity, depending on the country and the infection rate. Science is expected to succeed, since historically the defeat of other epidemic and pandemic diseases is evident with a view to an ecological paradigm based on a new social ethics, so necessary in this time of excessive industrialization¹¹. It is for all these reasons that this work proposes to determine the relationship between knowledge and attitudes about the COVID-19 vaccine in the inhabitants of the province of Trujillo.

METHODS

RESULTS

InTable 1, it can be seen that the majority (88%) of the inhabitants of the province of Trujillo have a good level of knowledge about the COVID-19 vaccine, specifically in the effectiveness and benefits it generates when it comes to its application, in the face of comments and rumors that exist in different media, they took the initiative to be able to obtain adequate information from reliable sources, thus achieving the understanding that this vaccine is the best alternative to be able to combat the disease, with the population between 30 and 59 years old being the who have the best knowledge, and inTable 2, it is observed that it is women who have acquired the greatest knowledge about the vaccine.

Below inTable 3, it can be seen that the majority (91%) of the inhabitants of the province of Trujillo have an adequate attitude towards the vaccine against COVID-19, this means that the people of Trujillo are willing to apply themselves. the vaccine after being adequately informed about its effectiveness, which has generated security and responsibility in the fight against the pandemic, it is also observed that people between 30 and 59 years of age are the ones who are most willing to be vaccinated, andTable 4shows that it is women who show a better attitude towards the vaccine.

Finally, inTable 5, it is shown that there is a significant relationship between the level of knowledge and attitudes towards the COVID-19 vaccine in the province of Trujillo (p<0.05), in addition, the good level of knowledge constitutes a factor of protection or advantage (OR: 0.4303; CI: 0.2315-0.8053) for the appropriate attitude towards the vaccine, this means that as long as a person is dedicated to researching and learning about the vaccine, this generates a disposition to be able to accept being vaccinated .

DISCUSSION

The first results of this research show us that 88% of the Trujillo population have a good level of knowledge about the COVID-19 vaccine, this means that the information that exists about the different vaccines and their degree of effectiveness in generating antibodies against the disease, it was enough to generate the appropriate knowledge, only 12% of the population has regular knowledge, they have only been informed about one to two brands of vaccines (Pfizer and Sinopharm), not knowing the effectiveness and benefits of the others that have been distributed worldwide. From these results it was also obtained that the population between 30 to 59 years and women are mostly those who have obtained greater knowledge about the vaccine. In this way, similarity is found with what was presented by Portero-Alonso et al¹⁵where from a total of 212 adolescents (134 men and 78 women), 79,85% of the women stated that they have a high knowledge that the human papillomavirus vaccine serves to prevent cervical cancer, despite having false beliefs about the effectiveness of the vaccine. Likewise, in the study presented by Fecyt innovation¹⁶, it was shown that in mid-2020 only a third of the Spanish population (32%) was willing to be vaccinated, this increased to 83% until January 2021, initially due to little knowledge they had about the effectiveness of the vaccine , gave weight to the belief that vaccines are not safe as well as a conspiratorial thought about them, as infections and information increased, this generated greater knowledge and therefore a better willingness to be vaccinated.

Regarding the second result, it has been found that 91% of the inhabitants of the city of Trujillo have an adequate attitude towards the COVID-19 vaccine, which means that the majority of Trujillo residents are willing to be vaccinated and thus being able to curb the mortality rate that has occurred throughout Peru, being the sixth in the world with the most deaths from this pathology. Like the first results, people between 30 and 59 years old and women are the ones who have shown the greatest willingness to be vaccinated. A study conducted by Ward, Alleaume and Peretti-Watel¹⁷revealed that a quarter (7,9%) of French people refuse to be vaccinated against COVID 19, the main reason being distrust of the vaccination process by the French government, and rushed vaccine development; while 16.1% of the population considers it probable to be vaccinated, compared to this, it is guaranteed that the majority (76%) of the French population is willing to be vaccinated, in the same way Fisher et al.¹⁸In a study carried out in the USA, it shows that 57,6% of American adults are willing to be vaccinated, 31.6% were not sure about being vaccinated, and 10.8% definitely would not be vaccinated. The most influential factors for not being willing to be vaccinated were educational level, race, young people under 25 years of age and those who did not receive the influenza vaccine the previous year, also stated that more information about the vaccine is necessary.

Finally, it has been determined that there is a relationship between the level of knowledge and attitudes towards the COVID-19 vaccine (p value <0,05). Likewise, the level of knowledge represents a protection factor (OR: 0,43; CI: 0,23-0,81) for an adequate attitude towards the vaccine, which means that people who have a good level of knowledge about the vaccine have more likely to agree to be vaccinated than those who have a low level of knowledge about the vaccine. Similarly, Roozenbeek et al.¹⁹in their study carried out in five countries (USA, Spain, Ireland, Mexico and the United Kingdom) maintain that the statement that the virus was made in a Wuhan laboratory is associated with a lower probability of accepting the vaccine (OR: 0,77; CI : 0,72-0,83) and recommending it to a family member and friend (OR: 0,72; CI: 0,67-0,78); In these countries, there was a great propensity to believe false news about the vaccine, which was associated with an inadequate attitude to get vaccinated. These results are also similar to those of Ruiz et al.²⁰where it was shown that there was a statistical dependence (p value < 0,05) between the perception of knowledge and types of attitudes towards COVID-19 by the inhabitants of the city of Huánuco.

In conclusion, the level of knowledge is significantly related to the attitudes towards the COVID-19 vaccine in the inhabitants of the province of Trujillo, which means that as long as they maintain a high level of knowledge, this will generate a greater willingness to get vaccinated, likewise having a good level of knowledge generates a protection factor to ensure that the population will decide to get vaccinated, this has been evidenced since the province of Trujillo is one of those that has been leading the vaccination day in Peru.