The COVID-19 pandemic has changed all aspects of human life. Every nation attempts to prevent the spread by boosting widespread immunity through vaccination programs. The target population for the distribution of vaccines in Indonesia is 208,266,720 individuals. Dose 1 and 2 that has been administered to 124,156,167 (19.61%) and 78,114,072 (37.51%) recipients on November 6, 2021 did not meet this target.1,2 Meanwhile, vaccine acceptance rates in several countries were recorded, and China was the highest recipient country at 91.3%, followed by European countries and the United States at 74% and 67%.3 Distrust and doubt in the government are the main obstacles to the failure of the vaccine.4 This literature study has a distinct benefit over prior studies, specifically the development of grounded theory through qualitative analysis with ATLAS.ti9.

The reason for the reluctance to get involved in the vaccine is the concern about the effect5 due to a history of past diseases such as heart and respiratory6 and the reluctance to receive vaccines. People who lack adequate documentation fear being humiliated, rejected, and made a burden on the state if they visit vaccination centers.7 The same opinion was conveyed by previous research on reluctance due to doubts and inequality of vaccines. Furthermore, political and religious conspiracy theories discourage Pakistanis from receiving vaccines.8

Based on this data, the formulation of the problem in writing a literature review is: what are the driving and inhibiting factors for community involvement in the COVID-19 vaccine? How is the community involved in the vaccine? Therefore, this literature review is useful as a strategy to succeed and support the implementation of the vaccine program.

Carson et al., 7 described community involvement in the COVID-19 vaccine as determined by trust in medical personnel, perception of infection, and safety. Sethi et al.9 explored the driving and inhibiting factors for the absorption and conducted a quantitative analysis. The main obstacle to the vaccine's success was dispelling public doubts about the side effect.9 This literature review has an advantage that previous research has not conducted, namely developing grounded theory through qualitative analysis using ATLAS.Ti9 software after analyzing several selected articles. Therefore, this literature review is a development of previous theoretical concepts that are systematic and can be accounted for their objectivity and validity.

The theoretical basis for building this prototype uses the Health Belief Model theory, adding to the perception of vulnerability. A person will take action to prevent disease and be willing to be vaccinated when they have low confidence and are susceptible to disease. Vaccines are believed to reduce their susceptibility to COVID-19 and encourage them to take positive action.10

This literature review aims to identify the factors that encourage and discourage community participation in the vaccine program. Therefore, this literature review found the right strategy to expand the reach and resolve public doubts on receiving the vaccine.

The literature review uses secondary data from previous studies, and data collection was carried out for 1 week. The data search was conducted through the PubMed database, Google Scholar, Scopus, Web of Science, and Proquest. The search used the “boolean searching” method using the keywords “community engagement” AND “COVID-19 vaccine” AND “vaccine program” AND “vaccine acceptance” AND “community participation”. The tracing steps for determining samples using PRISMA developed by Page et al.11 are described in Figure 1.

Figure 1.

Diagram of the process of searching for community involvement data in the COVID-19 vaccine.

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The total search for data based on the COVID-19 vaccine (n=11,599) focused on public acceptance (n=813) and community involvement (n=86), then searched by type of article (n=46). Furthermore, from 46 types, the selected articles were analyzed based on the PICOS inclusion criteria: 1) community population; 2) without intervention; 3) without comparison; 4) outcome: factors supporting, inhibiting, and accepting the vaccine; 5) research articles; 6) articles published in 2021; and 7) English.

Each article was studied and analyzed according to the inclusion criteria. Many articles were eliminated because they did not meet the criteria, including an intervention. The results section did not describe the specified variables, and the research year was not 2021. The articles were analyzed using the qualitative software ATLAS.Ti9 after carrying out the identification, screening, and criteria determination stages. Articles that meet the criteria are stored in one folder and inputted into the ATLAS.Ti9 software for further data analysis.

A total of seven international articles met the criteria and were sampled for synthesis and analysis. The inclusion criteria “outcome” was determined according to the purpose of writing a literature review. Variables were included in the PICOS method to reveal the factors that supported the community being involved and the vaccine. The issues that prevented the population from receiving immunizations were also identified, and the rationale for receiving the vaccine was examined in depth.

The seven articles that fit the criteria were examined, synthesized, and displayed in Table 1.

The literature review results were obtained after carrying out the stages of identification, screening, and determining criteria until seven articles were analyzed. The articles were analyzed using the qualitative software ATLAS.Ti9. A literature review showed encouraging, inhibiting, and community involvement in the COVID-19 vaccine.

In accordance with writing to show community involvement, a variable construct was built based on the Health Belief Model theory, supported by Adebisi et al.12 and Jones et al.10, which describes that messages or information can optimally achieve behavior change when they target obstacles. Therefore, factors that hinder the administration of the COVID-19 vaccination should be investigated in depth based on several prior research. According to Jones et al.10, self-efficacy can affect barriers, while self-confidence plays an important role in acting. This was described in the campaign (self-efficacy (perceived inhibition) scheme.

The three themes that became the purpose of writing a literature review were driving factors, inhibiting factors, and perceptions of vulnerability12. As illustrated in Figure 2, seven themes or constructs were obtained.

Figure 2.

The results of the analysis of the research theme.

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The results of data analysis showed that seven themes are related to driving factors, inhibiting factors, and perceptions of community vulnerability. Previous studies analyzed seven articles with similarities and differences. In several countries such as America, Carson's research7 found that people's reluctance to participate in vaccination programs results from one day of lost productivity. Green et al.13 states that the inhibiting factor for people to receive the vaccine is their beliefs and doubt. Seale et al.14 explained that Australians are involved in the vaccine because they are susceptible to the disease. Therefore, people with chronic diseases are 1.4 times more likely to strongly agree to be vaccinated, in addition to family support. The results are the basis for the perception of vulnerability which is a variable between the driving and inhibiting factors. Based on research by Jones et al.10, Green et al.13 and Seale et al.14, it is important to add the perception of vulnerability as a constructed variable in the prototype.

Some of the themes were found using the ATLAS.Ti9 software is the basis for developing the theory. The next phase in producing this theory is to examine the tight relationship between the literature study's themes and create a prototype model based on grounded theory. Meanwhile, the co-occurrence values are shown in Table 2.