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Volume 4 Issue 2, August 2024, pp 218-230
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eISSN 2503-2801, pISSN 2985-3435
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Level of Anxiety with COVID-19 Vaccine Screening Results
Level of Anxiety with COVID-19 Vaccine Screening Results
in Jember Regency
Alfid Tri Afandi1, Prestasianita Putri2* , Rosita Oktavia Djuanda3, Ahmad Rifai1
1 Faculty of Nursing, Universitas
Jember, Indonesia
2 Faculty of Health Science,
University of Dr. Soebandi,
Indonesia
3 Staff at Karsa Husada Batu
Hospital, Indonesia
Article History
Submitted: 27-06-2024
Revised: 28-07-2024
Accepted: 16-08-2024
doi.org/10.58545/jkki.v4i2.392
Copyright (c) 2024
Authors
This is an open-access article
under the CC-BY-SA License.
Abstract
Anxiety can decrease concentration, so it can be dangerous if it happens
to someone who is going to do work that could pose a risk of injury. This
research aims to identify anxiety levels, identify vaccine screening
results COVID-19, and analyze the relationship between anxiety levels
and vaccine screening results COVID-19. The independent variable in
this study was the level of anxiety, while the dependent variable was the
results of vaccine screening for COVID-19. This research had 115
respondents using a sampling technique, namely consecutive sampling.
This research design uses a cross-sectional correlation type approach.
Use bivariate statistical tests. The results of this study were that most
of the vaccine participants' anxiety levels were high, COVID-19 was
mild anxiety 54.8%, most respondents had vaccine screening results for
COVID-19, namely passing the screening at 92.2%, and there is a
relationship between the level of anxiety and the results of the vaccine
screening COVID-19 with a value of p=0.000 (p<0.05). It is hoped that
this research can provide input and additional information for nursing
education regarding people's anxiety levels.
Keywords: Anxiety, COVID-19, Vaccine Screening
Correspondence
Prestasianita Putri
Faculty of Health Science, University of Dr. Soebandi,
Jl. DR. Soebandi No.99, Cangkring, Kec. Patrang, Jember, East Java 68111 Indonesia
Email: prestasi.nursing@uds.ac.id
How to cite:
Afandi, A. T., Putri, P., Djuanda, R. O. & Rifai, A. (2024). Level of Anxiety with COVID-19 Vaccine Screening Results in Jember
Regency. Jurnal Kesehatan Komunitas Indonesia, 4(2), 218-230. https://doi.org/10.58545/jkki.v4i2.392
1. BACKGROUND
Coronavirus is an RNA virus with a
particle size of 120-160 nm. This virus
mainly infects animals, including bats and
camels. Before the outbreak COVID-19,
there are 6 types of corona virus that can
infect humans, namely alpha coronavirus
229E, alphacoronavirus NL63, beta
coronavirus OC43, beta coronavirus
HKU1, Severe Acute Respiratory Illness
Coronavirus (SARS-CoV), and Middle
East Respiratory Syndrome Coronavirus
(MERS-CoV) (Susilo et al., 2020). So, the
side effects of this virus can cause a
decrease in immunity. Other impacts can
cause excessive anxiety due to fear of
contracting the COVID-19 virus (Afandi et
al., 2021). To reduce the number of cases,
the government is carrying out
vaccinations. Providing vaccines is one of
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Afandi (2024)
the efforts considered to be the most
effective in overcoming the pandemic
COVID-19. Vaccination or immunization is
a procedure of administering a disease
antigen, usually in the form of a weakened
or dead virus or bacteria. The goal is to
make the body's immune system recognize
and be able to fight when exposed to the
disease (Nareza., 2021).
Vaccinations have been given in all
countries, a total of 595,923,114 vaccine
doses (7.6%). In Indonesia, the target
number of vaccinations is 181,554,465, with
the number of vaccine targets for health
workers, public officials, and the elderly
reaching 40,349,051. The number of those
receiving the 1st vaccination is 6,389,837,
and as many as 2,941,016 have received the
2nd vaccination (WHO., 2021). During the
vaccination process, screening is carried
out to confirm the vaccine COVID-19 given
to the appropriate group, eliminates
contraindications to vaccination, and
minimizes the risk of post-immunization
adverse events (AEFI). After passing the
screening, potential recipients will receive
a vaccination injection. Each hospital can
be a health facility providing vaccination
services for COVID-19 (Putri et al., 2021).
Based on interviews with the vaccine plan
community in March 2021, it was found
that 4 out of 5 vaccine plan patients
experienced anxiety problems
characterized by difficulty sleeping,
waking up feeling dizzy in the morning,
nausea, and decreased appetite. The
patient appeared to be pacing back and
forth in front of the registration area. Of the
4 patients who experienced anxiety
disorders, 1 patient experienced an increase
in blood pressure, so the vaccine had to be
postponed.
Anxiety is an emotional disorder
(affective) characterized by feelings of deep
and ongoing fear or worry, not
experiencing disturbances in assessing
reality (reality testing ability), the
personality still remains intact (does not
suffer from personality cracks/splitting of
personality), behavior may be disturbed
but still within normal limits. Everyone's
views on vaccination are different, so
responses are different. Every time facing
surgery it causes fear and anxiety in
patients. Anxiety often appears before the
age of 30 years (Afandi et al., 2023).
Someone who is so anxious that they
cannot speak and tries to adjust to anxiety
often becomes an obstacle, the patient
becomes irritable, confused, and more
irritable due to psychological reactions,
compared to mildly anxious people (Afandi
et al., 2023).
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Level of Anxiety with COVID-19 Vaccine Screening Results
COVID-19 causes emotional stress,
such as anxiety, in everyone. All individuals
and groups experience feelings of
hopelessness, excessive sadness, and loss of
purpose in life due to anxiety during the
pandemic (Yuliyanti et al., 2023). Some
groups are more vulnerable to experiencing
emotional stress due to the pandemic, such
as the elderly, people with impaired
immune function, and those who live, give
or receive care in hospitals, such as health
workers. This is because health workers
have a high risk of exposure to the virus due
to close contact with patient COVID-19,
feelings of worry about transmitting the
disease to the family, lack of personal
protective equipment and increased
working hours (Nur et al., 2022).
There are many people who may
experience panic when they are about to
receive a vaccine injection COVID-19.
Moreover, there is a lot of news about the
side effects of vaccines, which can cause
dangerous things, including death. The
pandemic is a time of great uncertainty and
unanswered questions, so, naturally, some
of us are more prone to anxiety. Anxiety
when getting a vaccine injection and
afterward takes various forms. You can
have cold sweats, body tremors, dizziness,
and even nausea. Excessive anxiety will
have an impact on increasing blood
pressure, which can affect vaccine
screening results COVID-19 did not pass,
and in the end, vaccination was postponed.
Several things that need to be done to
reduce anxiety before taking the vaccine
are using breathing strategies, shifting
attention, and visualization exercises to
imagine yourself feeling good (Afandi &
Putri, 2023; Voss et al., 2023).
Based on the description above, the
author is interested in researching the
relationship between anxiety levels and
vaccine screening results COVID-19 at the
Hospital in Jember Regency
2. METHODS
The design of this research uses a
quantitative design with a cross-sectional
approach. The population of this study was
nurses who were active in treating COVID-
19 patients at one of the hospitals in
Jember. The selected sample was 115 using
a consecutive sampling technique with the
criteria being that the respondent was aged
(17-60 years), could communicate well, had
had their first vaccination, and was willing
to be a respondent. Data collection was
carried out using a questionnaire sheet. The
assessment of community anxiety levels
was carried out when respondents visited
the hospital and screened the results of the
COVID-19 vaccination. Data interpretation
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is carried out after the results of the
questionnaire review have been obtained.
The hospital team carried out the ethical
suitability test where the data was taken.
3. RESULTS
The results of this research are
presented through data on respondent
characteristics such as gender, age,
education, occupation, and history of
illness. Apart from that, the results of
identifying the level of anxiety and the
results of the COVID-19 vaccine screening
are also presented, as well as the results of
the cross-tabulation between the level of
anxiety and the results of the COVID-19
vaccine screening.
Table 1. Characteristics of Respondents (n=115)
Characteristics
Parameter
Frequency
Percentage
Gender
Man
55
47,8%
Woman
60
52,2%
Age
17 – 25 years
32
27,8%
26 – 45 years
63
54,8%
>45 years
20
17,4%
Education
Junior High School
14
27%
Senior High School
70
60,8 %
College
31
12,2%
Work
Student
8
7 %
Private
60
52,2 %
Self-employed
35
30,4 %
State Civil Apparatus
12
10,4 %
Disease history
Hypertension
5
4,3%
Diabetes mellitus
0
0
Nothing
110
95,7%
Respondent characteristics data based
on gender, the majority of respondents
were female, namely 60 respondents
(52.2%). Data on the characteristics of
respondents based on age shows that the
majority of respondents were aged 26-45
years, namely 63 respondents (54.8%).
Data on the characteristics of respondents
based on education shows that the
majority of respondents, namely 70
respondents (60.8%), have a high school
education. Data on the characteristics of
respondents based on work shows that the
majority of respondents have private jobs,
namely 60 respondents (52.2%). Data on
the characteristics of respondents based on
disease history shows that the majority of
respondents, namely 110 respondents
(95.7%), had no previous history of disease.
Table 2. Anxiety Level of COVID-19 Vaccine Participants
No.
Emergency level
Amount
Percentage
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Level of Anxiety with COVID-19 Vaccine Screening Results
1.
Normal/not anxious
37
32,2%
2.
Mild anxiety
63
54,8%
3.
Moderately anxious
15
13%
Total
115
100%
From Table 2, it can be seen that most of
the respondents' levels of anxiety were
vaccine participants COVID-19 63
respondents (54.8%) were mildly anxious.
Table 3. COVID-19 Vaccine screening
results.
Table 3. COVID-19 vaccine screening results
No.
Screening results
Amount
Percentage
1.
Passed screening
106
92,2%
2.
Did not pass screening
9
7,8%
Total
115
100%
From Table 3 it is explained that the
majority of respondents had passed the
vaccine screening results COVID-19 as
many as 106 respondents (92.2%), with a
mean of 1.08. This can be interpreted as the
average vaccine screening results COVID-
19 Respondents are asking for vaccine
screening COVID-19.
Table 4. Cross tabulation of anxiety and COVID-19 vaccine screening results
Emergency level
Screening results
Total
p-value
Passed screening
Did not pass screening
Normal/not anxious
37
0
37
Mild anxiety
60
3
63
0,000
Moderately anxious
9
6
15
Total
106
9
115
In table 4, all respondents who were
not worried about their screening results
passed. Meanwhile, the majority of
respondents with mild anxiety passed the
screening results, amounting to 60
respondents. And of respondents with
moderate anxiety, 9 respondents were
declared to have passed the screening.
Significance value Kendalls Tau 0.000<α
(α= 0.05), then there is a relationship
between anxiety level and vaccine
screening results COVID-19.
4. DISCUSSION
Based on data on the characteristics
of respondents based on gender, most
respondents are female. In line with
Tasnim's research (2020), the gender of the
community regarding the perception of the
COVID-19 vaccine is 146 respondents
(69.5%) women (Tasnim, 2021). In another
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study, 143 respondents (76%) showed that
women were willing to get the COVID-19
vaccine. Women have a more careful
attitude and can receive information well.
The COVID-19 vaccine, which is given free
of charge, makes people move quickly to
get it (Widayanti & Kusumawati, 2021).
Women are needed more when caring for
their families, so they must get vaccines to
look after family members.
Based on data on the characteristics
of respondents based on age, most
respondents were aged 26-45 years. In line
with the results of other research,
respondents aged 20-40 years were 90
respondents (84.7%). This is because this
age is most exposed to COVID-19
(Khairunnisa & Ghinanda, 2022).
Vaccination is carried out at an early stage
for health workers and continues with
people aged 18-59 years. Vaccines at this
age will produce a strong immune response
(Safira et al., 2021). Neutralizing antibody
titers decrease in proportion to increasing
age. Young respondents in the 18-39 years
age group had higher titer neutralizing
antibodies (Safira et al., 2021). One of the
requirements for getting the vaccine is
being over 12 years of age. At the age of 18-
59 years, antibody immunity will be
produced. Vaccines will protect the body
from viruses or bacteria that infect the
body. Because the body has previously
formed antibodies against a disease.
Based on data on the educational
characteristics of respondents, it was
found that most respondents had a high
school education. Vaccine participants had
higher education, namely upper secondary
and tertiary education, at 93.6%. Education
is an effort for someone to develop
something or information to make it better.
The higher a person's educational
background, the more knowledge they
gain. However, this does not mean that low
education will decrease knowledge, all of
which depends on each individual's
cognitive personality. A person's education
certainly influences the perception of
receiving a vaccine, whereas highly
educated people tend to have a positive
perception of the COVID-19 vaccine. This
may be related to the experience factors
possessed by the individual himself, thus
influencing perceptions and then
influencing a person's level of acceptance of
carrying out the COVID-19 vaccination
(Martoredjo, 2020; Putri et al., 2020).
Based on data on job characteristics
of respondents, the majority of respondents
have private jobs. Another study found that
58.9% of the recipients of the COVID-19
vaccine were respondents who had jobs.
Work is one of the factors that influences a
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Level of Anxiety with COVID-19 Vaccine Screening Results
person's level of perception. In other
research, it was found that there is a
relationship between work and a person's
health status. People carry out vaccines for
activities. As more and more people receive
vaccines, private companies also require
their employees to receive at least the first
dose of the vaccine. The vaccine will
increase the body's immunity and reduce
the risk of worsening when infected with
COVID-19 (Djamaludin et al., 2022; Solon
et al., 2021; Masitha et al., 2021).
Based on data on the characteristics
of respondents with disease history, most
respondents had no previous history of
disease. In line with other research, it was
found that the frequency of respondents
with a history of disease that did not have
infectious diseases was 93%. Non-
communicable diseases are diseases that
cannot be transmitted from one person to
another through any form of contact
(Masitha et al., 2021). A person who has a
history of non-communicable diseases is
suffering from heart disease, hypertension,
diabetes, rheumatism, cancer or tumors,
stroke, traffic accidents, and osteoporosis
or bone fractures. Someone with a history
of non-communicable diseases tends to
have a positive perception as do people
who do not have a history of non-
communicable diseases. Where people
who have congenital diseases are more
unwilling to vaccinate because they are
worried about the side effects they will
experience. This is because their bodies
cannot withstand the pain of the side
effects of the COVID-19 vaccine, and this
will then cause complications between
congenital diseases. or comorbid with the
COVID-19 vaccine. Therefore, people with
a history of non-communicable diseases are
advised to maintain their health by
implementing health protocols and
consuming nutritious food (Ardiansyah &
Lestari, 2023).
Based on the data, it can be seen the
average level of anxiety among vaccine
participant respondents COVID-19 is 46.5
with a minimum value of 25 and a
maximum value of 72. It can be interpreted
as the average level of anxiety of
respondents, namely the level of mild
anxiety. In line with research conducted by
Kholidiyah, the public's anxiety when
undergoing a vaccine in Bangkok Village,
Lamongan Regency, most respondents had
moderate anxiety, 80.3% (Kholidiyah et al,
2021). Anxiety is a feeling of fear that
something will happen caused by
anticipation of danger and is a signal that
helps individuals to prepare to take action
to face the threat. The influence of
demands, competition, and disasters that
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Afandi (2024)
occur in life can impact physical and
psychological health (Lidiana et al., 2022).
Anxiety is a natural thing that every human
being experiences. Anxiety is considered a
part of everyday life. Anxiety is a general
feeling where a person feels afraid or loses
self-confidence whose origin or form is
unclear (Putri & Afandi, 2022). Anxiety is
something that affects almost everyone at
some time in their lives. Anxiety is a normal
reaction to situations that are very stressful
in a person's life. Anxiety can appear alone
or combined with other symptoms of
various emotional disorders. The anxiety
experienced by respondents is a natural
thing, considering that the current
COVID-19 pandemic is a type of disease
that society has never experienced before
(Putri et al., 2022). Anxious responses
emerged as a result of the vaccine program
being implemented and increasingly
increased as time approached. Anxiety
occurs because people have received
information from the media that provides
vaccination information daily. Anxiety
increases when people receive information
about AEFI (adverse events after
immunization), COVID-19 regarding pain
at the injection site, muscle pain, and
headaches.
Based on the data, it can be seen that
the majority of respondents passed the
vaccine screening results COVID-19 as
many as 106 respondents (92.2%), with a
mean of 1.08. This can be interpreted as the
average of vaccine screening results
COVID-19 Respondents are asking for
vaccine screening COVID-19. Screening is a
health examination to determine whether
someone is at higher risk of experiencing a
health problem (Khoirunisa, 2021). The
goal is to ensure the COVID-19 vaccine is
given to the appropriate group. Eliminate
contraindications for vaccination.
Minimizing the risk of adverse events after
immunization and optimizing the
effectiveness or benefits of vaccines.
Screening must be carried out for the
public before receiving the vaccine
injection COVID-19. Because people who
will receive the vaccine must ensure that
their bodies are in good health. A healthy
body condition and no complaints will
cause these people to pass the vaccine
screening stage COVID-19(Gunawan,
2021).
Based on the data, it can be seen that
the correlation coefficient value is 0.348,
meaning the level of anxiety with the
vaccine screening results. COVID-19 has a
sufficient correlation coefficient.
Significance value Kendall,s Tau 0.000<α
(α= 0.05), then there is a relationship
between anxiety level and vaccine
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Level of Anxiety with COVID-19 Vaccine Screening Results
screening results COVID-19 at Bina Sehat
Jember Hospital. The + (positive) value
indicates that the anxiety level data
corresponds to the vaccine screening
results. COVID-19 is unidirectional.
Vaccination turns out to cause anxiety in
the community. Anxiety occurs during a
pandemic COVID-19, and it is also felt
when there is a vaccination program in the
community (Putri et al., 2021). Source of
public concern regarding vaccines COVID-
19 is about the safety and efficacy of
vaccines, vaccine side effects,
misunderstanding of the need for
vaccination, lack of trust in the health care
system, and also the public's lack of
knowledge of the disease COVID-19 can be
prevented with vaccines. The feelings of
anxiety experienced by people can make
people hesitate or not be willing to get
vaccinated. Public anxiety occurred during
the early days of the pandemic COVID-19
and continues when there is a vaccination
program for the community. The study
results show that there is a relationship
between willingness to vaccinate and
anxiety (P-value: 0.001). In accordance
with the results of other studies which
state that there is a correlation between
vaccine acceptance and COVID-19 with
anxiety (Nurtanti & Husna, 2023; Afandi
& Ardiana, 2020).
People willing to be vaccinated
express that they believe vaccination can
protect themselves, their families, and
others. Meanwhile, people who refuse
vaccines have doubts about vaccines.
Doubts can be caused by the accuracy of
the source of the information received.
Group of students accessing information
sources about Vaccination COVID-19 from
the Ministry of Health, television
programs, news, health workers, scientific
journals, and websites have better
knowledge than those who access
information from social media platforms
like Facebook, Instagram, WhatsApp, and
Twitter. Accurate and reliable information
can help individuals plan appropriate
actions even if the situation seems
vulnerable to the media presenting
inaccurate information. On the other hand,
wrong information will create an anxiety
and panic response, which can hinder the
individual's response in taking appropriate
action (Asmaningrum & Afandi, 2022;
Rifai et al., 2021). People experience
anxiety before taking the vaccine because
people can easily get information about
vaccines from the media. When people get
information from the right sources, they are
better prepared to carry out vaccines. This
results in lower levels of anxiety so that it
does not affect their health and has the
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Afandi (2024)
effect of passing the vaccine acceptance
screening COVID-19.
5. CONCLUSION
The results of this research showed that
there was a significant relationship
between anxiety and COVID-19 screening
results. So, the mechanism for screening
and educating patients needs to be
modified. It is hoped that the anxiety of
patients who will undergo screening can be
reduced.
AUTHOR CONTRIBUTIONS
The author contribute all research
activity such as conceptualization, data
curation, analysis, writing & editing,
manuscript revisions.
ACKNOWLEDGMENT
We would like to thank you for the
respondents who crontribute the
information in research.
CONFLICT OF INTEREST
The authors declare no conflict of
interest for this publication.
DATA AVAILABILITY STATEMENT
The data that support the findings of
this study are available from the
corresponding author upon reasonable
request.
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