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 Epidemiology and Society Health Review| ESHR 
Vol. 4, No. 2, 2022, pp. 61-68 ISSN 2656-6052 (online) | 2656-1107 (print) 
 
 

      10.26555/eshr.v4i2.5514  

 
 

 
 

  

61 

Research Article 
 
Correlation Between Education and Age to the Perception 
of COVID-19 Vaccination 
 
Lana Unwanah1*, Sitti Nur Djannah1, Dyah Suryani1, Yanasta Yudo Pratama1,2,3, 
Annisa Tristifanny3, Andita Khoilina Rahmanda3, Hamza Sameeh Abd El Qader 
AbuHilail4 
1 Faculty of Public Health, Universitas Ahmad Dahlan, Yogyakarta, Indonesia 
2 Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, 

Indonesia 
3 Faculty of Medicine, Universitas Islam Indonesia, Yogyakarta, Indonesia 
4 Faculty of Medicine, Arab American University, Palestine 
 
* Correspondence: lana.unwanah@gmail.com.  Phone: +6282227246918 
 
Received 04 January 2022; Accepted 22 April 2022; Published 2 August 2022 
 

ABSTRACT 

Background: COVID-19, a pneumonia-like disease, started to spread at the end of 2019 
and became a pandemic globally. Vaccination is one of the programs to reduce the severity 
of particular conditions, including COVID-19. However, in Indonesia, the response to 
COVID-19 vaccination remains low. This study aimed to assess the correlation between 
age and educational background to the perception of COVID-19 in Yogyakarta City, 
Indonesia. 
Method: This cross-sectional study was conducted from August to September 2021 at 
several vaccination centers in Yogyakarta City of Yogyakarta province. Total sampling was 
used to recruit participants during the mass vaccination period. Data were analyzed using 
univariate and bivariate analysis. 
Results: 1,068 participants joined this study, with an age average of 29.8. Most 
respondents graduated from senior high school 528 (49.4%). Bivariate analysis showed a 
significant correlation between education and knowledge about Adverse Events Following 
Immunization (p=0.01).  
Conclusion: Perception of the adverse event following immunization was significantly 
associated with education. 

Keywords: COVID-19; Age; Education; COVID-19 Vaccine 

INTRODUCTION 

At the end of 2019, the pneumonia-like disease spread in Wuhan, China, later known as 
COVID-19. This disease is caused by severe acute respiratory syndrome coronavirus 2 
(SARS-CoV-2). The manifestation of COVID-19 varies, ranging from an asymptomatic 
symptom to acute respiratory distress syndrome and multi-organ dysfunction (1). COVID-19 



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is one of the health problems in Indonesia and even globally. The second wave of COVID-19 
in Indonesia, in June 2021, reported a 381% increase in COVID-19 cases from 25,396 to 
26,067. Then, in August 2021, active patients in Indonesia were 3,979,456, with total mortality 
of 126,372 (2). It was estimated that this peak occurred after the long holidays when health 
protocols and physical distancing do not apply correctly among mobile people. The cases 
mainly increased in Jakarta, West Java, Central Java, and Yogyakarta.  

The common severe risk factors of COVID-19 are older and medical comorbidities like 
hypertension, diabetes, and cancer (3). The Indonesian government took an essential 
vaccination program to prevent fatality from developing herd immunity in society. The 
government targeted 208,265,720 people who had been vaccinated. This program was 
started on January 13, 2021, beginning with the priority population, such as health workers, 
the elderly, and public servants (4). Based on the government official data, on 1 January 2022, 
as many as 165,779,292 residents received the first dose and 114,044,659 second doses.  

Yogyakarta is the third province in Indonesia with 98.85% and 89.53% of COVID-19 
vaccination coverage for first and second doses, respectively. Yogyakarta became one of the 
top 10 provinces with low active cases on December 31, 2021. During that time, only found 
102 active cases; this number was relatively fewer than DKI Jakarta, West Java, and Central 
Java (5). A study from the WHO in collaboration with the Indonesia Ministry of Health revealed 
that 74% of the respondents reported knowledge about the government's intention to deploy 
COVID-19 vaccines. About 65% of the respondents expressed their willingness to receive 
COVID-19 vaccination if provided by the Indonesian government, 27% reported hesitancy, 
and 8% refused to accept the COVID-19 vaccine (6).  

Referring to the health belief model, individual health behavior is determined by the threat of 
illness or disease with the belief of recommended health behavior (7). Health behavior can 
also be predicted by intentions to do an action. Intention refers to the need to perform a 
behavior, social norms, and the control that people perceive (8). Other factors related to 
willingness to get vaccinated recommended by the government (9) are age, gender, location 
(urban/rural), level of education, income, perceived risk of being infected with COVID-19 in 
the future, perceived severity of infection, having previous vaccination experience after age 
18, having higher knowledge about COVID-19 and vaccination were significantly associated 
with the acceptance of COVID-19 vaccines (10).  

In the digital era, information about COVID-19 spreads rapidly through social media. 
Unfortunately, not all information spread on social media is accurate. Even though this 
information will significantly affect a person's response to a government program, including 
the COVID-19 vaccination (11), this leads to misinformation and conspiracy theories against 
vaccination. Previous research reported that people exposed to anti-vaccine conspiracy 
theories showed less intention to vaccinate than those in the anti-conspiracy condition (12). 

Although the vaccination rate in Yogyakarta was relatively high, some groups still refused to 
receive the COVID-19 vaccine. Considering all backgrounds, this study aimed to assess the 
correlation between age and education to the perception of COVID-19 in Yogyakarta. 

 

 



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METHOD 

This cross-sectional approach was conducted during mass COVID-19 vaccination from 1 
August to 1 September 2021 in several vaccination spots in Yogyakarta City. The population 
of this study was everyone who came to the vaccination spot during the mentioned period. 
Total sampling was employed to recruit the participants. A questionnaire was used to collect 
the pre-tested data before using Cronbach Alpha 0.68. The questionnaire was installed on the 
Google Form platform, and the link was shared with the respondent via barcode. The 
respondents used their smartphones to access the questionnaire. If the respondent came 
without a smartphone, the researcher provided them with a smartphone. Written informed 
consent was received before the participant filled out the questionnaire—deceptive and chi-
square tests were used to analyze the data. 

The ethical consideration was approved by the research committee of Universitas Islam 
Indonesia (12/Ka. Kom.Et / 70/ KE/ III/ 2022).  

RESULTS 

One thousand sixty-eight people participated in this study; all mass vaccination participants 
agreed to participate.  The average participant was 29.8 years old, with a standard deviation 
of 14.07.  In this study, the age ranged from 12 – 25 years old, 537 people (50.3%), 26 – 45 
years old, 341 people (31.9%), 46 – 65 years old, 178 (16.7%), and >65 years old, 12 people 
(1.1%). 24 (2.2%) of participants graduated from elementary school, 108 (10.1%) graduated 
from junior high school, 528 (49.4%) graduated from senior high school, 355 (33.2%) 
graduated with a bachelor's degree, 50 (4.7%) graduated with a master's degree, and 2 (0.2%) 
graduated with a doctoral degree  (Table 1). 

Table 1. Distribution of Research Sample Characteristics 

Variable         Class n (%) 
Age 12 – 25 537 50.3 

 26 – 45 341 31.9 
 46 – 65 178 16.7 
 >65 12 1.1 

Education Elementary School 24 2.2 
 Junior High School 108 10.1 
 Senior High School 528 49.4 
 Bachelor Degree 355 33.2 
 Magister Degree 50 4.7 
 Doctoral Degree 2 0.2 

 
Table 2 shows the result of the bivariate analysis. We found a significant correlation between 
education and knowledge regarding Adverse Events Following Immunization (AEFI)  
(p=0.001). Meanwhile, other dependent variable analyses did not show a significant 
correlation (p-value >0.05). A total of 1025 from 1068 participants said that they believed in 
COVID-19. However, this didn't correlate with the last educational background (p-value = 
0.821). Of 1068 participants, only 16 (1.5%) didn't believe in the COVID-19 vaccine. This didn't 
correlate with the last educational background (p-value = 0.667). Most participants (97%) in 
our study were motivated to recommend COVID-19 vaccination to other people, and they also 
stated that they would obey the health protocols even after vaccination (99.7%). Seven 
hundred fifty-two participants said they did not feel afraid or anxious before vaccination. This 
condition didn't correlate with educational background (p=0.403). We were also looking for the 



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Vol. 4, No. 2, 2022, pp. 61-68    10.26555/eshr.v4i2.5514 
  

64 

motivation behind vaccination on each participant; 85.2% of reasons were the personal 
intention, 5.9% came from an external factor, and the rest were from other intentions (8.9%) 
such as hajj travel conditions and domestic or international traveling term. 

 
Table 2. The characteristics of respondents to the COVID-19 vaccine perception 

Statement n (%) 
Belief in COVID-19 

Yes  
No 

 
1,025 (96) 
     43 (4) 

Belief in the COVID-19 vaccine 
Yes  

      No 

 
1,052 (98.5) 
      16 (1.5) 

Know about AEFI 
Yes  

      No 

 
741 (69.4) 
327 (30.6) 

Willingness to recommend the COVID-19 vaccine to 
others 

Yes  
      No 

 
 

1,036 (97) 
      32 (3) 

Willingness to comply with health protocols after 
vaccinated 

Yes  
No 

 
 

1,065 (99.7) 
        3 (0.3) 

Feeling Before Vaccination 
Afraid 
Not Afraid 

 
356 (33.3) 
712 (66.7) 

Motivation to Take Part in Vaccination Program 
Personal Intention 
Encouragement from an external factor 
Other Intention 

 
910 (85.2) 

63 (5.9) 
95 (8.9) 

 

Most respondents believe in COVID-19 (96%). The majority of them believed in the COVID-
19 vaccine (98.5%). More than half (69.4%) of respondents reported they know about AEFI. 
Most respondents (97%) were willing to recommend the COVID-19 vaccine to others. Most 
(99.7%) said they would comply with health protocols after vaccination. Regarding their feeling 
before vaccination, the majority of the respondent (66.7%) said they were not afraid. More 
than 80% of the respondents reported personal intention as their motivation to join the 
vaccination (Table 2). 

Table 3 shows the association between education background and age in the variables 
measured. It presents a significant association between educational background and 
knowledge about AEFI with a p-value=0.01. While for age, there was no significant association 
among the variable measure.  
 
DISCUSSION  

The pandemic of COVID-19 caused many impacts on life, increasing the mortality rate and 
causing difficulties in economic and social aspects. The Indonesian government started the 
vaccination program in early 2021 for health workers, the elderly, and other public servants. 
The purpose of the vaccination program was to reach herd immunity and prevent the severity 
of symptoms. Vaccination has been considered one "self-care" treatment for a long time. But, 
in this pandemic era, some people's opinions about vaccinations might create hazards for 
others (13). During the COVID-19 vaccination program, the government found some 
obstacles, such as the hesitation to participate in this program because society doubts the 



Unwanah (Correlation Between Education and Age to the Perception of COVID-19 in Yogyakarta) 
 

 

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safety and side effects of COVID-19 vaccines. Some people avoid getting vaccinated or 
recommend vaccines to others (14). Various information from many sources is easily 
accessed today, but not everyone has a good filter on reliable information.  

Table 3. Correlation Between Education Background and Age to the COVID-19 and the 
Vaccine  

Variable Indicator p-Value 
Educational 
Background 

Belief in COVID-19 0.82 
Belief in COVID-19 Vaccine 0.66 
Know about AEFI 0.01 
Willingness to recommend the COVID-19 vaccine to 
others 

0.09 

Willingness to comply with health protocols after 
vaccinated 

0.13 

Feeling Before Vaccination 0.40 
Motivation to Take Part in Vaccination Program 0.64 

 Age Belief in COVID-19 0.93 
Belief in COVID-19 Vaccine 0.72 
Know about AEFI 0.56 
Willingness to recommend the COVID-19 vaccine to 
others 

0.90 

Willingness to comply with health protocols after 
vaccinated 

0.48 

Feeling Before Vaccination 0.324 
Motivation to Take Part in Vaccination Program 0.519 

 

Demographic characteristics such as age and educational experience influenced the quality 
of human resources. In this study, we assessed the association between education and age 
to some variables measured related to the perspective of COVID-19. We found that 
educational background is associated with people's knowledge about AEFI. Adverse Events 
Following Immunization (AEFI) generally happen to vaccinated people. They might feel pain, 
mild fever, redness in the injection area, tiredness, headache, muscle ache, or even diarrhea 
(15). These are normal reactions, but if they cause shortness of breath or any other life-
threatening reaction, health workers should be aware of and educate people about this 
condition after getting vaccinated. However, severe reactions after vaccination, such as 
cardiovascular events like hypertension, hypotension, tachycardia, and peripheral coldness, 
were also reported. Myocardial infarction effects after vaccination of COVID-19 were reported 
in individuals above 75 years old (16). A cross-sectional study about knowledge and 
perception of AEFI conducted in Nigeria found that the majority of health workers knew about 
AEFI (92%) and had been trained to treat AEFI (80%) (17).  

Our finding shows that education level determines people's knowledge about AEFI; it could 
be because educated people have access to news media and have a positive cycle to get the 
correct information.  A study on 1,000 participants aged 18 – 74 in Germany found 
associations between low education level and higher perceived severity and between low 
education level and lower perceived probability. Highly educated men were more worried 
about COVID-19 than those with low levels of education. This study also showed no 
educational differences in perceived susceptibility or fear (18). Another study in Bangladesh 
about factors associated with COVID-19 vaccines found that participants above 30 years old 
heard less about this information. This study also found that level of education was significant; 
respondents with university-level education heard more about COVID-19 vaccines (19). 



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Another study in Bangladesh shows that more educated people are more knowledgeable 
about their health (20).  

Our study was conducted in early 2021 and targeted the elderly and public servants who are 
a priority during the vaccination mass. This significant association may be due to convenient 
access to recently updated information about adverse events related to COVID-19 
vaccination. This is also related to our study population, primarily young people with high 
educational backgrounds (senior high school and bachelor's degrees).  

Complying with health protocols is one of the crucial factors in the control of COVID-19 and 
also the vaccination process. Those who adhere to and understand health protocols will 
realize the importance of vaccines. In our study, most respondents reported accepted 
vaccines because of personal intentions. This is also related to variables regarding the 
relationship of the last level of education with the information received. The better details about 
vaccines received by the public will tend to do vaccines of their own accord. However, it does 
not include rules from the government that require doing vaccines as one of the conditions for 
doing activities. One of the health protocols that need to be considered is masks. Masks are 
one way to prevent the virus from becoming airborne, based on research conducted in 
California regarding pandemic simulations. Masks do not have much effect if not combined 
with other health protocols such as hand washing, maintaining distance, and hand sanitizers 
in the absence of water (21). 

Similar research was reported fromLangsa, Aceh; that said the most significant number of 
respondents in adulthood with high school education level received a value of p=0.000, 
meaning meaningful. In the majority, there is a better level of compliance among adolescents 
and the elderly. And secondary education and college levels have higher adherence to health 
protocols: high school (80.6%) and lectures (92.1%). In our study, 1065 people agreed to 
follow health protocols, and only three refused. This is due to various aspects, such as the 
role of social media and excellent communication and media delivery, rather than the 
educator. 

The concern level before the COVID-19 vaccine can occur due to several things, such as fear 
of side effects (49%), waiting for other people to use it until proven safe (35%), and different 
reasons. In our study, 712 respondents were not afraid (worried, anxious), and the remaining 
356 felt concerned. This worry can be caused by scattered hoaxes and information less 
obtained by respondents (6). There is a lot of fear in people aged 18 – 24 years. This is 
because, in this age, social media be a favorite information source (22) , and much information 
spreads under uncontrol, including news about the side effects of COVID-19 vaccination (6). 

The government and the public collaborate in voicing vaccines for the wider community. In our 
study, respondents were willing to recommend vaccines to people because they already 
understood the importance of vaccines. Vaccines are not the most successful weapon or 
prevention; vaccines serve to provide immunity where immunity must be maintained with 
various health protocols. Vaccines without health protocols will not succeed in making 
Indonesia survive in the pandemic era and vice versa. All components must collaborate to 
protect us from the COVID-19 pandemic. 

 



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CONCLUSION 

This study examined the relationship between age, education, and people's perception of 
COVID-19 and the COVID-19 vaccine. We found that knowledge about AEFI is significantly 
associated with an educational background.  

Authors' contribution 

LU contributes to research ideas, designing research concepts to collecting research data. 
YYP contributed to the collection of research data. AT and AKR contribute to research data 
processing and research data analysis. SND and DS contributed by providing input in writing 
this manuscript. 

Funding 

This research has not received external funding.  

Conflict of interest 

There is no conflict of interest in this research.  

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