Knowledge, acceptance and perception on COVID-19 vaccine among Malaysians: A web-based survey

Background Coronavirus disease 2019 or COVID-19 is caused by a newly discovered coronavirus, SARS-CoV-2. The Malaysian government has planned to procure COVID-19 vaccine through multiple agencies and companies in order to vaccinate at least 70% of the population. This study aimed to determine the knowledge, acceptance and perception of Malaysian adults regarding the COVID-19 vaccine. Methodology An online survey was conducted for two weeks in December 2020. A bilingual, semi-structured questionnaire was set up using Google Forms and the generated link was shared on social media (i.e., Facebook and WhatsApp). The questionnaire consisted of questions on knowledge, acceptance and perception of COVID-19 vaccine. The association between demographic factors with scores on knowledge about COVID-19 vaccine were analysed using the Mann-Whitney test for two categorical variables, and the Kruskal-Wallis test used for more than two categorical variables. Results A total of 1406 respondents participated, with the mean age of 37.07 years (SD = 16.05) years, and among them 926 (65.9%) were female. Sixty two percent of respondents had poor knowledge about COVID-19 vaccine (mean knowledge score 4.65; SD = 2.32) and 64.5% were willing to get a COVID-19 vaccine. High knowledge scores associated with higher education background, higher-income category and living with who is at higher risk of getting severe COVID-19. They were more likely to be willing to get vaccinated if they were in a lower age group, have higher education levels and were female. Conclusion Even though knowledge about vaccine COVID-19 is inadequate, the majority of the respondents were willing to get vaccinated. This finding can help the Ministry of Health plan for future efforts to increase vaccine uptake that may eventually lead to herd immunity against COVID-19.

• Gagneux-Brunon A, Detoc M, Bruel S, in French healthcare workers during the first pandemic wave: a crosssectional survey. J Hosp Infect. 2021;108:168-173. doi:10.1016/j.jhin.2020 Response: We appreciate the reviewer's comment. We have accordingly added all the related literature as suggested by the reviewer in the introduction section.
As safe and effective vaccines are being made available, the next challenge will be in dealing with vaccine hesitancy. Vaccine hesitancy, identified as one of the ten most important current health threats, is defined as the reluctance or refusal to vaccinate despite the availability of vaccines. 10 Wong et al. (2011) Table 2: score system analysis is considered a binary qualitative data (expressed 1: correct, 0: Not correct) which can't be presented as mean (SD) like continuous (scale) quantitative data; it will not be informative.
Response: Agree. We have, accordingly, modified the Table 2. The mean (SD) was removed from the Table 2. 4.2 Tables 1 and 5: Education categories' should follow the common international classifications or standardized (example: Diploma = High school, it may be conflicted with another postgraduate degree in other countries). Also, Currency should be converted (or symbol) to a dollar ($) to be more understood, especially with changes of currency all over the world.
Response: Thank you. As suggested, the education categories were amended following the common international classification for Tables, 1, 3 and 5. Information on the converted currency of dollar ($) were added next to the Ringgit Malaysia currency in Table  1 and 4. Table 5: The authors should clarify the operational definition (high-risk someone) in the variable "Live with someone who is at a higher risk of getting severe COVID-19," what they meant?

4.3
Response: We agree with this and have added the details on the definition used for "Live with someone who is at a higher risk of getting severe COVID-19," in the methodology section, in the independent variables of variables subheading.
….. living with someone who is at higher risks of getting severe COVID-19 including living with elderly or family members with comorbidity or having long-term medical follow up or chronic medication.
Comments from Reviewer 2 1. In the introduction, please refrain from using social media references (such as the BBC). In addition, please rework paragraph 2 on page 3 to more accurately reflect the number of people enrolled each vaccine trial, and that these vaccines were effective at preventing symptomatic/severe disease, and data on preventing disease transmission is less robust.
Response: Thank for pointing this. As suggested, we had revised the reference used for paragraph 2 that used the social media reference. Additionally, we also have rework paragraph 2 reflect the number of people enrolled each vaccine trial, and that these vaccines were effective in protecting the recipient from a COVID-19 infection.  4 There are also other companies in the race for vaccine development and in the final stages of trials. It is expected that many vaccines will be ready for distribution by early or mid-2021. 7 The United Kingdom was among the first countries that have started mass immunization