{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T14:08:50Z","timestamp":1740146930796,"version":"3.37.3"},"reference-count":50,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T00:00:00Z","timestamp":1719187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>In the first year of roll-out, vaccination for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevented almost 20 million deaths from coronavirus disease 2019 (COVID-19). Yet, little is known about the factors influencing access to vaccination at the individual level within rural poor settings of low-income countries. The aim of this study was to examine determinants of vaccine receipt in rural India.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A census of a rural village in Tamil Nadu was undertaken from June 2021 to September 2022. We surveyed 775 participants from 262 households. Household-level data on socioeconomic status (SES), water, sanitation, and hygiene practices, and individual-level demographic information, travel history, and biomedical data, including anthropometry, vital signs, and comorbidities, were collected. Logistic regression models with 5-fold cross-validation were used to identify the biomedical, demographic, and socioeconomic determinants of vaccine receipt and the timing of receipt within the first 30 days of eligibility. Vaccine ineligible participants were excluded leaving 659 eligible participants. There were 650 eligible participants with complete biomedical, demographic, and socioeconomic data.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>There were 68.0% and 34.0% of individuals (N = 650) who had received one and two vaccine doses, respectively. Participants with household ownership of a permanent account number (PAN) or ration card were 2.15 (95% CI:1.32\u20133.52) or 3.02 (95% CI:1.72\u20135.29) times more likely to receive at least one vaccine dose compared to households with no ownership of such cards. Participants employed as housewives or self-employed non-agricultural workers were 65% (95% CI:0.19\u20130.67) or 59% (95% CI:0.22\u20130.76) less likely to receive at least one vaccine dose compared to salaried workers. Household PAN card ownership, occupation and age were linked to the timing of vaccine receipt. Participants aged \u226418 and 45\u201360 years were 17.74 (95% CI:5.07\u201362.03) and 5.51 (95% CI:2.74\u201311.10) times more likely to receive a vaccine within 30 days of eligibility compared to 19-44-year-olds. Biomedical factors including BMI, vital signs, comorbidities, and COVID-19 specific symptoms were not consistently associated with vaccine receipt or timing of receipt. No support was found that travel history, contact with COVID-19 cases, and hospital admissions influenced vaccine receipt or timing of receipt.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Factors linked to SES were linked to vaccine receipt, more so than biomedical factors which were targeted by vaccine policies. Future research should explore if government interventions including vaccine mandates, barriers to vaccine access, or peer influence linked to workplace or targeted vaccine promotion campaigns underpin these findings.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0305819","type":"journal-article","created":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T17:22:12Z","timestamp":1719249732000},"page":"e0305819","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Relative contribution of biomedical, demographic, and socioeconomic factors to COVID-19 vaccine receipt in rural India"],"prefix":"10.1371","volume":"19","author":[{"given":"Bethany F.","family":"Ferris","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0861-7975","authenticated-orcid":true,"given":"Suganthi","family":"Balasubramanian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anuradha","family":"Rajamanickam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saravanan","family":"Munisankar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bindu","family":"Dasan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pradeep A.","family":"Menon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P'ng","family":"Loke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Subash","family":"Babu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4653-0846","authenticated-orcid":true,"given":"Goylette F.","family":"Chami","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,6,24]]},"reference":[{"key":"pone.0305819.ref001","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1016\/S1473-3099(22)00320-6","article-title":"Global impact of the first year of COVID-19 vaccination: a mathematical modelling study","volume":"22","author":"OJ Watson","year":"2022","journal-title":"Lancet Infect Dis"},{"key":"pone.0305819.ref002","doi-asserted-by":"crossref","first-page":"e0250495","DOI":"10.1371\/journal.pone.0250495","article-title":"Willingness to vaccinated against COVID-19 among Bangladeshi adults: Understanding the strategies to optimize vaccination coverage","volume":"16","author":"M Abedin","year":"2021","journal-title":"PloS One"},{"key":"pone.0305819.ref003","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/21645515.2021.1993689","article-title":"The mediational role of trust in the healthcare system in the association between generalized trust and willingness to get COVID-19 vaccination in Iran","volume":"18","author":"DK Ahorsu","year":"2022","journal-title":"Hum Vaccin Immunother"},{"key":"pone.0305819.ref004","doi-asserted-by":"crossref","first-page":"515","DOI":"10.3390\/vaccines9050515","article-title":"Factors Affecting COVID-19 Vaccine Acceptance: An International Survey among Low- and Middle-Income Countries","volume":"9","author":"SA Bono","year":"2021","journal-title":"Vaccines (Basel)"},{"key":"pone.0305819.ref005","doi-asserted-by":"crossref","first-page":"e0261929","DOI":"10.1371\/journal.pone.0261929","article-title":"COVID-19 vaccine acceptance among Bangladeshi adults: understanding predictors of vaccine intention to inform vaccine policy","volume":"17","author":"C Lee","year":"2022","journal-title":"PloS One"},{"key":"pone.0305819.ref006","doi-asserted-by":"crossref","first-page":"e0257096","DOI":"10.1371\/journal.pone.0257096","article-title":"Knowledge, beliefs, attitudes and perceived risk about COVID-19 vaccine and determinants of COVID-19 vaccine acceptance in Bangladesh","volume":"16","author":"A Mahmun","year":"2021","journal-title":"PloS One"},{"key":"pone.0305819.ref007","doi-asserted-by":"crossref","first-page":"112","DOI":"10.11604\/pamj.2022.41.112.31219","article-title":"Prevalence and factors associated with COVID-19 vaccine acceptance in Zambia: a web-based cross-sectional study","volume":"41","author":"S Mudenda","year":"2022","journal-title":"Pan Afr Med J"},{"key":"pone.0305819.ref008","doi-asserted-by":"crossref","first-page":"e451","DOI":"10.1002\/hsr2.451","article-title":"Status and perception toward the COVID-19 vaccine: A cross-sectional online survey among adult population of Bangladesh","volume":"4","author":"MM Rahman","year":"2021","journal-title":"Health Sci Rep"},{"key":"pone.0305819.ref009","doi-asserted-by":"crossref","first-page":"e0256493","DOI":"10.1371\/journal.pone.0256493","article-title":"Peoples\u2019 understanding, acceptance, and perceived challenges of vaccination against COVID-19: A cross-sectional study in Bangladesh","volume":"16","author":"A Paul","year":"2021","journal-title":"PloS One"},{"key":"pone.0305819.ref010","doi-asserted-by":"crossref","first-page":"e0010103","DOI":"10.1371\/journal.pntd.0010103","article-title":"Perceived COVID-19 vaccine effectiveness, acceptance, and drivers of vaccination decision-making among the general adult population: A global survey of 20 countries","volume":"16","author":"RR Marzo","year":"2022","journal-title":"PloS Negl Trop Dis"},{"key":"pone.0305819.ref011","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-021-11814-5","article-title":"Population preferences and attitudes towards COVID-19 vaccination: a cross-sectional study from Pakistan","volume":"21","author":"MJ Tahir","year":"2021","journal-title":"BMC Public Health"},{"key":"pone.0305819.ref012","doi-asserted-by":"crossref","first-page":"183","DOI":"10.7774\/cevr.2021.10.2.183","article-title":"A nationwide survey of the potential acceptance and determinants of COVID-19 vaccines in Ghana","volume":"10","author":"E Lamptey","year":"2021","journal-title":"Clin Exp Vaccine Res"},{"key":"pone.0305819.ref013","doi-asserted-by":"crossref","first-page":"20","DOI":"10.3390\/vaccines10010020","article-title":"Factors influencing decision making regarding the acceptance of the COVID-19 vaccination in Egypt: A cross-sectional study in an urban, well-educated sample","volume":"10","author":"M Elsayed","year":"2021","journal-title":"Vaccines (Basel)"},{"key":"pone.0305819.ref014","doi-asserted-by":"crossref","first-page":"e0266724","DOI":"10.1371\/journal.pone.0266724","article-title":"Assessment of COVID-19 vaccine hesitancy among Zimbabweans: A rapid national survey","volume":"17","author":"PT Mundagowa","year":"2022","journal-title":"PloS One"},{"key":"pone.0305819.ref015","doi-asserted-by":"crossref","first-page":"e0264371","DOI":"10.1371\/journal.pone.0264371","article-title":"Factors influencing COVID-19 vaccine uptake among adults in Nigeria","volume":"17","author":"H Adedeji-Adenola","year":"2022","journal-title":"PloS One"},{"key":"pone.0305819.ref016","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.3390\/vaccines9101109","article-title":"Factors associated with COVID-19 vaccine intentions in eastern Zimbabwe: a cross-sectional study","volume":"9","author":"L McAbee","year":"2021","journal-title":"Vaccines (Basel)"},{"key":"pone.0305819.ref017","doi-asserted-by":"crossref","first-page":"e12887","DOI":"10.7717\/peerj.12887","article-title":"Interrogating COVID-19 vaccine intent in the Philippines with a nationwide open-access online survey","volume":"10","author":"A Caple","year":"2022","journal-title":"PeerJ"},{"key":"pone.0305819.ref018","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1186\/s40249-021-00900-w","article-title":"COVID-19 vaccination intention and vaccine characteristics influencing vaccination acceptance: a global survey of 17 countries","volume":"7","author":"LP Wong","year":"2021","journal-title":"Infect Dis Poverty"},{"key":"pone.0305819.ref019","doi-asserted-by":"crossref","first-page":"148","DOI":"10.3390\/bs11110148","article-title":"COVID-19 vaccine hesitancy and emerging variants: evidence from six countries","volume":"11","author":"S Mangla","year":"2021","journal-title":"Behav Sci"},{"key":"pone.0305819.ref020","doi-asserted-by":"crossref","first-page":"2060020","DOI":"10.1080\/21645515.2022.2060020","article-title":"Factors associated with COVID-19 vaccine hesitancy in Senegal: a mixed study","volume":"18","author":"MF Ba","year":"2022","journal-title":"Human Vaccin Immunother"},{"key":"pone.0305819.ref021","doi-asserted-by":"crossref","first-page":"2847","DOI":"10.2147\/JMDH.S325529","article-title":"Sociodemographic and behavioral predictors of COVID-19 vaccine hesitancy in Pakistan","volume":"14","author":"O Al-Wutayd","year":"2021","journal-title":"J Multidiscip Healthc"},{"key":"pone.0305819.ref022","doi-asserted-by":"crossref","first-page":"e0260821","DOI":"10.1371\/journal.pone.0260821","article-title":"COVID-19 vaccine hesitancy among the adult population in Bangladesh: A nationwide cross-sectional survey","volume":"16","author":"MB Hossain","year":"2021","journal-title":"PloS One"},{"key":"pone.0305819.ref023","doi-asserted-by":"crossref","first-page":"936","DOI":"10.3390\/vaccines9080936","article-title":"Assessing the level and determinants of COVID-19 vaccine confidence in Kenya","volume":"9","author":"S Orangi","year":"2021","journal-title":"Vaccines (Basel)"},{"key":"pone.0305819.ref024","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1038\/s41591-021-01454-y","article-title":"COVID-19 vaccine acceptance and hesitancy in low- and middle-income countries","volume":"27","author":"J.S. Sol\u00eds Arce","year":"2021","journal-title":"Nat Med"},{"key":"pone.0305819.ref025","unstructured":"COVID-19 Vaccines Operational Guidelines. Ministry of Health and Family Welfare, Government of India; 2020. 148 p."},{"key":"pone.0305819.ref026","unstructured":"World Bank. Population, total\u2014India. [cited 2022 Dec 16] [about 9 p.] https:\/\/data.worldbank.org\/indicator\/SP.POP.TOTL?locations=IN"},{"key":"pone.0305819.ref027","doi-asserted-by":"crossref","first-page":"100636","DOI":"10.1016\/j.hlpt.2022.100636","article-title":"COVID-19 management: The vaccination drive in India","volume":"11","author":"N Purohit","year":"2022","journal-title":"Health Policy Technol"},{"key":"pone.0305819.ref028","doi-asserted-by":"crossref","first-page":"100915","DOI":"10.1016\/j.eclinm.2021.100915","article-title":"Second wave of COVID-19 pandemic in India: Barriers to effective governmental response [letter]","volume":"36","author":"SK Kar","year":"2021","journal-title":"EclinicalMedicine"},{"key":"pone.0305819.ref029","first-page":"10286","article-title":"India\u2019s COVID-19 emergency [editorial]","volume":"397","year":"2021","journal-title":"Lancet"},{"key":"pone.0305819.ref030","unstructured":"Liberalised Pricing and Accelerated National Covid-19 Vaccination Strategy. India. Ministry of Health and Family Welfare Government of India; 2021. 5 p."},{"key":"pone.0305819.ref031","unstructured":"Guidelines for COVID-19 vaccination of children between 15\u201318 years and precaution dose to HCWs, FLWs & 60+ population with comorbidities. India. Ministry of Health and Family Welfare Government of India; 2021. 4 p."},{"key":"pone.0305819.ref032","unstructured":"Guidelines for COVID-19 vaccination of children between 12\u201314 years of age. India. Ministry of Health and Family Welfare Government of India; 2021. 3 p."},{"key":"pone.0305819.ref033","unstructured":"Babu S, Loke P. The Effect of Helminth Infection Plus COVID-19 Infection on the Immune Response and Intestinal Microorganisms 2021. https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04813328"},{"key":"pone.0305819.ref034","unstructured":"Progress on Drinking Water, Sanitation and Hygiene. Geneva. World Health Organisation\/UNICEF; 2017. 116 p."},{"key":"pone.0305819.ref035","unstructured":"UCLA. Regression with STATA Chaper 4 \u2013Beyond OLS. [cited 2022 December 16] https:\/\/stats.oarc.ucla.edu\/stata\/webbooks\/reg\/chapter4\/regressionwith-statachapter-4-beyond-ols-2\/."},{"key":"pone.0305819.ref036","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1080\/09720502.2010.10700699","article-title":"Collinearity diagnostics of binary logistic regression model","volume":"13","author":"H Midi","year":"2013","journal-title":"J. Interdiscip. Math"},{"key":"pone.0305819.ref037","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1214\/09-SS054","article-title":"A survey of cross validation procedures for model selection","volume":"4","author":"S Arlot","year":"2010","journal-title":"Stat. Surv"},{"issue":"4","key":"pone.0305819.ref038","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1177\/109019817400200405","article-title":"The health belief model and preventive health behavior","volume":"2","author":"IM Rosenstock","year":"1974","journal-title":"Health education monographs"},{"issue":"1","key":"pone.0305819.ref039","doi-asserted-by":"crossref","first-page":"994","DOI":"10.1186\/s12913-021-07037-4","article-title":"Attitude towards COVID 19 vaccines and vaccine hesitancy in urban and rural communities in Tamil Nadu, India\u2014a community based survey","volume":"21","author":"KG Danabal","year":"2021","journal-title":"BMC Health Services Research"},{"issue":"6","key":"pone.0305819.ref040","doi-asserted-by":"crossref","first-page":"e0269299","DOI":"10.1371\/journal.pone.0269299","article-title":"A cross sectional study to examine factors influencing COVID-19 vaccine acceptance, hesitancy and refusal in urban and rural settings in Tamil Nadu, India","volume":"17","author":"A Joshi","year":"2022","journal-title":"PloS One"},{"issue":"5","key":"pone.0305819.ref041","doi-asserted-by":"crossref","first-page":"739","DOI":"10.3390\/vaccines10050739","article-title":"COVID-19 vaccine hesitancy and vaccination coverage in India: An exploratory analysis","volume":"10","author":"P Dhalaria","year":"2022","journal-title":"Vaccines (Basel)"},{"key":"pone.0305819.ref042","unstructured":"National Food Security Portal, Department of Food and Public Distribution, Government of India. Public Distribution System (PDS). 2021 March 18 [cited 2022 December 16]. https:\/\/nfsa.gov.in\/portal\/PDS_page"},{"key":"pone.0305819.ref043","unstructured":"The Times of India. Tamil Nadu makes two vaccine doses must for industrial employees. 2021 July 25 [cited 2022 December 16]. https:\/\/timesofindia.indiatimes.com\/city\/chennai\/tn-makes-two-vaccine-doses-must-for-industrial-employees\/articleshow\/84717185.cms"},{"key":"pone.0305819.ref044","unstructured":"The Hindu. Vaccination must for being in public places. 2021 November 19 [cited 2022 December 16]. https:\/\/www.thehindu.com\/news\/national\/tamil-nadu\/vaccination-must-for-being-in-public-places\/article37588675.ece"},{"key":"pone.0305819.ref045","unstructured":"Republic World. Tamil Nadu Govt Makes COVID-19 Vaccination Mandatory For All Under Eligible Population. 2021 November 25 [cited 2022 December 16]. https:\/\/www.republicworld.com\/india-news\/general-news\/tamil-nadu-govt-makes-covid-19-vaccination-mandatory-for-all-under-eligible-population.html."},{"key":"pone.0305819.ref046","unstructured":"The Economic Times. No individual can be forced to be vaccinated, says SC; \u201cBodily integrity protected under Constitution\u201d. 2022 May 2 [cited 2022 December 16]. https:\/\/economictimes.indiatimes.com\/news\/india\/nobody-can-be-forced-to-undergo-covid-19-vaccinations-supreme-court\/articleshow\/91251555.cms"},{"key":"pone.0305819.ref047","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1080\/01296612.2022.2066836","article-title":"Gender disparity in India\u2019s COVID-19 vaccine communication program","volume":"49","author":"R Nanda","year":"2022","journal-title":"Media Asia"},{"key":"pone.0305819.ref048","unstructured":"United Nations Women. Your questions answered: Women and COVID-19 in India. 2021 July 27 [cited 2022 December 16]. https:\/\/www.unwomen.org\/en\/news\/stories\/2021\/7\/faq-women-and-covid-19-in-india"},{"key":"pone.0305819.ref049","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1007\/s41027-022-00359-9","article-title":"Reducing Rural Poverty Through Non-farm Job Creation in India","volume":"65","author":"SS Pattayat","year":"2022","journal-title":"Indian J Labour Econ"},{"key":"pone.0305819.ref050","unstructured":"Duggal R. Covid-19 in India: vaccine shortages are leading to discrimination in access [blog]. 2021 August 10 [cited 2022 December 16]. In The BMJ Opinion [Internet]. UK: BMJ [about 2 screens]. https:\/\/blogs.bmj.com\/bmj\/2021\/08\/10\/covid-19-in-india-vaccine-shortages-are-leading-to-discrimination-in-access\/"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0305819","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T17:22:46Z","timestamp":1719249766000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0305819"}},"subtitle":[],"editor":[{"given":"Ranjit Kumar","family":"Dehury","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,6,24]]},"references-count":50,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,6,24]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0305819","relation":{},"ISSN":["1932-6203"],"issn-type":[{"type":"electronic","value":"1932-6203"}],"subject":[],"published":{"date-parts":[[2024,6,24]]}}}