Sicilians' knowledge, perceptions, prevention and practices during the pandemic in relation to vaccination: A questionnaire-based survey

Background: COVID-19 has influenced Sicily, Italy as any other part of the world, and people had various types of reactions to this global epidemic. This study aimed to assess the behavior, perception, and willingness of the Sicilian population to accept vaccination, as well as their attitudes toward conspiracy theories, which have been a concern for governments around the globe. Methods: Study design: cross sectional-descriptive study. The data were collected through a survey developed based on a protocol from the World Health Organization's regional office in Europe, which was distributed in two waves. The first wave took place in April and May 2020, and a modified survey was distributed during June and July. Results: Sicilians showed a very good knowledge of the virus, while their positive attitude has changed toward vaccination in the second wave. Furthermore, Sicilians showed an average trust in the governmental institutions, which allow the doubts of conspiracy to exist in the population. Conclusions: Although the results indicate a good level of knowledge and positive attitude toward vaccination, we believe that further studies should be conducted in the Mediterranean to better understand how to face future epidemics with limited resources in the healthcare system, as compared with other countries.