The Level of Anxiety for the Elderly in Giving the Covid-19 Vaccine at the Central City Health Center

. Corona Virus or currently known as Covid-19 is a type of virus that causes disorders of the respiratory tract to more severe diseases, such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV) (Airlangga, 2020). Based on data from WHO and PHEOC of the Ministry of Health on April 13, 2021, the total confirmed cases of Covid-19 were 136,291,755. Cases with 2,941,128 deaths and have spread in 222 countries and 190 countries with local transmission (Emerging, 2021). Currently, in more than a year scientist have found a vaccine to help the body's immune system fight the corona virus, in Indonesia the COVID-19 vaccination target has reached 181.5 million people (Purbaya, 2021). One of the stages in this vaccination is the elderly with a target over 60 years. Anxiety is one of spectrum of emotional disorders that includes a combination of cognitive, emotional (feeling), and physical dysfunction. The spectrum of emotional disorders includes general emotional disorders, special emotional disorders (phobia, obsessive compulsive, panic, post-traumatic), sleep disorders, failure to recover, depression, bipolar disorder) (Geriatrics, 2020). Counseling will be given in the Pangmas project agenda. The Pangmas Project (community service) is one of the efforts made by the study program in an effort to improve public health through several programs implemented. Through this program, it is hoped that the elderly can find out 1) Covid-19 2) Covid-19 vaccines 3) Reduce anxiety in giving vaccinations .


INTRODUCTION
Currently, there is often anxiety in the elderly caused by some uncertain thoughts about the clarity and certainty of the effectiveness of the COVID-19 vaccine. Not only that, this anxiety occurs because of some hoax information that is spread on social media as if it has a negative impact on the effects of the COVID-19 vaccine. The government, in this case the ministry of health and research experts, continues to monitor the effectiveness of the COVID-19 vaccine. Corona Virus is a positive single strain RNA virus, encapsulated and not segmented. Corona Virus belongs to the order Nidovirales, family Corona Viridae. The structure of the Corona Virus is shaped like a cube with the S protein located on the surface of the virus. S protein or spike protein is one of the main viral antigens and is the main structure for gene writing. This S protein plays a role in the attachment and entry of viruses into host cells (interaction of protein S with host cell receptors) (Wang, 2020).
Corona virus Disease 2019 (COVID-19) is a new type of disease that has never been previously identified in humans. The virus that causes COVID-19 is called Sars-CoV-2. Corona virus is zoonotic (transmitted between animals and humans). Common signs and symptoms of COVID-19 infection include cough, fever (temperature > 380 C), shortness of breath and aches all over the body, sore throat and fatigue (Ministry of Health, 2020). Therefore, it is necessary to immediately intervene not only in terms of implementing health protocols but also other effective interventions are needed to break the chain of disease transmission, namely through vaccination efforts. Efforts have been made by various countries, including Indonesia, to develop ideal vaccines for the prevention of SARS-CoV-2 infection with various platforms, namely inactivated virus vaccines, live attenuated virus vaccines, virus vector vaccines, nucleic acid vaccines. , virus-like vaccines, and protein subunit vaccines.
The COVID-19 vaccination aims to reduce the transmission/transmission of COVID-19, reduce morbidity and mortality due to COVID-19, achieve herd immunity and protect the community from COVID-19 in order to remain socially and economically productive. Herd immunity can only be formed if vaccination coverage is high and evenly distributed throughout the region. Prevention efforts through the provision of vaccination programs if assessed from an economic point of view, will be much more costeffective, when compared to treatment efforts (RI, 2021).
Likewise with the elderly group. The vulnerability of the elderly is caused by a degenerative process that causes a decrease in the body's immunity so that the elderly are susceptible to being infected with diseases, including the corona virus. In the midst of a pandemic that is full of uncertainty, it is easy for the elderly to feel excessive anxiety which then affects their physical health condition. Such a complex and psychologically stressful situation from every age group requires prompt attention and treatment so that it does not become a more serious mental disorder (Vibriyanti, 2020).
The level of anxiety in the elderly arises from an unclear and widespread sense of concern related to uncertain, helpless, and non-specific objects. Anxiety is manifested directly through physiological changes such as (shaking, sweating, increased heart rate, abdominal pain, shortness of breath) and behavioral changes such as (restlessness, rapid speech, startled reaction) and indirectly through the onset of symptoms in an effort to fight anxiety (Febrina & Lesmana, 2015).
As for the results of the problems above, so that solutions and targets can be made as follows: (1) There is a need for regular and sustainable counseling; (2) There is a need for comprehensive counseling for the elderly at the central city health center; (3) Providing information that the importance of information and knowledge to the elderly regarding covid-19, prevention of covid-19, the benefits of injecting the covid 19 vaccine and reducing anxiety when the vaccine will be given.

Mechanism of Implementation of Community Service Activities (Community Service) Materials for Preparation and Implementation of Community Service (Community Service) at the Central City Health Center Implementation of Extension Activities (Pengmas)
The form of activities carried out as a form of assignment in Community Service (Community Service) activities at the MK Department, is given as a form of service that is included in one of the tridharma of higher education, namely community service. This activity was carried out at the Central City Health Center targeting the elderly. The topic of discussion in this activity was to provide an overview and motivation for the elderly in implementing the Covid-19 vaccination. The method of activities carried out in this activity is lectures and discussions with the help of banners and leaflets, and is documented.
The counseling was carried out at the Central City Health Center, Gorontalo City. With the counseling participants are the elderly (elderly). This activity was attended by the elderly who are members of the prolanist group. Counseling is aimed at increasing the knowledge and description of the elderly regarding the covid-19 vaccination. The expected result with this activity is that the elderly can find out about the process and stages of covid-19 vaccination in the elderly. Then during the counseling process, it appears that the client already understands and knows the stages of vaccination.

CONCLUSION
In the counseling activities carried out at the Central City Health Center of Gorontalo City, it can be concluded that: (1) Doubts arise from several statements by the elderly who are afraid of injections, then have experienced side effects after being immunized and assume that the COVID-19 pandemic is propaganda, conspiracy, hoax, and a deliberate attempt to sow fear through the media in order to gain an advantage. (2) The covid-19 vaccine works by weakening or deactivating microorganisms that enter the body and will initiate an immune response in the body, which is supported by virologists stating that the purpose of COVID-19 is to provide an immune response to individuals receiving the vaccine. (3) In preventing anxiety during the covid-19 vaccination, there are several efforts that must be made and avoided, namely: looking for reliable information, avoiding hoax news, and considering the advantages and risks when vaccinating covid-19.