Determinants of COVID-19 vaccine readiness and hesitancy among adults in sub-Saharan Africa

Sulemana Watara Abubakari, Research and Development Division, Kintampo Health Research Centre, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana.
Firehiwot Workneh, Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
Kwaku Poku Asante, Research and Development Division, Kintampo Health Research Centre, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana.
Elena C. Hemler, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America.
Isabel Madzorera, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America.
Dongqing Wang, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America.
Abbas Ismail, College of Natural and Mathematical Sciences, University of Dodoma, Dodoma, Tanzania.
Nega Assefa, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
Temesgen Azemraw, Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
Bruno Lankoande, Institut Superieur des Sciences de la Population, University of Ouagadougou, Ouagadougou, Burkina Faso.
Abdul Razak Nuhu, Research and Development Division, Kintampo Health Research Centre, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana.
Angela Chukwu, Department of Statistics, University of Ibadan, Ibadan, Nigeria.
Frank Mapendo, Africa Academy for Public Health, Dar es Salaam, Tanzania.
Ourohiré Millogo, Nouna Health Research Center, Nouna, Burkina Faso.
Adedokun A. Olufemi, University of Ibadan Research Foundation, University of Ibadan, Ibadan, Nigeria.
Daniel Okpara, University of Ibadan Research Foundation, University of Ibadan, Ibadan, Nigeria.
Valentin Boudo, Nouna Health Research Center, Nouna, Burkina Faso.
Mary Mwanyika-Sando, Africa Academy for Public Health, Dar es Salaam, Tanzania.
Yemane Berhane, Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
Till Baernighausen, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America.
Ayoade Oduola, University of Ibadan Research Foundation, University of Ibadan, Ibadan, Nigeria.
Said Vuai, College of Natural and Mathematical Sciences, University of Dodoma, Dodoma, Tanzania.
Ali Sie, Nouna Health Research Center, Nouna, Burkina Faso.
Abdramane Soura, Institut Superieur des Sciences de la Population, University of Ouagadougou, Ouagadougou, Burkina Faso.
Japhet Killewo, Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Raji Tajudeen, Division of Public Health Institutes and Research, Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia.
Wafaie W. Fawzi, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America.
Emily R. Smith, Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States of America.

Document Type

Journal Article

Publication Date

1-1-2023

Journal

PLOS global public health

Volume

3

Issue

7

DOI

10.1371/journal.pgph.0000713

Abstract

There is very limited data on the extent and determinants of COVID-19 vaccine hesitancy among adults living in sub-Saharan Africa since the global roll-out of vaccines began in 2021. This multi-country survey sought to investigate COVID-19 vaccine hesitancy and other predictors of readiness to get vaccinated. We conducted surveys among adults residing in nine urban and rural areas in Burkina Faso, Ethiopia, Ghana, Nigeria, and Tanzania in late 2021. Log binomial regression models were used to identify prevalence and factors associated with vaccine hesitancy and beliefs around COVID-19 misinformation. We completed a total of 2,833 interviews. Among all respondents, 9% had never heard of a COVID-19 vaccine, 12% had been vaccinated, and 20% knew someone else who had been vaccinated. The prevalence of vaccine hesitancy varied by country (Ethiopia 29%, Burkina Faso 33%, Nigeria 34%, Ghana 42%, Tanzania 65%), but not by rural or urban context. People who did not think the vaccine was safe or effective, or who were unsure about it, were more likely to be vaccine hesitant. Those who reported they did not have a trusted source of information about the vaccine (aPR: 1.25, 95% CI: 1.18,1.31) and those who thought the vaccine would not be made available to them within the year were more likely to be vaccine hesitant. Women were more likely to be vaccine hesitant (aPR: 1.31, 95% CI: 1.19,1.43) and believe COVID-19 falsehoods (aPR: 1.05, 95% CI: 1.02,1.08). The most commonly believed falsehoods were that the vaccine was developed too fast and that there was not enough information about whether the vaccine was effective or not. Educational campaigns targeted at misinformation and tailored to suit each country are recommended to build trust in COVID-19 vaccines and reduce hesitancy.

Department

Global Health

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