Perceptions and predictors of COVID-19 vaccine hesitancy among healthcare providers across five countries in sub-Saharan Africa

Isabel Madzorera, Division of Community Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America.
Livesy Naafoe Abokyi, Kintampo Health Research Center, Research and Development Division, Ghana Health Service, Kintampo, Ghana.
Edward Apraku, Kintampo Health Research Center, Research and Development Division, Ghana Health Service, Kintampo, Ghana.
Temesgen Azemraw, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
Valentin Boudo, Nouna Health Research Center, Nouna, Burkina Faso.
Christabel James, University of Ibadan Research Foundation, Ibadan, Nigeria.
Dongqing Wang, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America.
Frank Mapendo, Africa Academy for Public Health, Dar es Salaam, Tanzania.
Ourohiré Millogo, Nouna Health Research Center, Nouna, Burkina Faso.
Nega Assefa, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
Angela Chukwu, Department of Statistics, University of Ibadan, Ibadan, Nigeria.
Firehiwot Workneh, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
Bruno Lankoande, Institut Supérieur des Sciences de la Population, University of Ouagadougou, Ouagadougou, Burkina Faso.
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.
Abbas Ismail, College of Natural and Mathematical Sciences, University of Dodoma, Dodoma, Tanzania.
Sulemana Abubakari, Kintampo Health Research Center, Research and Development Division, Ghana Health Service, Kintampo, Ghana.
Kwaku Poku Asante, Kintampo Health Research Center, Research and Development Division, Ghana Health Service, Kintampo, Ghana.
Yemane Berhane, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
Japhet Killewo, Africa Academy for Public Health, Dar es Salaam, Tanzania.
Ayoade Oduola, University of Ibadan Research Foundation, Ibadan, Nigeria.
Ali Sie, Nouna Health Research Center, Nouna, Burkina Faso.
Abdramane Soura, Institut Supérieur des Sciences de la Population, University of Ouagadougou, Ouagadougou, Burkina Faso.
Mary Mwanyika-Sando, Africa Academy for Public Health, Dar es Salaam, Tanzania.
Said Vuai, College of Natural and Mathematical Sciences, University of Dodoma, Dodoma, Tanzania.
Emily Smith, Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States of America.
Till Baernighausen, Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany.
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.

Document Type

Journal Article

Publication Date

1-1-2025

Journal

PLOS global public health

Volume

5

Issue

2

DOI

10.1371/journal.pgph.0003956

Abstract

The African continent has some of the world's lowest COVID-19 vaccination rates. While the limited availability of vaccines is a contributing factor, COVID-19 vaccine hesitancy among healthcare providers (HCP) is another factor that could adversely affect efforts to control infections on the continent. We sought to understand the extent of COVID-19 vaccine hesitancy among HCP, and its contributing factors in Africa. We evaluated COVID-19 vaccine hesitancy among 1,499 HCP enrolled in a cross-sectional study conducted as a telephone survey in Burkina Faso, Ethiopia, Nigeria, Tanzania, and Ghana between July to December of 2021. We defined COVID-19 vaccine hesitancy among HCP as self-reported responses of definitely not, maybe, unsure, or undecided on whether to get the COVID-19 vaccine, compared to definitely getting the vaccine. We used log-binomial or modified Poisson regression models to evaluate factors influencing vaccine hesitancy among HCP. Approximately 65.6% of the HCP interviewed were nurses and the mean age (±SD) of participants was 35.8 (±9.7) years. At least 67% of the HCP reported being vaccinated. COVID-19 vaccine hesitancy affected 45.7% of the HCP in Burkina Faso, 25.7% in Tanzania, 9.8% in Ethiopia, 9% in Ghana and 8.1% in Nigeria. Among unvaccinated HCP reasons for low vaccine uptake included concern about vaccine effectiveness, side effects, and fear of receiving experimental and unsafe vaccines. HCP reporting that COVID-19 vaccines are very effective (RR: 0.21, 95% CI: 0.08, 0.55), and older HCP (45 or older vs.20-29 years, RR: 0.65, 95% CI: 0.44, 0.95) were less likely to be vaccine-hesitant. Nurses were more likely to be vaccine-hesitant (RR 1.38, 95% CI: 1.01, 1.89) than doctors. Information asymmetry among HCP, beliefs about vaccine effectiveness, and the endorsement of vaccines by public health institutions may be important. Efforts to address hesitancy should consider information and knowledge gaps among different cadres of HCP alongside efforts to increase vaccine supply.

Department

Global Health

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