COVID-19 vaccine hesitancy in Zambia: a glimpse at the possible challenges ahead for COVID-19 vaccination rollout in sub-Saharan Africa

Abstract

With unprecedented speed, multiple vaccines against SARS-CoV-2 are available 1 year after the COVID-19 pandemic was first identified. As we push to achieve global control through these new vaccines, old challenges present themselves, including cold-chain storage, the logistics of mass vaccination, and vaccine hesitancy. Understanding how much hesitancy toward COVID-19 vaccines might occur and what factors may be driving these concerns can improve the ability of public health workers and communicators to maximize vaccine uptake. We nested a survey within a measles-rubella mass vaccination campaign in Zambia in November 2020 and asked about sentiments and beliefs toward COVID-19 and COVID-19 vaccines. Among parents bringing their children to receive a measles-rubella vaccine, we found high acceptability of COVID-19 vaccination of their children, but substantial uncertainty and hesitancy about receiving the vaccine themselves. COVID-19 vaccination hesitancy was correlated with beliefs around COVID-19 severity and risk, as well as vaccine safety and effectiveness.

Keywords: COVID-19; Zambia; vaccine; vaccine acceptance; vaccine hesitancy; vaccine safety.

Figure 1.

Caregivers’ intent to vaccinate their child (a) and receive the vaccine (b) against COVID-19 by district and campaign setting, among caregivers attending supplemental immunization activity in Zambia. Facilities designated as C3 and C4 represent peri-urban settings.

Figure 2.

Relationship between intent to vaccinate child and perceptions of disease and vaccine among caregivers attending supplemental immunization activity in Zambia. Campaign daily summaries of the perceptions of COVID-19 disease and vaccine were calculated for each facility then plotted against similar summaries for intent to vaccinate child.