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

Sulemana Watara Abubakari¹, Firehiwot Workneh², Kwaku Poku Asante¹, Elena C Hemler³, Isabel Madzorera³, Dongqing Wang³, Abbas Ismail⁴, Nega Assefa⁵, Temesgen Azemraw², Bruno Lankoande⁶, Abdul Razak Nuhu¹, Angela Chukwu⁷, Frank Mapendo⁸, Ourohiré Millogo⁹, Adedokun A Olufemi¹⁰, Daniel Okpara¹⁰, Valentin Boudo⁹, Mary Mwanyika-Sando⁸, Yemane Berhane², Till Baernighausen^{3

11

12}, Ayoade Oduola¹⁰, Said Vuai⁴, Ali Sie⁹, Abdramane Soura⁶, Japhet Killewo¹³, Raji Tajudeen¹⁴, Wafaie W Fawzi^{3

15

16}, Emily R Smith^{17

18}

Affiliations

¹ Research and Development Division, Kintampo Health Research Centre, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana.
² Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
³ Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America.
⁴ College of Natural and Mathematical Sciences, University of Dodoma, Dodoma, Tanzania.
⁵ College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
⁶ Institut Superieur des Sciences de la Population, University of Ouagadougou, Ouagadougou, Burkina Faso.
⁷ Department of Statistics, University of Ibadan, Ibadan, Nigeria.
⁸ Africa Academy for Public Health, Dar es Salaam, Tanzania.
⁹ Nouna Health Research Center, Nouna, Burkina Faso.
¹⁰ University of Ibadan Research Foundation, University of Ibadan, Ibadan, Nigeria.
¹¹ Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany.
¹² Africa Health Research Institute, KwaZulu-Natal, South Africa.
¹³ Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
¹⁴ Division of Public Health Institutes and Research, Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia.
¹⁵ Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America.
¹⁶ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America.
¹⁷ Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States of America.
¹⁸ Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, DC, United States of America.

PMID: 37450441
PMCID: PMC10348558
DOI: 10.1371/journal.pgph.0000713

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

Sulemana Watara Abubakari et al. PLOS Glob Public Health. 2023.

. 2023 Jul 14;3(7):e0000713.

doi: 10.1371/journal.pgph.0000713. eCollection 2023.

Authors

Affiliations

¹ Research and Development Division, Kintampo Health Research Centre, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana.
² Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
³ Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America.
⁴ College of Natural and Mathematical Sciences, University of Dodoma, Dodoma, Tanzania.
⁵ College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
⁶ Institut Superieur des Sciences de la Population, University of Ouagadougou, Ouagadougou, Burkina Faso.
⁷ Department of Statistics, University of Ibadan, Ibadan, Nigeria.
⁸ Africa Academy for Public Health, Dar es Salaam, Tanzania.
⁹ Nouna Health Research Center, Nouna, Burkina Faso.
¹⁰ University of Ibadan Research Foundation, University of Ibadan, Ibadan, Nigeria.
¹¹ Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany.
¹² Africa Health Research Institute, KwaZulu-Natal, South Africa.
¹³ Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
¹⁴ Division of Public Health Institutes and Research, Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia.
¹⁵ Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America.
¹⁶ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America.
¹⁷ Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States of America.
¹⁸ Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, DC, United States of America.

PMID: 37450441
PMCID: PMC10348558
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.

Copyright: © 2023 Abubakari et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

**Fig 1**
Willingness to receive (A), perceived effectiveness (B), and perceived safety (C) of the COVID-19 vaccine by country and overall.

**Fig 2. Proportion of respondents who believe or are unsure about vaccine falsehoods by study site.**

See this image and copyright information in PMC

References

1. World Health Organization, Others. COVID 19 Public Health Emergency of International Concern (PHEIC). Global research and innovation forum: towards a research roadmap. World Health Organization. 2020. Available: https://covid19-evidence.paho.org/handle/20.500.12663/714.
1. World Health Organization. WHO Coronavirus Dashboard. C2020-[updated 2023 Feb 21; cited 2022 May 1]-Available from: https://covid19. who. int. Geneva: World Health Organization; (WHO). 2021.
1. World Health Organization, Others. Seventy-Third World Health Assembly 73.3: COVID-19 Response. Geneva, Switzerland: World Health Organization. 2020.
1. Wouters OJ, Shadlen KC, Salcher-Konrad M, Pollard AJ, Larson HJ, Teerawattananon Y, et al. Challenges in ensuring global access to COVID-19 vaccines: production, affordability, allocation, and deployment. Lancet. 2021;397: 1023–1034. doi: 10.1016/S0140-6736(21)00306-8 - DOI - PMC - PubMed
1. World Health Organization. COVID-19 vaccines. [cited 18 Feb 2022]. Available: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/covid-19....

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

Affiliations

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

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

LinkOut - more resources

Full Text Sources

Miscellaneous