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Basholli FM, Berisha M, Scherzer M, Humolli I, Ramadani N, Habersaat KB, Kiss Z. "Using behavioral insights to inform the COVID-19 vaccine response in Kosovo [1]: Population perceptions and interventions". PEC INNOVATION 2024; 4:100279. [PMID: 38590340 PMCID: PMC11000163 DOI: 10.1016/j.pecinn.2024.100279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 02/23/2024] [Accepted: 03/27/2024] [Indexed: 04/10/2024]
Abstract
Objective Understand population perceptions in Kosovo[1] regarding COVID-19 vaccination to inform the pandemic response. Methods Five rounds of a cross-sectional survey in representative samples of adults during 2020-2021. Analysis includes descriptive statistics, hierarchical cluster analysis, segmentation and logistic regressions. Results Self-reported intention to vaccinate increased after the introduction of COVID-19 vaccines in Kosovo.[1] In less than one year, vaccination intentions increased from 36% to 66% of those unvaccinated. Predictors for vaccine intentions included gender, age, trust in health authorities. Segmentation analysis identified population segments that had high vaccine nintentions but low uptake, informing messages and campaign initiatives designed to translate intentions into behavior. Conclusion Identifying people's perceptions and behavior is essential to support evidence-based policy making, especially during outbreak response. Innovation BI is an innovative focus of research in Kosovo [1] where little BI data had been collected prior, and provided a unique understanding of population views, attitudes and behaviors related to COVID-19. These findings were not only essential for an evidence-based pandemic response but also laid the foundation for future broad application of BI to inform interventions that seek to enable, support and promote health-related behaviurs in Kosovo[1].
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Affiliation(s)
- Florie Miftari Basholli
- Medical Faculty, University of Pristina, Pristina, Kosovo
- Institute of Public Health of Kosovo, Pristina, Kosovo
| | - Merita Berisha
- Medical Faculty, University of Pristina, Pristina, Kosovo
- Institute of Public Health of Kosovo, Pristina, Kosovo
| | | | | | - Naser Ramadani
- Medical Faculty, University of Pristina, Pristina, Kosovo
- Institute of Public Health of Kosovo, Pristina, Kosovo
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Eyawo O, Ugoji UC, Pan S, Oyibo P, Rehman A, Mahboob M, Esimai OA. Predictors of the willingness to accept a free COVID-19 vaccine among households in Nigeria. Vaccine 2024; 42:126225. [PMID: 39216208 DOI: 10.1016/j.vaccine.2024.126225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 06/19/2024] [Accepted: 08/12/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND To inform vaccination policy and programmatic strategies to increase COVID-19 vaccine uptake, an understanding of the factors associated with the willingness to vaccinate is needed. METHODS We analyzed data collected from the sixth and tenth round of the Nigerian COVID-19 National Longitudinal Phone Survey conducted by the National Bureau of Statistics and the World Bank in 2020 and 2021, respectively. Exploratory data analysis and feature selection techniques were used to identify important variables. Multivariable logistic regression models were fitted to assess the association between socio-demographic and economic factors and the willingness to receive a free COVID-19 vaccine among Nigerian households at two different time points before vaccines became widely available. RESULTS Data from 1,733 and 1,651 Nigerian households who completed the sixth and tenth round of the survey, respectively, were included. Most respondents (>85% of households) were willing to receive a free COVID-19 vaccine from both survey rounds. The median household size was 6 (IQR: [4, 8]) with females heading about 18% of the households. Approximately 22% of the household heads had not received any formal education. Compared to households whose head had no education, households whose heads had completed tertiary education or higher had significantly lower odds of willingness to be vaccinated (ORround 6: 0.46, 95% CI: [0.31, 0.68], ORround 10: 0.49, 95% CI: [0.34, 0.71]). An increasing proportion of male household members was associated with greater willingness to receive a free COVID-19 vaccine (ORround 6: 1.84, 95% CI: [1.01, 3.33], ORround 10: 5.25, 95% CI: [2.86, 9.65]). Significant associations with vaccine willingness were also observed across geopolitical zones of residence with households in South-East Nigeria (ORround 6: 0.16, 95% CI: [0.10, 0.24]; ORround 10: 0.29, 95% CI: [0.19, 0.43]) and South-South Nigeria (ORround 6: 0.57, 95% CI: [0.36, 0.90], ORround 10: 0.32, 95% CI: [0.22, 0.48]) less likely to be willing to receive a free vaccine compared to households in North-Central Nigeria. CONCLUSION These findings from two different time points before vaccine roll-out suggest that the educational level of household head, proportion of male household members, and the geopolitical zone of residence are important baseline predictors of the willingness to receive a free COVID-19 vaccine in Nigeria. These factors should be carefully considered and specifically targeted when designing public health programs to inform early-stage strategies that address underlying vaccine hesitancy, improve vaccine uptake, promote ongoing COVID-19 vaccination efforts, and potentially enhance other immunization programs in Nigeria.
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Affiliation(s)
- Oghenowede Eyawo
- School of Global Health, York University, Toronto, ON, Canada; School of Kinesiology and Health Science, York University, Toronto, ON, Canada.
| | | | - Shenyi Pan
- Department of Statistics, University of British Columbia, Vancouver, BC, Canada
| | - Patrick Oyibo
- Department of Health Services Research and Management, School of Health and Psychological Sciences, City University of London, London, United Kingdom; Department of Community Medicine, Faculty of Clinical Medicine, Delta State University, Abraka, Nigeria
| | - Amtull Rehman
- School of Global Health, York University, Toronto, ON, Canada
| | - Mishel Mahboob
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
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Senoga U, Guwatudde D, Isunju JB, Ojiambo KO. Factors associated with full COVID-19 vaccination among persons living with diabetes mellitus in Uganda-A cross-sectional study. BMC Public Health 2024; 24:2422. [PMID: 39237915 PMCID: PMC11378392 DOI: 10.1186/s12889-024-19869-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 08/23/2024] [Indexed: 09/07/2024] Open
Abstract
BACKGROUND Diabetes mellitus (DM) is associated with severe outcomes of coronavirus disease (COVID-19), including death. COVID-19 vaccination is crucial for preventing infection and severe disease in the general population, but most importantly, among high-risk populations such as persons with DM. However, while COVID-19 vaccination uptake in the general population is regularly tracked, information on vaccination behavior specific to persons with DM is scarce. This study aimed to identify factors associated with the uptake of full COVID-19 vaccination among persons living with DM at Kiruddu National Referral Hospital (KRH). METHODS We employed a cross-sectional study design and administered a structured questionnaire on a systematically selected random sample of 340 people with DM attending Kiruddu National Referral Hospital from March 08 to May 25, 2023. We used a Modified Poisson Regression model to identify the factors associated with full COVID-19 vaccination and present adjusted prevalence ratios, along with their 95% confidence intervals. Full COVID-19 vaccination in this study was defined as having completed the last dose in the primary series of a COVID-19 vaccine. RESULTS We administered the questionnaire to 340 participants, with 75% (255 of 340) being female. The mean age of the participants was 52 years (± 12 years) and their median duration with diabetes mellitus was 5 years (± 7.3 years). Overall, 195 out of 340 participants (57.35%, 95% CI: 52-63%) completed the last dose in the primary series of a COVID-19 vaccine. The likelihood of receiving full vaccination was higher when a health provider advised one to receive a vaccine (aPR = 1.91, 95% CI: 1.20-3.02), when one reported having a comorbidity (aPR = 1.26, 95% CI: 1.06-1.53), and when one had a strong perceived benefit of vaccination (aPR = 1.76, 95% CI: 1.23-2.53). However, having a strong perceived barrier to vaccination was negatively associated with the likelihood of being fully vaccinated (aPR = 0.71, 95% CI: 0.60-0.84). CONCLUSION The uptake of COVID-19 vaccines among persons with DM at KRH is low, with only 57% having a full COVID-19 vaccination status. This underscores the progress in meeting the WHO recommendation of having a 100% COVID-19 vaccination uptake among people with underlying health conditions, including diabetes mellitus. At the policy level, the Ugandan Ministry of Health (MoH) may implement a provider-initiated vaccination strategy where healthcare providers who attend to DM patients during their routine clinic visits initiate the idea of vaccinating, sensitize, and spearhead myth-bursting around COVID-19 vaccines.
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Affiliation(s)
- Umar Senoga
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala, Uganda.
| | - David Guwatudde
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala, Uganda
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala, Uganda
| | - Kevin Ouma Ojiambo
- Clinical Epidemiology Unit, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
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Suleman A, Vicente P. COVID-19 vaccination reluctance across Europe: Lessons for the future. Vaccine 2024; 42:126168. [PMID: 39069463 DOI: 10.1016/j.vaccine.2024.126168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 07/09/2024] [Accepted: 07/20/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND Vaccine reluctance is both a complex and context-specific issue and is the result of many complicating factors that need to be addressed more systematically. In Europe, several country-based ad-hoc studies have been carried out on COVID-19 vaccines/vaccination and vaccine reluctance but a comprehensive overview covering all 27 European Union (EU27) countries is lacking. Such study can help understand vaccine reluctance in the overall EU as well as examine differences between individual countries. METHODS This study relies on data from Flash Eurobarometer 505, covering all 27 European Union member states; the sample size is N=26,641. It takes a fuzzy clustering approach to construct typologies of attitudes towards COVID-19 vaccination, and subsequently develops an "Index of Attitudes" (IA) which accounts for individual positioning of EU citizens. The data analysis is based on grade of membership (GoM) model which is a reliable statistical tool to tackle heterogeneous populations. RESULTS The output of GoM model unveiled a hierarchical fuzzy 3-partition corresponding to three clearly identified typologies of feelings towards COVID-19 vaccination: Typology 1 entails favourable feelings while moderate-favourable feelings describe the Typology 2. Finally, Tipology 3 encompasses the scepticism towards COVID-19 vaccines. The IA, which quantifies the sentiment of European citizens towards COVID-19 vaccination in a 0-1 scale, reveals that although EU27 citizens overall are not against COVID-19 vaccination (index mean =0.44) some, mostly in eastern countries, deviate from this prevailing trend. CONCLUSION Distrust in the safety and efficacy of all kinds of vaccines, as well as a generalised distrust in European and national institutions, are associated with the reluctance in relation towards COVID-19 vaccination. However, this reluctance varies across countries. The outcomes of our study not only inform national government and health care agents but also help define communication strategies to reach the most reluctant citizens. The segmentation it provides makes it easier to customise campaigns that raise awareness of the consequences of not being vaccinated, particularly as new SARS-CoV-2 variants emerge.
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Affiliation(s)
- Abdul Suleman
- Iscte-Instituto Universitário de Lisboa, Business Research Unit (BRU-Iscte), Lisboa, Portugal.
| | - Paula Vicente
- Iscte-Instituto Universitário de Lisboa, Business Research Unit (BRU-Iscte), Lisboa, Portugal.
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Nhamo G, Maoela MA. Gendered (SDG5) and other perspectives on COVID-19 vaccination status: a focus on South Africa's Limpopo province. Front Glob Womens Health 2024; 5:1420967. [PMID: 39145152 PMCID: PMC11322973 DOI: 10.3389/fgwh.2024.1420967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 07/11/2024] [Indexed: 08/16/2024] Open
Abstract
One of the key issues embedded in the 2030 Agenda for Sustainable Development is the need for disaggregated data. Given the nature of the Coronavirus disease 2019 (COVID-19), studies on such should respond to this call. This paper investigates gendered and other perspectives on COVID-19 vaccination status in South Africa's Limpopo Province. The work utilises a household survey (n = 4,571), data from Our World in Data and Johns Hopkins University, as well as policy documents and academic literature. The findings are that the government moved away from a goal to attain 67% herd immunity, to the containment strategy. While the country attained 35% of population fully vaccinated, the current study reveals 72.84% of the respondents fully vaccinated in Limpopo (including those receiving a booster). Noteworthy findings include 7.1% of the respondents reporting partial vaccination and 19.8% expressing vaccine hesitancy. Gender differences were significant, with females exhibiting higher vaccination rates than males, and age-related variations were observed, particularly among the youngest participants. Further analysis stratified by gender and age groups unveiled substantial disparities, emphasizing the need for targeted interventions. Additionally, the study highlights patterns in COVID-19 vaccine uptake based on education levels, with higher education associating with increased vaccination rates. Significant gender-based differences in vaccine uptake across education levels indicate potential areas for focused public health efforts. The findings emphasise the complexity of factors influencing vaccination behaviour, providing valuable insights for policymakers, public health practitioners, and researchers aiming to enhance vaccine uptake and address disparities in diverse demographic groups.
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Affiliation(s)
- Godwell Nhamo
- Institute for Corporate Citizenship, University of South Africa, Pretoria, South Africa
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Makonokaya L, Kapanda L, Maphosa T, Kalitera LU, Machekano R, Nkhoma H, Chamanga R, Zimba SB, Mwale AC, Maida A, Woelk G. Factors associated with COVID-19 vaccine receipt among mobile phone users in Malawi: Findings from a national mobile-based syndromic surveillance survey, July 2021-April 2022. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002722. [PMID: 38206893 PMCID: PMC10783752 DOI: 10.1371/journal.pgph.0002722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 11/23/2023] [Indexed: 01/13/2024]
Abstract
Malawi recommended COVID-19 vaccines for adults aged ≥18 years in March 2021. We assessed factors associated with receiving COVID-19 vaccines in Malawi as part of a telephone-based syndromic surveillance survey. We conducted telephone-based syndromic surveillance surveys with questions on COVID-19 vaccine receipt among adults (≥18 years old) upon verbal consent from July 2021 to April 2022. We used random digit dialing to select mobile phone numbers and employed electronic data collection forms on secure tablets. Survey questions included whether the respondent had received at least one dose of a COVID-19 vaccine. We used multivariable analysis to identify factors associated with COVID-19 vaccine receipt. Of the 51,577 participants enrolled; 65.7% were male. Males were less likely to receive the COVID-19 vaccine than females (AOR 0.83, 95% CI 0.80-0.86). Compared to those aged 18-24 years, older age had increased odds of vaccine receipt: 25-34 years (AOR 1.32, 95% CI 1.24-1.40), 35-44 years (AOR 2.00, 95% CI 1.88-2.13), 45-54 years (AOR 3.02, 95% CI 2.82-3.24), 55-64 years (AOR 3.24, 95% CI 2.93-3.57) and 65 years+ (AOR 3.98, 95% CI 3.52-4.49). Respondents without formal education were less likely to receive vaccination compared to those with primary (AOR 1.30, 95% CI 1.14-1.48), secondary (AOR 1.76, 95% CI 1.55-2.01), and tertiary (AOR 3.37, 95% CI 2.95-3.86) education. Respondents who thought COVID-19 vaccines were unsafe were less likely to receive vaccination than those who thought it was very safe (AOR 0.26, 95% CI 0.25-0.28). Residents of the Central and Southern regions had reduced odds of vaccine receipt compared to those in the North (AORs 0.79, (95% CI 0.74-0.84) and 0.55, (95% CI 0.52-0.58) respectively). Radio (72.6%), health facilities (52.1%), and social media (16.0%) were the more common self-reported sources of COVID-19 vaccine information. COVID-19 vaccine receipt is associated with gender, age, education, and residence. It is important to consider these factors when implementing COVID-19 vaccination programs.
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Affiliation(s)
| | - Lester Kapanda
- Elizabeth Glaser Pediatric AIDS Foundation, Lilongwe, Malawi
| | - Thulani Maphosa
- Elizabeth Glaser Pediatric AIDS Foundation, Lilongwe, Malawi
| | | | - Rhoderick Machekano
- Elizabeth Glaser Pediatric AIDS Foundation, Washington, DC, United States of America
| | - Harrid Nkhoma
- Elizabeth Glaser Pediatric AIDS Foundation, Lilongwe, Malawi
| | - Rachel Chamanga
- Elizabeth Glaser Pediatric AIDS Foundation, Lilongwe, Malawi
| | - Suzgo B. Zimba
- Elizabeth Glaser Pediatric AIDS Foundation, Lilongwe, Malawi
| | | | - Alice Maida
- Centers for Disease Control and Prevention, Lilongwe, Malawi
| | - Godfrey Woelk
- Elizabeth Glaser Pediatric AIDS Foundation, Washington, DC, United States of America
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Ashkir S, Abel T, Khaliq OP, Moodley J. COVID-19 vaccine hesitancy among pregnant women in an antenatal clinic in Durban, South Africa. S Afr J Infect Dis 2023; 38:516. [PMID: 37670934 PMCID: PMC10476234 DOI: 10.4102/sajid.v38i1.516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/19/2023] [Indexed: 09/07/2023] Open
Abstract
Background Mass administration of vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the most efficient intervention against the coronavirus disease 2019 (COVID-19) pandemic. Recently, vaccinations were shown to be safe and effective during pregnancy. However, vaccination rates are low in low- and middle-income countries, and vaccine hesitancy is a major limiting factor. Objectives To investigate the rate of COVID-19 vaccine hesitancy among pregnant women. Method A cross-sectional questionnaire-based investigation of 313 unvaccinated pregnant women attending an antenatal clinic in Durban, South Africa (SA). The questionnaire included clinical and socio-demographic data, and reasons for vaccine hesitancy were recorded and evaluated. Results Of 313 women participating, 126 (40.3%) were vaccinated against COVID-19, 21/313 = 6.7%; for those unvaccinated, 21/187 (13.9%) were planning to be vaccinated. However, most unvaccinated women, 174 of 187 (93%), showed COVID-19 vaccine hesitancy. Conclusion The COVID-19 vaccination hesitancy among pregnant women in Durban, SA, is exceptionally high. This requires urgent attention by the relevant health authorities (both professional health organisations and the SA Department of Health) as many countries experience different waves of the variants of SARS-CoV-2 and herd immunity may not have been achieved. Contribution This study showed a high vaccine acceptance hesitancy rate among pregnant women in SA.
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Affiliation(s)
- Sahra Ashkir
- Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Tashlen Abel
- Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Olive P. Khaliq
- Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Jagidesa Moodley
- Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Naidoo D, Meyer-Weitz A, Govender K. Factors Influencing the Intention and Uptake of COVID-19 Vaccines on the African Continent: A Scoping Review. Vaccines (Basel) 2023; 11:vaccines11040873. [PMID: 37112785 PMCID: PMC10146577 DOI: 10.3390/vaccines11040873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 03/31/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
The COVID-19 pandemic is a severe concern worldwide, particularly in Africa. Vaccines are crucial in the fight against the COVID-19 pandemic. This scoping review examined existing literature from 2020 to 2022 on individual, interpersonal, and structural barriers and facilitators to COVID-19 vaccination within Africa to facilitate more informed health promotion interventions to improve vaccine uptake. This review was conducted using Arksey and O'Malley's five-stage methodological framework. A comprehensive search was undertaken from 2021 to 2022 using six electronic databases: EBSCOhost, PubMed, Web of Science, ProQuest, WorldCat Discovery, and Google Scholar. Data was collected, charted into themes, and summarized using a standard data extraction sheet in Microsoft Excel. A total of forty (n = 40) published academic articles were reviewed, with many conducted in Nigeria (n = 10), followed by Ethiopia (n = 5) and Ghana (n = 4) and the rest elsewhere in Africa. Thematic narratives were used to report data into six themes: attitudes and perceptions about COVID-19 vaccines, intention to uptake COVID-19 vaccines; factors and barriers associated with COVID-19 vaccine uptake; socio-demographic determinants affecting the intention and uptake; and information sources for COVID-19 vaccines. The intention for uptake ranged from 25% to 80.9%, resulting in a suboptimal uptake intention rate (54.2%) on the African continent. Factors that promoted vaccine acceptance included confidence in the COVID-19 vaccines and the desire to protect people. Age, education, and gender were the most common factors significantly associated with vaccine acceptance. Most studies revealed that considerable barriers to vaccine uptake exist in Africa. Concerns about potential side effects, vaccine ineffectiveness, a perceived lack of information, and inaccessibility were among the individual, interpersonal, and structural barriers to COVID-19 vaccine uptake. The unwillingness to receive the COVID-19 vaccine was strongly correlated with being female. Mass and social media were the main sources of information regarding COVID-19 vaccines. To encourage vaccine uptake, governments should pay attention to refuting misinformation through integrated community-based approaches, such as creating messages that convey more than just information.
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Affiliation(s)
- Damian Naidoo
- Discipline of Psychology, School of Applied Human Sciences, Howard College, University of KwaZulu-Natal, Durban 4041, South Africa
- Health Promotion Unit, KwaZulu-Natal Department of Health, Pietermaritzburg, Private Bag X9051, Pietermaritzburg 3200, South Africa
| | - Anna Meyer-Weitz
- Discipline of Psychology, School of Applied Human Sciences, Howard College, University of KwaZulu-Natal, Durban 4041, South Africa
| | - Kaymarlin Govender
- HEARD, College of Law and Management Studies, University of KwaZulu-Natal, Durban 4041, South Africa
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Makadzange AT, Gundidza P, Lau C, Dietrich J, Myburgh N, Elose N, James W, Stanberry L, Ndhlovu C. Investigating Attitudes, Motivations and Key Influencers for COVID-19 Vaccination Uptake among Late Adopters in Urban Zimbabwe. Vaccines (Basel) 2023; 11:411. [PMID: 36851288 PMCID: PMC9958877 DOI: 10.3390/vaccines11020411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/24/2023] [Accepted: 01/31/2023] [Indexed: 02/15/2023] Open
Abstract
The rapid development of vaccines in response to the COVID-19 pandemic has provided an effective tool for the management of COVID-19. However, in many African countries there has been a poor uptake of COVID-19 vaccines with only 32.5% first vaccine dose coverage compared to the WHO global target of 70%. As vaccine access improves, one of the important drivers of low uptake has been vaccine hesitancy, driven by levels of confidence, convenience, and complacency. Between 4 January-11 February 2022, we conducted a survey of vaccine late adopters to assess factors that influenced adults in Harare, Zimbabwe to present for their first COVID-19 vaccine dose almost 12 months after the vaccination program began. Of the 1016 adults enrolled, 50% were female and 12.4% had HIV co-infection. Binary logistic regression models were developed to understand factors associated with vaccine confidence. Women were more likely to have negative views about the COVID-19 vaccine compared to men (OR 1.51 (95%CI 1.16, 1.97, p = 0.002). Older adults (≥40 years) compared with youth (18-25 years) were more likely to have 'major concerns' about vaccines. When asked about their concerns, 602 (59.3%) considered immediate side effects as a major concern and 520 (52.1%) were concerned about long-term health effects. People living with HIV (PLWH) were more likely to perceive vaccines as safe (OR 1.71 (95%CI: 1.07, 2.74, p = 0.025) and effective (1.68 (95%CI: 1.07, 2.64, p = 0.026). Internet users were less likely to perceive vaccines as safe (OR 0.72 (95% CI: 0.55, 0.95, p = 0.021) compared to non-Internet users; and social media was a more likely source of information for youth and those with higher education. Family members were the primary key influencers for 560 (55.2%) participants. The most important reason for receiving the COVID-19 vaccine for 715 (70.4%) participants was the protection of individual health. Improving vaccine coverage will need targeted communication strategies that address negative perceptions of vaccines and associated safety and effectiveness concerns. Leveraging normative behavior as a social motivator for vaccination will be important, as close social networks are key influences of vaccination.
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Affiliation(s)
| | - Patricia Gundidza
- Charles River Medical Group, 155 King George Avenue, Avondale, Harare, Zimbabwe
| | | | - Janan Dietrich
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa
- African Social Sciences Unit of Research and Evaluation (ASSURE), Division of the Wits Health Consortium, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa
- Health Systems Research Unit, South African Medical Research Council, Bellville 7530, South Africa
| | - Nellie Myburgh
- Wits Vaccines & Infectious Diseases Analytics (VIDA) Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa
| | - Nyasha Elose
- Charles River Medical Group, 155 King George Avenue, Avondale, Harare, Zimbabwe
| | - Wilmot James
- Institute for Social and Economic Research and Policy, Columbia University, IAB 118th Street, New York, NY 10025, USA
| | - Lawrence Stanberry
- Vaccine Information Network, Columbia University, 533 W 218th St., New York, NY 10032, USA
- Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Chiratidzo Ndhlovu
- Charles River Medical Group, 155 King George Avenue, Avondale, Harare, Zimbabwe
- Internal Medicine Unit, Faculty of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
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Azanaw J, Endalew M, Zenbaba D, Abera E, Chattu VK. COVID-19 vaccine acceptance and associated factors in 13 African countries: A systematic review and meta-analysis. Front Public Health 2023; 10:1001423. [PMID: 36761336 PMCID: PMC9903367 DOI: 10.3389/fpubh.2022.1001423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 12/09/2022] [Indexed: 01/26/2023] Open
Abstract
Background The COVID-19 pandemic has severely affected the entire world, especially sub-Saharan Africa. As a result, researchers and government agencies are working to create effective COVID-19 vaccinations. While vaccination campaigns are moving rapidly in high-income nations, COVID-19 is still ruthlessly affecting people in low-income nations. However, this difference in the spread of the disease is not because of a lack of a COVID-19 vaccine but mainly due to people's reluctance. As a result, this review summarized the data on COVID-19 vaccination adoption and factors related among nations in sub-Saharan Africa. Method Comprehensive searches were conducted using PubMed, Embase, Medline, Web of Science, Google Scholar, and the Cochrane Library databases. The risk of bias and methodological quality of each published article that fit the selection criteria were evaluated using Critical Appraisal Checklist tools. All statistical analysis was done by STATA 16. Results This review was based on 29 studies with 26,255 participants from sub-Saharan Africa. Using a random-effects model, the pooled prevalence of COVID-19 vaccine acceptance among study participants was 55.04% (95 % CI: 47.80-62.27 %), I2 = 99.55%. Being male [POR = 1.88 (95% CI: 1.45, 2.44)], having a positive attitude toward the COVID-19 vaccine [POR = 5.56 (95% CI: 3.63, 8.51)], having good knowledge in the COVID-19 vaccine [POR = 4.61 (95% CI: 1.24, 8.75)], having government trust [POR = 7.10 (95% CI: 2.37, 21.32)], and having undergone COVID-19 testing in the past [POR = 4.41 (95%CI: (2.51, 7.75)] were significant predictor variables. Conclusion This analysis showed that respondents had a decreased pooled prevalence of COVID-19 vaccination acceptance. Sex, attitude, knowledge, government trust, and COVID-19 testing were statistically significantly correlated characteristics that affected the acceptability of the COVID-19 vaccine. All stakeholders should be actively involved in increasing the uptake of the COVID-19 vaccine and thereby reducing the consequences of COVID-19. The acceptance of the COVID-19 vaccination can be increased by using this conclusion as an indicator for governments, healthcare professionals, and health policymakers in their work on attitude, knowledge, government trust, and COVID-19 testing.
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Affiliation(s)
- Jember Azanaw
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mastewal Endalew
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Demisu Zenbaba
- Department of Public Health, School of Health Sciences, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Eshetu Abera
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Vijay Kumar Chattu
- Department of Community Medicine, Faculty of Medicine, Datta Meghe Institute of Medical Sciences, Wardha, India
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Center for Transdisciplinary Research, Saveetha Institute of Medical and Technological Sciences, Saveetha University, Chennai, India
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11
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Gudayu TW, Mengistie HT. COVID-19 vaccine acceptance in sub-Saharan African countries: A systematic review and meta-analysis. Heliyon 2023; 9:e13037. [PMID: 36686610 PMCID: PMC9846884 DOI: 10.1016/j.heliyon.2023.e13037] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 01/19/2023] Open
Abstract
Vaccination is the most effective intervention for the primary prevention of COVID-19. Several studies have been conducted in sub-Saharan African countries on the acceptance and associated factors of COVID-19 vaccine. This review and meta-analysis aimed to recapitulate the pooled magnitude of vaccine acceptance and its favoring factors in sub-Saharan African countries. PUBMED, MEDLINE, Science Direct, Web of Science, and SCOPUS were the main databases searched from 15 March to 5 June 2022; and all the articles written in the English language were included. Also, some articles were retrieved from biomedical peer-reviewed journal sites and Google scholar. The quality of thirty-five selected articles was evaluated using an adapted scale for evaluating cross-sectional studies based on the Newcastle-Ottawa Scale. The result of the review and meta-analysis revealed that COVID-19 vaccine acceptance rate varied across studies. In a pooled analysis, factors such as; higher-level perception of infection risk (OR (95% CI (2.7 (2.1, 3.4))), perceived vaccine safety (13.9 (9.2, 20.9)), virus-related good knowledge (2.7 (2.3, 3.2)) and appropriate attitude (5.9 (4.4, 7.8)), adherence to safety precautions (5.5 (4.8, 6.2)), and infection experience (4.4 (2.8, 6.9)) were positively affected the COVID-19 vaccine acceptance. Also, vaccine acceptance was found to be high among males and chronically ill individuals. Thus, understanding factors that enhance vaccine acceptance would support planners to augment vaccine uptake in the region.
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Affiliation(s)
- Temesgen Worku Gudayu
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia,Corresponding author.
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12
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Mengistu DA, Demmu YM, Asefa YA. Global COVID-19 vaccine acceptance rate: Systematic review and meta-analysis. Front Public Health 2022; 10:1044193. [PMID: 36568768 PMCID: PMC9773145 DOI: 10.3389/fpubh.2022.1044193] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/15/2022] [Indexed: 12/13/2022] Open
Abstract
Background A vaccine against COVID-19 is a vital tool in managing the current pandemic. It is becoming evident that an effective vaccine would be required to control COVID-19. Effective use of vaccines is very important in controlling pandemics and paving the way for an acceptable exit strategy. Therefore, this systematic review and meta-analysis aims to determine the global COVID-19 acceptance rate that is necessary for better management of COVID-19 pandemic. Methods This review was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocols and considered the studies conducted on acceptance and/or hesitancy of COVID-19 vaccine. Articles were searched using electronic databases including PubMed, Scopus, Web of Science, Embase, CINAHL, and Google Scholar. The quality of the study was assessed using the Joanna Briggs Institute (JBI) critical assessment tool to determine the relevance of each included article to the study. Results Of the 6,021 articles identified through the electronic database search, 68 articles were included in the systematic review and meta-analysis. The global pooled acceptance rate of the COVID-19 vaccine was found to be 64.9% [95% CI of 60.5 to 69.0%]. Based on the subgroup analysis of COVID-19 vaccine acceptance rate by the World Health Organization's region, the countries where the study was conducted, occupation, and survey period, the prevalence of COVID-19 vaccine acceptance rate was 60.8% [95% CI: 56.3, 65.2%], 61.9% [95% CI: 61.3, 62.4%], 81.6% [95% CI: 79.7, 83, 2%] and 64.5% [95% CI: 60.3, 68.5%], respectively. Conclusions This review revealed the variation in the level of COVID-19 vaccine acceptance rate across the world. The study found that the overall prevalence of COVID-19 vaccine acceptance was 64.9%. This finding indicated that even if the COVID-19 vaccine is developed, the issue of accepting or taking the developed vaccine and managing the pandemic may be difficult.
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13
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Njoga EO, Awoyomi OJ, Onwumere-Idolor OS, Awoyomi PO, Ugochukwu ICI, Ozioko SN. Persisting Vaccine Hesitancy in Africa: The Whys, Global Public Health Consequences and Ways-Out-COVID-19 Vaccination Acceptance Rates as Case-in-Point. Vaccines (Basel) 2022; 10:1934. [PMID: 36423029 PMCID: PMC9697713 DOI: 10.3390/vaccines10111934] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/02/2022] [Accepted: 11/11/2022] [Indexed: 08/29/2023] Open
Abstract
Vaccine hesitancy (VH) is the seventh among the WHO's top 10 threats to global public health, which has continued to perpetuate the transmission of vaccine preventable diseases (VPDs) in Africa. Consequently, this paper systematically reviewed COVID-19 vaccine acceptance rates (VARs)-including the vaccine uptake and vaccination intention-in Africa from 2020 to 2022, compared the rates within the five African regions and determined the context-specific causes of VH in Africa. Generally, COVID-19 VARs ranged from 21.0% to 97.9% and 8.2% to 92.0% with mean rates of 59.8 ± 3.8% and 58.0 ± 2.4% in 2021 and 2022, respectively. Southern and eastern African regions had the top two VARs of 83.5 ± 6.3% and 68.9 ± 6.6% in 2021, and 64.2 ± 4.6% and 61.2 ± 5.1% in 2022, respectively. Based on population types, healthcare workers had a marginal increase in their mean COVID-19 VARs from 55.5 ± 5.6% in 2021 to 60.8 ± 5.3% in 2022. In other populations, the mean VARs decreased from 62.7 ± 5.2% in 2021 to 54.5 ± 4% in 2022. As of 25 October 2022, Africa lags behind the world with only 24% full COVID-19 vaccinations compared to 84%, 79% and 63% reported, respectively, in the Australian continent, upper-middle-income countries and globally. Apart from the problems of confidence, complacency, convenience, communications and context, the context-specific factors driving COVID-19 VH in Africa are global COVID-19 vaccine inequality, lack of vaccine production/maintenance facilities, insecurity, high illiteracy level, endemic corruption, mistrust in some political leaders, the spreading of unconfirmed anti-vaccination rumors and political instability. With an overall mean COVID-19 acceptance rate of 58%, VH still subsists in Africa. The low VARs in Africa have detrimental global public health implications, as it could facilitate the emergence of immune invading SARS-CoV-2 variants of concern, which may spread globally. Consequently, there is a need to confront these challenges frontally and engage traditional and religious leaders in the fight against VH in Africa, to restore public trust in the safety and efficacy of vaccines generally. As the availability of COVID-19 vaccines improves, the vaccination of pets and zoo-animals from which reverse zoonotic transmission of SARS-CoV-2 have been reported is recommended, to limit the evolution and spread of new variants of concern and avert possible SARS-CoV-2 epizootic or panzootic diseases in susceptible animal species.
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Affiliation(s)
- Emmanuel O. Njoga
- Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, University of Nigeria, Nsukka 410001, Nigeria
| | - Olajoju J. Awoyomi
- Department of Veterinary Public Health and Preventive Medicine, College of Veterinary Medicine, Federal University of Agriculture, Abeokuta PMB 2240, Nigeria
| | - Onyinye S. Onwumere-Idolor
- Department of Animal Production, Faculty of Agriculture, Delta State University of Science and Technology, Ozoro PMB 005, Nigeria
| | - Priscilla O. Awoyomi
- Department of Medicine and Surgery, College of Medicine, University of Ibadan, Ibadan 200005, Nigeria
| | - Iniobong C. I. Ugochukwu
- Department of Veterinary Pathology and Microbiology, Faculty of Veterinary Medicine, University of Nigeria, Nsukka 410001, Nigeria
- Department of Veterinary Medicine, Faculty of Veterinary Medicine, Universita degli Studi di Bari, 70010 Valenzano, Italy
| | - Stella N. Ozioko
- Institute of Aquaculture, Faculty of Natural Sciences, University of Stirling, Stirling FK9 4LA, UK
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14
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Taboe HB, Asare-Baah M, Yesmin A, Ngonghala CN. Impact of age structure and vaccine prioritization on COVID-19 in West Africa. Infect Dis Model 2022; 7:709-727. [PMID: 36097593 PMCID: PMC9454155 DOI: 10.1016/j.idm.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/29/2022] [Accepted: 08/29/2022] [Indexed: 11/17/2022] Open
Abstract
The ongoing COVID-19 pandemic has been a major global health challenge since its emergence in 2019. Contrary to early predictions that sub-Saharan Africa (SSA) would bear a disproportionate share of the burden of COVID-19 due to the region's vulnerability to other infectious diseases, weak healthcare systems, and socioeconomic conditions, the pandemic's effects in SSA have been very mild in comparison to other regions. Interestingly, the number of cases, hospitalizations, and disease-induced deaths in SSA remain low, despite the loose implementation of non-pharmaceutical interventions (NPIs) and the low availability and administration of vaccines. Possible explanations for this low burden include epidemiological disparities, under-reporting (due to limited testing), climatic factors, population structure, and government policy initiatives. In this study, we formulate a model framework consisting of a basic model (in which only susceptible individuals are vaccinated), a vaccine-structured model, and a hybrid vaccine-age-structured model to assess the dynamics of COVID-19 in West Africa (WA). The framework is trained with a portion of the confirmed daily COVID-19 case data for 16 West African countries, validated with the remaining portion of the data, and used to (i) assess the effect of age structure on the incidence of COVID-19 in WA, (ii) evaluate the impact of vaccination and vaccine prioritization based on age brackets on the burden of COVID-19 in the sub-region, and (iii) explore plausible reasons for the low burden of COVID-19 in WA compared to other parts of the world. Calibration of the model parameters and global sensitivity analysis show that asymptomatic youths are the primary drivers of the pandemic in WA. Also, the basic and control reproduction numbers of the hybrid vaccine-age-structured model are smaller than those of the other two models indicating that the disease burden is overestimated in the models which do not account for age-structure. This result is confirmed through the vaccine-derived herd immunity thresholds. In particular, a comprehensive analysis of the basic (vaccine-structured) model reveals that if 84%(73%) of the West African populace is fully immunized with the vaccines authorized for use in WA, vaccine-derived herd immunity can be achieved. This herd immunity threshold is lower (68%) for the hybrid model. Also, all three thresholds are lower (60% for the basic model, 51% for the vaccine-structured model, and 48% for the hybrid model) if vaccines of higher efficacies (e.g., the Pfizer or Moderna vaccine) are prioritized, and higher if vaccines of lower efficacy are prioritized. Simulations of the models show that controlling the COVID-19 pandemic in WA (by reducing transmission) requires a proactive approach, including prioritizing vaccination of more youths or vaccination of more youths and elderly simultaneously. Moreover, complementing vaccination with a higher level of mask compliance will improve the prospects of containing the pandemic. Additionally, simulations of the model predict another COVID-19 wave (with a smaller peak size compared to the Omicron wave) by mid-July 2022. Furthermore, the emergence of a more transmissible variant or easing the existing measures that are effective in reducing transmission will result in more devastating COVID-19 waves in the future. To conclude, accounting for age-structure is important in understanding why the burden of COVID-19 has been low in WA and sustaining the current vaccination level, complemented with the WHO recommended NPIs is critical in curbing the spread of the disease in WA.
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Affiliation(s)
- Hemaho B Taboe
- Department of Mathematics, University of Florida, Gainesville, FL, 32611, USA.,Laboratoire de Biomathématiques et d'Estimations Forestières, University of Abomey-Calavi, Cotonou, Benin
| | - Michael Asare-Baah
- Department of Epidemiology, University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA.,Emerging Pathogens Institute, University of Florida, Gainesville, FL, 32610, USA
| | - Afsana Yesmin
- Department of Mathematics, University of Florida, Gainesville, FL, 32611, USA
| | - Calistus N Ngonghala
- Department of Mathematics, University of Florida, Gainesville, FL, 32611, USA.,Emerging Pathogens Institute, University of Florida, Gainesville, FL, 32610, USA
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15
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Dinga JN, Njoh AA, Gamua SD, Muki SE, Titanji VPK. Factors Driving COVID-19 Vaccine Hesitancy in Cameroon and Their Implications for Africa: A Comparison of Two Cross-Sectional Studies Conducted 19 Months Apart in 2020 and 2022. Vaccines (Basel) 2022; 10:vaccines10091401. [PMID: 36146479 PMCID: PMC9503216 DOI: 10.3390/vaccines10091401] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/15/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022] Open
Abstract
Many efficacious COVID-19 vaccines have been approved for general use but their ability to control the disease is being undermined by slow uptake. Resources are needed to persuade people to obtain a COVID-19 vaccine. Here we compare this present study and a previous one to assess the impact of the Cameroon government’s policy and efforts to reduce COVID-19 vaccine hesitancy after one year of implementation. After obtaining ethical clearance and informed consent, 6732 participants completed a questionnaire about COVID-19 vaccine hesitancy and acceptance. It was observed that the government’s policies and efforts reduced COVID-19 vaccine hesitancy significantly, but this was not enough to ensure the herd immunity necessary to control the disease. The risk factors associated with vaccine hesitancy were the consumption of traditional herbal remedies; living in an urban setting; being female, jobless or a student; working in the education sector; being a politician/policy maker/administrator, engineer or technician; medium income; no education/primary school/secondary/high school/professional training; and working in the informal sector. In contrast, people who were male, healthcare personnel, high-income earners, participants who do not consume traditional herbal remedies, infected or knowing someone who has been infected by COVID-19, and having a chronic illness or comorbidity, were associated with COVID-19 vaccine acceptance. Participants also gave several reasons they were either hesitant or willing to take the vaccine. A more rigorous surveillance system is needed to systematically monitor drivers of vaccine hesitancy, establish tailored interventions promoting vaccine acceptance, and evaluate the impact of these interventions.
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Affiliation(s)
- Jerome Nyhalah Dinga
- Michael Gahnyam Gbeugvat Foundation, Buea P.O. Box 63, Cameroon
- Biotechnology Unit, University of Buea, Buea P.O. Box 63, Cameroon
- Correspondence: ; Tel.: +237-233-322-134
| | - Andreas Ateke Njoh
- Expanded Programme on Immunization, Ministry of Public Health, Yaounde P.O. Box 2084, Cameroon
- School of Global Health and Bioethics, Euclid University, Bangui BP 157, Central African Republic
| | - Stanley Dobgima Gamua
- Michael Gahnyam Gbeugvat Foundation, Buea P.O. Box 63, Cameroon
- Biotechnology Unit, University of Buea, Buea P.O. Box 63, Cameroon
| | | | - Vincent P. K. Titanji
- Biotechnology Unit, University of Buea, Buea P.O. Box 63, Cameroon
- Faculty of Science, University of Buea, Buea P.O. Box 63, Cameroon
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16
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Fajar JK, Sallam M, Soegiarto G, Sugiri YJ, Anshory M, Wulandari L, Kosasih SAP, Ilmawan M, Kusnaeni K, Fikri M, Putri F, Hamdi B, Pranatasari ID, Aina L, Maghfiroh L, Ikhriandanti FS, Endiaverni WO, Nugraha KW, Wiranudirja O, Edinov S, Hamdani U, Rosyidah L, Lubaba H, Ariwibowo R, Andistyani R, Fitriani R, Hasanah M, Nafis FAD, Tamara F, Latamu FO, Kusuma HI, Rabaan AA, Alhumaid S, Mutair AA, Garout M, Halwani MA, Alfaresi M, Al Azmi R, Alasiri NA, Alshukairi AN, Dhama K, Harapan H. Global Prevalence and Potential Influencing Factors of COVID-19 Vaccination Hesitancy: A Meta-Analysis. Vaccines (Basel) 2022; 10:1356. [PMID: 36016242 PMCID: PMC9412456 DOI: 10.3390/vaccines10081356] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 08/08/2022] [Accepted: 08/15/2022] [Indexed: 02/08/2023] Open
Abstract
Countries worldwide have deployed mass COVID-19 vaccination drives, but there are people who are hesitant to receive the vaccine. Studies assessing the factors associated with COVID-19 vaccination hesitancy are inconclusive. This study aimed to assess the global prevalence of COVID-19 vaccination hesitancy and determine the potential factors associated with such hesitancy. We performed an organized search for relevant articles in PubMed, Scopus, and Web of Science. Extraction of the required information was performed for each study. A single-arm meta-analysis was performed to determine the global prevalence of COVID-19 vaccination hesitancy; the potential factors related to vaccine hesitancy were analyzed using a Z-test. A total of 56 articles were included in our analysis. We found that the global prevalence of COVID-19 vaccination hesitancy was 25%. Being a woman, being a 50-year-old or younger, being single, being unemployed, living in a household with five or more individuals, having an educational attainment lower than an undergraduate degree, having a non-healthcare-related job and considering COVID-19 vaccines to be unsafe were associated with a higher risk of vaccination hesitancy. In contrast, living with children at home, maintaining physical distancing norms, having ever tested for COVID-19, and having a history of influenza vaccination in the past few years were associated with a lower risk of hesitancy to COVID-19 vaccination. Our study provides valuable information on COVID-19 vaccination hesitancy, and we recommend special interventions in the sub-populations with increased risk to reduce COVID-19 vaccine hesitancy.
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Affiliation(s)
- Jonny Karunia Fajar
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang 65145, Indonesia
| | - Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 11942, Jordan
- Department of Translational Medicine, Faculty of Medicine, Lund University, 22184 Malmö, Sweden
| | - Gatot Soegiarto
- Division of Allergy and Immunology, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya 60286, Indonesia
| | - Yani Jane Sugiri
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Brawijaya, Malang 65145, Indonesia
| | - Muhammad Anshory
- Division of Allergy and Immunology, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang 65145, Indonesia
| | - Laksmi Wulandari
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya 60286, Indonesia
| | | | - Muhammad Ilmawan
- Department of Urology, Faculty of Medicine, Universitas Brawijaya, Malang 65145, Indonesia
| | - Kusnaeni Kusnaeni
- Faculty of Matematics and Sciences, Institut Pertanian Bogor, Bogor 16680, Indonesia
| | - Muhammad Fikri
- Faculty of Matematics and Sciences, Institut Pertanian Bogor, Bogor 16680, Indonesia
| | - Frilianty Putri
- School of Veterinary Medicine and Biomedicine, Institut Pertanian Bogor, Bogor 16680, Indonesia
| | - Baitul Hamdi
- Faculty of Economy and Business, Universitas Airlangga, Surabaya 60286, Indonesia
| | | | - Lily Aina
- Faculty of Pharmacy, Universitas Airlangga, Surabaya 60286, Indonesia
| | - Lailatul Maghfiroh
- Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya 60286, Indonesia
| | | | - Wa Ode Endiaverni
- Faculty of Economy and Business, Universitas Brawijaya, Malang 65145, Indonesia
| | | | - Ory Wiranudirja
- Faculty of Economy and Business, Universitas Brawijaya, Malang 65145, Indonesia
| | - Sally Edinov
- Faculty of Economics and Business, Riau University, Pekanbaru 28293, Indonesia
| | - Ujang Hamdani
- Faculty of Economy and Business, Universitas Brawijaya, Malang 65145, Indonesia
| | - Lathifatul Rosyidah
- Faculty of Economy and Business, Universitas Brawijaya, Malang 65145, Indonesia
| | - Hanny Lubaba
- Faculty of Economy and Business, Universitas Brawijaya, Malang 65145, Indonesia
| | - Rinto Ariwibowo
- Faculty of Economy and Business, Universitas Brawijaya, Malang 65145, Indonesia
| | - Riska Andistyani
- Faculty of Economy and Business, Universitas Brawijaya, Malang 65145, Indonesia
| | - Ria Fitriani
- Faculty of Administrative Science, Universitas Brawijaya, Malang 65145, Indonesia
| | - Miftahul Hasanah
- Faculty of Animal Science, Universitas Brawijaya, Malang 65145, Indonesia
| | | | - Fredo Tamara
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang 65145, Indonesia
| | - Fitri Olga Latamu
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang 65145, Indonesia
| | - Hendrix Indra Kusuma
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
- Faculty of Mathematics and Natural Sciences, Universitas Syiah Kuala, Darussalam, Banda Aceh 23111, Indonesia
- Faculty of Tarbiyah and Teacher Training, Universitas Islam Negeri Ar-Raniry, Banda Aceh 23111, Indonesia
| | - Ali A. Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
- Department of Public Health and Nutrition, The University of Haripur, Haripur 22610, Pakistan
| | - Saad Alhumaid
- Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 31982, Saudi Arabia
| | - Abbas Al Mutair
- Research Center, Almoosa Specialist Hospital, Al Mubarrazs 36342, Saudi Arabia
- College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia
- School of Nursing, Wollongong University, Wollongong, NSW 2522, Australia
- Nursing Department, Prince Sultan Military College of Health Sciences, Dhahran 33048, Saudi Arabia
| | - Mohammed Garout
- Department of Community Medicine and Health Care for Pilgrims, Faculty of Medicine, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Muhammad A. Halwani
- Department of Medical Microbiology, Faculty of Medicine, Al Baha University, Al Baha 4781, Saudi Arabia
| | - Mubarak Alfaresi
- Department of Pathology and Laboratory Medicine, Sheikh Khalifa General Hospital, Umm Al Quwain 499, United Arab Emirates
- Department of Pathology, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 505055, United Arab Emirates
| | - Reyouf Al Azmi
- Infection Prevention and Control, Eastern Health Cluster, Dammam 32253, Saudi Arabia
| | - Nada A. Alasiri
- Scientific Advisory Council, InsanCare Group for Scientific Studies and Specialized Business Solutions, Riyadh 13313, Saudi Arabia
| | - Abeer N. Alshukairi
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
- Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah 12713, Saudi Arabia
| | - Kuldeep Dhama
- Division of Pathology, ICAR–Indian Veterinary Research Institute, Izatnagar, Bareilly 243122, India
| | - Harapan Harapan
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
- Tropical Disease Centre, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
- Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
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Oyekale AS. Indicators of Mental Health Disorder, COVID-19 Prevention Compliance and Vaccination Intentions among Refugees in Kenya. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:1032. [PMID: 36013499 PMCID: PMC9413478 DOI: 10.3390/medicina58081032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/19/2022] [Accepted: 07/27/2022] [Indexed: 11/16/2022]
Abstract
Background and Objectives: COVID-19 remains a major development challenge in many developing countries. This study analysed the effect of mental health disorder and indicators of COVID-19 preventive practices on vaccination intentions among refugees in Kenya. Materials and Methods: The data were the fourth and fifth waves of the High Frequency Phone Surveys on the impacts of COVID-19 that were collected by the Kenyan National Bureau of Statistics (KNBS) between May 2020 and June 2021. The data were collected from Kakuma, Kalobeyei, Dadaab and Shona camps using the stratified random sampling method. The data were analysed with random effects instrumental variable Probit regression model. Results: The results showed that 69.32% and 93.16% of the refugees were willing to be vaccinated during the 4th and 5th waves, respectively. The fear of dying was reported by 85.89% and 74.19% during the 4th and 5th waves, respectively. COVID-19 contact prevention and immune boosting indicators were differently influenced by some demographic and anxiety index variables, while being endogenous influenced vaccine hesitancy along with urban residence, age, knowing infected persons, days of depression, days of anxiety, days of physical reactions, members losing job, searching for jobs, accepting job offers and being employed. Conclusions: It was concluded that efforts to promote COVID-19 vaccination should address mental health disorder and compliance with existing COVID-19 contact and immune boosting behaviour with a focus on urban residents and youths.
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Affiliation(s)
- Abayomi Samuel Oyekale
- Department of Agricultural Economics and Extension, North-West University Mafikeng Campus, Mmabatho 2735, South Africa
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18
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Ackah BBB, Woo M, Stallwood L, Fazal ZA, Okpani A, Ukah UV, Adu PA. COVID-19 vaccine hesitancy in Africa: a scoping review. Glob Health Res Policy 2022; 7:21. [PMID: 35850783 PMCID: PMC9294808 DOI: 10.1186/s41256-022-00255-1] [Citation(s) in RCA: 73] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 06/10/2022] [Indexed: 11/10/2022] Open
Abstract
Background Vaccination against the novel coronavirus is one of the most effective strategies for combating the global Coronavirus disease (COVID-19) pandemic. However, vaccine hesitancy has emerged as a major obstacle in several regions of the world, including Africa. The objective of this rapid review was to summarize the literature on COVID-19 vaccine hesitancy in Africa.
Methods We searched Scopus, Web of Science, African Index Medicus, and OVID Medline for studies published from January 1, 2020, to March 8, 2022, examining acceptance or hesitancy towards the COVID-19 vaccine in Africa. Study characteristics and reasons for COVID-19 vaccine acceptance were extracted from the included articles.
Results A total of 71 articles met the eligibility criteria and were included in the review. Majority (n = 25, 35%) of the studies were conducted in Ethiopia. Studies conducted in Botswana, Cameroun, Cote D’Ivoire, DR Congo, Ghana, Kenya, Morocco, Mozambique, Nigeria, Somalia, South Africa, Sudan, Togo, Uganda, Zambia, Zimbabwe were also included in the review. The vaccine acceptance rate ranged from 6.9 to 97.9%. The major reasons for vaccine hesitancy were concerns with vaccine safety and side effects, lack of trust for pharmaceutical industries and misinformation or conflicting information from the media. Factors associated with positive attitudes towards the vaccine included being male, having a higher level of education, and fear of contracting the virus. Conclusions Our review demonstrated the contextualized and multifaceted reasons inhibiting or encouraging vaccine uptake in African countries. This evidence is key to operationalizing interventions based on facts as opposed to assumptions. Our paper provided important considerations for addressing the challenge of COVID-19 vaccine hesitancy and blunting the impact of the pandemic in Africa. Supplementary Information The online version contains supplementary material available at 10.1186/s41256-022-00255-1.
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Affiliation(s)
- Betty B B Ackah
- School of Communication, Simon Fraser University, Burnaby, BC, Canada
| | - Michael Woo
- School of Population and Public Health, University of British Columbia, 2206 E Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Lisa Stallwood
- School of Population and Public Health, University of British Columbia, 2206 E Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Zahra A Fazal
- School of Population and Public Health, University of British Columbia, 2206 E Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Arnold Okpani
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Ugochinyere Vivian Ukah
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Prince A Adu
- School of Population and Public Health, University of British Columbia, 2206 E Mall, Vancouver, BC, V6T 1Z3, Canada.
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Willingness to Accept the COVID-19 Vaccine and Related Factors among Indian Adults: A Cross-Sectional Study. Vaccines (Basel) 2022; 10:vaccines10071095. [PMID: 35891259 PMCID: PMC9317945 DOI: 10.3390/vaccines10071095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/03/2022] [Accepted: 07/05/2022] [Indexed: 01/22/2023] Open
Abstract
To achieve herd immunity to a disease, a large portion of the population needs to be vaccinated, which is possible only when there is broad acceptance of the vaccine within the community. Thus, policymakers need to understand how the general public will perceive the vaccine. This study focused on the degree of COVID-19 vaccine hesitancy and refusal and explored sociodemographic correlations that influence vaccine hesitancy and refusal. A cross-sectional online survey was conducted among the adult population of India. The survey consisted of basic demographic questions and questions from the Vaccination Attitudes Examination (VAX) Scale. Multinomial logistical regression was used to identify correlates of vaccine hesitancy and refusal. Of the 1582 people in the study, 9% refused to become vaccinated and 30.8% were hesitant. We found that both hesitancy and refusal predictors were nearly identical (lower socioeconomic status, female gender, and older age groups), except for three groups (subjects aged 45−64 years, those with approximate income <10,000 INR/month, and those residing in rural households) that showed slightly higher odds of vaccine hesitancy than refusal. We need to address the underlying sociodemographic determinants and formulate public awareness programs to address specific subgroups that are at higher risk of rejecting the vaccine and convert those who are undecided or hesitant into those willing to accept the vaccine.
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