Assessment of COVID-19 Vaccine Acceptance and Its Associated Factors during the Crisis: A Community-Based Cross-Sectional Study in Benin

Acceptance of COVID-19 vaccine and its related determinants in Nigeria: An online survey

BACKGROUND

Vaccine hesitancy is a major challenge in the fight against the coronavirus disease 2019 (COVID-19) pandemic. Identifying the sociodemographic factors associated with vaccine acceptance among Nigerians is crucial for improving vaccine uptake.

AIM

To assess the acceptance rate of COVID-19 vaccine and its related determinants among Nigerians.

METHODS

An online cross-sectional survey (observational study) was conducted between February 2021 and May 2021, using a questionnaire hosted on SurveyMonkey. The invitation to take part in the poll was sent out to participants through social networking platforms. A logistic regression was used to determine which sociodemographic factors were associated with vaccine acceptance constructs.

RESULTS

A total of 1800 persons responded to the survey, a larger proportion of whom were males (53.9%) and within the age group of 21-30 years (29.4%) and earned an average income of less than $500 per month (43.3%). Only 0.56% of participants had a high perceived risk of COVID-19 infection, while only 1.11% had a perceived risk of dying from COVID-19. The perception rate of the COVID-19 vaccine among participants was 51.1%, while the acceptance rate was 63.9%. There was no significant association between the COVID-19 vaccine acceptance rate and related determinants assessed, particularly age (χ² = 3.049, P = 0.550), sex (χ² = 0.102, P = 0.749), average income (χ² = 3.802, P = 0.875), and religion (χ² = 2.819, P = 0.420). Participants with chronic conditions demonstrated a higher acceptance rate compared to the general population.

CONCLUSION

Despite the positive perception observed and substantial vaccine acceptance rate among the study participants, more public health interventions are still needed to enhance vaccine acceptability in Nigeria.

Quantitative Synthesis of Factors Associated with COVID-19 Vaccine Acceptance and Vaccine Hesitancy in 185 Countries

Mass vaccination against COVID-19 is the best method to ensure herd immunity in order to curb the effect of the pandemic on the global economy. It is therefore important to assess the determinants of COVID-19 vaccine acceptance and hesitancy on a global scale. Factors were recorded from cross-sectional studies analyzed with t-Test, ANOVA, correlation, and meta-regression analyses and synthesized to identify global trends in order to inform policy. We registered the protocol (ID: CRD42022350418) and used standard Cochrane methods and PRISMA guidelines to collect and synthesize cross-sectional articles published between January 2020 and August 2023. A total of 67 articles with 576 studies from 185 countries involving 3081,766 participants were included in this synthesis. Global COVID-19 vaccine acceptance was 65.27% (95% CI; 62.72-67.84%), while global vaccine hesitancy stood at 32.1% (95% CI; 29.05-35.17%). One-Way ANOVA showed that there was no significant difference in the percentage Gross Domestic Product spent on vaccine procurement across the World Bank income levels (p < 0.187). There was a significant difference of vaccine acceptance (p < 0.001) and vaccine hesitancy (p < 0.005) across the different World Bank Income levels. World Bank income level had a strong influence on COVID-19 vaccine acceptance (p < 0.0004) and hesitancy (p < 0.003) but percentage Gross Domestic Product spent on vaccine procurement did not. There was no correlation between percentage Gross Domestic Product spent on vaccine procurement and COVID-19 vaccine acceptance (r = -0.11, p < 0.164) or vaccine hesitancy (r = -0.09, p < 0.234). Meta-regression analysis showed that living in an urban setting (OR = 4.83, 95% CI; 0.67-212.8), rural setting (OR = 2.53, 95% CI; 0.29-119.33), older (OR = 1.98, 95% CI; 0.99-4.07), higher education (OR = 1.76, 95% CI; 0.85-3.81), and being a low income earner (OR = 2.85, 95% CI; 0.45-30.63) increased the odds of high COVID-19 vaccine acceptance. Factors that increased the odds of high COVID-19 vaccine hesitancy were no influenza vaccine (OR = 33.06, 95% CI; 5.03-1395.01), mistrust for vaccines (OR = 3.91, 95% CI; 1.92-8.24), complacency (OR = 2.86, 95% CI; 1.02-8.83), pregnancy (OR = 2.3, 95% CI; 0.12-141.76), taking traditional herbs (OR = 2.15, 95% CI; 0.52-10.42), being female (OR = 1.53, 95% CI; 0.78-3.01), and safety concerns (OR = 1.29, 95% CI; 0.67-2.51). We proposed a number of recommendations to increase vaccine acceptance and ensure global herd immunity against COVID-19.