Assessing COVID-19 vaccine hesitancy and barriers to uptake in Sub-Saharan Africa

BackgroundDespite improved availability of COVID-19 vaccines in Sub-Saharan Africa, vaccination campaigns in the region have struggled to pick up pace and trail the rest of the world. Yet, a successful vaccination campaign in Sub-Saharan Africa will be critical to containing COVID-19 globally.MethodsHere, we present new descriptive evidence on vaccine hesitancy, uptake, last-mile delivery barriers, and potential strategies to reach those who remain unvaccinated. Our data comes from national high frequency phone surveys in six countries in East and West Africa with a total population of 415 million people. Samples were drawn from nationally representative samples of households interviewed in recent in-person surveys. Our estimates are based on a survey module harmonized across countries and are re-weighted to mitigate potential sample selection biases.ResultsWe show that vaccine acceptance remains generally high among respondents in Sub-Saharan Africa (between 95.1% and 63.3%) even though hesitancy is non-negligible among those pending vaccination. Many who are willing to get vaccinated are deterred by a lack of easy access to vaccines at the local level. Furthermore, social ties and perceptions as well as intra-household power relations matter for vaccine take-up. Among the unvaccinated population, radio broadcasts have widespread reach and medical professionals are highly trusted.ConclusionsOur findings highlight that creating a positive social norm around COVID-19 vaccination, messaging that leverages trusted and accessible information sources and channels, and more easily accessible vaccination sites at the community level are promising policy options to boost vaccination campaigns in the region and end the pandemic everywhere.Wollburg et al. use high frequency phone surveys in six African countries to investigate COVID-19 vaccine hesitancy, uptake, and barriers to delivery. Vaccine acceptance is high but variable across countries, with poor access to vaccines at a local level contributing to the rates of unvaccinated individuals.COVID-19 vaccine coverage in Sub-Saharan Africa is behind the rest of the world. As the region is home to nearly 1.2 billion people (15% of the world population), achieving high levels of COVID-19 vaccination in Sub-Saharan Africa is important to containing the pandemic globally. We conduct national phone surveys in six countries in East and West Africa to learn how to best promote COVID-19 vaccine uptake in the region. Our surveys focus on peoples' willingness to get vaccinated, barriers that prevent them from accessing COVID-19 vaccines, and strategies to reach out to those who have not been vaccinated yet. We find that vaccine acceptance is high but that poor access to vaccines at a local level prevents many from getting vaccinated. Our findings can help policymakers design more effective vaccination campaigns.