TY - JOUR
T1 - The evolution of COVID-19 vaccine hesitancy in Sub-Saharan Africa
T2 - evidence from panel survey data
AU - Wollburg, Philip
AU - Markhof, Yannick
AU - Kanyanda, Shelton
AU - Zezza, Alberto
N1 - Funding Information:
The authors are grateful for support in collecting the data by the country teams: Marco Tiberti for Burkina Faso; Wilbert Drazi Vundru for Malawi; Asmelash Haile Tsegay and Manex Bule Yonis for Ethiopia; Akiko Sagesaka, Amparo Palacios-Lopez, Ivette Contreras Gonzalez, and Gbemisola Oseni for Nigeria; and Giulia Ponzini and Frederic Cochinard for Uganda. We are also grateful for support by Alemayehu Ambel, Talip Kilic, and Gero Carletto. This article has been published as part of BMC Proceedings, Volume 17 Supplement 7, 2023: VARN2022: Shaping Global Vaccine Acceptance with Localized Knowledge. The full contents of the supplement are available at https://bmcproc.biomedcentral.com/articles/supplements/volume-17-supplement-7.
Funding Information:
This paper received funding support from the World Bank Research Support Budget grant “Understanding and estimating COVID-19 vaccination attitudes, uptake, and barriers in Sub-Saharan Africa” and the Global Financing Facility. The funders had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
PY - 2023/6/1
Y1 - 2023/6/1
N2 - Background: COVID-19 vaccination efforts are lagging in Sub-Saharan Africa, as just over 20 percent of the population has been fully vaccinated. COVID-19 vaccine hesitancy is considered important as a prerequisite for widespread vaccine take-up. Here, we study the dynamics of vaccine acceptance, its correlates, and reasons for hesitancy over time, drawing on two years of panel survey data. Methods: In this observational study, we use multiple rounds of data from national High Frequency Phone Surveys (HFPS) in five countries in East and West Africa (Burkina Faso, Ethiopia, Malawi, Nigeria, and Uganda), covering a period between 2020 and 2022. The surveys are cross-country comparable and draw their samples from nationally representative sampling frames. Based on this data source, the study presents population-weighted means and performs multivariate regression analysis. Results: COVID-19 vaccine acceptance was high throughout the study period (68% to 98%). However, acceptance levels were lower in 2022 than in 2020 in three countries (Burkina Faso, Malawi, Nigeria), and higher in one country (Uganda). Moreover, individuals are observed to change their stated vaccine attitudes between survey rounds, to a limited extent in some countries (Ethiopia) and more frequently in others (Burkina Faso, Malawi, Nigeria, Uganda). Vaccine hesitancy is higher in richer households, and those residing in urban areas; among women and those better educated. Hesitancy is lower in larger households and among heads of the household. The main reasons for hesitancy are concerns about side effects of the vaccine, its safety and efficacy, as well as assessments of COVID-19 risk, though these reasons fluctuate over time. Conclusions: Reported COVID-19 vaccine acceptance levels remain far above vaccination rates in the study countries, suggesting that vaccine hesitancy is not the primary obstacle to reaching greater vaccine coverage, which may instead be related to access and delivery barriers as well as supply shortages. Nevertheless, vaccine attitudes appear malleable so that continued efforts are needed to retain high levels of vaccine acceptance.
AB - Background: COVID-19 vaccination efforts are lagging in Sub-Saharan Africa, as just over 20 percent of the population has been fully vaccinated. COVID-19 vaccine hesitancy is considered important as a prerequisite for widespread vaccine take-up. Here, we study the dynamics of vaccine acceptance, its correlates, and reasons for hesitancy over time, drawing on two years of panel survey data. Methods: In this observational study, we use multiple rounds of data from national High Frequency Phone Surveys (HFPS) in five countries in East and West Africa (Burkina Faso, Ethiopia, Malawi, Nigeria, and Uganda), covering a period between 2020 and 2022. The surveys are cross-country comparable and draw their samples from nationally representative sampling frames. Based on this data source, the study presents population-weighted means and performs multivariate regression analysis. Results: COVID-19 vaccine acceptance was high throughout the study period (68% to 98%). However, acceptance levels were lower in 2022 than in 2020 in three countries (Burkina Faso, Malawi, Nigeria), and higher in one country (Uganda). Moreover, individuals are observed to change their stated vaccine attitudes between survey rounds, to a limited extent in some countries (Ethiopia) and more frequently in others (Burkina Faso, Malawi, Nigeria, Uganda). Vaccine hesitancy is higher in richer households, and those residing in urban areas; among women and those better educated. Hesitancy is lower in larger households and among heads of the household. The main reasons for hesitancy are concerns about side effects of the vaccine, its safety and efficacy, as well as assessments of COVID-19 risk, though these reasons fluctuate over time. Conclusions: Reported COVID-19 vaccine acceptance levels remain far above vaccination rates in the study countries, suggesting that vaccine hesitancy is not the primary obstacle to reaching greater vaccine coverage, which may instead be related to access and delivery barriers as well as supply shortages. Nevertheless, vaccine attitudes appear malleable so that continued efforts are needed to retain high levels of vaccine acceptance.
KW - Africa
KW - COVID-19
KW - Vaccination
KW - Vaccine hesitancy
U2 - 10.1186/s12919-023-00266-x
DO - 10.1186/s12919-023-00266-x
M3 - Article
C2 - 37415169
SN - 1753-6561
VL - 17
JO - BMC Proceedings
JF - BMC Proceedings
M1 - 8
ER -