Predictors of COVID-19 Vaccine Hesitancy in South African Local Communities: The VaxScenes Study

  1. Patrick D. M. C. Katoto
  2. Saahier Parker
  3. Nancy Coulson
  4. Nirvana Pillay
  5. Sara Cooper
  6. Anelisa Jaca
  7. Edison Mavundza
  8. Gregory Houston
  9. Candice Groenewald
  10. Zaynab Essack
  11. Jane Simmonds
  12. Londiwe Deborah Shandu
  13. Marilyn Couch
  14. Nonkululeko Khuzwayo
  15. Nobukhosi Ncube
  16. Phelele Bhengu
  17. Heidi van Rooyen
  18. Charles Shey Wiysonge

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Abstract

South Africa launched a mass COVID-19 vaccination campaign in May 2021, targeting 40 million adults. Understanding predictors of COVID-19 vaccine intentions was required to achieve this goal. We conducted a population-based survey in June–July 2021 using the WHO Behavioral and Social Drivers (BeSD) of COVID-19 Vaccination tool to determine predictors of vaccine hesitancy, defined as intention to refuse or uncertainty whether to accept COVID-19 vaccination. There were 1193 participants, mean age 39 (standard deviation 15) years, and 53% women, of whom 58% trusted information provided by healthcare workers and 32% were vaccine hesitant. Independent predictors of vaccine hesitancy included concerns about side effects (odds ratio (OR) 11.41; 95% confidence interval (CI) 3.5–50.80), lack of access to the online vaccine registration platform (OR 4.75; CI 2.15–10.37), distrust of government (OR 3.0; CI 1.33–6.77), belief in conspiracy theories (OR 3.01; CI 1.32–6.77), having no monthly income (OR 1.84; CI 1.12–3.07), and depending on someone else to make vaccination decision (OR 2.47; CI 1.06–5.77). We identified modifiable predictors of vaccine hesitancy at the start of South Africa’s COVID-19 vaccination rollout. These factors should be addressed by different stakeholders involved in the national immunization program through tailored communication and other effective strategies that increase vaccine literacy, reach low-income households, and engender confidence in government.

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  1. ScreenIT

    SciScore for 10.1101/2022.02.21.22271272: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsField Sample Permit: Each component of data collection will be complemented by a process of engagement with stakeholders at the community level, described as action research [30].
    IRB: A P-value less than 0.05 will be used to indicate statistically significant results. 2.8. Ethics: This study proposal was approved by the Human Research Ethics Committees of the University of the Witwatersrand in Johannesburg, South Africa (reference: H21/02/05) on 25 March 2021; the Human Sciences Research Council of South Africa (reference: REC 12/04/21) on 20 April 2021; and the South African Medical Research Council (reference: EC022-5/2021) on 27 May 2021.
    Consent: A consent form for participation and for audio-recording will be provided.
    Sex as a biological variableIt is expected that it may include priority groups at risk of COVID-19 (the elderly), essential service workers identified in each study site (for example, teachers, taxi drivers, and people working in institutional care facilities) and other adult men and women in the selected communities.
    Randomizationnot detected.
    Blindingnot detected.
    Power AnalysisA sample comprising at least 300 participants per site allows for the detection of small correlations (r=0.2) with at least 95% power [34]. 2.6.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Quantitative data analyses: Quantitative data will be cleaned and stored in the Statistical Package for Social Sciences software, version 27.0 (IBM SPSS Inc, Chicago, IL).
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.3390/vaccines10030353
  3. Version published to 10.1101/2022.02.21.22271272v1 on medRxiv