Acceptance of COVID-19 vaccines in sub-Saharan Africa: evidence from six national phone surveys

  1. Shelton Kanyanda
  2. Yannick Markhof
  3. Philip Wollburg
  4. Alberto Zezza

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Abstract

To estimate the willingness to accept a COVID-19 vaccine in six sub-Saharan African countries and identify differences in acceptance across countries and population groups.

Design

Cross-country comparable, descriptive study based on a longitudinal survey.

Setting

Six national surveys from countries representing 38% of the sub-Saharan African population (Burkina Faso, Ethiopia, Malawi, Mali, Nigeria and Uganda).

Participants

Respondents of national high-frequency phone surveys, aged 15 years and older, drawn from a nationally representative sample of households.

Main outcome measures

Willingness to get vaccinated against COVID-19 if an approved vaccine is provided now and for free, disaggregated by demographic attributes and socioeconomic factors obtained from national household surveys. Correlates of and reasons for vaccine hesitancy.

Results

Acceptance rates in the six sub-Saharan African countries studied are generally high, with at least four in five people willing to be vaccinated in all but one country. Vaccine acceptance ranges from nearly universal in Ethiopia (97.9%, 95% CI 97.2% to 98.6%) to below what would likely be required for herd immunity in Mali (64.5%, 95% CI 61.3% to 67.8%). We find little evidence for systematic differences in vaccine hesitancy by sex or age but some clusters of hesitancy in urban areas, among the better educated, and in richer households. Safety concerns about the vaccine in general and its side effects specifically emerge as the primary reservations toward a COVID-19 vaccine across countries.

Conclusions

Our findings suggest that inadequate demand is unlikely to represent the key bottleneck to reaching high COVID-19 vaccine coverage in sub-Saharan Africa. To turn intent into effective demand, targeted information, sensitisation and engagement campaigns bolstering confidence in the safety of approved vaccines and reducing concerns about side effects will be crucial to safeguard the swift progression of vaccine rollout in one of the world’s poorest regions.

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  1. Version published to 10.1136/bmjopen-2021-055159
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    SciScore for 10.1101/2021.06.28.21259320: (What is this?)

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

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    No key resources detected.

    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.

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    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.

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  3. Version published to 10.1101/2021.06.28.21259320v1 on medRxiv