COVID-19 Vaccine Hesitancy: The Experience of Congo, Democratic Republic of the Congo, and Guinea-Bissau

This article investigates the underlying causes of COVID-19 vaccine hesitancy in three sub-Saharan African countries: the Republic of Congo, the Democratic Republic of the Congo (DRC), and Guinea-Bissau. Employing a qualitative ethnographic design, the study engaged 752 participants, including healthcare professionals, community mem-bers, traditional practitioners, and various local leaders, through semi-structured inter-views and focus group discussions. Findings indicate that vaccine hesitancy is fluid and contextual with three principal drivers: (1) denial of COVID-19’s existence, often rein-forced by skepticism among healthcare workers and the belief that the disease is foreign or a governmental scheme for financial gain; (2) misinformation, including rumors about vaccine incompatibility with certain foods, and fears of sterility and witchcraft; and (3) a firm reliance on traditional medicine, seen as effective alternative to biomedical inter-ventions. The study highlights the significant role of inconsistent public health messaging and conspiracy theories in fueling resistance to vaccination. It reflects the necessity of a multisectoral approach that integrates government, health authorities, anthropologists, and other social scientists, as well as community leaders, to foster trust and improve vaccine acceptance. Enhanced education, transparent risk communication, and culturally sensitive community engagement and dialogue are recommended as critical strategies to counter misinformation and build public confidence. While the study’s multidisciplinary and multi-country scope strengthens its conclusions, it only included three countries and provided limited socio-demographic data about the participants. Ultimately, overcoming vaccine hesitancy in these settings requires addressing both historical and contemporary distrust, as well as integrating traditional health systems into public health strategies