SEARCHCROSS-SECTIONALpublic health, epidemiology

cross-sectional·public health, epidemiology, pediatrics, pediatric ophthalmology, observational study·PMC10022111

COVID-19 vaccine hesitancy and its determinants among sub-Saharan African adolescents

PLOS Global Public Health · 29 authors, 20 centres

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TL;DR

Perceived lack of safety and effectiveness were the strongest determinants of hesitancy.

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The study measured the prevalence of COVID-19 vaccine hesitancy (defined as definitely not getting vaccinated or being undecided) and its sociodemographic determinants. The prevalence of hesitancy varied widely, from 14% in rural Kersa, Ethiopia, to 88% in rural Dodoma, Tanzania. Log-binomial models identified perceived lack of safety (adjusted prevalence ratio: 3.52; 95% CI: 3.00, 4.13) and lack of effectiveness (adjusted prevalence ratio: 3.46; 95% CI: 2.97, 4.03) as factors strongly associated with greater hesitancy. Adolescent girls also showed higher hesitancy than boys. Limitations include non-probabilistic sampling based on existing infrastructure and potential underrepresentation of households without mobile phones. The findings indicate that vaccination campaigns must address safety and effectiveness misconceptions among adolescents in this region.

STUDY TYPE

cross-sectional

SPECIALTY

public health

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ORIGINAL PAPER

PMC10022111

COVID-19 vaccine hesitancy and its determinants among sub-Saharan African adolescents

PLOS Global Public Health

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ABSTRACT

Abstract COVID-19 vaccine hesitancy among adolescents poses a challenge to the global effort to control the pandemic. This multi-country survey aimed to assess the prevalence and determinants of COVID-19 vaccine hesitancy among adolescents in sub-Saharan Africa between July and December 2021. The survey was conducted using computer-assisted telephone interviewing among adolescents in five sub-Saharan African countries, Burkina Faso, Ethiopia, Ghana, Nigeria, and Tanzania. A rural area and an urban area were included in each country (except Ghana, which only had a rural area), with approximately 300 adolescents in each area and 2662 in total. Sociodemographic characteristics and perceptions and attitudes on COVID-19 vaccines were measured. Vaccine hesitancy was defined as definitely not getting vaccinated or being undecided on whether to get vaccinated if a COVID-19 vaccine were available. Log-binomial models were used to calculate the adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) for associations between potential determinants and COVID-19 vaccine hesitancy. The percentage of COVID-19 vaccine hesitancy was 14% in rural Kersa, 23% in rural Ibadan, 31% in rural Nouna, 32% in urban Ouagadougou, 37% in urban Addis Ababa, 48% in rural Kintampo, 65% in urban Lagos, 76% in urban Dar es Salaam, and 88% in rural Dodoma. Perceived low necessity, concerns about vaccine safety, and concerns about vaccine effectiveness were the leading reasons for hesitancy. Healthcare workers, parents or family members, and schoolteachers had the greatest impacts on vaccine willingness. Perceived lack of safety (aPR: 3.52; 95% CI: 3.00, 4.13) and lack of effectiveness (aPR: 3.46; 95% CI: 2.97, 4.03) were associated with greater vaccine hesitancy. The prevalence of COVID-19 vaccine hesitancy among adolescents is alarmingly high across the five sub-Saharan African countries, especially in Tanzania. COVID-19 vaccination campaigns among sub-Saharan African adolescents should address their concerns and misconceptions about vaccine safety and effectiveness.

CITATION EXPORT

Dongqing Wang, Angela Chukwu, Mary Mwanyika-Sando et al.. COVID-19 vaccine hesitancy and its determinants among sub-Saharan African adolescents. PLOS Global Public Health. (2022). https://doi.org/10.1371/journal.pgph.0000611

AUTHORS

29 · 20 CENTRES

Dongqing Wang, Angela Chukwu, Mary Mwanyika-Sando, Sulemana Watara Abubakari, Nega Assefa, Isabel Madzorera, Elena C Hemler, Abbas Ismail, Bruno Lankoande, Frank Mapendo, Ourohiré Millogo, Firehiwot Workneh, Temesgen Azemraw, Lawrence Gyabaa Febir, Christabel James, Amani Tinkasimile, Kwaku Poku Asante, Till Baernighausen, Yemane Berhane, Japhet Killewo, Ayoade M J Oduola, Ali Sie, Emily R Smith, Abdramane Bassiahi Soura, Tajudeen Raji, Said Vuai, Wafaie W Fawzi, Nnodimele Onuigbo Atulomah, Nnodimele Onuigbo Atulomah

1Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, Virginia, United States of America
2Department of Statistics, University of Ibadan, Ibadan, Nigeria
3Africa Academy for Public Health, Dar es Salaam, Tanzania
4Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana
5College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
6Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America
7College of Natural and Mathematical Sciences, University of Dodoma, Dodoma, Tanzania
8Institut Supérieur des Sciences de la Population, University of Ouagadougou, Ouagadougou, Burkina Faso
9Nouna Health Research Center, Nouna, Burkina Faso
10Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
11University of Ibadan Research Foundation, University of Ibadan, Ibadan, Nigeria
12Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
13Africa Health Research Institute, KwaZulu-Natal, South Africa
14Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
15Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States of America
16Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, DC, United States of America
17Division of Public Health Institutes and Research, Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
18Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America
19Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America
20Babcock University, NIGERIA