Background: The coronavirus disease 2019 (COVID-19) pandemic heralded an unprecedented race to the development of several vaccine candidates at record speeds never seen in global health. Within nine months, Pfizer-BioNTech’s COVID-19 vaccine was approved by the United States FDA. Unfortunately, while these advances were ongoing, there was a burgeoning epidemic of disinformation about the virus and the vaccines that affected the willingness of people, especially minority groups, to get vaccinated. In Nigeria, this wave of vaccine hesitancy was happening against the backdrop of landmark pharmaceutical litigations such as the 2007 Pfizer trovafloxacin lawsuit in the country. Aim: To assess the determinants of the COVID-19 vaccine's acceptability among Nigerians. Materials and methods: Following ethical approval, a population-based cross-sectional study was conducted from November 2020 to January 2021 using an adapted pretested, self-administered questionnaire originally designed by Amyn Malik and colleagues who conducted a similar study at Yale University School of Public Health. The participants were recruited through simple random sampling using a list of community and corporate sites obtained from Google Maps in the three regional zones of Nigeria (north, east, and west) in diverse occupational and residential settings. Information obtained includes socio-demographics, medical history related to COVID-19, level of knowledge, risk perception, and attitudes toward COVID-19 and the vaccines. Descriptive and inferential statistics were done, and results were summarized into percentages and associations. The level of statistical significance was set at a p-value of <0.05. Using the open EpiR package (Emory), we determined a minimum of 340 participants for a statistical power of 80%. Results: A total of 358 responses were obtained out of the 120 questionnaires distributed in each of the three regions, of which 189 (53%) were females. The mean age of respondents was 32 years (±11.2 SD). About 75% of the participants had at least a college education. The majority (66.2%) of the participants were willing to accept the approved vaccine. The mean risk perception score for COVID-19 was 5.1 (±2.2 SD) out of 10, while the mean COVID-19 symptom knowledge score was 8.6 (±4.1 SD) out of 19. Variables such as being male, identifying as Christian, Hausa ethnicity, and living in northern Nigeria had a statistically significant relationship with the willingness to get vaccinated. Conclusion: Over 60% of Nigerians are willing to take the COVID-19 vaccines if recommended by health workers. We found male gender, religion, ethnicity, and geographical location to positively influence the willingness of Nigerians to get vaccinated against COVID-19. Health workers should be supported to go beyond the confines of the hospital to educate the general public in schools, marketplaces, churches, and corporate organizations on the efficacy and safety of the approved vaccines.

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Introduction primary health care (PHC) is essential towards achieving universal health coverage. Improving PHC services require understanding context-specific factors influencing utilisation. We assessed the factors influencing utilisation of PHC services in a rural community in Enugu, Nigeria. Methods we conducted a cross-sectional community-based survey between May and June, 2017. Information on socio-demographic characteristics, utilisation of PHC services, community- and PHC facility-related factors associated with utilisation of PHC services was obtained from 335 adult residents aged ≥ 18 years using a pre-tested semi-structured interviewer-administered questionnaire. Data were analysed using descriptive and inferential statistics at 5% level of significance. Results of the 335 respondents, 155 (46.2%) reported utilisation of PHC services the last time they were sick. Of 178 respondents who did not utilise PHC services, 51 (28.7%) reported poor quality health services, 41 (23.0%) unavailability of medical doctors, 31 (17.4%) long patient waiting time and 25 (14.0%) unavailability of drugs as reasons for non-utilisation. Being a female (AOR = 2.3 (95% CI 1.3 - 4.0)), affordability of health services (AOR = 2.4 (95% CI 1.3 - 4.6)), inadequacy of healthcare staff (AOR = 0.3 (95% CI 0.1 - 0.5)), shorter hospital waiting time (AOR = 2.2 (95% CI 1.2 - 4.3)) and satisfaction with PHC services during previous visit (AOR = 2.6 (95% CI 1.1 - 6.3)) influenced utilisation of PHC services. Conclusion PHC services utilisation was low. Improving utilisation would require addressing cost of health services, adequacy of healthcare staff, patient waiting time and ensuring patient satisfaction with PHC services.

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AimTo assess the degree and determinants of COVID-19 Vaccine among NigeriansMaterials and methodsFollowing appropriate ethical protocol, a population-based cross-sectional study conducted from November 2020 to January 2021 using a pretested, self-administered questionnaire from a previous study adapted to suit the Nigeria setting and distributed among Nigerians aged 18 years and above. The country was grouped in to three regions: East, North and West representing the major ethnic groups in Nigeria. Participants were recruited based on six different catchments: residential, marketplace recreational areas, cooperate organizations, schools, and Faith-based organizations. Information obtained include socio-demographics, medical history related pertinent to COVID-19, level of knowledge, risk perception, and attitudes towards of COVID-19 and the vaccine amongst others. Descriptive and inferential statistics were done on the variables and results were summarized into percentages and associations noted.ResultsA total of 358 responses were obtained out of the 120 questionnaires distributed in each of the three regions of which. The mean age of respondents was 32years (± 11.2SD). Igbo and Yoruba were the major ethnic groups comprising 38% and 31% of study participants respectively. Three-quarter had tertiary education, 43% of them were civil servants and professionals, 34% of them were unemployed, and 8.9% of them were roadside traders. Majority (66.2%) were willing to accept the approved vaccine with male gender, identifying as Christian, Hausa ethnicity and living in the northern Nigeria had a significant positive association with COVID-19 vaccine uptake.Conclusiontwo out of three Nigerian adults indicated interest in accepting the corona virus vaccine. This calls with critical stakeholders and leaders at all levels to be involved in public education based on sound evidence and the discouragement of the spread of conspiracy theories to eliminate the negative associated factors will reduce vaccine hesitancy and increase COVID-19 vaccination rates in Nigeria.