Background The public health response to the global COVID-19 pandemic has varied widely by region. In Africa, uptake of effective COVID-19 vaccines has been limited by accessibility and vaccine hesitancy. The aim of this study was to compare perceptions of COVID-19 infection and vaccination between pregnant women and non-pregnant adults in four regions of Cameroon, located in Central Africa. Methods A cross-sectional survey study was conducted at urban and suburban hospital facilities in Cameroon. Participants were randomly selected from a convenience sample of adult pregnant and non-pregnant adults in outpatient clinical settings between June 1st and July 14th, 2021. A confidential survey was administered in person by trained research nurses after obtaining written informed consent. Participants were asked about self-reported sociodemographics, medical comorbidities, perceptions of COVID-19 infection, and vaccination. Descriptive statistics were used for survey responses and univariate and multivariable logistic regression models were created to explore factors associated with COVID-19 vaccine acceptability. Results Fewer than one-third of participants were interested in receiving the COVID-19 vaccine (31%, 257/835) and rates did not differ by pregnancy status. Overall, 43% of participants doubted vaccine efficacy, and 85% stated that the vaccine available in Africa was less effective than vaccine available in Europe. Factors independently associated with vaccine acceptability included having children (aOR = 1.5; p = 0.04) and higher education (aOR = 1.6 for secondary school vs primary/none; p = 0.03). Perceived risks of vaccination ranged from death (33%) to fetal harm (31%) to genetic changes (1%). Health care professionals were cited as the most trusted source for health information (82%, n = 681). Conclusion COVID-19 vaccine hesitancy and misinformation in Cameroon was highly prevalent among pregnant and non-pregnant adults in 2021 while vaccine was available but not recommended for use in pregnancy. Based on study findings, consistent public health messaging from medical professionals about vaccine safety and efficacy and local production of vaccine are likely to improve acceptability.

Background In Africa, uptake of effective COVID-19 vaccines has been limited by accessibility and vaccine hesitancy (VH). VH is multifactorial but influences include disinformation through social media with Whats App being the most popular form in Cameroon. The aim of this study was to test our hypothesis that frequent users of social media would have higher vaccine hesitancy due to exposure to disinformation in Cameroon in Central Africa. Methods A survey study was conducted at urban and suburban hospital facilities in four of the ten regions of Cameroon. Participants were asked to self-report socio-demographics, perceptions of COVID-19 infection, and interest in vaccination. They were also asked to rank their top two sources of health care information, including social media. Bivariate analysis was used to explore the perceptions of infection and vaccination stratified by social media preference with statistical significance set at p< 0.05. Results We found that 18% (151/835) of participants cited social media (SM) as a top source of health care information. Health care professionals were cited by 82% as the most trusted source for health information (n=681). Fewer than one-third of survey participants were interested in receiving the COVID-19 vaccine (31%, 257/835) and rates did not differ by SM preferences. More people in the social media group, 53% vs 38% (p=0.046) stated that more information about vaccine safety may help reduce hesitancy. Perceived risks of COVID-19 vaccination ranged from death (33%) to fetal harm (31%) to supernatural reactions (1.4%). The SM group was not more likely to site perceived risks of the vaccine (p=0.244). Participant Characteristics. Conclusion Although vaccine hesitancy in Cameroon was high at the time of the survey, adults who prefer to get health information from social media were not more likely to express vaccine hesitancy. Public education campaigns led by healthcare professionals may have the greatest impact on vaccine acceptability based on trusted information sources cited by participants. Disclosures All Authors: No reported disclosures.