Acceptance of COVID-19 Vaccines among Adults in Lilongwe, Malawi: A Cross-Sectional Study Based on the Health Belief Model

Abstract

The COVID-19 pandemic has had a significant economic and social impact on Malawi. Promoting vaccination is a key protection measure against COVID-19. Employing the health beliefs model (HBM), this study explores various factors that influence COVID-19 vaccination acceptance (intentions and behavior) among adult residents of Malawi. A semi-structured questionnaire was used for data collection. A field-based survey was conducted among adult residents in Lilongwe, Malawi. Descriptive statistics, linear regression, the Chi-square test, and Pearson’s correlation statistics were used for data analysis. A total of 758 questionnaires were involved. Respondents aged 18–24 (OR = 5.079, 95% CI 2.303–11.202), 25–34 (OR = 2.723, 95% CI 1.363–5.438), urban residents (OR = 1.915, 95% CI 1.151–3.187), graduates/professionals (OR = 1.193, 95% CI 0.857–1.651), health workers (OR = 4.080, 95% CI 1.387–12.000), perceived susceptibility (OR = 1.787, 95% CI 1.226–2.605), perceived benefit (OR = 2.992, 95% CI 1.851–4.834), and action cues (OR = 2.001, 95% CI 1.285–3.115) were predictors for “acceptance of COVID-19 vaccine”. The health belief model structure can be used as a good predictor of vaccine acceptance, especially “perceived susceptibility,” “perceived benefit,” and “action cues”. Strengthening COVID-19 vaccine education in these areas will be an important future intervention.

COVID-19 vaccination uptake among healthcare workers in Ghana: A comprehensive analysis of knowledge, attitude, perceived vaccine effectiveness, and health belief model constructs

“…In China, HCWs with high cues to action were 23 times (AOR = 23.66, 95% CI: 9.97–56.23) more likely to accept the COVID-19 vaccine compared to those with low cues to action [ 86 ]. Similar conforming results were reported by other researchers in China [ 79 ] and Malawi [ 80 ]. Cues to action work as “triggers” that prompt individuals to change their behavior [ 83 ].…”

“…Those who perceived themselves to be at high risk of getting infected with COVID-19, those who perceived the COVID-19 vaccination to be beneficial, and those with high cues to action were significantly more likely to have received the COVID-19 vaccine in the univariable analysis. Similar findings were reported among HCWs in China [ 79 ] and Ethiopia [ 44 ] and among the general population in Malawi [ 80 ], Israel [ 46 ] and Bangladesh [ 50 ]. These findings provide an evidence-based formulation of vaccination strategies.…”

COVID-19 vaccination uptake among healthcare workers in Ghana: A comprehensive analysis of knowledge, attitude, perceived vaccine effectiveness, and health belief model constructs

“…Those who perceived themselves to be at high risk of getting infected with COVID-19, those who perceived the COVID-19 vaccination to be beneficial, and those with high cues to action were significantly more likely to have received the COVID-19 vaccine in the univariable analysis. Similar findings were reported among HCWs in China [80] and Ethiopia [46] and among the general population in Malawi [81], Israel [82] and Bangladesh [79]. These findings provide an evidence-based formulation of vaccination strategies.…”

“…In China, a study found that HCWs with high cues to action were 23 times (AOR = 23.66, 95% CI: 9.97–56.23) more likely to accept the COVID-19 vaccine compared to those with low cues to action [83]. Similar conforming results were reported by other researchers in China [80] and Malawi [84]. Cues to action work as “triggers” that prompt individuals to change their behavior [85].…”

COVID-19 vaccination hesitancy among Malawians: a scoping review

“…Ao et al [ 21 ] investigated vaccination rates for COVID-19 among Malawians. They also assessed the level of COVID-19 vaccine hesitancy among Malawians and explored the factors influencing vaccination and willingness to get vaccinated against COVID-19.…”