COVID-19 vaccination acceptance among community members and health workers in Ebonyi state, Nigeria: study protocol for a concurrent-independent mixed method analyses of intention to receive, timeliness of the intention to receive, uptake and hesitancy to COVID-19 vaccination and the determinants

Abstract

IntroductionThe COVID-19 pandemic has gravely affected the lives and economies of the global population including Nigeria. The attainment of herd immunity through mass COVID-19 vaccination is the foremost control strategy, however, the deployments of COVID-19 vaccinations are facing challenges of non-acceptance. Despite the efforts of the Nigerian government and COVAX facility in making COVID-19 vaccination more available/accessible, the vaccination rate remains unexpectedly very low in Nigeria/Ebonyi state. Therefore, it is important to investigate the acceptability of COVID-19 vaccination to elucidate the explanations for the very low coverage rate. This study aims to evaluate/explore COVID-19 vaccination acceptance and the determinants among community members and health workers in Ebonyi state, Nigeria.Methods and analysesThe study is an analytical cross-sectional survey with a concurrent-independent mixed method design. Quantitative data will be collected from all consenting/assenting community members aged 15 years and above, in 28 randomly selected geographical clusters, through structured interviewer-administered questionnaire household survey using KoBoCollect installed in android devices. Quantitative data will be collected from all consenting health workers, selected via convenience and snowball techniques, through structured self-administered questionnaire survey distributed via WhatsApp and interviewer-administered survey using KoBoCollect installed in android devices. Qualitative data will be collected from purposively selected community members and health workers through focus group discussions. Quantitative analyses will involve descriptive statistics, generalised estimating equations (for community members data) and generalised linear model (for health workers data). Qualitative analyses will employ the thematic approach.Ethics and disseminationEthical approval for this study was obtained from the Ebonyi State Health Research and Ethics Committee (EBSHREC/15/01/2022–02/01/2023) and Research and Ethics Committee of Alex Ekwueme Federal University Teaching Hospital Abakaliki (14/12/2021–17/02/2022), and verbal consent will be obtained from participants. Study findings will be reported at local, national and international levels as appropriate.Trial registration numberISRCTN16735844.

COVID-19 vaccination acceptance (uptake, hesitancy, intention to receive and timeliness of the intention to receive) and the determinants among health workers in Ebonyi state, Nigeria: an analytical cross-sectional study

“…The greater details of the descriptions of the independent factors and their categories, scoring and grading are in the study protocol 5. The independent factors include: COVID-19 experiences and perceptions; COVID-19 vaccination expectations and perceptions; COVID-19 vaccination process experiences and perceptions (availability/access factor); acceptance factor (COVID-19 risk-COVID-19 vaccination benefit perception); acceptance-availability/access factor; knowledge, attitude, and practice about COVID-19; source of information about COVID-19; sociodemographic characteristics and professional/work-related attributes.…”

“…The greater details of the definitions of the study outcome measures are in the study protocol 5. The primary outcomes include: the intention to receive, timeliness of the intention to receive, uptake and hesitancy to COVID-19 vaccination.…”

“…Most of the previous studies were on the intention to receive or accept or hesitancy to hypothetical (non-existent/non-available) COVID-19 vaccines among health workers and were carried out during the research and development stage of the vaccines while some studies were about actual vaccines and carried out during the early stages of the introduction of COVID-19 vaccination 5. In addition, the assessment of hesitancy to COVID-19 vaccination in these studies were based on different concepts which in most instances did not reflect the definition of hesitancy by the Strategic Advisory Group of Experts on Immunisation (SAGE) Working Group on vaccine hesitancy—delay in receiving or refusal of COVID-19 vaccination despite its availability 6.…”

“…The relationships between the independent factors and the outcome measures are hypothesised as depicted in the study’s conceptual framework in figure 1 (the study hypotheses are listed in the published study protocol 5. Strong COVID-19 experience and perception (compared with not strong experience and perception), increase in COVID-19 experiences and perceptions score, and the positive categories of COVID-19 experiences and perceptions (compared with the negative categories) were expected to be associated with decrease in complacency about COVID-19 vaccination which would result in increase in the intention to receive, timeliness of the intention to receive, and uptake and decrease in hesitancy to COVID-19 vaccination (increase in COVID-19 vaccination acceptance).…”

Cognizance and mitigation of falsified immunization documentation: Analyzing the consequences for public health in Nigeria, with a focus on counterfeited COVID‐19 vaccination cards: A case report

“…Vaccine hesitancy even among healthcare workers, contributes to low vaccine acceptance rates 33 . Compromised records make it difficult to identify susceptible individuals and effectively plan immunization campaigns which can result in inefficient vaccine distribution, inadequate coverage, and increased disease transmission 34 . Circulation of fake cards undermines the credibility and effectiveness of COVID‐19 vaccination efforts which is a long‐term precursor to anticipated challenges in any epidemic, or pandemic.…”