Background
Despite evidence demonstrating the effectiveness of the COVID-19 vaccine, vaccine hesitancy has emerged as a major challenge for vaccine uptake. The objective of this study was to classify latent typologies of vaccine hesitant adults in Ethiopia and identify predictors of the latent classes.
Methods
We employed a cross-sectional household survey among 1,112 individuals aged 18 and above who were partially vaccinated (one dose) or not vaccinated at the time of the survey. Data was collected in August 2022. We collected information on participant socio-demographics, COVID-19 knowledge, prevention practices, disease history, and vaccine hesitancy. Latent class analysis was used to classify individuals into categories of vaccine hesitancy. We conducted multinomial logistic regression to test the associations between latent typologies and different demographic and COVID-19 related characteristics of study participants.
Results
Using latent class analysis we found a four-class solution for vaccine hesitancy typologies. The identified classes were
strong vaccine acceptors
(30%);
vaccine acceptors with some concerns
(7%);
vaccine sceptics
(13%); and
vaccine rejectors
(50%). In adjusted models with
vaccine sceptics
as the referent group, those with high COVID-19 vaccine knowledge were significantly more likely to belong to the
strong vaccine acceptors
class compared to those with low vaccine knowledge (adj. RRR: 17.36, 95% CI: 10.94–27.55). Better COVID-19 prevention practices were also significantly associated with belonging to the
vaccine acceptors with some concerns
class than the
vaccine sceptics
class (adj. RRR: 2.13, 95% CI: 1.09–4.16). Those who had one dose of the COVID-19 vaccine were significantly more likely to belong in the
vaccine acceptors
class than the
vaccine sceptics
class compared to those who had no dose (adj. RRR: 6.82, 95% CI: 3.06–15.21).
Conclusions
Half of the study participants were in the vaccine rejectors class. Individuals in the vaccine sceptics and rejector classes evidenced lower vaccine knowledge and worse COVD-19 prevention practices and were less likely to have been partially vaccinated. Future program interventions should focus on improving knowledge around the vaccine, decrease rumors and misconceptions, and target individuals who may be more amenable to changing their vaccination attitudes or behaviors like vaccine sceptics or acceptors with some concerns.