COVID-19 Vaccine hesitancy in Addis Ababa, Ethiopia: A mixed-methods study

Abstract

BackgroundCOVID-19 infection is a global pandemic threatening the public health. Due to the development and initiation of vaccination, currently significant difference upon vaccine acceptance is seen between developed and developing countries. However, there are no data on the level of COVID-19 vaccine hesitancy and its associated factors in Addis Ababa, Ethiopia.MethodsAn embedded mixed method study [QUAN(quali)] was conducted among residents of Akaki Kality sub-city in Addis Ababa, Ethiopia. For the quantitative part, a multi-stage sampling technique was used to recruit the study participants (n = 422). Twenty four adults were included purposively for the qualitative in-depth interview. Data was collected by face-to-face interview by using a semi-structured questionnaire. Factors associated with COVID-19 vaccine hesitancy were identified by multivariable binary logistic regression model.ResultThe mean age of the participants was 34.1 years (±12.9). Nearly half (46.7%) of the participants exhibited poor level of knowledge and 51.8% had negative attitude towards COVID-19 and its preventive measures. One out five (19.1%) participants were not willing to get vaccinated when it becomes available. In the multivariable analysis, vaccine hesitancy was significantly associated with being female (aOR=1.97; 95% CI: 1.10 - 3.89, p=0.03), negative attitude towards COVID-19 and its preventive measures (aOR=1.75; 95% CI: 1.08 - 3.02, p=0.04), and information source being social media (internet) (aOR=3.59; 95% CI: 1.75 - 7.37, P <0.0001).ConclusionA considerable proportion of the people in Addis Ababa have concerns on COVID-19 vaccine and unwilling to accept once it is available. Several conspiracy theories were put forth to justify their stance and this was mainly due to the misconceptions distributed from the use of social media as source of information. Overall, providing the community with health education and consistent government efforts in uphold the prevention measures are of paramount importance to tackle this pandemic.

COVID-19 Vaccine Acceptance and Its Associated Factors Among Pregnant Women Attending Antenatal Care Clinic in Southwest Ethiopia: Institutional-Based Cross-Sectional Study

“…The result was higher than studies conducted in Saudi Arabia (64.7%), 21 United States (67%), 26 Middle Eastern Population (36.8%), 27 and Poland (31.3%). 28 However, it was lower than studies conducted in Addis Ababa (80.9%), 20 in China (91.3%), 22 in Indonesia, Southeast Asia (93.3%), 29 and South Africa (81.6%), 17 would accept vaccine when it becomes available among the general population. The possible explanation for the difference might be due to the difference in access to health care service, awareness on the severity of COVID-19, and study population difference.…”

“…36 The finding was comparable with recent studies conducted in Addis Ababa among adult population and South Africa among pregnant mothers. 20 , 32 Similarly, those mothers who had good practice of COVID-19 and its preventive measures were 9 times more likely to accept COVID-19 vaccine compared to those who had poor practice regarding COVID-19 and its prevention measures. This could be due to pregnant mothers who had good practice knowing the impact of COVID-19 viruses on the health of the population.…”

The Willingness to Receive COVID-19 Vaccine and Its Associated Factors: “Vaccination Refusal Could Prolong the War of This Pandemic” – A Systematic Review

“… 26 Al-Qerem and Jarab 64 2021 1144 Adults (≥18 years) CS Jordan 36.8% NA 27 Askarian et al 65 2020 4933 Adults CS Iran 64.2% Having a greater exposure to social norms supportive of COVID-19 vaccination, higher perceived benefits of COVID-19 vaccination, having a greater COVID-19 vaccine safety concerns, age, gender (female), and working in the healthcare field 28 Barello et al 66 2020 735 University students CS Italy 86.1% NA 29 Barry et al 52 2020 1512 HCWs CS Saudi Arabia 70% Gender (male), believing in vaccine safety, believing vaccines can stop the pandemic, and relying on Centers for Disease Control and Prevention website for COVID 19 updates. 30 Dereje et al 67 2021 409 Adult (≥18 years) CS Ethiopia 80.9% NA 31 Detoc et al 68 2020 3259 Adult general population and patients CS France 77.6% Age (older), gender (male), fear...…”

“…They were two studies from the United States, 33 , 38 one study from Bangladesh, 63 one study from Jordan, 64 one study from Italy, 66 and one study from Ethiopia. 67 Generally, the present systematic review has briefly summarized factors associated with the willingness of receiving COVID-19 vaccine. They were; age, educational status, gender, income, residency, occupation, marital status, race/ethnicity, perceived risk of COVID-19, trust in healthcare system, health insurance, norms, attitude towards a vaccine, perceived benefit of vaccine, perceived vaccine barriers, self-efficacy, up-to-date on vaccinations, tested for COVID-19 in the past, responsibility, perceived efficacy of the COVID-19 vaccination, use of social media for COVID-19 vaccine-related information, recommended for vaccination, political leaning, perceived severity of COVID-19, perceived effectiveness of a COVID-19 vaccine, belief that vaccination makes them feel less worried about COVID-19, believing in mandatory COVID-19 vaccination, perceived potential vaccine harms, presence of chronic disease, previously received an influenza vaccine, confidence, having COVID-19 vaccine safety concern, working in the healthcare field, believing vaccines can stop the pandemic, relying on Centers for Disease Control and Prevention website for COVID-19 updates, fear about COVID-19, being HCWs, close attention to the latest news of the vaccine, cues to action, COVID-19 vaccine hesitancy, receiving any vaccine in the past 5 years, perception of disease can be prevented by vaccine, willingness to protect others by getting oneself vaccinated, taking direct care of COVID-19 patients, belief that only people who are at risk of serious illness should be vaccinated, trust in government, complacency, willingness to pay for and travel for a vaccine, themselves or a member of their household belonged to a vulnerable group, trust in public health authorities, believing COVID-19 virus was not developed in laboratories, believing COVID-19 is far more contagious and lethal relative to the H1N1 virus, compliance with community mitigation strategies, being in a private sector, encountering with suspected or confirmed COVID-19 patients, self-reported health outcomes, believing that next waves COVID-19 are coming, knowledge score regarding symptoms, transmission routes and prevention and control measures against COVID-19, and perception that COVID-19 will persist ( Table 1 ).…”

“…The study design of all these studies were cross-sectional. Nine studies were done in the United States, [30][31][32][33][34][35][36][37][38] nine studies were done in China, [39][40][41][42][43][44][45][46][47] one study was done in Australia, 48 four studies were done in Saudi Arabia, [49][50][51][52] one study was done in Kuwait, 53 one study was done in England, 54 one study was done in Congo, 55 one study was done in Greece, 56 two studies were done in UK, 57,58 one study was done in Malaysia, 59 two studies were done in Japan, 60,61 one study was done in Israel, 62 one study was done in Bangladesh, 63 one study was done in Jordan, 64 one study was done in Iran, 65 one study was done in Italy, 66 one study was done in Ethiopia, 67 two studies were done in France, 68,69 one study was done in Vietnam, 70 one study was done in Uganda, 71 one study was done in Pakistan, 72 one study was done in Nigeria, 73 an...…”