Introduction: It's been over 2 years since the pandemic started as a result of the coronavirus. There are striking data showing the incidence, mortality, and recoveries as a result of the viral infection. With several preventive measures established by public health policy, the roll-out of COVID-19 vaccines has been one of the best measures to curtail the menace of the COVID-19. However, there are certain impediments enhancing the hesitancy in the uptake of the vaccine in Africa.Methods: A literature search was made using PubMed and Google Scholar using the following keywords "COVID 19 vaccine", "knowledge," "perception," "vaccine uptake," "vaccine acceptance," "vaccine hesitancy". Upon using the inclusion and exclusion criteria, relevant studies were selected to access the acceptance and hesitancy to the COVID-19 vaccine.Results: There are various contributory factors that decide acceptance or ensure hesitancy among the populace which includes: Age, education, gender, residence, household income, marital status, religion, information source, access to vaccine and vaccine equity, etc. Major concerns, barriers, and motivators about vaccination were highlighted. Existing data was used to show how each factor played role in the acceptance and hesitancy in the COVID-19 vaccine.Conclusions: This present study identified key factors that influence vaccine confidence, hesitancy, and acceptance in Africa and in turn proffer sustainable solutions that can be used to address these factors. Through a cumulative review of existing data about COVID-19 vaccine knowledge, confidence, acceptance, and hesitancy, we hope to make contributions that would highlight major influencers of vaccine knowledge and percentage in Africa.