A Mapping Review on the Uptake of the COVID-19 Vaccine among Adults in Africa Using the 5As Vaccine Taxonomy

Abstract

Uptake of a vaccine is complete if individuals are aware of the associated risks of the vaccine, accept the vaccine, and respond positively to the nudges (activation) to increase the uptake, and respond when the vaccine is made accessible and affordable. We mapped systematically the existing literature concerning the 5As—acceptability, accessibility, affordability, awareness, and activation—of COVID-19 vaccination among adults and, specifically, older adults (55 years and older) in Africa. We searched multiple databases from 2020 to December 2021. Using predefined inclusion and exclusion criteria, two reviewers screened citations, conducted title and abstract screening, and extracted data independently. We included 68 articles conducted in 33 African countries, primarily cross-sectional studies (n = 49, 72%). None of the articles focused on older adults only, but 22 articles (32%) included at least one older adult (55 years and older) in their sample size. Acceptance (n = 58, 85%) was the most commonly researched aspect of vaccine uptake, followed by accessibility (n = 17, 25%), awareness (n = 13, 19%), and affordability (n = 5, 7.0%). We found only one report on activation. Factors affecting acceptance of the COVID-19 vaccine in Africa were grouped into sociodemographic factors; knowledge-, attitude-, and belief-related factors; a COVID-19 vaccine efficacy and safety concern factor; and trust in government and public health authorities. The governments of African nations should focus on strategies to influence the modifiable factors identified in this review. More studies are needed to evaluate the impact of nudges (activation) to improve COVID-19 vaccine uptake in African nations.

Models of determinants of COVID-19 vaccine hesitancy in non-pregnant and pregnant population: Review of current literature”

“…A mapping review of COVID-19 vaccine uptake among Adults 55 years and older in Africa with the 5A model taxonomy found that acceptance was the most commonly researched aspect of vaccine uptake (85%), followed by accessibility (25%), awareness (19%), and affordability (7%). 153 Activation was examined in only one study as a factor affecting COVID-19 vaccine acceptance. The review concluded that more studies are needed to evaluate the impact of nudges (activation) to improve COVID-19 vaccine uptake in African nations.…”

Enablers and Barriers to Handwashing and Vaccine Uptake in Kenya, Uganda, and Tanzania in Relation to COVID-19 Prevention and Control: A Systematic Review

“…A study (28)focusing Kenya indicated that understanding geographical access regarding to Covid-19 vaccination locations is key for successful planning of vaccination programmes. A study focusing Kenya, Uganda, Tanzania, and other countries noted that accessibility was based on location-distance to vaccination centers (29).…”

“…A study (32) focusing Kenya and other countries and another study (34) focusing Kisumu on Kenya reported concerns regarding vaccine safety and side effects. Similarly, a study (29) focusing Kenya, Uganda and Tanzania noted that safety concerns were still a barrier on vaccine uptake among adults.…”

“…Further, another study (33) noted that lack of trust in on COVID-19 vaccines had led to low uptake of Covid vaccinations in Uganda. Similarly, a study review focusing Kenya, Uganda, Tanzania and other countries indicated that lack of trust in government and public health authorities had led to low uptake of COVID-19 vaccines (29).…”

“…Two studies myths, misconceptions, and risk-perception had in uenced the low vaccine uptake witnessed. A study focusing Kenya, Uganda, Tanzania and other countries noted vaccine hesitancy was in uenced by perception of being at low risk (29). In addition, a review (17) focusing on Uganda also mentioned myth busting within the society had in uenced vaccine hesitancy.…”