Assessment of COVID-19 vaccine hesitancy among Zimbabweans: A rapid national survey

Abstract

Background As a way of minimising the devastating effects of the coronavirus disease 2019 (COVID-19) pandemic, scientists hastily developed a vaccine. However, the scale-up of the vaccine is likely to be hindered by the widespread social media misinformation. We therefore conducted a study to assess the COVID-19 vaccine hesitancy among Zimbabweans. Methods We conducted a descriptive online cross-sectional survey using a self-administered questionnaire among adults. The questionnaire assessed willingness to be vaccinated; socio-demographic characteristics, individual attitudes and perceptions, effectiveness and safety of the vaccine. Multivariable logistic regression analysis was utilized to examine the independent factors associated with vaccine uptake. Results We analysed data for 1168 participants, age range of 19–89 years with the majority being females (57.5%). Half (49.9%) of the participants reported that they would accept the COVID-19 vaccine. Majority were uncertain about the effectiveness of the vaccine (76.0%) and its safety (55.0%). About half lacked trust in the government’s ability to ensure availability of an effective vaccine and 61.0% mentioned that they would seek advice from a healthcare worker to vaccinate. Chronic disease [vs no chronic disease—Adjusted Odds Ratio (AOR): 1.50, 95% Confidence Interval (CI)I: 1.10–2.03], males [vs females—AOR: 1.83, 95%CI: 1.37–2.44] and being a healthcare worker [vs not being a health worker—AOR: 1.59, 95%CI: 1.18–2.14] were associated with increased likelihood to vaccinate. Conclusion We found half of the participants willing to vaccinate against COVID-19. The majority lacked trust in the government and were uncertain about vaccine effectiveness and safety. The policy makers should consider targeting geographical and demographic groups which were unlikely to vaccinate with vaccine information, education and communication to improve uptake.

Commentary on COVID-19 Vaccine Hesitancy in sub-Saharan Africa

“…This is despite the commendable efforts from global initiatives such as COVAX and the African Vaccine Acquisition Trust (AVAT) to attain equitable COVID-19 vaccine access. Such low levels of uptake are in part attributed to the high vaccine hesitancy, varying from 33% of the population in Mali [ 3 ], 50% of the people in Zimbabwe [ 4 ] and Ghana [ 5 ], and 85% reported in Cameroon [ 6 ].…”

“…Vaccine mistrust issues, vaccine safety, and the lack of reliable information are observed barriers to the uptake of COVID-19 vaccines [ 4 , 5 , 6 ]. The higher rate of observed COVID-19 vaccine hesitancy in some sub-Saharan African countries compared to high-income countries has been attributed to perceptions of low vaccine effectiveness, perceived low risk of contracting SARS CoV-2, misinformation and a fear of side effects [ 7 ].…”

“…However, the context changed after the vaccine was introduced, due to mistrust of the vaccine-manufacturing companies or countries [ 5 ], doubts about vaccine efficacy [ 6 , 7 ], and fear of severe adverse effects following vaccination [ 7 ]. In sub-Saharan Africa, misinformation is widespread [ 4 , 6 ], hence driving hesitancy [ 6 ].…”

Attitudes to Vaccine Mandates among Late Adopters of COVID-19 Vaccines in Zimbabwe

“…In our cohort, mandate acceptance rates were higher and wealth was associated with decreased acceptability of vaccine mandates including COVID-19 vaccines for children. An online survey conducted in Zimbabwe just prior to the availability of COVID-19 vaccines supports high levels of vaccine hesitancy in Zimbabwe, particularly in individuals of higher socioeconomic status with internet access [ 13 ]. Half of the participants indicated that they would not undergo voluntary vaccinations and most indicated that they had concerns about vaccine safety, effectiveness, and trust in government regulatory processes [ 13 ].…”

“…In Zimbabwe, by June 2022, only 50% of the population had received at least one dose of a COVID-19 vaccine despite the availability of COVID-19 vaccines for more than a year [ 6 ]. An online survey conducted in February 2021 in Zimbabwe just before vaccines became widely available, found that 49.9% of the study population would voluntarily receive the COVID-19 vaccine, with young adults (18–25 years) having the lowest vaccine acceptance rate [ 13 ]. Most of the population lacked confidence in the safety of the vaccine and half distrusted the government’s ability to ensure the safety of the vaccine [ 13 ].…”