COVID-19 Vaccine Acceptability Among Healthcare Facility Workers in Sierra Leone, the Democratic Republic of Congo and Uganda: A Multi-Centre Cross-Sectional Survey

Abstract

Objectives: This cross-sectional survey explored COVID-19 vaccine acceptability among public healthcare facility workers in Kambia (Sierra Leone), Goma (Democratic Republic of Congo) and Masaka (Uganda).Methods: Questionnaire-based interviews conducted between April–October 2021 explored participants’ knowledge and perceptions of, and attitudes towards, the COVID-19 pandemic and COVID-19 vaccines, as well as COVID-19 vaccine acceptability (defined as uptake of ≥1 dose or intent to get vaccinated).Results: Whilst most (n = 444; 81.8%) of the 543 participants had one or more concerns about COVID-19 vaccines, 487 (89.7%) nonetheless perceived that they were important for pandemic control. Most participants from Kambia or Masaka either were vaccinated (n = 137/355; 38.6%) or intended to get vaccinated (n = 211/355; 59.4%) against COVID-19. In Goma, all 188 participants were unvaccinated; only 81 (43.1%) participants intended to get vaccinated, and this was associated with positive perceptions about COVID-19 vaccines. In Goma, the most common reasons for not wanting a COVID-19 vaccine were concerns that the vaccines were new (n = 75/107; 70.1%) and fear of side effects (n = 74/107; 69.2%).Conclusion: Reported COVID-19 vaccine acceptability was high among healthcare facility workers in Kambia and Masaka. The lower vaccine acceptability in Goma may highlight the importance of social mobilisation and accurate, accessible information that addresses specific concerns.

The Social Ecological Model: A Framework for Understanding COVID-19 Vaccine Uptake among Healthcare Workers—A Scoping Review

“…Based on the included studies in this review, the intention rate to uptake the COVID-19 vaccine among HCWs was below average [ 23 , 25 , 46 , 47 , 54 , 59 , 76 , 77 , 80 , 83 , 88 ]. Conversely, fourteen studies reported an above-average intention rate [ 48 , 49 , 51 , 52 , 55 , 60 , 69 , 71 , 79 , 82 , 88 , 91 , 92 ]. The overall average intention rate for HCWs to uptake the COVID-19 vaccines across all included studies was approximately 52%, indicating a suboptimal level of uptake among this population.…”

“…Within the theme of COVID-19 vaccines, ten sub-themes were identified, all acting as barriers to vaccine uptake. The most prominent sub-theme was safety concerns, which was reported as the primary barrier [ 23 , 25 , 43 , 47 , 50 , 51 , 55 , 56 , 57 , 60 , 61 , 65 , 66 , 67 , 68 , 69 , 70 , 72 , 74 , 75 , 76 , 77 , 78 , 81 , 82 , 83 , 84 , 85 , 86 , 88 , 90 , 91 , 92 , 95 ]. However, only three studies mentioned confidence in the COVID-19 vaccines, facilitating uptake [ 47 , 52 , 88 ].…”

“…However, only three studies mentioned confidence in the COVID-19 vaccines, facilitating uptake [ 47 , 52 , 88 ]. Numerous studies [ 23 , 47 , 55 , 56 , 61 , 66 , 68 , 69 , 70 , 74 , 75 , 77 , 81 , 82 , 85 , 90 , 91 ] highlighted the prevalent mistrust in science among HCWs, often rooted in the belief that the COVID-19 vaccine has not undergone sufficient clinical trials. Concerns about the vaccine’s effectiveness were reported in 16 studies [ 23 , 25 , 65 , 67 , 69 , 70 , 76 , 77 , 78 , 82 , 84 , 85 , 86 , 88 , 92 , 95 ], with some expressing doubts about its ability to protect against COVID-19, particularly in Africa.…”

“…The perception of susceptibility to contracting COVID-19 among HCWs was mentioned as both a barrier and a facilitator for vaccine uptake. HCWs who perceived themselves to be at a higher risk of contracting COVID-19 [ 25 , 47 , 59 , 63 , 88 , 92 ] were more willing to get vaccinated compared to those who perceived themselves to have a low risk [ 23 , 66 , 67 , 78 , 91 ]. HCWs who believed they needed the vaccine for protection were more likely to get vaccinated than those who relied on their immune system to prevent infection [ 65 , 68 , 76 , 77 , 95 ].…”

“…HCWs who believed they needed the vaccine for protection were more likely to get vaccinated than those who relied on their immune system to prevent infection [ 65 , 68 , 76 , 77 , 95 ]. A prior diagnosis of COVID-19 was mentioned as a barrier to vaccine uptake as some HCWs believed that they had gained natural immunity and did not need the vaccine [ 23 , 67 , 91 , 92 ]. Side effects of COVID-19, such as loss of smell and taste, were mentioned as facilitators for vaccine uptake [ 56 ].…”