COVID-19 Vaccine Hesitancy among Healthcare Workers and Trainees in Freetown, Sierra Leone: A Cross-Sectional Study

Abstract

Despite having safe and efficacious vaccines against COVID-19, vaccine hesitancy is widespread. Although a trusted source of information, vaccine hesitancy has been reported among healthcare professionals, yet few studies have explored this phenomenon in sub-Saharan Africa. We conducted a cross-sectional survey of healthcare professionals in Sierra Leone from January to March 2022. Measures included sociodemographic/health-related information and COVID-19-related concerns. From the responses, we constructed a hesitancy (VAX) score, with higher scores implying negative attitudes or unwillingness to vaccinate. Multivariate linear regression was used to access factors associated with vaccine hesitancy. Overall, 592 participants submitted responses (67.2% female, mean age 29 years, 5.6% physicians/pharmacists, 44.3% medical students, 29.2% nurses, 20.9% nursing students). The mean VAX score was 43.27 ± 8.77, with 60.1% of respondents classified as vaccine hesitant (>50th percentile) and 11.5% as highly hesitant (>75th percentile). Worries about unforeseen future effects (76.3%), a preference for natural immunity (59.5%), and profiteering/mistrust of health authorities (53.1%) were the most common concerns. Being a medical student (β = 0.105, p = 0.011) and previously refusing a recommended vaccine (β = 0.177, p < 0.001) were predictors of COVID-19 vaccine hesitancy. Our findings call for addressing vaccine hesitancy among healthcare professionals as an essential component of strategies aimed at increasing COVID-19 vaccine uptake in this setting.

Perceptions and predictors of COVID-19 vaccine hesitancy among health care providers across five countries in sub-Saharan Africa

“…Similarly, another study in Ethiopia found that older age (>40 years) and being a medical doctor were associated with a lower risk of vaccine-hesitancy. In Nigeria, a study found that HCP who were younger, single and with lower income had more vaccine hesitancy, while being a nurse or doctor was associated with lower hesitancy [17]. In Ghana, being female and having a low income have also been associated with increased COVID-19 vaccine hesitancy [18].…”

“…Reported rates of vaccine hesitancy have been higher in other studies. A study conducted early in the COVID-19 emergency in Nigeria found higher rates of vaccine hesitancy among HCPs (50%) [17]. In a South African study, 41.0% of HCPs were vaccinehesitant [13] and in Ghana, three out of five HCP were hesitant early in the pandemic (22).…”

“…A few studies have assessed hesitancy in COVID-19 vaccine uptake among health workers in Africa (9, 14, 15). A systematic review found COVID-19 acceptance rates of 46% across Africa and elevated levels of vaccine hesitancy have been reported (16, 17). However, acceptance rates as low as 28% have been reported in Central Africa (16).…”

Predictors of COVID‐19 vaccine hesitancy among Jordanian older adults

“…Lower scores indicated increased positive attitudes towards vaccines (Martin & Petrie, 2017). For COVID-19 participants, VAX showed acceptable internal consistency (r = 0.70), which was deemed acceptable by Yendewa et al (2022). The reliability of VAX was reported to be 0.84 by Zaidi et al (2021) and >0.90 by Acar-Burkay and Cristian (2022).…”

The conundrum of new coronavirus variants and poor uptake of booster dose: building a narrative against vaccine hesitancy in Pakistan

“…The health care experts must first be trained to develop a scientific mind to gather knowledge on virology and novel COVID-19 strains. They often are the influencers in propagating the information, and a recent global survey suggested a greater proportion of health care workers showing their reservations towards vaccination [25] . Seminars must be held to upgrade their knowledge on emerging Delta and Omicron variants and importance of booster doses in relation to these novel strains.…”