Variations in COVID-19 vaccine hesitancy over time: a serial cross-sectional study in five West African countries

Objectives This study aims to identify the factors influencing vaccine hesitancy, willingness and its variation over time in order to inform more responsive strategies for increasing vaccination uptake. The specific objectives are: (1) to describe and compare levels of COVID-19 vaccine hesitancy amo...

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Main Authors: Seydou Doumbia, Kadari Cisse, Henri Gautier Ouedraogo, Dewi Ismajani Puradiredja, Jürgen May, Sylvain Landry Faye, Daniela Fusco, Moctar Tounkara, Ricardo Strauss, Tani Sagna, Alpha Mahmoud Barry, Abdul Karim Mbawah, Cheick Oumar Doumbia, Souleymane Diouf, Federico Di Meglio, Edouard Lhomme
Format: Article
Language:English
Published: BMJ Publishing Group 2024-11-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/14/11/e083766.full
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author Seydou Doumbia
Kadari Cisse
Henri Gautier Ouedraogo
Dewi Ismajani Puradiredja
Jürgen May
Sylvain Landry Faye
Daniela Fusco
Moctar Tounkara
Ricardo Strauss
Tani Sagna
Alpha Mahmoud Barry
Abdul Karim Mbawah
Cheick Oumar Doumbia
Souleymane Diouf
Federico Di Meglio
Edouard Lhomme
author_facet Seydou Doumbia
Kadari Cisse
Henri Gautier Ouedraogo
Dewi Ismajani Puradiredja
Jürgen May
Sylvain Landry Faye
Daniela Fusco
Moctar Tounkara
Ricardo Strauss
Tani Sagna
Alpha Mahmoud Barry
Abdul Karim Mbawah
Cheick Oumar Doumbia
Souleymane Diouf
Federico Di Meglio
Edouard Lhomme
author_sort Seydou Doumbia
collection DOAJ
description Objectives This study aims to identify the factors influencing vaccine hesitancy, willingness and its variation over time in order to inform more responsive strategies for increasing vaccination uptake. The specific objectives are: (1) to describe and compare levels of COVID-19 vaccine hesitancy among the general population in rural and urban settings in West Africa over time and (2) to identify factors associated with COVID-19 vaccination willingness and hesitancy among the general population across five West African countries over time.Design Following a baseline survey (Wave I), three serial cross-sectional surveys (Waves II-IV) were implemented.Setting The study was conducted in Burkina Faso, Guinea, Mali, Senegal and Sierra Leone from November 2021 to July 2022.Participants A total of 13 571 study participants were included in the study (n=4373, n=4593 and n=4605 for survey Waves II, III and IV, respectively). Inclusion criteria were being 18 years or older, living in the study area and willing to provide informed consent. A two-stage sampling strategy was used to select the sample from among the general population.Primary and secondary outcomes Primary outcomes were the variability of vaccine hesitancy over time and across the five West African countries. Secondary outcomes were factors associated with vaccine willingness.Results A small but steady increase in hesitancy to COVID-19-vaccination can be observed across countries, with an upward trend of vaccine hesitancy reported by 952 participants (33.9 %) in Wave II, 1055 (37.3%) in Wave III and 1089 (38.1%) in Wave IV. Among the countries included, Senegal shows the highest level of vaccine hesitancy (‘Definitely no’ and ‘Probably no’ ranging from 50.2% to 56.0% and 26.2 to 28.3%, respectively). At the same time, Senegal has the lowest vaccination coverage overall. Across all five countries and survey waves, the primary factor associated with vaccination willingness is fear of experiencing severe COVID-19 disease (Wave II: OR 0.42, 95% CI 0.34 to 0.51, Wave III: OR 0.48, 95% CI 0.40 to 0.59 and Wave IV: OR 0.54, 95% CI 0.44 to 0.66). Perceived improved financial status seems to influence willingness to get vaccinated negatively (OR 0.57, 95% CI 0.40 to 0.81) and unlike in Western, Educated, Industrialised, Rich and Democratic countries, men seem more reluctant to get vaccinated than women (OR 0.77, 95%, CI 0.65 to 0.93).Conclusions Our findings suggest that vaccine hesitancy should be monitored over time to inform communication strategies, which are responsive to changes in vaccination-related public sentiments. Additionally, a focus on social solidarity and the importance of women in vaccination advocacy can help improve COVID-19 vaccination coverage in West Africa.Trial registration number The general protocol is registered on clinicaltrial.gov (protocol number: NCT04912284).
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spelling doaj-art-a79bf85568194440b426fea7d4bea6022025-08-20T02:14:07ZengBMJ Publishing GroupBMJ Open2044-60552024-11-01141110.1136/bmjopen-2023-083766Variations in COVID-19 vaccine hesitancy over time: a serial cross-sectional study in five West African countriesSeydou Doumbia0Kadari Cisse1Henri Gautier Ouedraogo2Dewi Ismajani Puradiredja3Jürgen May4Sylvain Landry Faye5Daniela Fusco6Moctar Tounkara7Ricardo Strauss8Tani Sagna9Alpha Mahmoud Barry10Abdul Karim Mbawah11Cheick Oumar Doumbia12Souleymane Diouf13Federico Di Meglio14Edouard Lhomme156 Faculté de Medecine et d`OdontoStomatologie, Université des Sciences, Techniques et Technologiques de Bamako, Bamako, Mali4 Biomedical et santé publique, Université Joseph KI-ZERBO, Ouagadougou, Burkina Faso3 Biomédical et santé publique, Institut de Recherche en Sciences de la Santé (IRSS), Ouagadougou, Burkina Faso10 Infectious Disease Epidemiology, Bernhard Nocht Institute of Tropical Medicine, Hamburg, Germany10 Infectious Disease Epidemiology, Bernhard Nocht Institute of Tropical Medicine, Hamburg, Germany7 Département de Sociologie, Faculté Lettres et Sciences Humaines (FLSH) Université Cheikh Anta DIOP (UCAD) BP 5005 Dakar-Fann, Senegal, Dakar, Senegal10 Infectious Disease Epidemiology, Bernhard Nocht Institute of Tropical Medicine, Hamburg, Germany9 USTTB, Bamako, Bamako, Mali10 Infectious Disease Epidemiology, Bernhard Nocht Institute of Tropical Medicine, Hamburg, Germany3 Biomédical et santé publique, Institut de Recherche en Sciences de la Santé (IRSS), Ouagadougou, Burkina Faso5 Gamal Abdel Nasser University of Conakry, Conakry, Conakry, Guinea8 COMAHS, Freetown, Western Area, Sierra Leone10 Infectious Disease Epidemiology, Bernhard Nocht Institute of Tropical Medicine, Hamburg, Germany13 Sociologie, Université Cheikh Anta Diop Faculté des Lettres et Sciences Humaines, Dakar, Senegal1 Centre Hospitalier Universitaire Bordeaux, Bordeaux, France1 Centre Hospitalier Universitaire Bordeaux, Bordeaux, FranceObjectives This study aims to identify the factors influencing vaccine hesitancy, willingness and its variation over time in order to inform more responsive strategies for increasing vaccination uptake. The specific objectives are: (1) to describe and compare levels of COVID-19 vaccine hesitancy among the general population in rural and urban settings in West Africa over time and (2) to identify factors associated with COVID-19 vaccination willingness and hesitancy among the general population across five West African countries over time.Design Following a baseline survey (Wave I), three serial cross-sectional surveys (Waves II-IV) were implemented.Setting The study was conducted in Burkina Faso, Guinea, Mali, Senegal and Sierra Leone from November 2021 to July 2022.Participants A total of 13 571 study participants were included in the study (n=4373, n=4593 and n=4605 for survey Waves II, III and IV, respectively). Inclusion criteria were being 18 years or older, living in the study area and willing to provide informed consent. A two-stage sampling strategy was used to select the sample from among the general population.Primary and secondary outcomes Primary outcomes were the variability of vaccine hesitancy over time and across the five West African countries. Secondary outcomes were factors associated with vaccine willingness.Results A small but steady increase in hesitancy to COVID-19-vaccination can be observed across countries, with an upward trend of vaccine hesitancy reported by 952 participants (33.9 %) in Wave II, 1055 (37.3%) in Wave III and 1089 (38.1%) in Wave IV. Among the countries included, Senegal shows the highest level of vaccine hesitancy (‘Definitely no’ and ‘Probably no’ ranging from 50.2% to 56.0% and 26.2 to 28.3%, respectively). At the same time, Senegal has the lowest vaccination coverage overall. Across all five countries and survey waves, the primary factor associated with vaccination willingness is fear of experiencing severe COVID-19 disease (Wave II: OR 0.42, 95% CI 0.34 to 0.51, Wave III: OR 0.48, 95% CI 0.40 to 0.59 and Wave IV: OR 0.54, 95% CI 0.44 to 0.66). Perceived improved financial status seems to influence willingness to get vaccinated negatively (OR 0.57, 95% CI 0.40 to 0.81) and unlike in Western, Educated, Industrialised, Rich and Democratic countries, men seem more reluctant to get vaccinated than women (OR 0.77, 95%, CI 0.65 to 0.93).Conclusions Our findings suggest that vaccine hesitancy should be monitored over time to inform communication strategies, which are responsive to changes in vaccination-related public sentiments. Additionally, a focus on social solidarity and the importance of women in vaccination advocacy can help improve COVID-19 vaccination coverage in West Africa.Trial registration number The general protocol is registered on clinicaltrial.gov (protocol number: NCT04912284).https://bmjopen.bmj.com/content/14/11/e083766.full
spellingShingle Seydou Doumbia
Kadari Cisse
Henri Gautier Ouedraogo
Dewi Ismajani Puradiredja
Jürgen May
Sylvain Landry Faye
Daniela Fusco
Moctar Tounkara
Ricardo Strauss
Tani Sagna
Alpha Mahmoud Barry
Abdul Karim Mbawah
Cheick Oumar Doumbia
Souleymane Diouf
Federico Di Meglio
Edouard Lhomme
Variations in COVID-19 vaccine hesitancy over time: a serial cross-sectional study in five West African countries
BMJ Open
title Variations in COVID-19 vaccine hesitancy over time: a serial cross-sectional study in five West African countries
title_full Variations in COVID-19 vaccine hesitancy over time: a serial cross-sectional study in five West African countries
title_fullStr Variations in COVID-19 vaccine hesitancy over time: a serial cross-sectional study in five West African countries
title_full_unstemmed Variations in COVID-19 vaccine hesitancy over time: a serial cross-sectional study in five West African countries
title_short Variations in COVID-19 vaccine hesitancy over time: a serial cross-sectional study in five West African countries
title_sort variations in covid 19 vaccine hesitancy over time a serial cross sectional study in five west african countries
url https://bmjopen.bmj.com/content/14/11/e083766.full
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