Predictors of COVID-19 Vaccine Hesitancy in North-Central Nigeria

Abstract

AbstractCOVID-19 vaccine hesitancy has emerged as a major challenge to global efforts to control the pandemic, particularly in Nigeria, where hesitancy to other effective vaccines such as polio and measles has been widely reported. Several individual, societal, and structural factors contribute to this behaviour and prevent the effectiveness of COVID-19 prevention efforts.ObjectivesThis study sought to assess the factors associated with COVID-19 vaccine hesitancy in the six states of north-central Nigeria.MethodsA population-based cross-sectional online survey was conducted among residents using a semi-structured questionnaire adapted from the WHO SAGE vaccine hesitancy scale and distributed via social media networks over 8-weeks.ResultsA total of 1,999 responses were received, of which 570 were set aside comprising 512 respondents that resided outside the study area, 12 respondents that reported no knowledge of the COVID-19 vaccine, and 46 entries with missing data. Of 1,429 included in the analysis, 1,008 (70.5%) were willing to be vaccinated and/or already vaccinated and 421 (29.5%) were unwilling to receive the COVID-19 vaccine. Post-secondary education (AOR: 0.51, 0.37-0.69), household income above the minimum wage of 30,000 Naira per month (AOR: 0.68, 0.50-0.94) and people of the Islamic faith (AOR: 0.69, 0.53-0.90) were found to be associated with lower levels of hesitancy. The dominant reasons for hesitancy were concerns about side effects (37.5%), doubt about the existence of COVID-19 (11.0%), and the perception of time required to receive the vaccine (9.6%). Hesitant respondents relied on health workers (33.0%) and social media (23.3%) as their trusted sources of health information, and less than a third (31.4%) followed the advice of their religious and community leaders.ConclusionAll three factors of confidence, complacency and convenience influenced hesitancy in our study. Socioeconomic factors are major drivers of hesitancy. Therefore, hesitancy is as much a social issue as health and requires a multisectoral approach to educating communities and building trust in health and social institutions.