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Factors Affecting COVID-19 Vaccine Acceptance: An International Survey among Low- and Middle-Income Countries

Bono SA 1 , Faria de Moura Villela E 2 , Siau CS 3 , Chen WS 4 , Pengpid S 5 , Hasan MT 6 Show all authors , Sessou P 7 , Ditekemena JD 8 , Amodan BO 9 , Hosseinipour MC 10 , Dolo H 11 , Siewe Fodjo JN 12 , Low WY 13 , Colebunders R 12

Affiliations 

  • 1 School of Social Science, Universiti Sains Malaysia, Gelugor 11800, Malaysia
  • 2 Disease Control Coordination, São Paulo State Health Department, São Paulo 01246-000, Brazil
  • 3 Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
  • 4 Department of Health Science and Biostatistics, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
  • 5 ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom 73170, Thailand
  • 6 Public Health Foundation, Bangladesh (PHF, BD), Dhaka 1217, Bangladesh
  • 7 Research Unit on Communicable Diseases, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Cotonou 01 BP 526, Benin
  • 8 Kinshasa School of Public Health, University of Kinshasa, Kinshasa 7948, Democratic Republic of the Congo
  • 9 Uganda Public Health Fellowship Program, Loudel Towers, Level 4, Kampala, Uganda
  • 10 University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27599, USA
  • 11 International Center of Excellence in Research, Faculty of Medicine and OdontoStomatology, Bamako, Mali
  • 12 Global Health Institute, University of Antwerp, 2000 Antwerp, Belgium
  • 13 Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
Vaccines (Basel), 2021 May 17;9(5).
PMID: 34067682 DOI: 10.3390/vaccines9050515

Abstract

Vaccination is fast becoming a key intervention against the ongoing COVID-19 pandemic. We conducted cross-sectional online surveys to investigate COVID-19 vaccine acceptance across nine Low- and Middle-Income Countries (LMICs; N = 10,183), assuming vaccine effectiveness at 90% and 95%. The prevalence of vaccine acceptance increased from 76.4% (90% effectiveness) to 88.8% (95% effectiveness). Considering a 90% effective vaccine, Malaysia, Thailand, Bangladesh, and five African countries (Democratic Republic of Congo, Benin, Uganda, Malawi, and Mali) had lower acceptance odds compared to Brazil. Individuals who perceived taking the vaccine as important to protect themselves had the highest acceptance odds (aOR 2.49) at 95% effectiveness.Vaccine acceptance was also positively associated with COVID-19 knowledge, worry/fear regarding COVID-19, higher income, younger age, and testing negative for COVID-19. However, chronic disease and female gender reduced the odds for vaccine acceptance. The main reasons underpinning vaccine refusal were fear of side effects (41.2%) and lack of confidence in vaccine effectiveness (15.1%). Further research is needed to identify country-specific reasons for vaccine hesitancy in order to develop mitigation strategies that would ensure high and equitable vaccination coverage across LMICs.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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