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Examining confidence and hesitancy towards COVID-19 vaccines: a cross-sectional survey using in-person data collection in rural Ghana

Examining confidence and hesitancy towards COVID-19 vaccines: a cross-sectional survey using in-person data collection in rural Ghana
Examining confidence and hesitancy towards COVID-19 vaccines: a cross-sectional survey using in-person data collection in rural Ghana

Background: in Ghana, as of 30 July 2022, around one-third of the eligible population are considered fully-vaccinated against COVID-19, and efforts are being made to increase coverage. Vaccine hesitancy is defined by the World Health Organization (WHO) as the delay in the acceptance, or blunt refusal of, vaccines. This study assesses vaccine hesitancy and confidence in Nkwanta South, a rural municipal in Oti region, Ghana.

Methods: data collection within Nkwanta South took place in sub-municipalities of Alokpatsa (11,028 population), Brewaniase (14,483), and Tutukpene (15,453). Data was collected by 47 local residents, known as Community-Based Surveillance Volunteers (CBSVs), using Kobo Toolbox forms on electronic devices (tablets). Information collected included numerous demographic variables, including age, gender, relationship status, and religion. Further questions covered reasons for vaccine hesitancy and COVID-19 vaccine status. Descriptive and inferential statistics assessed the association between variables to identify predictors of hesitancy.

Findings: across 1500 respondents, 700 (46.7%) reported having received at least one COVID-19 vaccine dose, and 800 (53.3%) reported being unvaccinated against COVID-19. Among unvaccinated respondents, 556 (69.4%) reported willingness to receive the vaccine once available, 190 (23.7%) said they would not be willing to be vaccinated, and 55 (6.9%) said they were unsure. Overall, this represented 30.6% hesitancy within the currently-unvaccinated group. Common reasons for hesitancy included believing that they did not need the vaccine (33.8%), believing the vaccine to be dangerous (30.6%), concerns about side effects (25.3%), and not having enough information (20.1%). Key predictors of hesitancy among our participants included high levels of mistrust, being female, greater years of education, and being Christian.

Interpretations: the information gathered here can inform how best to target national and local health promotion strategies. Locally-tailored efforts, that understand local context and social dynamics, must remain a core component of public health activity to achieve a high vaccine uptake.

COVID-19, Ghana, pandemic, rural, vaccine hesitancy, vaccines
0264-410X
2113-2119
Afreh, O K
02dad4aa-359b-4d08-8397-631a334ec4a1
Angwaawie, P
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Attivor, E.J.K.
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Boateng, L.A.
a6ab463d-7910-48ff-befa-d3bccc41d6af
Brackstone, K.
33db3628-3171-4a7f-99cc-ad15db871fc5
Head, M.G.
67ce0afc-2fc3-47f4-acf2-8794d27ce69c
Manyeh, A K
aa872ac1-5f89-445b-b384-097e3075a99f
Vidzro, G.A.A.
52b716d3-fd9d-4e19-8849-bbcce3885d59
Afreh, O K
02dad4aa-359b-4d08-8397-631a334ec4a1
Angwaawie, P
6912dd31-81af-45be-b6a7-d6a6ed7ee769
Attivor, E.J.K.
94906472-1e29-4af2-85b9-35ca3df872e4
Boateng, L.A.
a6ab463d-7910-48ff-befa-d3bccc41d6af
Brackstone, K.
33db3628-3171-4a7f-99cc-ad15db871fc5
Head, M.G.
67ce0afc-2fc3-47f4-acf2-8794d27ce69c
Manyeh, A K
aa872ac1-5f89-445b-b384-097e3075a99f
Vidzro, G.A.A.
52b716d3-fd9d-4e19-8849-bbcce3885d59

Afreh, O K, Angwaawie, P, Attivor, E.J.K., Boateng, L.A., Brackstone, K., Head, M.G., Manyeh, A K and Vidzro, G.A.A. (2023) Examining confidence and hesitancy towards COVID-19 vaccines: a cross-sectional survey using in-person data collection in rural Ghana. Vaccine, 41 (13), 2113-2119. (doi:10.1016/j.vaccine.2023.02.024).

Record type: Article

Abstract

Background: in Ghana, as of 30 July 2022, around one-third of the eligible population are considered fully-vaccinated against COVID-19, and efforts are being made to increase coverage. Vaccine hesitancy is defined by the World Health Organization (WHO) as the delay in the acceptance, or blunt refusal of, vaccines. This study assesses vaccine hesitancy and confidence in Nkwanta South, a rural municipal in Oti region, Ghana.

Methods: data collection within Nkwanta South took place in sub-municipalities of Alokpatsa (11,028 population), Brewaniase (14,483), and Tutukpene (15,453). Data was collected by 47 local residents, known as Community-Based Surveillance Volunteers (CBSVs), using Kobo Toolbox forms on electronic devices (tablets). Information collected included numerous demographic variables, including age, gender, relationship status, and religion. Further questions covered reasons for vaccine hesitancy and COVID-19 vaccine status. Descriptive and inferential statistics assessed the association between variables to identify predictors of hesitancy.

Findings: across 1500 respondents, 700 (46.7%) reported having received at least one COVID-19 vaccine dose, and 800 (53.3%) reported being unvaccinated against COVID-19. Among unvaccinated respondents, 556 (69.4%) reported willingness to receive the vaccine once available, 190 (23.7%) said they would not be willing to be vaccinated, and 55 (6.9%) said they were unsure. Overall, this represented 30.6% hesitancy within the currently-unvaccinated group. Common reasons for hesitancy included believing that they did not need the vaccine (33.8%), believing the vaccine to be dangerous (30.6%), concerns about side effects (25.3%), and not having enough information (20.1%). Key predictors of hesitancy among our participants included high levels of mistrust, being female, greater years of education, and being Christian.

Interpretations: the information gathered here can inform how best to target national and local health promotion strategies. Locally-tailored efforts, that understand local context and social dynamics, must remain a core component of public health activity to achieve a high vaccine uptake.

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Accepted/In Press date: 8 February 2023
e-pub ahead of print date: 13 February 2023
Published date: 22 March 2023
Additional Information: Funding Information: This work received financial support from the Coalition for Operational Research on Neglected Tropical Diseases (reference number NTD-SC 189D), which is funded at The Task Force for Global Health primarily by the Bill & Melinda Gates Foundation, by the United States Agency for International Development through its Neglected Tropical Diseases Program, and with UK aid from the British people.
Keywords: COVID-19, Ghana, pandemic, rural, vaccine hesitancy, vaccines

Identifiers

Local EPrints ID: 477107
URI: http://eprints.soton.ac.uk/id/eprint/477107
ISSN: 0264-410X
PURE UUID: 8a6a9d6f-4640-4443-ab84-080e090b3f25
ORCID for K. Brackstone: ORCID iD orcid.org/0000-0002-6882-3260
ORCID for M.G. Head: ORCID iD orcid.org/0000-0003-1189-0531

Catalogue record

Date deposited: 26 May 2023 16:44
Last modified: 06 Jun 2024 01:54

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Contributors

Author: O K Afreh
Author: P Angwaawie
Author: E.J.K. Attivor
Author: L.A. Boateng
Author: K. Brackstone ORCID iD
Author: M.G. Head ORCID iD
Author: A K Manyeh
Author: G.A.A. Vidzro

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