COVID-19 vaccine acceptance and hesitancy in low- and middle-income countries

Принятие вакцин против COVID-19 и сомнения в их применении в странах с низким и средним уровнем дохода
Baobao Zhang, Saad B. Omer, Ahmed Mushfiq Mobarak, Sarah Kreps, Macartan Humphreys, Rebecca Littman, Melina Platas, Jakob Svensson, Antonella Bancalari, Taimur T. Shah, Dean Karlan, Maarten Voors, Amyn A. Malik, Alex Armand, Julio S. Solís Arce, Shana S. Warren, Niccolò F. Meriggi, Alexandra Scacco, Nina McMurry, Georgiy Syunyaev, Samya Aboutajdine, Opeyemi S. Adeojo, Deborah Anigo, Saher Asad, Martin Atyera, Britta Augsburg, Manisha Awasthi, Gloria Eden Ayesiga, Martina Björkman Nyqvist, Ekaterina Borisova, Constantin Manuel Bosancianu, Magarita Rosa Cabra García, Ali Cheema, Elliott Collins, Filippo Cuccaro, Ahsan Zia Farooqi, Tatheer Fatima, Mattia Fracchia, Mery Len Galindo Soria, Andrea Guariso, Ali Hasanain, Sofía Jaramillo, Sellu Kallon, Anthony Kamwesigye, Arjun Kharel, Madison Levine, Mohammad Bilal Malik, Gisele Manirabaruta, Jean Léodomir Habarimana Mfura, Fatoma Momoh, Alberto Mucauque, Imamo Mussa, Jean Aime Nsabimana, Isaac Obara, María Juliana Otálora, Béchir Wendemi Ouédraogo, Touba Bakary Pare, Laura Polanco, Javaeria A. Qureshi, Mariam Raheem, Vasudha Ramakrishna, Ismail Rendrá, Sarene Eyla Shaked, Jacob N. Shapiro, Ahsan Tariq, Achille Mignondo Tchibozo, Hamid Ali Tiwana, Bhartendu Trivedi, Corey Vernot, Pedro C. Vicente, Laurin Weissinger, Basit Zafar, Michael Callen, Matthieu Teachout
2021-07-16

COVID-19 vaccine acceptancehealth workerslow- and middle-income countriesvaccination uptakevaccine hesitancy
Widespread acceptance of COVID-19 vaccines is crucial for achieving sufficient immunization coverage to end the global pandemic, yet few studies have investigated COVID-19 vaccination attitudes in lower-income countries, where large-scale vaccination is just beginning. We analyze COVID-19 vaccine acceptance across 15 survey samples covering 10 low- and middle-income countries (LMICs) in Asia, Africa and South America, Russia (an upper-middle-income country) and the United States, including a total of 44,260 individuals. We find considerably higher willingness to take a COVID-19 vaccine in our LMIC samples (mean 80.3%; median 78%; range 30.1 percentage points) compared with the United States (mean 64.6%) and Russia (mean 30.4%). Vaccine acceptance in LMICs is primarily explained by an interest in personal protection against COVID-19, while concern about side effects is the most common reason for hesitancy. Health workers are the most trusted sources of guidance about COVID-19 vaccines. Evidence from this sample of LMICs suggests that prioritizing vaccine distribution to the Global South should yield high returns in advancing global immunization coverage. Vaccination campaigns should focus on translating the high levels of stated acceptance into actual uptake. Messages highlighting vaccine efficacy and safety, delivered by healthcare workers, could be effective for addressing any remaining hesitancy in the analyzed LMICs.
1
Across 15 surveys of 44,260 individuals in 10 LMICs, mean COVID-19 vaccine acceptance was 80.3%, exceeding acceptance in the United States (64.6%) and Russia (30.4%).
2
Health workers were the most trusted sources of COVID-19 vaccine guidance in the analyzed countries.
3
LMIC vaccine acceptance varied substantially across samples, with a reported range of 30.1 percentage points.
4
Personal protection against COVID-19 was the primary motivation for vaccine acceptance, while concerns about side effects were the leading reason for hesitancy.
5
Prioritizing vaccine distribution to the Global South could substantially advance global immunization coverage, but campaigns must convert stated willingness into actual uptake through messages emphasizing efficacy and safety.

Individuals in low- and middle-income countries (LMICs) surveyed about COVID-19 vaccination attitudes

Willingness to receive COVID-19 vaccination and the motivations, concerns, and trusted guidance sources underlying acceptance or hesitancy

Publication Details
Publication Date
2021-07-16
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Authors
Baobao Zhang
Saad B. Omer
Ahmed Mushfiq Mobarak
Sarah Kreps
Macartan Humphreys
Rebecca Littman
Melina Platas
Jakob Svensson
Antonella Bancalari
Taimur T. Shah
Dean Karlan
Maarten Voors
Amyn A. Malik
Alex Armand
Julio S. Solís Arce
Shana S. Warren
Niccolò F. Meriggi
Alexandra Scacco
Nina McMurry
Georgiy Syunyaev
Samya Aboutajdine
Opeyemi S. Adeojo
Deborah Anigo
Saher Asad
Martin Atyera
Britta Augsburg
Manisha Awasthi
Gloria Eden Ayesiga
Martina Björkman Nyqvist
Ekaterina Borisova
Constantin Manuel Bosancianu
Magarita Rosa Cabra García
Ali Cheema
Elliott Collins
Filippo Cuccaro
Ahsan Zia Farooqi
Tatheer Fatima
Mattia Fracchia
Mery Len Galindo Soria
Andrea Guariso
Ali Hasanain
Sofía Jaramillo
Sellu Kallon
Anthony Kamwesigye
Arjun Kharel
Madison Levine
Mohammad Bilal Malik
Gisele Manirabaruta
Jean Léodomir Habarimana Mfura
Fatoma Momoh
Alberto Mucauque
Imamo Mussa
Jean Aime Nsabimana
Isaac Obara
María Juliana Otálora
Béchir Wendemi Ouédraogo
Touba Bakary Pare
Laura Polanco
Javaeria A. Qureshi
Mariam Raheem
Vasudha Ramakrishna
Ismail Rendrá
Sarene Eyla Shaked
Jacob N. Shapiro
Ahsan Tariq
Achille Mignondo Tchibozo
Hamid Ali Tiwana
Bhartendu Trivedi
Corey Vernot
Pedro C. Vicente
Laurin Weissinger
Basit Zafar
Michael Callen
Matthieu Teachout
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