Department of Medicine, Yobe State University Teaching Hospital, Damaturu, Nigeria.
Department of Community Medicine, Bayero University Kano/Aminu Kano Teaching Hospital, Kano Nigeria.
Vaccine. 2023 Feb 17;41(8):1503-1512. doi: 10.1016/j.vaccine.2023.01.060. Epub 2023 Jan 31.
Malaria contributes to an enormous global burden of disease and mortality, especially in children. Approximately one in every four global cases and deaths from malaria occurs in Nigeria. This study aims to evaluate the prevalence and correlates of community hesitancy to the malaria vaccine, including the reasons for the hesitancy, following the approval of the RTS,S malaria vaccine by the World Health Organization (WHO).
This was a nationwide cross-sectional online survey of Nigerian adults conducted from 20th October to 30th November 2021. Participants who replied 'no' or 'maybe' to a question assessing their willingness to accept the RTS,S malaria vaccine were considered "hesitant". We fit a multivariate logistic regression model to report the adjusted odds ratio (aOR) and 95 % confidence interval (CI) for the factors associated with vaccine hesitancy.
Among 3377 total respondents (1961 [57.86 %] males; mean age [SD]: 30[9.1]), 1010 (29.91 %) were hesitant. Receiving information about the RTS,S malaria vaccine initially from healthcare workers (vs. the internet) (aOR:0.55; 95 % CI:0.35-0.87) was significantly associated with lower odds of hesitancy. Conversely, earning a high income of over NGN100, 000 (vs. < NGN 30,000) per month (aOR: 2.10, 95 % CI: 1.36-3.24), belonging to other religious groups (vs. Islam) (aOR:3.25, 95 % CI:1.18-8.98), and having a family size of more than ten (vs. < 5) (aOR:1.84; 95 % CI:1.08-3.13) were significantly associated with a higher odds of hesitancy. The main reasons for vaccine hesitancy included fear of vaccine adverse effects (34.95 %), availability of other malaria preventive measures (33.96 %) and not seeing the positive effect of the vaccine in others first (32.97 %).
The findings of this survey provide a valuable blueprint for the development of targeted interventions to facilitate caregiver acceptance of the RTS,S vaccine.
疟疾对全球疾病和死亡率造成了巨大负担，尤其是在儿童中。在疟疾病例和死亡病例中，约有四分之一发生在尼日利亚。本研究旨在评估社区对接种疟疾疫苗的犹豫程度，包括在世界卫生组织（WHO）批准 RTS,S 疟疾疫苗后的犹豫原因。
这是一项于 2021 年 10 月 20 日至 11 月 30 日期间在尼日利亚成年人中进行的全国性横断面在线调查。对评估其接受 RTS,S 疟疾疫苗意愿的问题回答“否”或“可能”的参与者被认为是“犹豫”。我们拟合了多变量逻辑回归模型，以报告与疫苗犹豫相关因素的调整后优势比（aOR）和 95%置信区间（CI）。
在 3377 名总受访者中（男性 1961 名[57.86%]；平均年龄[SD]：30[9.1]），有 1010 名（29.91%）表示犹豫。最初从医疗保健工作者（而非互联网）处获取 RTS,S 疟疾疫苗信息（aOR：0.55；95%CI：0.35-0.87）与较低的犹豫几率显著相关。相反，月收入超过 100000 奈拉（vs. <30000 奈拉）（aOR：2.10，95%CI：1.36-3.24），属于其他宗教团体（vs. 伊斯兰教）（aOR：3.25，95%CI：1.18-8.98），家庭规模大于 10 人（vs. <5 人）（aOR：1.84；95%CI：1.08-3.13）与更高的犹豫几率显著相关。疫苗犹豫的主要原因包括担心疫苗不良反应（34.95%）、有其他疟疾预防措施（33.96%）和尚未看到疫苗对他人的积极效果（32.97%）。
这项调查的结果为制定有针对性的干预措施以促进看护人接受 RTS,S 疫苗提供了宝贵蓝图。
