Makadzange Azure Tariro, Gundidza Patricia, Lau Charles, Dietrich Janan, Myburgh Nellie, Elose Nyasha, James Wilmot, Stanberry Lawrence, Ndhlovu Chiratidzo
Charles River Medical Group, 155 King George Avenue, Avondale, Harare, Zimbabwe.
GeoPoll, Washington, DC 20036, USA.
Vaccines (Basel). 2023 Feb 10;11(2):411. doi: 10.3390/vaccines11020411.
The rapid development of vaccines in response to the COVID-19 pandemic has provided an effective tool for the management of COVID-19. However, in many African countries there has been a poor uptake of COVID-19 vaccines with only 32.5% first vaccine dose coverage compared to the WHO global target of 70%. As vaccine access improves, one of the important drivers of low uptake has been vaccine hesitancy, driven by levels of confidence, convenience, and complacency. Between 4 January-11 February 2022, we conducted a survey of vaccine late adopters to assess factors that influenced adults in Harare, Zimbabwe to present for their first COVID-19 vaccine dose almost 12 months after the vaccination program began. Of the 1016 adults enrolled, 50% were female and 12.4% had HIV co-infection. Binary logistic regression models were developed to understand factors associated with vaccine confidence. Women were more likely to have negative views about the COVID-19 vaccine compared to men (OR 1.51 (95%CI 1.16, 1.97, = 0.002). Older adults (≥40 years) compared with youth (18-25 years) were more likely to have 'major concerns' about vaccines. When asked about their concerns, 602 (59.3%) considered immediate side effects as a major concern and 520 (52.1%) were concerned about long-term health effects. People living with HIV (PLWH) were more likely to perceive vaccines as safe (OR 1.71 (95%CI: 1.07, 2.74, = 0.025) and effective (1.68 (95%CI: 1.07, 2.64, = 0.026). Internet users were less likely to perceive vaccines as safe (OR 0.72 (95% CI: 0.55, 0.95, = 0.021) compared to non-Internet users; and social media was a more likely source of information for youth and those with higher education. Family members were the primary key influencers for 560 (55.2%) participants. The most important reason for receiving the COVID-19 vaccine for 715 (70.4%) participants was the protection of individual health. Improving vaccine coverage will need targeted communication strategies that address negative perceptions of vaccines and associated safety and effectiveness concerns. Leveraging normative behavior as a social motivator for vaccination will be important, as close social networks are key influences of vaccination.
为应对新冠疫情而迅速研发的疫苗为新冠疫情防控提供了一种有效工具。然而，在许多非洲国家，新冠疫苗的接种率很低，首剂疫苗接种覆盖率仅为32.5%，而世界卫生组织设定的全球目标是70%。随着疫苗可及性的提高，接种率低的一个重要原因是疫苗犹豫，其受到信心、便利性和自满情绪等因素的影响。2022年1月4日至2月11日期间，我们对疫苗延迟接种者进行了一项调查，以评估影响津巴布韦哈拉雷成年人在疫苗接种计划开始近12个月后接种首剂新冠疫苗的因素。在登记的1016名成年人中，50%为女性，12.4%合并感染艾滋病毒。我们建立了二元逻辑回归模型来了解与疫苗信心相关的因素。与男性相比，女性对新冠疫苗更可能持负面看法（比值比1.51（95%置信区间1.16，1.97，P = 0.002）。与年轻人（18 - 25岁）相比，老年人（≥40岁）更可能对疫苗“极为担忧”。当被问及担忧之处时，602人（59.3%）认为立即出现的副作用是主要担忧，520人（52.1%）担心长期健康影响。艾滋病毒感染者更可能认为疫苗是安全的（比值比1.71（95%置信区间：1.07，2.74，P = 0.025）和有效的（1.68（95%置信区间：1.07，2.64，P = 0.026）。与非互联网用户相比，互联网用户不太可能认为疫苗是安全的（比值比0.72（95%置信区间：0.55，0.95，P = 0.021）；社交媒体更可能是年轻人和受过高等教育者获取信息的来源。560名（55.2%）参与者的主要关键影响因素是家庭成员。715名（70.4%）参与者接种新冠疫苗的最重要原因是保护个人健康。提高疫苗接种覆盖率需要有针对性的沟通策略，以解决对疫苗的负面看法以及相关的安全性和有效性担忧。将规范行为作为疫苗接种的社会激励因素将很重要，因为紧密的社会网络是疫苗接种的关键影响因素。
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