Ghazy Ramy Mohamed, Gebreal Assem, Saleeb Marina Raouf Abdelmessih, Sallam Malik, El-Deen Ahmed El-Sayed Nour, Sheriff Swaliho Dauda, Tessema Eyerusalem Amossa, Ahurwendeire Salvias, Tsoeu Nthabiseng, Chamambala Prince C, Cibangu Patrick B, Okeh Debra Ukamaka, Traoré Adama Sy, Eshun Gilbert, Kengo Nathan Ezie, Kubuka Amos Elisha, Awuah Lydia Baffour, Salah Assia, Aljohani Moath, Fadl Noha
Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt.
Faculty of Medicine, Alexandria University, Alexandria, Egypt.
J Community Health. 2024 Apr;49(2):193-206. doi: 10.1007/s10900-023-01261-1. Epub 2023 Aug 30.
The coronavirus disease 2019 (COVID-19) pandemic is a global threat, challenging health services' provision and utilization. This study aimed to assess compulsory vaccination coverage in 12 Sub-Saharan African countries two years following the COVID-19 pandemic using the Health Belief Model. A cross-sectional survey was conducted from November 1 to December 15, 2022. Multivariate logistic regression was conducted to identify the determinants of vaccination coverage. Among the 5032 respondents, 73.1% reported that their children received compulsory vaccination. The lowest coverage was observed in Ghana (36.5%), while the highest was in Burkina Faso and Congo (92.0%). Factors associated with non-vaccination included older mothers (adjusted odds ratio (AOR) = 1.04, 95%CI: 1.03-1.05), lower mothers' education, older children (AOR = 0.76, 95%CI: 0.60-0.96), children with chronic illnesses (AOR = 0.55, 95%CI: 0.45-0.66), and difficult accessibility to healthcare facilities (AOR = 11.27, 95%CI: 9.48-13.44). Low perceived risk, in which non-vaccinated children were believed to be at no higher risk for infectious diseases and the disease severity would not worsen among non-vaccinated children, increased the likelihood of non-vaccination (AOR = 2.29, 95%CI: 1.75-2.99 and AOR = 2.12, 95%CI: 1.64-2.73, respectively). Perceiving vaccines as unnecessary, and needless for breastfed babies increased the probability of non-vaccination (AOR = 1.38, 95%CI: 1.10-1.73 and AOR = 1.69, 95%CI: 1.31-2.19, respectively). Higher odds of non-vaccination were found when the provision of vaccine information did not motivate parents to vaccinate their children (AOR = 4.29, 95%CI: 3.15-5.85). Conversely, believing that vaccines were safe for children decreased the odds of non-vaccination (AOR = 0.72, 95%CI: 0.58-0.88). Parental perceptions and concerns should be considered in interventions aiming to increase compulsory vaccine acceptance and coverage.
2019年冠状病毒病（COVID-19）大流行是一项全球性威胁，对卫生服务的提供和利用构成挑战。本研究旨在运用健康信念模型评估COVID-19大流行两年后撒哈拉以南非洲12个国家的强制疫苗接种覆盖率。于2022年11月1日至12月15日进行了一项横断面调查。采用多因素逻辑回归来确定疫苗接种覆盖率的决定因素。在5032名受访者中，73.1%报告其子女接受了强制疫苗接种。加纳的覆盖率最低（36.5%），而布基纳法索和刚果的覆盖率最高（92.0%）。与未接种疫苗相关的因素包括母亲年龄较大（调整优势比（AOR）=1.04，95%置信区间：1.03 - 1.05）、母亲受教育程度较低、孩子年龄较大（AOR = 0.76，95%置信区间：0.60 - 0.96）、患有慢性病的孩子（AOR = 0.55，95%置信区间：0.45 - 0.66）以及难以获得医疗保健设施（AOR = 11.27，95%置信区间：9.48 - 13.44）。低感知风险，即认为未接种疫苗的儿童患传染病的风险不会更高且疾病严重程度在未接种疫苗的儿童中不会恶化，增加了未接种疫苗的可能性（AOR分别为2.29，95%置信区间：1.75 - 2.99和AOR为2.12，95%置信区间：1.64 - 2.73）。认为疫苗不必要且母乳喂养婴儿无需接种疫苗增加了未接种疫苗的概率（AOR分别为1.38，95%置信区间：1.10 - 1.73和AOR为1.69，95%置信区间：1.31 - 2.19）。当疫苗信息的提供未能促使父母为其子女接种疫苗时，未接种疫苗的几率更高（AOR = 4.29，95%置信区间：3.15 - 5.85）。相反地，认为疫苗对儿童安全降低了未接种疫苗的几率（AOR = 0.72，95%置信区间：0.58 -
