Understanding the vaccine hesitancy of COVID-19 in Benin.

Vaccination campaigns against COVID-19 have been set up in all countries. The aim was to reach a sufficient vaccination threshold to ensure herd immunity. In Benin, the objective was to achieve 60% coverage. However, coverage was only 35% in May 2022. People were reluctant to be vaccinated. We had set up a population-based study to investigate these barriers to vaccination. Our approach was qualitative (80 semi-structured interviews with vaccinated and non-vaccinated people) and quantitative (179 questionnaires with CHWs (Community Health Workers) in urban and rural areas. To analyse the qualitative data, thematic sorting was carried out, while the statistical analysis of the data was carried out using SPSS and Excel software. Perceptions and concerns about COVID-19 revealed widespread mistrust of the disease and vaccination. Part of the population doubted the existence or seriousness of the disease, with over 70% of CHWs reporting that people did not perceive the reality of the disease in their daily lives. These doubts were reinforced by the limited impact of the disease and political interpretations of the pandemic, often viewed as a tool for state control. Mistrust of vaccines was even more pronounced, with over 90% of CHWs indicating that people were concerned about the novelty of vaccines and doubts their effectiveness. Rumours circulating on social networks amplified these concerns, fuelling fears about vaccine safety. Fear of stigmatisation, forced isolation and the impossibility of carrying out traditional funeral rituals heightened people's reluctance. The requirement to sign a consent form absolving the state of responsibility for side-effects further deepened these suspicions. Our study confirmed a strong reluctance to vaccinate against COVID-19. It highlighted the critical role of media and social networks and the necessity for authorities to address these factors in communication diseases to ensure efficient disease control.