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

Julio S. Solís Arce; Shana S. Warren; Niccolò F. Meriggi; Alexandra Scacco; Nina McMurry; Maarten Voors; Georgiy Syunyaev; Amyn Abdul Malik; Samya Aboutajdine; Opeyemi Adeojo; Deborah Anigo; Alex Armand; Saher Asad; Martin Atyera; Britta Augsburg; Manisha Awasthi; Gloria Eden Ayesiga; Antonella Bancalari; 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; Sarah Kreps; Madison Levine; Rebecca Littman; Mohammad 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; Melina R. Platas; Laura Polanco; Javaeria Ashraf Qureshi; Mariam Raheem; Vasudha Ramakrishna; Ismail Rendrá; Taimur Shah; Sarene Eyla Shaked; Jacob N. Shapiro; Jakob Svensson; Ahsan Tariq; Achille Mignondo Tchibozo; Hamid Ali Tiwana; Bhartendu Trivedi; Corey Vernot; Pedro C. Vicente; Laurin B. Weissinger; Basit Zafar; Baobao Zhang; Dean Karlan; Michael Callen; Matthieu Teachout; Macartan Humphreys; Ahmed Mushfiq Mobarak; Saad B. Omer

doi:10.1038/s41591-021-01454-y

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

Julio S. Solís Arce, Shana S. Warren, Niccolò F. Meriggi, Alexandra Scacco, Nina McMurry, Maarten Voors, Georgiy Syunyaev, Amyn Abdul Malik, Samya Aboutajdine, Opeyemi Adeojo, Deborah Anigo, Alex Armand, Saher Asad, Martin Atyera, Britta Augsburg, Manisha Awasthi, Gloria Eden Ayesiga, Antonella Bancalari, Martina Björkman Nyqvist, Ekaterina BorisovaConstantin 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, Sarah Kreps, Madison Levine, Rebecca Littman, Mohammad 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, Melina R. Platas, Laura Polanco, Javaeria Ashraf Qureshi, Mariam Raheem, Vasudha Ramakrishna, Ismail Rendrá, Taimur Shah, Sarene Eyla Shaked, Jacob N. Shapiro, Jakob Svensson, Ahsan Tariq, Achille Mignondo Tchibozo, Hamid Ali Tiwana, Bhartendu Trivedi, Corey Vernot, Pedro C. Vicente, Laurin B. Weissinger, Basit Zafar, Baobao Zhang, Dean Karlan, Michael Callen, Matthieu Teachout, Macartan Humphreys, Ahmed Mushfiq Mobarak, Saad B. Omer

Research output: Contribution to journal › Article › peer-review

Abstract

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.

Original language	English
Number of pages	21
Journal	Nature Medicine
Volume	First Online
Early online date	16 Jul 2021
DOIs	https://doi.org/10.1038/s41591-021-01454-y
Publication status	E-pub ahead of print - 16 Jul 2021

Keywords

COVID-19

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

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Cite this

Solís Arce, J. S., Warren, S. S., Meriggi, N. F., Scacco, A., McMurry, N., Voors, M., Syunyaev, G., Malik, A. A., Aboutajdine, S., Adeojo, O., Anigo, D., Armand, A., Asad, S., Atyera, M., Augsburg, B., Awasthi, M., Ayesiga, G. E., Bancalari, A., Björkman Nyqvist, M., ... Omer, S. B. (2021). COVID-19 vaccine acceptance and hesitancy in low- and middle-income countries. Nature Medicine, First Online. Advance online publication. https://doi.org/10.1038/s41591-021-01454-y

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abstract = "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.",

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Solís Arce, JS, Warren, SS, Meriggi, NF, Scacco, A, McMurry, N, Voors, M, Syunyaev, G, Malik, AA, Aboutajdine, S, Adeojo, O, Anigo, D, Armand, A, Asad, S, Atyera, M, Augsburg, B, Awasthi, M, Ayesiga, GE, Bancalari, A, Björkman Nyqvist, M, Borisova, E, Bosancianu, CM, Cabra García, MR, Cheema, A, Collins, E, Cuccaro, F, Farooqi, AZ, Fatima, T, Fracchia, M, Galindo Soria, ML, Guariso, A, Hasanain, A, Jaramillo, S, Kallon, S, Kamwesigye, A, Kharel, A, Kreps, S, Levine, M, Littman, R, Malik, M, Manirabaruta, G, Mfura, JLH, Momoh, F, Mucauque, A, Mussa, I, Nsabimana, JA, Obara, I, Otálora, MJ, Ouédraogo, BW, Pare, TB, Platas, MR, Polanco, L, Qureshi, JA, Raheem, M, Ramakrishna, V, Rendrá, I, Shah, T, Shaked, SE, Shapiro, JN, Svensson, J, Tariq, A, Tchibozo, AM, Tiwana, HA, Trivedi, B, Vernot, C, Vicente, PC, Weissinger, LB, Zafar, B, Zhang, B, Karlan, D, Callen, M, Teachout, M, Humphreys, M, Mobarak, AM & Omer, SB 2021, 'COVID-19 vaccine acceptance and hesitancy in low- and middle-income countries', Nature Medicine, vol. First Online. https://doi.org/10.1038/s41591-021-01454-y

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T1 - COVID-19 vaccine acceptance and hesitancy in low- and middle-income countries

AU - Solís Arce, Julio S.

AU - Warren, Shana S.

AU - Meriggi, Niccolò F.

AU - Scacco, Alexandra

AU - McMurry, Nina

AU - Voors, Maarten

AU - Syunyaev, Georgiy

AU - Malik, Amyn Abdul

AU - Aboutajdine, Samya

AU - Adeojo, Opeyemi

AU - Anigo, Deborah

AU - Armand, Alex

AU - Asad, Saher

AU - Atyera, Martin

AU - Augsburg, Britta

AU - Awasthi, Manisha

AU - Ayesiga, Gloria Eden

AU - Bancalari, Antonella

AU - Björkman Nyqvist, Martina

AU - Borisova, Ekaterina

AU - Bosancianu, Constantin Manuel

AU - Cabra García, Magarita Rosa

AU - Cheema, Ali

AU - Collins, Elliott

AU - Cuccaro, Filippo

AU - Farooqi, Ahsan Zia

AU - Fatima, Tatheer

AU - Fracchia, Mattia

AU - Galindo Soria, Mery Len

AU - Guariso, Andrea

AU - Hasanain, Ali

AU - Jaramillo, Sofía

AU - Kallon, Sellu

AU - Kamwesigye, Anthony

AU - Kharel, Arjun

AU - Kreps, Sarah

AU - Levine, Madison

AU - Littman, Rebecca

AU - Malik, Mohammad

AU - Manirabaruta, Gisele

AU - Mfura, Jean Léodomir Habarimana

AU - Momoh, Fatoma

AU - Mucauque, Alberto

AU - Mussa, Imamo

AU - Nsabimana, Jean Aime

AU - Obara, Isaac

AU - Otálora, María Juliana

AU - Ouédraogo, Béchir Wendemi

AU - Pare, Touba Bakary

AU - Platas, Melina R.

AU - Polanco, Laura

AU - Qureshi, Javaeria Ashraf

AU - Raheem, Mariam

AU - Ramakrishna, Vasudha

AU - Rendrá, Ismail

AU - Shah, Taimur

AU - Shaked, Sarene Eyla

AU - Shapiro, Jacob N.

AU - Svensson, Jakob

AU - Tariq, Ahsan

AU - Tchibozo, Achille Mignondo

AU - Tiwana, Hamid Ali

AU - Trivedi, Bhartendu

AU - Vernot, Corey

AU - Vicente, Pedro C.

AU - Weissinger, Laurin B.

AU - Zafar, Basit

AU - Zhang, Baobao

AU - Karlan, Dean

AU - Callen, Michael

AU - Teachout, Matthieu

AU - Humphreys, Macartan

AU - Mobarak, Ahmed Mushfiq

AU - Omer, Saad B.

PY - 2021/7/16

Y1 - 2021/7/16

N2 - 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.

AB - 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.

KW - COVID-19

UR - https://www.scopus.com/pages/publications/85110615244

U2 - 10.1038/s41591-021-01454-y

DO - 10.1038/s41591-021-01454-y

M3 - Article

SN - 1546-170X

VL - First Online

JO - Nature Medicine

JF - Nature Medicine

ER -

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

Abstract

Keywords

UN SDGs

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