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NISH (NITAG Support Hub) 2: Covid-19 vaccine hesitancy/confidence in Africa

This Library Guide contains published and unpublished information on vaccine hesitancy and related issues in the context of COVID-19 vaccination in Subsaharan Africa

WHO Africa

World Health Organization (WHO), 2021. Risks and challenges in Africa’s COVID-19 vaccine rollout. 2021e.


Opening statement, COVID-19 Press Conference, 25 November ...                                                                                                                                                                    

PERC, 2020. Responding to COVID-19 in Africa: Using Data to Find a Balance.
WHO Regional Office for Africa. 2022. Covid-19 vaccination the in the WHO African region. WHO Monthly Bulletin.
Twenty priority countries, at high risk of slow COVID-19 vaccination roll out, have been identified for this initiative. WHO AFRO has already deployed 30 experts in 18 out of the 20 priority countries. Six countries out of the 20 priority countries (Côte d’Ivoire, Ethiopia, Ghana, DR Congo,Guinea Bissau and Kenya) have started to implement phased vaccination campaigns to ramp up COVID-vaccination rates.
Overall, the number of doses administered in the African region increased by 23% in February 2022 compared to January 2022.
WHO Africa. 2021. Key lessons from Africa's COVID-19 vaccine rollout. 2021.
“Fighting misinformation that fuels vaccine hesitancy is by no means easy,” says Dr Gilson Paluku, an Immunization Officer...
WHO Africa. 2021. Frontline Health workers in Hoima District (Uganda) Hesitate about COVID-19 vaccination, then Embrace it after WHO Assurance - April 2021.
WHO Africa. April 2021. Less than 2% of world’s COVID-19 vaccines administered in Africa.



Lustig, Y., Nemet, I., Kliker, L., Zuckerman, N., Yishai, R., Alroy-Preis, S., Mendelson, E. and Mandelboim, M., 2021. Neutralizing response against variants after SARS-CoV-2 infection and one dose of BNT162b2. New England Journal of Medicine, 384(25), pp.2453-2454. (Not OA)

Pubmed : Covid-19 AND "vaccination hesitancy" AND Africa

Liu, Y., Procter, S.R., Pearson, C.A., Montero, A.M., Torres-Rueda, S., Asfaw, E., Uzochukwu, B., Drake, T., Bergren, E., Eggo, R.M. and Ruiz, F., 2023. Assessing the impacts of COVID-19 vaccination programme’s timing and speed on health benefits, cost-effectiveness, and relative affordability in 27 African countries. BMC medicine21(1), pp.1-15.

Cardoso Pinto, A.M., Shariq, S., Ranasinghe, L., Sundar Budhathoki, S., Skirrow, H., Whittaker, E. and Seddon, J.A., 2023. Reasons for reductions in routine childhood immunisation uptake during the COVID-19 pandemic in low-and middle-income countries: A systematic review. PLOS Global Public Health3(1), p.e0001415.

Onyeaghala, A.A., Anyiam, A.F., Husaini, D.C., Onyeaghala, E.O. and Obi, E., 2023. Herbal supplements as treatment options for COVID-19: A call for clinical development of herbal supplements for emerging and re-emerging viral threats in Sub-Saharan Africa. Scientific African20, p.e01627.

Couch, M.A., Katoto, P.D., Cinini, S.F. and Wiysonge, C.S., 2023. Integrating civil liberty and the ethical principle of autonomy in building public confidence to reduce COVID-19 vaccination inequity in Africa. Human Vaccines & Immunotherapeutics19(1), p.2179789.

Amiebenomo, O.M., Osuagwu, U.L., Envuladu, E.A., Miner, C.A., Mashige, K.P., Ovenseri-Ogbomo, G., Abu, E.K., Timothy, C.G., Ekpenyong, B.N., Langsi, R. and Oloruntoba, R., 2023. Acceptance and Risk Perception of COVID-19 Vaccination among Pregnant and Non Pregnant Women in Sub-Saharan Africa: A Cross-Sectional Matched-Sample Study. Vaccines11(2), p.484.

Montcho, Y., Nalwanga, R., Azokpota, P., Doumatè, J.T., Lokonon, B.E., Salako, V.K., Wolkewitz, M. and Glèlè Kakaï, R., 2023. Assessing the Impact of Vaccination on the Dynamics of COVID-19 in Africa: A Mathematical Modeling Study. Vaccines11(4), p.857.

Naidoo, D., Meyer-Weitz, A. and Govender, K., 2023. Factors Influencing the Intention and Uptake of COVID-19 Vaccines on the African Continent: A Scoping Review. Vaccines11(4), p.873.

Miner, C.A., Timothy, C.G., Percy, K. et al. Acceptance of COVID-19 vaccine among sub-Saharan Africans (SSA): a comparative study of residents and diasporan dwellers. BMC Public Health 23, 191 (2023).

Ochola, E.A., 2023. Vaccine Hesitancy in Sub-Saharan Africa in the Context of COVID-19 Vaccination Exercise: A Systematic Review. Diseases11(1), p.32.
Gudayu, T.W. and Mengistie, H.T., 2023. COVID-19 vaccine acceptance in sub-Saharan African countries: A systematic review and meta-analysis. Heliyon, p.e13037.
Abu El Kheir-Mataria, W., Saleh, B.M., El-Fawal, H. and Chun, S., 2023. COVID-19 vaccine hesitancy among parents in Low-and Middle-Income Countries: A meta-analysis. Frontiers in Public Health11, p.417.
Naidoo, D., Meyer-Weitz, A. and Govender, K., 2023. Factors Influencing the Intention and Uptake of COVID-19 Vaccines on the African Continent: A Scoping Review. Vaccines11(4), p.873.
Ukwishaka, J., Ndayishimiye, Y., Destine, E., Danwang, C. and Kirakoya-Samadoulougou, F., 2023. Global prevalence of coronavirus disease 2019 reinfection: a systematic review and meta-analysis. BMC Public Health23(1), pp.1-20.
Osuagwu, U.L., Mashige, K.P., Ovenseri-Ogbomo, G., Envuladu, E.A., Abu, E.K., Miner, C.A., Timothy, C.G., Ekpenyong, B.N., Langsi, R., Amiebenomo, O.M. and Oloruntoba, R., 2023. The impact of information sources on COVID-19 vaccine hesitancy and resistance in sub-Saharan Africa. BMC Public Health, 23(1), p.38.

World Health Organization, 2022. COVID-19 response for Africa-monthly bulletin: situation and response actions in the African Region, October 2022. COVID-19 response for Africa-monthly bulletin, (8), pp.1-24.

Wang, D., Chukwu, A., Mwanyika-Sando, M., Abubakari, S.W., Assefa, N., Madzorera, I., Hemler, E.C., Ismail, A., Lankoande, B., Mapendo, F. and Millogo, O., 2022. COVID-19 vaccine hesitancy and its determinants among sub-Saharan African adolescents. PLOS Global Public Health2(10), p.e0000611

Njoga, E.O., Awoyomi, O.J., Onwumere-Idolor, O.S., Awoyomi, P.O., Ugochukwu, I.C. and Ozioko, S.N., 2022. Persisting Vaccine Hesitancy in Africa: The Whys, Global Public Health Consequences and Ways-Out—COVID-19 Vaccination Acceptance Rates as Case-in-Point. Vaccines, 10(11), p.1934.

Goldenberg, R.L., Naqvi, S., Saleem, S. and McClure, E., 2022. Variability in COVID‐19 vaccination rates in pregnant women: Vaccine hesitancy or supply limitations?. Bjog.
doi: 10.1111/1471-0528.17257 (Preprint)
Deml, M.J. and Githaiga, J.N., 2022. Determinants of COVID-19 vaccine hesitancy and uptake in sub-Saharan Africa: a scoping review. BMJ Open, 12(11), p.e066615.
Azanaw, J., Endalew, M., Zenbaba, D., Abera, E. and Chattu, V.K., 2022. COVID-19 vaccine acceptance and associated factors in 13 African countries: A systematic review and meta-analysis. Frontiers in public health10.
Sallam, M., Al-Sanafi, M. and Sallam, M., 2022. A global map of COVID-19 vaccine acceptance rates per country: an updated concise narrative review. Journal of Multidisciplinary Healthcare, 15, p.21.

Mutombo PN, Fallah MP, Munodawafa D, Kabel A, Houeto D, Goronga T, Mweemba O, Balance G, Onya H, Kamba RS, Chipimo M, Kayembe JN, Akanmori B. COVID-19 vaccine hesitancy in Africa: a call to action. Lancet Glob Health. 2022 Mar;10(3):e320-e321. doi: 10.1016/S2214-109X(21)00563-5. Epub 2021 Dec 20. PMID: 34942117; PMCID: PMC8687664.

Taylor-Robinson, S.D., Morgan, M.Y., Spearman, C.W., Suliman, A.A., Corrah, T., Oleribe, O.O. and Taylor-Robinson, A.W., 2022. Why SARS-CoV-2 vaccination still matters in Africa. QJM: An International Journal of Medicine, 115(3), pp.191-192. (Not OA)
Greyling T, Rossouw S (2022) Positive attitudes towards COVID-19 vaccines: A cross-country analysis. PLoS ONE 17(3): e0264994.

Amponsah, S.K., Tagoe, B. and Afriyie, D.K., 2021. Possible future trajectory of COVID-19: emphasis on Africa. The Pan African Medical Journal, 40.

Kanyanda, S., Markhof, Y., Wollburg, P. and Zezza, A., 2021. Acceptance of COVID-19 vaccines in sub-Saharan Africa: Evidence from six national phone surveys. BMJ open, 11(12), p.e055159.

Anjorin, A.A., Odetokun, I.A., Abioye, A.I., Elnadi, H., Umoren, M.V., Damaris, B.F., Eyedo, J., Umar, H.I., Nyandwi, J.B., Abdalla, M.M. and Tijani, S.O., 2021. Will Africans take COVID-19 vaccination?. PloS one, 16(12), p.e0260575.

Wirsiy, F.S., Nkfusai, C.N., Ako-Arrey, D.E., Dongmo, E.K., Manjong, F.T. and Cumber, S.N., 2021. Acceptability of COVID-19 vaccine in Africa. International Journal of Maternal and Child Health  10(1), p.134.

Noushad, M., Rastam, S., Nassani, M.Z., Al-Saqqaf, I.S., Hussain, M., Yaroko, A.A., Arshad, M., Kirfi, A.M., Koppolu, P., Niazi, F.H. and Elkandow, A., 2021. A Global Survey of COVID-19 Vaccine Acceptance Among Healthcare Workers. Frontiers in Public Health, 9.
Mmadu-Okoli C, Nsofor Ifeanyi. 2021 WhatsApp, COVID-19 related misinformation in Africa and the need for continuous infoveillance. HPHR. 2021;39. 10.54111/0001/MM8
Ekwebelem, O.C., Yunusa, I., Onyeaka, H., Ekwebelem, N.C. and Nnorom-Dike, O., 2021. COVID-19 vaccine rollout: will it affect the rates of vaccine hesitancy in Africa?. Public health. (Not OA)
Afolabi, A.A. and Ilesanmi, O.S., 2021. Dealing with vaccine hesitancy in Africa: the prospective COVID-19 vaccine context. The Pan African Medical Journal, 38.



Ogunleye, O.O., Godman, B., Fadare, J.O., Mudenda, S., Adeoti, A.O., Yinka-Ogunleye, A.F., Ogundele, S.O., Oyawole, M.R., Schönfeldt, M., Rashed, W.M. and Galal, A.M., 2022. Coronavirus disease 2019 (COVID-19) pandemic across Africa: current status of vaccinations and implications for the future. Vaccines, 10(9), p.1553.
Mohamed, R., White, T.M., Lazarus, J.V., Salem, A., Kaki, R., Marrakchi, W., Kheir, S.G., Amer, I., Ahmed, F.M., Khayat, M.A. and Al-Abdullah, N., 2022. COVID-19 vaccine acceptance and associated factors among people living with HIV in the Middle East and North Africa region. Southern African Journal of HIV Medicine, 23(1), p.9.
Nachega, J.B., Sam-Agudu, N.A., Siedner, M.J., Rosenthal, P.J., Mellors, J.W., Zumla, A., Hermans, M.P., Ntakwinja, M.B., Mukwege, D.M., Langenegger, E. and Mofenson, L.M., 2022. Prioritizing Pregnant Women for Coronavirus Disease 2019 Vaccination in African Countries. Clinical Infectious Diseases. (Not OA)
Abstract: Coronavirus disease 2019 (COVID-19) in pregnancy is associated with excess maternal and infant morbidity and mortality in both African and higher-resource settings. Furthermore, mounting evidence demonstrates the safety and efficacy of COVID-19 vaccination for pregnant women and infants. However, national guidelines in many African countries are equivocal or lack recommendations on COVID-19 vaccine in pregnancy. We summarize key data on COVID-19 epidemiology and vaccination among pregnant African women to highlight major barriers to vaccination and recommend 4 interventions. First, policymakers should prioritize pregnant women for COVID-19 vaccination, with a target of 100% coverage. Second, empirically supported public health campaigns should be sustainably implemented to inform and support pregnant women and their healthcare providers in overcoming vaccine hesitancy. Third, COVID-19 vaccination for pregnant women should be expanded to include antenatal care, obstetrics/gynecology, and targeted mass vaccination campaigns. Fourth, national monitoring and evaluation of COVID-19 vaccine uptake, safety, surveillance, and prospective outcomes assessment should be conducted.





Google Scholar

Lazarus, J.V., Wyka, K., White, T.M., Picchio, C.A., Gostin, L.O., Larson, H.J., Rabin, K., Ratzan, S.C., Kamarulzaman, A. and El-Mohandes, A., 2023. A survey of COVID-19 vaccine acceptance across 23 countries in 2022Nature Medicine, pp.1-10.

Kagina, B. 2022. Making COVID vaccines in Africa: advances and sustainability issues. The Conversation

Kwon, R. and Rahmati, M., 2022. Global, regional, and national COVID-19 vaccination rate in 237 countries and territories, March 2022: a systematic analysis for World Health Organization COVID-19 Dashboard, Release 2. Life Cycle, 2.
Stewart, R., Madonsela, A., Tshabalala, N., Etale, L. and Theunissen, N., 2022. The importance of social media users’ responses in tackling digital COVID-19 misinformation in Africa. Digital Health, 8, p.20552076221085070.
The Immunization Action Coalition

SA Corana Virus Academic Articles (Ministerial Advisory Committee) MAC

Combrink, H MvE, Smart, B T H, Hazelhurst, S, Marivate, V. 2022. COVID lessons: scientists without quality data are like unarmed soldiers in a war zone. The Conversation.

Panero, M.S., Khuri-Bulos, N., Biscayart, C., Bonvehí, P., Hayajneh, W. and Madhi, S.A., 2020. The role of National Immunization Technical Advisory Groups (NITAG) in strengthening health system governance: Lessons from three middle-income countries—Argentina, Jordan, and South Africa (2017–2018). Vaccine38(45), pp.7118-7128. (Not OA)


Web of Science



Struyf, T., Deeks, J.J., Dinnes, J., Takwoingi, Y., Davenport, C., Leeflang, M.M., Spijker, R., Hooft, L., Emperador, D., Domen, J. and Horn, S.R., 2021. Signs and symptoms to determine if a patient presenting in primary care or hospital outpatient settings has COVID‐19. Cochrane Database of Systematic Reviews, (2). (Not OA)
Houghton, C., Meskell, P., Delaney, H., Smalle, M., Glenton, C., Booth, A., Chan, X.H.S., Devane, D. and Biesty, L.M., 2020. Barriers and facilitators to healthcare workers’ adherence with infection prevention and control (IPC) guidelines for respiratory infectious diseases: a rapid qualitative evidence synthesis. Cochrane Database of Systematic Reviews, (4). (Not OA)