Factors associated with COVID-19 vaccine hesitancy among healthcare workers in Cameroon and Nigeria: a web-based cross-sectional study

Introduction: Vaccination against COVID-19 is an effective strategy to curb the burden of COVID-19, but vaccine acceptance and uptake among African healthcare workers (HCWs) remain low. This study investigated the determinants of COVID-19 vaccine hesitancy among HCWs in Cameroon and Nigeria. Methods: We conducted an analytic cross-sectional study from May to June 2021, including consenting HCWs > 18 years identified using snowball sampling. Vaccine hesitancy was defined as indecisiveness or unwillingness to receive the COVID-19 vaccine. Multilevel logistic regression yielded adjusted odds ratios (aOR) for vaccine hesitancy. Results: We included a total of 598 (~60% women) participants. Vaccine hesitancy was estimated at 56.9% and 42.4% in Cameroon and Nigeria. Little or no trust in the approved COVID-19 vaccines (aOR= 2.28, 95% CI=1.24-4.20), lower perception of the importance of the vaccine on their personal health (5.26, 2.38-11.6), greater concerns about vaccine-related adverse effects (3.45, 1.83-6.47), and uncertainty about colleagues’ acceptability of the vaccine (2.98, 1.62-5.48) were associated with higher odds of vaccine hesitancy. In addition, participants with chronic disease (aOR= 0.34, 95% CI=0.12-0.97) and higher levels of concerns about getting COVID-19 (0.40, 0.18-0.87) were less likely to be hesitant to receive the COVID-19 vaccine. Conclusion: COVID-19 vaccine hesitancy among HCWs in this study was high and was determined, broadly, by the perceived risk of COVID-19 and COVID-19 vaccines on personal health, mistrust in COVID-19 vaccines, and uncertainty about colleagues’ vaccine acceptability. Targeted interventions addressing these concerns are warranted to improve COVID-19 uptake among HCWs in these settings.