Characterising Covid-19 Vaccine Hesitancy in Harare Central, Zimbabwe

Abstract

Vaccine hesitancy is one of the top ten threats of any public health vaccination program. Zimbabwe is grappling in reaching its vaccination targets because of increasing vaccine hesitancy due to conspiracies associated with the vaccine and need support from civil society. Thus, this study aimed at characterizing vaccine hesitancy and determining factors associated with vaccine hesitancy amongst the general populace in Harare central district. An analytical cross- sectional study was conducted on 398 participants using a standard questionnaire. Of the 398 participants, 53.% were hesitant whilst 47% were not sure. Those hesitant opted for steaming (72%) and traditional herbs (42%). The ones willing to vaccinate were mostly driven by valuing their health (48%), important in saving dependents health (52%) and to control COVID-19 (45%). Bivariate analysis was performed on demographic variables Gender at (p=0.223) was not statistically associated with vaccine hesitancy. Educational level being attained at tertiary level was associated with reduced likelihood of Covid 19 vaccine hesitancy [COR:0.26(95%CI: 0.19-0.37)p<0.001.Being married was a protective factor as it was associated with reduced likelihood of vaccine hesitancy at (27%, p=0.012).Being formally employed was statistically significant at [COR:0.59(95% CI:0.42-0.83)p=0.003]. 224 of them were males whilst 174 were women which literally translates to a cumulative percentage of 56.% for males and 44.% for females. The percentage gap was 13% in favour of males. Multi-variate logistic regression was conducted to determine the socio-demographic factors associated with vaccine hesitancy. Level of education at tertiary level was associated with reduced likelihood of vaccine hesitancy (p=0.001). Marital status of being married was associated with reduced likelihood of not being vaccinated by 26% (p=0.040). Employment status and being selfemployed had a protective effect of 34%. Half of hesitant respondents (70%) n=279) lacked trust in health care provider capacity to provide adequate and accurate information whereas 37% of those willing to take up the vaccine did not trust in the health care providers. Those willing to take up the vaccine were 2 times more likely to trust the service provider than those not willing to vaccinate (OR 2.12 (95% CI 1.02 – 4.41) p = 0.043).Study findings indicated that 205(52%) of the study participants believed that Covid -19 is a demon that need spiritual interventions not a vaccine whilst 197(49%) people revealed that the vaccine is not safe and 167(42%) said the vaccine might not be even preventing the diseases ,they would rather prefer natural remedies to alleviate the diseases.155 (39%) of the participants thought that the vaccine alters their DNA at the same time leading to them to premature deaths whilst 148(37%) thought that the vaccine was a placebo. Choice of vaccine was found to be statistically significant with more respondents opting for Pfizer (p<0.001), Johnson and Johnson (p<0.001) compared to Sinovac (13%; p= 0.098). Many of the participants relied on WhatsApp (77.8%) and internet (60.3%) for covid 19 information. Vaccine hesitancy is relatively high (29.1%) amongst the general populace in Harare Central district. Based on this study the government through ministry of health and health promotion department must work closely with various stakeholders in designing an intense and effective vaccination campaign and at the same time doing door to vaccination.