COVID-19 vaccine uptake, confidence and hesitancy in rural KwaZulu-Natal, South Africa between April 2021 and April 2022: A continuous cross-sectional surveillance study
High COVID-19 vaccine hesitancy in South Africa limits protection against future epidemic waves. We evaluated how vaccine hesitancy and its correlates evolved April 2021-April 2022 in a well-characterized rural KwaZulu-Natal setting. All residents aged >15 in the Africa Health Research Institute’...
Main Authors: | , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Public Library of Science (PLoS)
2023-01-01
|
Series: | PLOS Global Public Health |
Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10298801/?tool=EBI |
_version_ | 1797699517223534592 |
---|---|
author | Rachael Piltch-Loeb Lusanda Mazibuko Eva Stanton Thobeka Mngomezulu Dickman Gareta Siyabonga Nxumalo John D. Kraemer Kobus Herbst Mark J. Siedner Guy Harling |
author_facet | Rachael Piltch-Loeb Lusanda Mazibuko Eva Stanton Thobeka Mngomezulu Dickman Gareta Siyabonga Nxumalo John D. Kraemer Kobus Herbst Mark J. Siedner Guy Harling |
author_sort | Rachael Piltch-Loeb |
collection | DOAJ |
description | High COVID-19 vaccine hesitancy in South Africa limits protection against future epidemic waves. We evaluated how vaccine hesitancy and its correlates evolved April 2021-April 2022 in a well-characterized rural KwaZulu-Natal setting. All residents aged >15 in the Africa Health Research Institute’s surveillance area were invited to complete a home-based, in-person interview. We described vaccine uptake and hesitancy trends, then evaluated associations with pre-existing personal factors, dynamic environmental context, and cues to action using ordinal logistic regression. Among 10,011 respondents, vaccine uptake rose as age-cohorts became vaccine-eligible before levelling off three months post-eligibility; younger age-groups had slower uptake and plateaued faster. Lifetime receipt of any COVID-19 vaccine rose from 3.0% in April-July 2021 to 32.9% in January-April 2022. Among 7,445 unvaccinated respondents, 47.7% said they would definitely take a free vaccine today in the first quarter of the study time period, falling to 32.0% in the last. By March/April 2022 only 48.0% of respondents were vaccinated or said they would definitely would take a vaccine. Predictors of lower vaccine hesitancy included being male (adjusted odds ratio [aOR]: 0.70, 95% confidence interval [CI]: 0.65–0.76), living with vaccinated household members (aOR:0.65, 95%CI: 0.59–0.71) and knowing someone who had had COVID-19 (aOR: 0.69, 95%CI: 0.59–0.80). Mistrust in government predicted greater hesitancy (aOR: 1.47, 95%CI: 1.42–1.53). Despite several COVID-19 waves, vaccine hesitancy was common in rural South Africa, rising over time and closely tied to mistrust in government. However, interpersonal experiences countered hesitancy and may be entry-points for interventions. |
first_indexed | 2024-03-12T04:09:56Z |
format | Article |
id | doaj.art-73384d920a9d4d3e9bbf08190d804c60 |
institution | Directory Open Access Journal |
issn | 2767-3375 |
language | English |
last_indexed | 2024-03-12T04:09:56Z |
publishDate | 2023-01-01 |
publisher | Public Library of Science (PLoS) |
record_format | Article |
series | PLOS Global Public Health |
spelling | doaj.art-73384d920a9d4d3e9bbf08190d804c602023-09-03T11:07:12ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752023-01-0136COVID-19 vaccine uptake, confidence and hesitancy in rural KwaZulu-Natal, South Africa between April 2021 and April 2022: A continuous cross-sectional surveillance studyRachael Piltch-LoebLusanda MazibukoEva StantonThobeka MngomezuluDickman GaretaSiyabonga NxumaloJohn D. KraemerKobus HerbstMark J. SiednerGuy HarlingHigh COVID-19 vaccine hesitancy in South Africa limits protection against future epidemic waves. We evaluated how vaccine hesitancy and its correlates evolved April 2021-April 2022 in a well-characterized rural KwaZulu-Natal setting. All residents aged >15 in the Africa Health Research Institute’s surveillance area were invited to complete a home-based, in-person interview. We described vaccine uptake and hesitancy trends, then evaluated associations with pre-existing personal factors, dynamic environmental context, and cues to action using ordinal logistic regression. Among 10,011 respondents, vaccine uptake rose as age-cohorts became vaccine-eligible before levelling off three months post-eligibility; younger age-groups had slower uptake and plateaued faster. Lifetime receipt of any COVID-19 vaccine rose from 3.0% in April-July 2021 to 32.9% in January-April 2022. Among 7,445 unvaccinated respondents, 47.7% said they would definitely take a free vaccine today in the first quarter of the study time period, falling to 32.0% in the last. By March/April 2022 only 48.0% of respondents were vaccinated or said they would definitely would take a vaccine. Predictors of lower vaccine hesitancy included being male (adjusted odds ratio [aOR]: 0.70, 95% confidence interval [CI]: 0.65–0.76), living with vaccinated household members (aOR:0.65, 95%CI: 0.59–0.71) and knowing someone who had had COVID-19 (aOR: 0.69, 95%CI: 0.59–0.80). Mistrust in government predicted greater hesitancy (aOR: 1.47, 95%CI: 1.42–1.53). Despite several COVID-19 waves, vaccine hesitancy was common in rural South Africa, rising over time and closely tied to mistrust in government. However, interpersonal experiences countered hesitancy and may be entry-points for interventions.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10298801/?tool=EBI |
spellingShingle | Rachael Piltch-Loeb Lusanda Mazibuko Eva Stanton Thobeka Mngomezulu Dickman Gareta Siyabonga Nxumalo John D. Kraemer Kobus Herbst Mark J. Siedner Guy Harling COVID-19 vaccine uptake, confidence and hesitancy in rural KwaZulu-Natal, South Africa between April 2021 and April 2022: A continuous cross-sectional surveillance study PLOS Global Public Health |
title | COVID-19 vaccine uptake, confidence and hesitancy in rural KwaZulu-Natal, South Africa between April 2021 and April 2022: A continuous cross-sectional surveillance study |
title_full | COVID-19 vaccine uptake, confidence and hesitancy in rural KwaZulu-Natal, South Africa between April 2021 and April 2022: A continuous cross-sectional surveillance study |
title_fullStr | COVID-19 vaccine uptake, confidence and hesitancy in rural KwaZulu-Natal, South Africa between April 2021 and April 2022: A continuous cross-sectional surveillance study |
title_full_unstemmed | COVID-19 vaccine uptake, confidence and hesitancy in rural KwaZulu-Natal, South Africa between April 2021 and April 2022: A continuous cross-sectional surveillance study |
title_short | COVID-19 vaccine uptake, confidence and hesitancy in rural KwaZulu-Natal, South Africa between April 2021 and April 2022: A continuous cross-sectional surveillance study |
title_sort | covid 19 vaccine uptake confidence and hesitancy in rural kwazulu natal south africa between april 2021 and april 2022 a continuous cross sectional surveillance study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10298801/?tool=EBI |
work_keys_str_mv | AT rachaelpiltchloeb covid19vaccineuptakeconfidenceandhesitancyinruralkwazulunatalsouthafricabetweenapril2021andapril2022acontinuouscrosssectionalsurveillancestudy AT lusandamazibuko covid19vaccineuptakeconfidenceandhesitancyinruralkwazulunatalsouthafricabetweenapril2021andapril2022acontinuouscrosssectionalsurveillancestudy AT evastanton covid19vaccineuptakeconfidenceandhesitancyinruralkwazulunatalsouthafricabetweenapril2021andapril2022acontinuouscrosssectionalsurveillancestudy AT thobekamngomezulu covid19vaccineuptakeconfidenceandhesitancyinruralkwazulunatalsouthafricabetweenapril2021andapril2022acontinuouscrosssectionalsurveillancestudy AT dickmangareta covid19vaccineuptakeconfidenceandhesitancyinruralkwazulunatalsouthafricabetweenapril2021andapril2022acontinuouscrosssectionalsurveillancestudy AT siyabonganxumalo covid19vaccineuptakeconfidenceandhesitancyinruralkwazulunatalsouthafricabetweenapril2021andapril2022acontinuouscrosssectionalsurveillancestudy AT johndkraemer covid19vaccineuptakeconfidenceandhesitancyinruralkwazulunatalsouthafricabetweenapril2021andapril2022acontinuouscrosssectionalsurveillancestudy AT kobusherbst covid19vaccineuptakeconfidenceandhesitancyinruralkwazulunatalsouthafricabetweenapril2021andapril2022acontinuouscrosssectionalsurveillancestudy AT markjsiedner covid19vaccineuptakeconfidenceandhesitancyinruralkwazulunatalsouthafricabetweenapril2021andapril2022acontinuouscrosssectionalsurveillancestudy AT guyharling covid19vaccineuptakeconfidenceandhesitancyinruralkwazulunatalsouthafricabetweenapril2021andapril2022acontinuouscrosssectionalsurveillancestudy |