Behavioural Determinants of COVID-19-Vaccine Acceptance in Rural Areas of Six Lower- and Middle-Income Countries
Delayed acceptance or refusal of COVID-19 vaccines may increase and prolong the threat to global public health and the economy. Identifying behavioural determinants is considered a critical step in explaining and addressing the barriers of vaccine refusal. This study aimed to identify the behavioura...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-01-01
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| Series: | Vaccines |
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| Online Access: | https://www.mdpi.com/2076-393X/10/2/214 |
| _version_ | 1797476155052261376 |
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| author | Thomas P. Davis Adugna Kebede Yimam Md Abul Kalam Asrat Dibaba Tolossa Robert Kanwagi Sarah Bauler Loria Kulathungam Heidi Larson |
| author_facet | Thomas P. Davis Adugna Kebede Yimam Md Abul Kalam Asrat Dibaba Tolossa Robert Kanwagi Sarah Bauler Loria Kulathungam Heidi Larson |
| author_sort | Thomas P. Davis |
| collection | DOAJ |
| description | Delayed acceptance or refusal of COVID-19 vaccines may increase and prolong the threat to global public health and the economy. Identifying behavioural determinants is considered a critical step in explaining and addressing the barriers of vaccine refusal. This study aimed to identify the behavioural determinants of COVID-19-vaccine acceptance and provide recommendations to design actionable interventions to increase uptake of the COVID-19 vaccine in six lower- and middle-income countries. Taking into consideration the health belief model and the theory of reasoned action, a barrier analysis approach was employed to examine twelve potential behavioural determinants of vaccine acceptance in Bangladesh, India, Myanmar, Kenya, the Democratic Republic of the Congo (DRC), and Tanzania. In all six countries, at least 45 interviews with those who intended to get the vaccine (“Acceptors”) and another 45 or more interviews with those who did not (“Non-acceptors”) were conducted, totalling 542 interviews. Data analysis was performed to find statistically significant (<i>p</i> < 0.05) differences between Acceptors and Non-acceptors of COVID-19 vaccines and to identify which beliefs were most highly associated with acceptance and non-acceptance of vaccination based on the estimated relative risk. The analysis showed that perceived social norms, perceived positive and negative consequences, perceived risk, perceived severity, trust, perceived safety, and expected access to COVID-19 vaccines had the highest associations with COVID-19-vaccine acceptance in Bangladesh, Kenya, Tanzania, and the DRC. Additional behavioural determinants found to be significant in Myanmar and India were perceived self-efficacy, trust in COVID-19 information provided by leaders, perceived divine will, and perceived action efficacy of the COVID-19 vaccines. Many of the determinants were found to be significant, and their level of significance varied from country to country. National and local plans should include messages and activities that address the behavioural determinants found in this study to significantly increase the uptake of COVID-19 vaccines across these countries. |
| first_indexed | 2024-03-09T20:54:55Z |
| format | Article |
| id | doaj.art-d9ec06b2b6544a2786afb23471841568 |
| institution | Directory Open Access Journal |
| issn | 2076-393X |
| language | English |
| last_indexed | 2024-03-09T20:54:55Z |
| publishDate | 2022-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Vaccines |
| spelling | doaj.art-d9ec06b2b6544a2786afb234718415682023-11-23T22:25:22ZengMDPI AGVaccines2076-393X2022-01-0110221410.3390/vaccines10020214Behavioural Determinants of COVID-19-Vaccine Acceptance in Rural Areas of Six Lower- and Middle-Income CountriesThomas P. Davis0Adugna Kebede Yimam1Md Abul Kalam2Asrat Dibaba Tolossa3Robert Kanwagi4Sarah Bauler5Loria Kulathungam6Heidi Larson7World Vision International, 1202 Geneva, SwitzerlandWorld Vision International, 1202 Geneva, SwitzerlandBangladesh Country Office, Helen Keller International, Dhaka 1212, BangladeshWorld Vision Canada, Mississauga, ON L5T 2Y4, CanadaWorld Vision International, 1202 Geneva, SwitzerlandWorld Vision International, 1202 Geneva, SwitzerlandWorld Vision International, 1202 Geneva, SwitzerlandVaccine Confidence Project, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UKDelayed acceptance or refusal of COVID-19 vaccines may increase and prolong the threat to global public health and the economy. Identifying behavioural determinants is considered a critical step in explaining and addressing the barriers of vaccine refusal. This study aimed to identify the behavioural determinants of COVID-19-vaccine acceptance and provide recommendations to design actionable interventions to increase uptake of the COVID-19 vaccine in six lower- and middle-income countries. Taking into consideration the health belief model and the theory of reasoned action, a barrier analysis approach was employed to examine twelve potential behavioural determinants of vaccine acceptance in Bangladesh, India, Myanmar, Kenya, the Democratic Republic of the Congo (DRC), and Tanzania. In all six countries, at least 45 interviews with those who intended to get the vaccine (“Acceptors”) and another 45 or more interviews with those who did not (“Non-acceptors”) were conducted, totalling 542 interviews. Data analysis was performed to find statistically significant (<i>p</i> < 0.05) differences between Acceptors and Non-acceptors of COVID-19 vaccines and to identify which beliefs were most highly associated with acceptance and non-acceptance of vaccination based on the estimated relative risk. The analysis showed that perceived social norms, perceived positive and negative consequences, perceived risk, perceived severity, trust, perceived safety, and expected access to COVID-19 vaccines had the highest associations with COVID-19-vaccine acceptance in Bangladesh, Kenya, Tanzania, and the DRC. Additional behavioural determinants found to be significant in Myanmar and India were perceived self-efficacy, trust in COVID-19 information provided by leaders, perceived divine will, and perceived action efficacy of the COVID-19 vaccines. Many of the determinants were found to be significant, and their level of significance varied from country to country. National and local plans should include messages and activities that address the behavioural determinants found in this study to significantly increase the uptake of COVID-19 vaccines across these countries.https://www.mdpi.com/2076-393X/10/2/214COVID-19vaccinehesitancyacceptancebehaviourdeterminants |
| spellingShingle | Thomas P. Davis Adugna Kebede Yimam Md Abul Kalam Asrat Dibaba Tolossa Robert Kanwagi Sarah Bauler Loria Kulathungam Heidi Larson Behavioural Determinants of COVID-19-Vaccine Acceptance in Rural Areas of Six Lower- and Middle-Income Countries Vaccines COVID-19 vaccine hesitancy acceptance behaviour determinants |
| title | Behavioural Determinants of COVID-19-Vaccine Acceptance in Rural Areas of Six Lower- and Middle-Income Countries |
| title_full | Behavioural Determinants of COVID-19-Vaccine Acceptance in Rural Areas of Six Lower- and Middle-Income Countries |
| title_fullStr | Behavioural Determinants of COVID-19-Vaccine Acceptance in Rural Areas of Six Lower- and Middle-Income Countries |
| title_full_unstemmed | Behavioural Determinants of COVID-19-Vaccine Acceptance in Rural Areas of Six Lower- and Middle-Income Countries |
| title_short | Behavioural Determinants of COVID-19-Vaccine Acceptance in Rural Areas of Six Lower- and Middle-Income Countries |
| title_sort | behavioural determinants of covid 19 vaccine acceptance in rural areas of six lower and middle income countries |
| topic | COVID-19 vaccine hesitancy acceptance behaviour determinants |
| url | https://www.mdpi.com/2076-393X/10/2/214 |
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