They have produced a vaccine, but we doubt if COVID-19 exists: correlates of COVID-19 vaccine acceptability among adults in Kano, Nigeria

Vaccination is a critical tool in the global response to the COVID-19 pandemic. Yet, COVID-19 vaccine hesitancy has not been well explored in parts of Nigeria. We assessed the predictors of acceptability of the COVID-19 vaccine and identified reasons for vaccine hesitancy among adults in urban Kano, northern Nigeria. Using a mixed-methods design, we administered structured questionnaires to a cross-section of adults (n = 446), complemented with 20 in-depth interviews. Binary logistic regression and the framework approach were used to analyze the data. About one-half (51.1%, n = 228) of the respondents were willing to take the COVID-19 vaccine. Vaccine acceptance was higher among older respondents (>= 30 years) (adjusted Odds Ratio (aOR) = 1.76, 95% Confidence Interval (CI): 1.14-2.99 (>= 30 vs. <30), higher-income earners (>= 30,000 Naira) (aOR = 2.06, 95%CI:1.12-3.80, >= 30,000 vs. <30,000), and those with a history of a chronic medical disorder (aOR = 1.90, 95%CI:1.06-3.72). Vaccine acceptance was also higher in persons with high risk perception (aOR = 1.61, 95%CI:1.13-2.81, high vs. low), those who were unconcerned about vaccine safety (aOR = 1.71, 95%CI:1.13-3.55), and those who were not worried about efficacy (aOR = 2.02, 95%CI:1.14-4.11) and infertility-related rumors (aOR = 1.98, 95%CI:1.24-3.18). Themes revealed doubts about the existence of COVID-19, mistrust for authorities, and popular credence to rumors and conspiracy theories. In conclusion, COVID-19 vaccine acceptance was sub-optimal and influenced by respondent's age, income, co-morbidities, risk perception, and concerns about vaccine safety, efficacy, and rumors. Context-specific, evidence-based risk communication strategies and trust-building measures could boost vaccine confidence in similar settings.

Automated summary

The study conducted in urban Kano, northern Nigeria, revealed that half of the adults were willing to take the COVID-19 vaccine, with acceptance influenced by factors such as age, income, comorbidities, risk perception, and concerns about vaccine safety, efficacy, and rumors.