Perception and willingness to accept COVID-19 Vaccines: A cross-sectional survey of the general population of Sokoto State, Nigeria

Oche Mansur Oche; Habibullah Adamu; Musa Yahaya; Hudu Garba Illo; Abdulaziz Mohammad Danmadami; Adamu Ijapa; Asmau Mohammad Wali; Hamza Yusuf; Hafsat Muhammad; Abba Aji

doi:10.1371/journal.pone.0278332

. 2022 Dec 1;17(12):e0278332. doi: 10.1371/journal.pone.0278332

Perception and willingness to accept COVID-19 Vaccines: A cross-sectional survey of the general population of Sokoto State, Nigeria

Oche Mansur Oche ^1,^2,^*, Habibullah Adamu ^1,², Musa Yahaya ¹, Hudu Garba Illo ², Abdulaziz Mohammad Danmadami ², Adamu Ijapa ², Asmau Mohammad Wali ², Hamza Yusuf ², Hafsat Muhammad ², Abba Aji ²

Editor: Harapan Harapan³

PMCID: PMC9714919 PMID: 36454892

Abstract

The number of confirmed cases of COVID-19 globally is well over 400 million, however, the number of cases is showing a downward trend especially in developed countries largely as a result of effective vaccination against COVID-19. In developing countries, vaccination coverage is still very low as a result of vaccine hesitancy, which could be attributed to misconceptions about COVID-19 itself and its newly developed vaccines. This study assessed COVID-19 vaccine acceptance and perception amongst the adult population in Sokoto state, Nigeria. A cross-sectional study was conducted in Sokoto state among 854 respondents selected via a multi-stage sampling technique. Data was collected electronically using a set of structured questionnaire and analysis was done using IBM SPSS version 25. Respondents’ perception was assessed using a 5-point Likert scale ranging from strongly disagree (1) to strongly agree (5). Respondents having a score of 3 and below were graded as having poor perception and those having scores above 3 were graded as having good perception. Respondents’ ages ranged from 17 to 76 years, with a mean of 34.8±12.07; more than half [474(53.7%)] of the respondents were males, 667(75.5%) were married and 539(61.0%) had formal education. The majority [839(95.0%)] of the respondents had a good perception of COVID -19 vaccine; 49.9% agreed enough research would be required on the safety of the vaccine. The majority, (72.4%) expressed their willingness to accept the COVID- 19 vaccine (male 38.4% vs. female 34.0%); 410(47.4%) said they can spend more than one hour to get the vaccine. Significant predictors of willingness to accept COVID 19 vaccine include age (p = 0.006; aOR = 0.223; 95% CI = 0.077–0.645), education (p<0.001; aOR = 1.720; 95% CI = 1.274–2.321) and perception of COVID 19 vaccine (p<0.001; aOR = 0.020; 95% CI = 0.009–0.044). The majority of the respondents had a good perception of COVID- 19 vaccine and more than two-thirds were willing to be vaccinated with the vaccine. Government should make the vaccine available for vaccination since a significant proportion of the respondents expressed their willingness to accept the vaccine

Introduction

Corona Virus disease (COVID-19) is a viral pandemic that was discovered in China, in the year 2019. The origin of the viral disease was traced to a wet market in Wuhan, a Chinese City in Hubei province. The disease is caused by a novel virus called Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1].

As of 10^th February 2022, the global confirmed cases of COVID-19 stand at 402,044,502, with 5,770,023 deaths and the number keeps growing on a daily basis [2]. In Nigeria, 253,838 confirmed cases of COVID-19 were reported as of 8^th February, 2022 with 3,139 deaths [3]. The COVID-19 pandemic has inflicted almost unimaginable harm on the life, health, and economy of many nations. Along with hygienic and behavioral control measures, vaccination is the most successful way of limiting or eliminating viral infection and spread. Even the best vaccine cannot be effective if it is not used. Recent surveys found that 50% of Americans said they are willing to take the vaccine, 30% are unsure, and 20% are refusing the vaccine [4]. In another survey of adult Americans, 58% intended to be vaccinated, 32% were not sure, and 11% did not intend to be vaccinated [5]. This number of participants is likely below the threshold needed for homogeneous herd immunity [6] and will leave many residents vulnerable to the disease, even with a vaccine available. Promoting the uptake of vaccines (particularly those against COVID-19) will require understanding whether people are willing to be vaccinated, the reasons why they are willing or unwilling to do so, and the most trusted sources of information in their decision-making [7,8]. Survey among the general public in African countries reported an acceptance rate of 81.6% in South Africa and 65.2% in Nigeria [9]. Early knowledge, attitudes and practices studies regarding COVID-19 from North-Central Nigeria reported an acceptance rate of 29.0%, which highlights the need for more studies for an accurate depiction of COVID-19 vaccine hesitancy in Africa due to possible large regional and sub-regional variations [10]. The World Health Organization (WHO) recommends a preemptive strategy to overcome vaccine hesitancy and build trust in a vaccine to prepare for maximum efficacy when a vaccine is available [11,12].

There are several COVID-19 candidate vaccines at various stages of development with few approved for use by regulatory authorities and WHO. The Pfizer/BoiNTech vaccine, Astrazeneca/University of Oxford vaccine, Sinovac vaccine, and Moderna COVID-19 vaccines are already approved for use by regulatory authorities in different countries across the globe [13]. Some of these vaccines are in activated viral particles while others are live attenuated viruses. There are some candidate vaccines that are viral subunits while few are mRNA vaccines. Some of these candidate vaccines are scheduled to be administered only once but the majority are to be administered twice (2doses) in other to achieve vaccine efficacy above 90%. About 84% of these vaccines are to be administered by injection with 76%, 5% and 3% through the intramuscular, intradermal and subcutaneous routes respectively. A few of the vaccines are to be administered by oral route [13].

Several groups of people and individuals across the globe have developed negative perceptions and misconceptions about the developed COVID-19 vaccines [14]. This has led to vaccine hesitancy among various populations with a reasonable proportion of the population not willing to be vaccinated with the newly developed vaccines due to perceived safety issues. In a broader context, vaccine hesitancy as defined by the WHO is the delay in acceptance or refusal of vaccination despite the availability of vaccination services [14]. The complex nature of motives behind vaccine hesitancy can be analyzed using the epidemiologic triad; environment, agent and host factors [15,16]. Environmental factors include public health policies, social factors and the messages spread by the media [17–19]. The agent (vaccine and disease) factors involve the perception of vaccine safety and effectiveness, besides the perceived susceptibility to the disease [19–21]. Host factors are dependent on knowledge, previous experience, educational and income levels [16,22]. Previous studies have shown that vaccine hesitancy is a common phenomenon globally, with variability in the cited reasons behind the refusal of vaccine acceptance [23–25]. The most common reasons include perceived risks vs. benefits, certain religious beliefs and lack of knowledge and awareness [26,27]. The aforementioned reasons can be applied to COVID-19 vaccine hesitancy, as shown by recent publications that showed a strong correlation between intent to get coronavirus vaccines and its perceived safety [28]. Association of the negative attitude towards COVID-19 vaccines and unwillingness to get the vaccines, and the association of religiosity with lower intention to get COVID-19 vaccines [29]. To date, there has been no prior study among the general population of Sokoto State investigating their perceptions, acceptance and hesitancy to receive COVID-19 vaccine. This study, was therefore aimed at determining the perception and hesitancy of the adult population of Sokoto state towards COVID- 19 vaccines. It is hoped that findings will help further interventions aimed at increasing the acceptability of the vaccines.

Materials and method

The study was conducted in Sokoto state in Northwestern part of Nigeria; it has 23 Local Government Areas (LGAs) comprising three senatorial zones namely Sokoto East, Sokoto North and Sokoto South senatorial zones respectively. Sokoto State has a population (projected) of 6,391,000 as of 2022 based on the 2006 general census [30].

The study utilized a cross- sectional design involving all adults residing or plying their trades in the state. Only those 18 years and above (male and female) resident within the study area, who have spent not less than six months in the study area were recruited into the study.

Using a prevalence of 66.1% for the proportion of parents who refused COVID- 19 vaccine in a previous study, a sample size of 344 was calculated using the Cochrane formula for estimating sample size in descriptive studies n = z²pq/d² [31].

With an anticipated response rate of 95%, the sample size was adjusted to 362. However, since cluster sampling was used to select respondents, the sample size was further adjusted to 905 using a 2.5 design effect.

The sampling technique for Lots Quality Assurance Sampling (LQAS) was modified and adopted for the selection of study participants [32], who were selected via a four- stage sampling process. One LGA was selected from each of the 3 senatorial zones in the state by simple random sampling through balloting to yield a total of 3 LGAs. Three catchment areas (wards) were selected from each of the selected LGAs by simple random sampling through balloting to yield a total of 9 catchment areas. Five supervision areas (settlements) were selected from each of the selected catchment areas by simple random sampling through balloting to yield a total of 45 supervision areas (settlements). Nineteen (19) participants (males and females) were selected from each of the selected supervision areas (settlements) to obtain a total of 855 study participants.

Data was collected using a set of interviewer administered questionnaire which was prepared in English language and translated to the local language–Hausa through a two-way process to verify the accuracy of the translation by two Hausa scholars. The questionnaire comprised four sections; socio-demographic characteristics, perception, acceptance/hesitancy and willingness to be vaccinated. It was pretested in two selected communities in a different LGA outside the selected LGAs after which necessary amendments were made. The questionnaire was uploaded on Open Data Kit (ODK) software using android hand–held smart devices which were scripted to prevent or minimize data entry errors, ease timely data collection, ensured completeness of the information and subsequent processing and analysis.

Seven Resident Doctors of the Department of Community Medicine of Usmanu Danfodiyo University Teaching Hospital, (UDUTH) Sokoto were used as research assistants for the data collection. They were trained by the Researchers for two days; each training session lasted for 2 hours. The training covered an overview of COVID-19 and covid-19 vaccine, general principles of research, objectives of the study, conduct of research, interpersonal communication skills and administration of research instruments.

Data collected was transmitted daily and temporally stored in the kobo collect server, which also helped in the monitoring of data collection activities. Data was subsequently downloaded in excel format for analysis and later exported to IBM SPSS version 25 for analysis; data editing and cleaning were done using constraints, restrictions and required functions on ODK.

Respondents’ perception was assessed using a 5-point Likert scale ranging from strongly disagree (1) to strongly agree (5). For each of the variables, the median score was calculated and graded as 1 = Strongly disagree, 2 = disagree, 3 = don’t know, 4 = agree, and 5 = strongly agree. All the Likert type items for perception that were framed negatively were reversed so that each of the items follow the same direction (positive direction). Each positive response to a perception question was awarded a score of one mark while zero mark was awarded to each negative response; the scores were summarized as mean score ranging from 1–5. A score of 1–3 was graded as poor perception whereas scores of 4 and 5 were graded as good perception. Continuous variables were summarized as mean and standard deviation, whereas categorical variables were summarized as frequencies and percentages. The Chi-square test was performed to assess the existence of an association between categorical variables; the level of statistical significance was set at p< 0.05.

Ethical approval was sought and obtained from the Health Research Ethics Committee of Usmanu Danfodiyo University Teaching Hospital Sokoto and individual verbal informed consent was sought from the participants before administering the questionnaire to them.

Results

The mean age of the respondents was 34.82 ± 12.06 years, the age group 20–29 years had the highest proportion [293 (33.2%)] of respondents. More than half of the respondents were males [474 (53.7%)], three-quarters of the respondents were married [667 (75.5%)] and the majority were Muslims [824 (93.3%)] and belonged to Hausa ethnic group 718 (81.3%). More than three- fifth of the respondents had formal education [539 (61.0%)] however, only a third of the respondents were gainfully employed [308 (34.9%)] (Table 1).

Table 1. Sociodemographic characteristics of respondents.

Variable	Frequency (%)
Age group (years) <20 years 20–29 years 30–39 years 40–49 years 50–59 years ≥60 years Mean ±SD	41 (4.6) 293 (33.2) 274 (31.0) 157 (17.8) 63 (7.1) 55 (6.2) 34.82 ± 12.068
Sex Male Female	474 (53.7) 409 (46.3)
Marital status Married Unmarried^*	667 (75.5) 216 (25.5)
Education None Qur’anic Primary Secondary Tertiary	21(2.4) 323(36.6) 56(6.3) 257(29.1) 226(25.6)
Religion Islam Christianity Others^*	824 (93.3) 46 (5.2) 13 (1.5)
Ethnicity Hausa Fulani Yoruba Igbo Others^**	718 (81.3) 26 (2.9) 94 (10.6) 28 (3.2) 17 (1.9)
Occupation Civil servant Farmer Business Others^***	147(16.6) 127(14.4) 301(34.1) 308(34.9)
Residence Rural Urban	439 (49.7) 444 (50.3)

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* African tradional religion and Artheism

** other ethnic minorities

*** Artisan, Hauling, Blogging, Real estate.

Regarding respondents’ perception of the Covid-19 vaccine, about half [430(49.9%)] of them agreed enough research has been conducted on the safety of the vaccine, 302(35.1%) disagreed with the statement that Covid- 19 vaccine can lead to infertility. Regarding its effectiveness, 285(33.7%) agreed the vaccine is effective in stopping Covid-19; 139(16.2%) agreed that the side effects of the vaccine are worse than the Covid -19 disease itself (Table 2).

Table 2. Perception of respondents regarding the COVID-19 vaccine.

Variable	Response					Aggregate response (Median score)
Variable	SD n(%)	D n(%)	N n(%)	A n(%)	SA n(%)	Aggregate response (Median score)
Enough scientific research has been conducted on the safety of the COVID-19 vaccine	32(3.7)	116(13.5)	181(21.0)	(430(49.9)	102(11.8	Agree
Covid 19 vaccine should be trusted if available	62(7.1)	86(9.8)	136(1.5)	419(47.7)	176(20.0)	Agree
Believe Covid-19 is man-made	53(7.6)	321(46.1)	258(37.1)	0(0.0)	64(9.2)	Disagree
Believe Covid-19 vaccine can lead infertility	60(7.0)	338(39.3)	302(35.1)	112(13.0)	49(5.7)	Neutral
Covid-19 vaccine is a way of implanting microchip into the body	84(9.7)	337(39.0)	223(25.8)	165(19.1)	54(6.3)	Neutral
Covid-19 vaccine is effective in stopping Covid-19	39(4.6)	257(30.4)	190(22.5)	285(33.7)	74(8.8)	Neutral
There are side effects associated with the vaccine are worse than Covid-19 itself	113(13.2)	353(40.0)	187(21.8)	139(16.2)	66(7.7)	Disagree

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Key: SD = Strongly disagree, D = Disagree, N = Neutral, A = Agree, SA = Strongly agree.

Fig 1 shows the perception of respondents regarding the Covid-19 vaccines where the majority of the respondents [785(89.4%)] had a poor perception regarding covid-19 vaccine.

Close to three-quarters [636(72.4%)] of the respondents would want to be vaccinated for COVID- 19, majority of the respondents [731(83.2%)] have never rejected vaccines for their children. Close to half [410(47.4%)] of the respondents were willing to travel more than one hour to get a vaccine, and more than half 487(55.4%) reported that they will accept the vaccine for their families if a new coronavirus (COVID-19) vaccine became available (Table 3).

Table 3. Willingness of respondents to accept COVID- 19 vaccine.

Variable	Response
Variable	Yes (%)	No (%)
Would want to be vaccinated for COVID-19	636(72.4)	243(27.6)
Ever rejected a vaccine for my child	148(16.8)	731(83.2)
Ever decided against vaccinating myself	264(30.0)	615(70.0)
Willing to spend more than one hour in travel time to get a vaccine	410(47.4)	455(52.6)
If a new COVID-19 vaccine becomes available I will accept the vaccine for my family	487(55.4)	392(44.6)

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Fig 2 depicts the willingness of respondents to accept the Covi-19 vaccines. Up to 636(72.4%) of the respondents expressed their willingness to accept Covid -19 vaccine once it is made available [males 337(38.4%) vs. females 299(34.0%)] (Fig 2).

In Fig 3, the major reason why respondents said they would not accept COVID-19 vaccine was that they felt they were healthy (35.2%), followed by those that said they do not think they will contract the disease (31%). A very small proportion said it was because they got some discouraging messages regarding the vaccine on social media (1.3%).

More than three-quarters 228(78.1%) of the respondents in the age group 20–29 years were willing to be vaccinated compared to three fifth 35(63.9%) of the respondents aged greater than 60 years old and the difference was statistically significant. Slightly close to three-quarters 490(73.8%) of the respondents that were married were willing to be vaccinated with covid-19 vaccines compared to slightly more than two thirds 146(67.9%) of unmarried respondents. More than three quarter 413(76.6%) of the respondents who had formal education compared to three fifth 223(65.6%) who had no formal education were willing to accept covid -19 vaccine. A quarter 10 (25.0%) of the respondents who had good perception compared to 626(74.7%) who had poor perception were willing to accept the covid-19 vaccine and the difference was statistically significant (Table 4).

Table 4. Factors influencing willingness to accept COVID-19 vaccine.

VARIABLE	Willingness to vaccinate		Test statistics	P-value
VARIABLE	Willing f (%)	Not willing f (%)	Test statistics	P-value
Age (years) <40 40–59 ≥60	45575.2) 146(66.7) 35(63.9)	150(24.8) 73(33.3) 20(36.4)	χ² = 8.092	0.017
Sex Male Female	337(71.7) 299(73.1)	133(28.3) 110(26.9)	χ² = 0.215	0.651
Marital status Married ^*Unmarried	490(73.8) 146(67.9)	174(26.2) 69(32.1)	χ² = 15.991	0.001
Education No formal Formal	223(65.6) 413(76.6)	117(34.4) 126(23.4)	χ² = 27.177	<0.001
Religion Islam Christianity Others	593(72.3) 34(73.9) 9(69.2)	227(27.7) 12(26.1) 4(30.8)	χ² = 0.120	0.970
Ethnicity Hausa Fulani Yoruba Igbo Others	518(72.5) 65(69.1) 20(76.9) 21(75.0) 12(70.6)	196(27.5) 29(30.9) 6(23.1) 7(25.0) 5(29.4)	χ² = 0.892	0.927
Occupation Unemployed Employed	199(64.6) 437(76.5)	109(35.4) 134(23.5)	χ² = 37.818	<0.001
Residence Rural urban Perception Poor Good	324 (74.5) 312 (70.3) 626(74.7) 10(25.0)	111 (25.5) 132 (29.7) 212(25.3) 30(75.0)	χ² = 1.949 χ² = 47.235	0.175 <0.001

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Pearson’s chi–square test

* single, divorced or widowed.

Factors significantly associated with perception about COVID 19 vaccine are marital status (p<0.001), ethnicity (p = 0.015) and occupation (p = 0.018). Other sociodemographic factors were not significantly associated with perception (p>0.05) (Table 5).

Table 5. Factors influencing the perception of respondents regarding the COVID-19 vaccine.

VARIABLE	Perception		Test statistics	P-value
VARIABLE	Good perception f(%)	Poor perception f(%)	Test statistics	P-value
Age (years) <40 40–59 ≥60	63(10.4) 20(9.1) 10(18.2)	541(89.6) 199(90.9) 45(81.8)	χ² = 3.855	0.143
Sex Male Female	59(12.6) 34(8.3)	411(87.4) 374(91.7)	χ² = 4.107	0.048
Marital status Married Unmarried	55(8.3) 38(17.7)	608(91.7) 177(82.3)	χ² = 15.080	<0.001
Education No formal Formal	32(9.4) 61(11.3)	308(90.6) 477(88.7)	χ² = 0.816	0.372
Religion Islam Christianity	82(10,0) 8(17.4)	737(90.0) 38(82.6)	FE χ² = 4.959	0.061
Ethnicity Hausa Fulani Yoruba Igbo Others^*	66(9.2) 1(3.8) 17(18.3) 5(17.9) 4(23.5)	648(90.8) 76(81.7) 25(96.2) 23(82.1) 13(76.5)	χ² = 12.989	0.015
Occupation Civil servant Farmer Business Others	10(6.8) 17(13.7) 23(7.7) 43(14.0)	137(93.2) 107(86.3) 277(92.3) 264(83.5)	χ² = 9.992	0.018
Place of Residence Rural Urban	20(4.6) 73(16.5)	415 (95.4) 379(83.5)	χ² = 32.714	<0.001

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Pearson’s chi–square test.

*Others (Religion = African traditional religion); (Ethnicity = Ethnic minority tribes).

In Table 6, all independent variables that were found to be significantly associated with willingness to vaccinate against Covid -19 in the bivariate analysis were included in the logistic regression model; age was found to be a significant predictor of willingness to accept Covid -19 vaccine; those below the age of 20 years were about 5 times less likely to take Covid -19 vaccine compared to those who were aged 60 years and above (p = 0.006, aOR = 0.223, 95%CI = 0.077–0.645). Those with formal education almost twice more likely to accept the vaccine compared to those with non-formal education (p<0.001, OR = 1.720, 95% CI = 1.274–2.321). Those with poor perception regarding Covid -19 vaccine were up to 50 times less likely to accept Covid -19 vaccine (Table 6).

Table 6. Logistic regression analysis for predictors of willingness to take COVID 19 vaccine.

Predictor	p-value	aOR	95% CI for OR
Predictor	p-value	aOR	Lower	Upper
Age <20 vs ≥60^* 20–29 vs ≥60^*	0.006 0.014	0.223 0.408	0.077 0.200	0.645 0.833
Form of education Formal vs no formal^*	<0.001	1.720	1.274	2.321
Occupation Civil servant vs Others^* Business vs Others^*	0.003 <0.001	0.352 0.466	0.178 0.312	0.695 0.698
Perception Poor vs Good^*	<0.001	0.020	0.009	0.044

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*Reference category aOR = adjusted odds ratio.

Discussion

This study was carried out amongst the adult general population of Sokoto state to access their perception, acceptance and hesitancy to covid-19 vaccines.

The perception and willingness of the general population are a sine qua non for improving the vaccination rates and thus the herd immunity of the general population. In this study, only a few of our respondents (9.2%) believed that Covid-19 is man- made; however this is in contrast to the findings from a 15-nation study on perceptions of covid-19 where more than half (67%) of the general population of Nigeria felt that the threat from coronavirus is exaggerated and therefore could not pose any significant risk as some have suggested [33].

Also in our study, most of the respondents disagreed that vaccines are effective against covid-19. However, in a separate multi-center study involving health workers from southern Nigeria, 66.7% of the respondents had some reservations concerning the vaccine with 43% of them believing that the vaccine might not be safe [34]. In the study by Islam and colleagues, they observed that 89% of their study subjects believed the covid-19 vaccine may have side effects [35].

Overall, 10.6% of our study subjects had good perception of the covid-19 vaccines which is not good for eventual acceptance of the vaccine. In a similar study amongst the general population in Saudi Arabia, about 71.3% of their respondents exhibited a good perception of the vaccine [36]. In contrast to these findings, Lee and his colleagues in South Korea noted a very high negative perception of the covid-19 vaccine [37]. The difference in the perception levels observed in our study and that of South Korea may not be unrelated to the fact that as of April 2021, South Korea has reported only 10,683 confirmed Covid-19 cases and 232 covid-19 related deaths [38].

It should be noted that the first case of the novel coronavirus (COVID-19) in South Korea occurred in late January 2020, approximately two months after the first case globally occurred in the Hubei province of China [39].

So far, a total of 61.8% of the world population has received at least one dose of covid-19 vaccine with 10.38 billion doses administered globally and only 10.6% of the people in low- income countries receiving one dose [40].

The increasing number of fatalities associated with the Covid-19 pandemic at its onset may not be unrelated to the non-availability of vaccines to combat the disease. To arrest the increasing morbidity and mortality due to COVID-19, researches have been conducted for the development of a COVID-19 vaccine, and COVID-19 vaccines are currently available in some countries [41]. However, because clinical trials for vaccines advanced very rapidly, and vaccines were approved in accelerated processes over a short period, negative information regarding COVID-19 vaccines has proliferated [42], due to which the number of people refusing to be vaccinated has increased.

Findings from this study showed that about 72.4% of our respondents were willing to accept the covid-19 vaccines when made available. This high acceptance rate follows the pattern obtained in some other countries such as India 70% [43], USA 70% [44], Turkey 69% [45], France 74% [46] UK and Italy 86 and 92% respectively [47].

In Africa, the lowest vaccine acceptance rate was observed in Congo 27.7% [48], while the highest was reported in South Africa where 91% of healthcare workers opined that they would accept vaccination [49]. In this study, respondents who are of younger ages (20-29years), married, employed, having good perception and formal education were more likely to accept covid-19 vaccination. Other studies have corroborated our findings that males and persons of younger ages were more likely to accept the vaccines [50–52]. In contrast to our findings, El-Elimat and colleagues observed in their study that being employed was less likely to favour acceptance of covid-19 vaccines [50].

In contrast to the high acceptance rate of covid-19 vaccines in our study, low rates were observed in other settings such as Lebanon 21.4% [53], Syria 35.9% [54] Jordan 37.4% [50], Delta State Nigeria 48.6% [55]and 49% in Chile [56] Findings from our study indicated that more males were willing to accept covid-19 vaccines compared to females (38.4% vs 34.0%) and this is similar to the findings from Kuwait where male subjects were more likely than female subjects to accept vaccination against COVID-19 (58.3 vs. 50.9%) [57] and also the study from low and middle-income countries [58] and elsewhere [51]. A global study observed lower odds of vaccine willingness among male participants [59]. However, women in Japan demonstrated very high vaccine hesitancy compared with men [60]. The relatively low acceptance rate in these countries could be a result of general vaccine hesitancy. With low vaccine acceptance, it would be extremely difficult to manage and control the current covid-19 pandemic and by extension prolong the period of the pandemic.

High vaccination rates can ultimately lead to the achievement of herd immunity which is necessary if the devastating effects and rapid spread of covid-19 are to be nipped in the bud. This herd immunity can be achieved through a threshold range of between 50–65% [61,62].

One obvious major obstacle militating against the achievement of such a goal is believed to be vaccine hesitancy and skepticism among the populations worldwide [63–66].

Vaccine hesitancy was defined by the WHO Strategic Advisory Group of Experts (SAGE) as “a delay in acceptance or refusal of vaccination despite the availability of vaccination services” [67] and is a major obstacle to vaccination among the general population and health workers. The acceptance of the vaccine is instrumental to ending the pandemic, especially in the face of prevailing conspiracies and myths about the vaccine. In this study, about 27.6% of our respondents were reluctant or refused (hesitancy) to receive a covid-19 vaccine. In a similar study from rural northern Nigeria, 13% of the study subjects were reluctant to receive the vaccines [68]. Low rates of vaccine hesitancy have similarly been recorded from other studies; 32.5% in Bangladesh [69], 35% amongst the adult population in Ghana [70], 19.4 and 35.8% in South Africa and Nigeria respectively [71]. Similarly, reports from Brazil and Ecuador reported about 30% hesitancy rate [71,72].

These low vaccine hesitancy rates recorded are in support of the research done by the Wellcome Trust in the Wellcome Monitor 2018 which observed that “the Low and Middle- Income countries (LMIC), in general, had lower rates of vaccine hesitancy and, for example, had fewer safety concerns about vaccines compared to High Income Countries (HICs)“[73]. In contrast to these findings, high rates of vaccine hesitancy have been recorded in Western and Eastern Europe in addition to Russia [74]. Additionally, the Middle East has been reported to have one of the highest hesitancy rates globally with rates of 72.4, 71.6 and 35.3% in Kuwait, Jordan, and Saudi Arabia respectively [75,76]. The high hesitancy rates reported in some of these countries may not be unrelated to the lack of confidence in the safety of these vaccines when they were first rolled out.

The hesitancy associated with the covid-19 vaccines did not come as a surprise because the new mRNA-based vaccines as a novel technology were received with some skepticism since no prior experience or successes with such an approach have been reported in the past. Also, the speed of development and registration of the vaccines in record time might have been associated with the hesitancy seen with the vaccines.

Findings from our study showed that some of the reasons for hesitancy included fear of side effects, lack of knowledge of the vaccines, mistrust as a result of the speed of vaccine roll-out, belief of not being at risk of getting a covid-19 disease, and misleading media messages amongst others. Similar to our findings, several studies alluded to some of the reasons volunteered by our study subjects [56,77–79].

Given the novelty of the covid-19 vaccines and based on the theory of Diffusion of Innovation, it is envisaged that many current vaccine refusers and those undecided might accept vaccination at a later time [80,81].

Conclusion

Encouraging the uptake of vaccines (particularly those against COVID-19) requires the understanding of people whether they are willing to be vaccinated, the reasons why they are willing or unwilling to do so, and also making available the most trusted sources of information for informed decision making.

Although the willingness of our respondents to accept the covid-19 vaccines is high, there is still a handful of them who are hesitant due mainly to safety concerns, mistrust as a result of the rapidity of vaccine roll out and the negative influence of the social and traditional media. This underscores the need for proper risk communication and also to bring on board religious and traditional leaders, healthcare providers and other civil organizations who are gatekeepers on community health issues to do away with all the conspiracy theories associated with the covid-19 vaccines if the ravaging effects of the pandemic are to be nipped in the bud.

Supporting information

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Click here for additional data file.^{(175.2KB, sav)}

Acknowledgments

Authors are thankful to the Resident Doctors in the Department of Community Medicine of Usmanu Danfodiyo University Teaching Hospital for their role as research assistants and participants for providing the information used to conduct the study.

Data Availability

All relevant data are within the paper and its Supporting Information files.

Funding Statement

The authors of this paper received no specific funding for this work.

References

1.Cucinotta D, and Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Biomed. 2020;91(1): 157–160. doi: 10.23750/abm.v91i1.9397 [DOI] [PMC free article] [PubMed] [Google Scholar]
2.World Health Organization(WHO). WHO Coronavirus Disease (COVID-19) Dashboard, Geneva,Switzerland,: WHO; 2022. [Available from: https://covid19.who.int/]. [Google Scholar]
3.Nigeria Center for Disease Control(NCDC). COVID-19 in Nigeria, Abuja, Nigeria: Nigeria Center for Disease Control; 2022. [Available from: https://covid19.ncdc.gov.ng/]. [Google Scholar]
4.Neergaard L, Fingerhut H. AP-NORC poll: Half of Americans would get a COVID-19 vaccine: Associated Press; May 28, 2020. [cited 2020 December 14]. Available from: https://apnews.com/article/dacdc8bc428dd4df6511bfa259cfec44. [Google Scholar]
5.Fisher KA, Bloomstone SJ, Walder J, Crawford S, Fouayzi H, Mazor KM. Attitudes Toward a Potential SARS-CoV-2 Vaccine: A Survey of U.S. Adults. Ann Intern Med. 2020. doi: 10.7326/M20-3569 ; PubMed Central PMCID: PMC7505019. [DOI] [PMC free article] [PubMed] [Google Scholar]
6.Kwok K.O, Lai F,. Wei WI, Wong S.Y.S, Tang J.W.T. Herd immunity—Estimating the level required to halt the COVID-19 epidemics in affected countries. J. Infect. 2020, 80, e32–e33. doi: 10.1016/j.jinf.2020.03.027 [DOI] [PMC free article] [PubMed] [Google Scholar]
7.Palamenghi L, Barello S, Boccia S, Graffigna G. Mistrust in biomedical research and vaccine hesitancy: The forefront challenge in the battle against COVID-19 in Italy. Eur. J. Epidemiol. 2020;35: 785–788. doi: 10.1007/s10654-020-00675-8 [DOI] [PMC free article] [PubMed] [Google Scholar]
8.Machingaidze S and Wiysonge C S. Understanding COVID-19 vaccine hesitancy; A new study unpacks the complexities of COVID-19 vaccine hesitancy and acceptance across low-, middle- and high-income countries. Nature Medicine 2021;27:1338–1344. [DOI] [PubMed] [Google Scholar]
9.Lazarus J.V, Ratzan S.C, Palayew A, Gostin L.O, Larson H.J, Rabin K, et al. global survey of potential acceptance of a COVID-19 vaccine. Nat. Med. 2020. [DOI] [PMC free article] [PubMed] [Google Scholar]
10.Reuben R.C, Danladi M.M.A, Saleh D.A, Ejembi P.E, Knowledge, Attitudes and Practices TowardsCOVID-19: An Epidemiological Survey in North-Central Nigeria. J. Community Health 2020. [DOI] [PMC free article] [PubMed] [Google Scholar]
11.French J, Deshpande S, Evans W, Obregon R. Key Guidelines in Developing a Pre-Emptive COVID-19 Vaccination Uptake Promotion Strategy. Int. J. Environ. Res. Public Health 2020, 17, 5893. doi: 10.3390/ijerph17165893 [DOI] [PMC free article] [PubMed] [Google Scholar]
12.Butler R, MacDonald N. Diagnosing the determinants of vaccine hesitancy in specific subgroups: The Guide to Tailoring Immunization Programmes (TIP). Vaccine 2015, 33, 4176–4179. doi: 10.1016/j.vaccine.2015.04.038 [DOI] [PubMed] [Google Scholar]
13.World Health Organizatioin (WHO). Landscape of novel coronavirus candidate (COVID-19) vaccine development worldwide WHO: Geneva, Switzerland; 2021. [Available from: https://www.who.int/publications/m/item/draft-landscape-of-covid-19-candidate- vaccines. [Google Scholar]
14.Noni E. MacDonald, The SAGE Working Group on Vaccine Hesitancy. Vaccine hesitancy: Definition, scope and determinants. Vaccine 33 (2015) 4161–4164. 2015. doi: 10.1016/j.vaccine.2015.04.036 [DOI] [PubMed] [Google Scholar]
15.Gowda C, Dempsey A.F. The rise (and fall?) of parental vaccine hesitancy. Hum. Vaccines Immunother. 2013, 9, 1755–1762. [DOI] [PMC free article] [PubMed] [Google Scholar]
16.Kumar D, Chandra R, Mathur M, Samdariya S, Kapoor N. Vaccine hesitancy: Understanding better to address better. Isr. J. Health Policy Res. 2016, 5, 2. doi: 10.1186/s13584-016-0062-y [DOI] [PMC free article] [PubMed] [Google Scholar]
17.Daley M.F., Narwaney K.J., Shoup J.A., Wagner N.M., Glanz J.M. Addressing Parents ‘ Vaccine Concerns: A Randomized Trial of a Social Media Intervention. Am. J. Prev. Med. 2018, 55, 44–54. doi: 10.1016/j.amepre.2018.04.010 [DOI] [PMC free article] [PubMed] [Google Scholar]
18.Arede M, Bravo-Araya M, Bouchard E, Singh G.G, Plajer V, Shehraj A, et al. Combating Vaccine Hesitancy: Teaching the Next Generation to Navigate Through the Post Truth Era. Front. Public Health 2018, 6, 381. doi: 10.3389/fpubh.2018.00381 [DOI] [PMC free article] [PubMed] [Google Scholar]
19.Dube E, Vivion M, MacDonald N.E, Vaccine hesitancy, vaccine refusal and the anti-vaccine movement: Influence, impact and implications. Expert Rev. Vaccines 2015, 14, 99–117. doi: 10.1586/14760584.2015.964212 [DOI] [PubMed] [Google Scholar]
20.Salmon D.A, Dudley M.Z, Glanz J.M, Omer S.B. Vaccine Hesitancy: Causes, Consequences, and a Call to Action. Am. J. Prev. Med. 2015, 49, S391–S398. doi: 10.1016/j.amepre.2015.06.009 [DOI] [PubMed] [Google Scholar]
21.Larson H.J, Cooper L.Z, Eskola J, Katz S.L, Ratzan S. Addressing the vaccine confidence gap. Lancet 2011, 378, 526–535. doi: 10.1016/S0140-6736(11)60678-8 [DOI] [PubMed] [Google Scholar]
22.Olson O, Berry C, Kumar N. Addressing Parental Vaccine Hesitancy towards Childhood Vaccines in the United States: A Systematic Literature Review of Communication Interventions and Strategies. Vaccines 2020, 8, 590. doi: 10.3390/vaccines8040590 [DOI] [PMC free article] [PubMed] [Google Scholar]
23.Lane S, MacDonald N.E, Marti M. Dumolard L. Vaccine hesitancy around the globe: Analysis of three years of WHO/UNICEF Joint Reporting Form data-2015–2017. Vaccine 2018, 36, 3861–3867. doi: 10.1016/j.vaccine.2018.03.063 [DOI] [PMC free article] [PubMed] [Google Scholar]
24.Wagner A.L, Masters N.B, Domek G.J, Mathew J.L, Sun X, Asturias E.J, et al. Comparisons of Vaccine Hesitancy across Five Low- and Middle-Income Countries. Vaccines 2019, 7, 155. doi: 10.3390/vaccines7040155 [DOI] [PMC free article] [PubMed] [Google Scholar]
25.The Lancet Child & Adolescent Health. Vaccine hesitancy: A generation at risk. Lancet Child Adolesc. Health 2019, 3, 281. [DOI] [PubMed] [Google Scholar]
26.Karafillakis E, Larson H.J, Consortium A. The benefit of the doubt or doubts over benefits? A systematic literature review of perceived risks of vaccines in European populations. Vaccine 2017, 35, 4840–4850. doi: 10.1016/j.vaccine.2017.07.061 [DOI] [PubMed] [Google Scholar]
27.Pelcic G, Karacic S, Mikirtichan G.L, Kubar O.I, Leavitt F.J, Cheng-Tek TM, et al. Religious exception for vaccination or religious excuses for avoiding vaccination. [DOI] [PMC free article] [PubMed] [Google Scholar]
28.Karlsson L.C, Soveri A, Lewandowsky S, Karlsson L, Karlsson H, Nolvi S, et al. Fearing the disease or the vaccine: The case of COVID-19. Personal. Individ. Differ. 2021, 172, 110590. [DOI] [PMC free article] [PubMed] [Google Scholar]
29.Olagoke A.A, Olagoke O.O, Hughes A.M, Intention to Vaccinate Against the Novel 2019 Coronavirus Disease: The Role of Health Locus of Control and Religiosity. J. Relig. Health 2020. doi: 10.1007/s10943-020-01090-9 [DOI] [PMC free article] [PubMed] [Google Scholar]
30.National Population Commission (NPopC) [Nigeria] and ICF. Demographic and Health Survey 2018. Abuja, Nigeria and Rockvile, Maryland USA: (NPopC) and ICF; 2018. [Google Scholar]
31.Ibrahim T. Research methodology and dissertation writing for health and allied health professionals. Cress Global Link Limited Abuja; 2009.74. [Google Scholar]
32.Pham K, Sharpe EC, Weiss WM,Vu A. The use of a lot quality assurance sampling methodology to assess and manage primary health interventions in conflict-affected West Darfur, Sudan. Popul Health Metrics; 2016:3–4. doi: 10.1186/s12963-016-0103-3 [DOI] [PMC free article] [PubMed] [Google Scholar]
33.CDC Africa COVID-19 Vaccine Perceptions 2020.
34.Adejumo OA, Ogundele OA Madubuko CR, Oluwafemi RO, Okoye OC, Okonkwo KC. Perceptions of the COVID-19 vaccine and willingness to receive vaccination among health workers in Nigeria. Osong Public Health Res Perspect 2021;12(4):236–243. doi: 10.24171/j.phrp.2021.0023 [DOI] [PMC free article] [PubMed] [Google Scholar]
35.Islam MS, Siddique AS, Akter R, Tasnim R, Sujan MSH, Ward PR et al. Knowledge, attitudes and perceptions towards COVID-19 vaccinations: a community survey in Banglades. BMC Public Health (2021) 21:1851, 10.1186/s12889-021-11880-9. [DOI] [PMC free article] [PubMed] [Google Scholar]
36.Al-Zalfawi S.M.; Rabbani S.I.; Asdaq S.M.B.; Alamri A.S.; Alsanie W.F.; Alhomrani M.; et al. Public Knowledge, Attitude, and Perception towards COVID-19 Vaccination in Saudi Arabia. Int. J. Environ. Res.Public Health 2021, 18, 10081. doi: 10.3390/ijerph181910081 [DOI] [PMC free article] [PubMed] [Google Scholar]
37.Lee H1, Noh EB, Park SJ, Hae Kweun Nam HK, Lee TH1, Ram Lee GR, et al. COVID-19 Vaccine Perception in South Korea: Web Crawling Approach. JMIR Public Health Surveill 2021. vol. 7 iss. 9 e31409 p. 1. doi: 10.2196/31409 [DOI] [PMC free article] [PubMed] [Google Scholar]
38.Soneji S, Beltrán-Sánchez H, Yang JW, Mann C Population-Level Mortality Rates from Novel Coronavirus (COVID-19) in South Korea. medRxiv 2020.03.23.20041814; 10.1101/2020.03.23.20041814 Asia Pacific Journal of Public Health doi: [DOI] [PMC free article] [PubMed] [Google Scholar]
39.Park WB, Kwon N-J, Choi S-J, et al. Virus Isolation from the First Patient with SARS-CoV-2 in Korea. J Korean Med Sci. 2020;35(7). doi: 10.3346/jkms.2020.35.e84) [DOI] [PMC free article] [PubMed] [Google Scholar]
40.Ritchie H, Mathieu E, Rodes-Gurao L, Appel C, Giattino C, Ortiz-Ospina E, et al. A global database of COVID-19 vaccinations. Nat Hum Behav (2021) 5, 947–953 (2021). 10.1038/s41562-021-01122-8. Accessed 15/01/2022. [DOI] [PubMed] [Google Scholar]
41.NHS. Coronavirus (COVID-19) vaccine. Accessed 11thDecember 2020.
42.Burki T. Vaccine misinformation and social media. The Lancet Digital Health 2019. Oct;1(6):e258–e259. doi: 10.1016/S2589-7500(19)30136-0 [DOI] [Google Scholar]
43.Kishore J, Venkatesh U, Ghai G, Heena, Kumar P. Perception and attitude towards COVID-19 vaccination: A preliminary online survey from India. J Family Med Prim Care 2021;10:3116–21. doi: 10.4103/jfmpc.jfmpc_2530_20 [DOI] [PMC free article] [PubMed] [Google Scholar]
44.Reiter PL, Pennell ML, Katz ML. Acceptability of a COVID-19 vaccine among adults in the United States: How many people would get vaccinated? Vaccine 2020:6500–7. doi: 10.1016/j.vaccine.2020.08.043 [DOI] [PMC free article] [PubMed] [Google Scholar]
45.Salali GD, Uysal MS. COVID-19 vaccine hesitancy is associated with beliefs on the origin of the novel coronavirus in the UK and Turkey. Psychol Med 2020;1–3. doi: 10.1017/S0033291720004067 [DOI] [PMC free article] [PubMed] [Google Scholar]
46.Biasio LR, Bonaccorsi G, Lorini C, Pecorelli S. Assessing COVID-19 vaccine literacy: A preliminary online survey. Hum Vaccin Immunother 2021;1304–1312. doi: 10.1080/21645515.2020.1829315 [DOI] [PMC free article] [PubMed] [Google Scholar]
47.Peretti-Watel P, Seror V, Cortaredona S, Launay O, Raude J, Verger P, et al. A future vaccination campaign against COVID-19 at risk of vaccine hesitancy and politicisation. Lancet Infect Dis 2020:769–70. doi: 10.1016/S1473-3099(20)30426-6 [DOI] [PMC free article] [PubMed] [Google Scholar]
48.Nzaji MK, Ngombe LK, Mwamba GN, Ndala DBB, Miema JM, Lungoyo CL, et al. Acceptability of vaccination against COVID-19 among healthcare workers in the Democratic Republic of the Congo. Pragmat Obs Res 2020;11:103. doi: 10.2147/POR.S271096 [DOI] [PMC free article] [PubMed] [Google Scholar]
49.Adeniyi OV, Stead D, Singata-Madliki M, Batting J, Wright M, Jelliman E, et al. Acceptance of COVID-19 vaccine among the healthcare workers in the Eastern Cape, South Africa: a cross sectional study. Vaccines. 2021;9(6):666. doi: 10.3390/vaccines9060666 [DOI] [PMC free article] [PubMed] [Google Scholar]
50.El-Elimat T, AbuAlSamen MM, Almomani BA, Al-Sawalha NA, Alali FQ(2021) Acceptance and attitudes toward COVID-19 vaccines: A crosssectional study from Jordan. PLoS ONE 16(4): e0250555. doi: 10.1371/journal.pone.0250555 [DOI] [PMC free article] [PubMed] [Google Scholar]
51.Malik AA, McFadden SM, Elharake J, Omer SB. Determinants of covid-19 vaccine acceptance in the US. EClinicalMedicine. 2020. Aug 12; 26: 100495. doi: 10.1016/j.eclinm.2020.100495 [DOI] [PMC free article] [PubMed] [Google Scholar]
52.Di Gennaro F, Murri R, Segala FV, Cerruti L, Abdulle A, Saracino A, et al. Attitudes towards Anti-SARS-CoV2 Vaccination among Healthcare Workers: Results from a National Survey in Italy. Viruses 2021;13(3). doi: 10.3390/v13030371 . [DOI] [PMC free article] [PubMed] [Google Scholar]
53.COVID-19 vaccination. BMC Public Al Halabi C.K.; Obeid S.; Sacre H.; Akel M.; Hallit R.; Salameh P.; et al. Attitudes of Lebanese adults regarding Health 2021, 21, 1–7. [DOI] [PMC free article] [PubMed] [Google Scholar]
54.Mohamad O.; Zamlout A.; AlKhoury N.; Mazloum A.; Alsalkini M.; Shaaban R. Factors associated with the intention of Syrian adult population to accept COVID19 vaccination: A cross-sectional study. BMC Public Health 2021, 21, 1–10. [DOI] [PMC free article] [PubMed] [Google Scholar]
55.Josiah B O Kantaris M. Perception of Covid-19 and acceptance of vaccination in Delta State Nigeria Nigerian Health Journal 2021;21(2):60–85. [Google Scholar]
56.Cerda AA and García LY (2021) Hesitation and Refusal Factors in Individuals’ Decision- Making Processes Regarding a Coronavirus Disease 2019 Vaccination. Front. Public Health 9:626852 doi: 10.3389/fpubh.2021.626852 [DOI] [PMC free article] [PubMed] [Google Scholar]
57.Alqudeimat Y., Alenezi D, AlHajri B, Alfouzan H, Almokhaizeem Z, Altamimi S, et al. COVID-19 Vaccine Acceptability and Its Determinants among Adults in Kuwait. Med Princ Pract 2021;30:262–271 271 doi: 10.1159/000514636 [DOI] [PMC free article] [PubMed] [Google Scholar]
58.Solís Arce J S, Warren S S, Meriggi N F, Scacco A, McMurry N Voors M et al. (COVID-19 vaccine acceptance and hesitancy in low- and middle-income countries. Nature Medicine 2021; 27: 1385–1394. doi: 10.1038/s41591-021-01454-y [DOI] [PMC free article] [PubMed] [Google Scholar]
59.Lazarus JV, Ratzan SC, Palayew A, Lazarus J.V, Ratzan S.C, Palayew A. et al. A global survey of potential acceptance of a COVID-19 vaccine. Nat Med 2021;27:225–8. doi: 10.1038/s41591-020-1124-9 [DOI] [PMC free article] [PubMed] [Google Scholar]
60.Yoda T, Katsuyama H. Willingness to receive COVID-19 vaccination in Japan. Vaccines 2021;9:48. doi: 10.3390/vaccines9010048 [DOI] [PMC free article] [PubMed] [Google Scholar]
61.Omer SB, Yildirim I, Forman HP. Herd Immunity and Implications for SARS-CoV-2 Control. JAMA. 2020; 324(20):2095–6. doi: 10.1001/jama.2020.20892 . [DOI] [PubMed] [Google Scholar]
62.Fine P, Eames K, Heymann DL. “Herd Immunity”: A Rough Guide. Clin Infect Dis. 2011; 52(7):911–6. doi: 10.1093/cid/cir007 . [DOI] [PubMed] [Google Scholar]
63.Coustasse A, Kimble C, Maxik K. COVID-19 and Vaccine Hesitancy: A Challenge the United States Must Overcome. J Ambul Care Manage. 2021; 44(1). doi: 10.1097/JAC.0000000000000360 . [DOI] [PubMed] [Google Scholar]
64.Schoch-Spana M, Brunson EK, Long R, Ruth A, Ravi SJ, Trotochaud M, et al. The public’s role in COVID-19 vaccination: Human-centered recommendations to enhance pandemic vaccine awareness, access, and acceptance in the United States. Vaccine. 2020. doi: 10.1016/j.vaccine.2020.10.059 ; PubMed Central PMCID: PMC7598529. [DOI] [PMC free article] [PubMed] [Google Scholar]
65.MacDonald NE. Vaccine hesitancy: Definition, scope and determinants. Vaccine. 2015; 33(34):4161–4. doi: 10.1016/j.vaccine.2015.04.036 . [DOI] [PubMed] [Google Scholar]
66.Neumann-Bohme S, Varghese NE, Sabat I, Barros PP, Brouwer W, van Exel J, et al. Once we have it,will we use it? A European survey on willingness to be vaccinated against COVID-The European Journal of Health Economics. 2020; 21(7):977–82. 10.1007/s10198-020-01208-6 3259195718–20. [DOI] [PMC free article] [PubMed] [Google Scholar]
67.World Health Organization (WHO). Ten threats to global health in 2019 [Internet]. Geneva: WHO; 2019. [cited 2020 Dec 20]. Available from: https://www.who.int/news-room/spotlight/ten-threats-to-global-health-in-2019. [Google Scholar]
68.Sato R and Takasaki Y. Vaccine Hesitancy and Refusal: Behavioural evidence from Rural Northern Nigeria. Vaccines 2021;9(9): 1023. [DOI] [PMC free article] [PubMed] [Google Scholar]
69.Ali M, Hossain A. What is the extent of COVID-19 vaccine hesitancy in Bangladesh? A cross-sectional rapid national survey. BMJ Open 2021;11:e050303. doi: 10.1136/bmjopen-2021-050303 [DOI] [PMC free article] [PubMed] [Google Scholar]
70.Aberese-Ako M, Doegah PT, Immurana M, Dalaba MA, Manyeh AK, Klu D, et al. COVID-19 vaccine hesitancy among the adult population in Ghana: evidence from a pre-vaccination rollout survey.Tropical Medicine and Health (2021) 49:96 10.1186/s41182-021-00357-5. [DOI] [PMC free article] [PubMed] [Google Scholar]
71.Lazarus J.V.; Ratzan S.C.; Palayew A.; Gostin L.O.; Larson H.J.; Rabin K.; et al. A global survey of potential acceptance of a COVID-19 vaccine. Nat. Med. 2020. [DOI] [PMC free article] [PubMed] [Google Scholar]
72.Sarasty O.; Carpio C.E.; Hudson D.; Guerrero-Ochoa P.A.; Borja I. The demand for a COVID-19 vaccine in Ecuador. Vaccine 2020, 38, 8090–8098. doi: 10.1016/j.vaccine.2020.11.013 [DOI] [PMC free article] [PubMed] [Google Scholar]
73.Trust Wellcome. Wellcome Global Monitor: How Does the World Feel about Science and Health? 2019. Available online: https://wellcome.ac.uk/sites/default/files/wellcome-global-monitor-questionnairedevelopment-report_0.pdf (accessed on 25 June 2021). [Google Scholar]
74.Wellcome Global Monitor. How Does the World Feel about Science and Health? Available online: https://wellcome.org/sites/default/files/wellcome-global-monitor-2018.
75.Sallam M.; Dababseh D.; Eid H.; Al-Mahzoum K.; Al-Haidar A.; Taim D.; et al. High rates of COVID-19 vaccine hesitancy and its association with conspiracy beliefs: A study in Jordan and Kuwait among other Arab countries. Vaccines 2021; 9: 42. doi: 10.3390/vaccines9010042 [DOI] [PMC free article] [PubMed] [Google Scholar]
76.Al-Mohaithef M.; Padhi B.K. Determinants of COVID-19 Vaccine Acceptance in Saudi Arabia: A Web-Based National Survey. J. Multidiscip. Health. 2020, 13, 1657–1663. doi: 10.2147/JMDH.S276771 [DOI] [PMC free article] [PubMed] [Google Scholar]
77.Schrading WA, Trent SA, Paxton JH et al. Vaccination Rates and Acceptnce of SARS-CoV2 CVaccination Among US Emergency Department Health Care Personnael. Acad Emerg Med. 2021. Mar 15: doi: 10.1111/acem.14236 [DOI] [PMC free article] [PubMed] [Google Scholar]
78.Seydou A. Who wants COVID-19 vaccination? In 5 West African countries, hesitancy is high, trust low. Afro barometer, 2021. Available: https://bit.ly/3hz1wZg. [Google Scholar]
79.Solís Arce JS, Warren SS, Meriggi NF. COVID-19 vaccine acceptance and Hesitancy in low and middle income countries, and implications for messaging. Public and Global Health 2021;27. [DOI] [PMC free article] [PubMed] [Google Scholar]
80.Rogers EM. Diffusion of Innovations. 3rd ed New York, NY: The Free Press; 1983. [Google Scholar]
81.Dzieciolowska S, Hamel D, Gadio S, Dionne M, Gagnon D, Robitaille L, et al. Covid-19 vaccine acceptance, hesitancy, and refusal among Canadian healthcare workers: A multicenter survey, American Journal of Infection Control 00 (2021) 1−6. doi: 10.1016/j.ajic.2021.04.079 [DOI] [PMC free article] [PubMed] [Google Scholar]

PLoS One. doi: 10.1371/journal.pone.0278332.r001

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PONE-D-22-08801PERCEPTION AND WILLINGNESS TO ACCEPT COVID-19 VACCINES: A CROSS-SECTIONAL SURVEY OF THE GENERAL POPULATION OF SOKOTO STATE, NIGERIAPLOS ONE

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Authors,

There are conflicting views of reviewers on this manuscript and I will give the chance to revise the manuscript based on reviewer comments. I read this manuscript carefully and found that it should be re-written by someone expert both in the field as well as English native. I will evaluate again carefully this manuscript and see how well all the comments from reviewers are addressed. Unsatisfactory might result rejection. Master data should be provided online.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

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Reviewer #1: Yes

Reviewer #2: No

Reviewer #3: Partly

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: No

Reviewer #3: Yes

**********

3. Have the authors made all data underlying the findings in their manuscript fully available?

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Reviewer #1: Yes

Reviewer #2: No

Reviewer #3: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

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Reviewer #1: Yes

Reviewer #2: No

Reviewer #3: No

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Review comments

General comments

This is a very good study and well written manuscript. I commend the Authors for their good efforts in this direction.

I implore the Authors to take note of the following comments and make some amendments to the manuscript based on them.

I expect the Authors to include multivariate analysis (binary logistic regression) in the result.

Authors should ensure that their manuscript is organized according to Journal guidelines.

Abstract

Results

Why were respondents less than 18 years included in the study?

Include years after indicating the mean age of the respondents

Define how good perception was determined in the methods section of the abstract

Introduction

Second line; The origin of the virus was traced……….

Line 5, change stands to stood

Page 2, line 14, focus was on studies but only one reference was give. Change studies to study. Do the same for attitudes and practices

Always indicate Sokoto state, Nigeria so as to enhance the understanding of readers

I think the focus of the study is on willingness and not hesitancy. The aim of the study as stated towards the end of the introduction section should be reviewed

Very good introduction. My commendations to the Authors.

Materials and method

Sampling technique

Since a four stage sampling technique was used, it will be good to explain the stages in sequence. In the first stage, ……….in second stage. Also, in using a probability sampling technique, the sampling frame should be indicated.

An explanation may also be required on how the sampling interval for the systematic random sampling technique was derived

There is no indication of the number of variables used to assess perception of covid-19 vaccine

Explain also how willingness to receive COVID-19 vaccine was derived

Data analysis

I wonder why binary logistic regression analysis was not done in this study especially with such a high sample size of 883. Authors are advised to include logistic regression analysis in the result.

Ethical considerations

Include the ethical approval number from the Health Research and Ethics Committee

What information was provided to the respondents on participation in the study, confidentiality, benefits and risks associated with participation in the study?

Results

Table 1

Include sample size, (n=883) under Frequency. Create a separate column for Percent (%)

The sample size for the study as obtained for Table 1 is 883 and this is different from that indicated in the abstract, (854). This should be reconciled.

Table 4

Indicate sample size, (n=883) under willingness to vaccinate

Use variable instead of variables

Use the Chi square sign instead of Test statistics

Instead of f use N

Reduce the age groupings to three or four (three will be more meaningful)

Explain others under ethnicity and religion as footnotes

1st line, page 12. ……. and the difference in proportions was found to be statistically significant. Correct for others

Do the same corrections for Table 5

Table on factors affecting perception should come first before that for willingness

Reviewer #2: Thank you for giving me the opportunity to review this article. Find below my submission

1.The abstract is unstructured

2.The introduction is bereft of justification to the study

3.The author mentioned the prevalence of COVID 19 as at 10th of February This is an old statistics

In the methods

1.How did the authors calculate perception and hesitancy

2.Chi square alone will not do justice to this work. Linear regression will help

3.How was this patients selected

4.there is gender bias here

5.Study design, sampling technique, study population and even sample size determination are not well elaborated

In the Discussion

The authors should explain their results and give a proper critic on their findings and then compare with that of other authors

The conclusion is verbose

There is no recommendation

In the references

Please visit instruction to authors on how to cite references. This is not Vancouver

Reviewer #3: Authors surveyed the general population of the Northwestern part of Nigeria for their perception and willingness to accept COVID-19 vaccines. I find the findings reported therein are interesting that despite Nigeria is a developing nation, the willingness is high (72.4%) and comparable to India, USA, France and UK. But I have several concerns before the manuscript can be accepted for publication.

1. First of all, the typos and grammatical errors could be found almost in the entire manuscript. I understand that they are technical, but enhancing the English could be very helpful to improve the readability of the manuscript. Moreover, authors need to be consistent in using COVID-19 or covid-19 (capital or simple letters).

2. Both in the Abstract and Introduction, authors framed the narrative that developing countries tend to have low willingness to COVID-19 vaccine. However, the present findings therein suggest otherwise. In my opinion, the discussion could be made more interesting if authors could explore as to why high level of willingness was obtained in Nigeria. Authors need to be more critical as to why previous study reported low vaccine acceptance in Nigeria. Implications of these findings could be useful for other developing countries to lower vaccine hesitancy.

3. In introduction, authors mentioned about behavioral control as a means to overcome the pandemic. I strongly suggest author to include the development of oral bioavailable drugs such as molnupiravir, which is suggested could be the key for the COVID-19 pandemic. Indeed, the efficacy and safety of this drug should be further studied. Cite: Masyeni et al. J Med Virol. 2022;94(7):3006-3016 – doi: 10.1002/jmv.27730

4. Authors perhaps could discuss the type of vaccine used in Nigeria. A study found that inactivated viral vaccine has a waning efficacy. Could this be attributed to the vaccine hesitance in Nigeria? Please incorporate this study: Surawan et al. Narra J 2022; 2(1): e71-doi:10.52225/narra.v2i1.71

5. Methods should be more structured: add sub-sections (such as study design, determination of sample, questionnaire and survey, and data analysis) would be very helpful for readers.

6. Authors should be more careful when comparing their results with other previously published literatures. Such as in the second paragraph of the discussion, where authors highlighted their findings that only 9.2% believed COVID-19 was man-made. Then, authors compared the finding with the fact that 67% respondents of the previous study felt the exaggeration of COVID-19 threat. The two findings are NOT relevant, therefore not comparable. This is a major weakness of the manuscript. I strongly suggest author to make revision of the entire discussion regarding this matter.

7. “Disinformation, along with ‘haram’ notion negatively affects the COVID-19 vaccine acceptance.” This is suitable with the findings because samples with non-formal education (supposedly from Qur’anic education) is less-likely to be willing. And also cite: Hassan et al. Narra J 2021; 1(3): e 57 - doi: 10.52225/narra.v1i3.57

8. “This herd immunity can be achieved through a threshold range of between 50-65% [61,62].” The cited literatures did not consider the emergence of COVID variants. Please refer to the recent literatures such as this one: Caldwell et al. Paediatric Respiratory Reviews2021; 39: 32-39 – doi: 0.1016/j.prrv.2021.07.002

9. A study from Rosiello et al. (Narra J 2021; 1(3): e55-doi: 10.52225/narra.v1i3.55) suggests that population of North African region are still low in vaccine acceptance. Please incorporate this study in your discussion.

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Reviewer #3: No

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PLoS One. 2022 Dec 1;17(12):e0278332. doi: 10.1371/journal.pone.0278332.r002

Author response to Decision Letter 0

13 Sep 2022

A rebuttal letter responding to all the queries raised by reviewers have been included

All corrections and additional information requested have been made through the tracking system

A clean copy of the final revised manuscript is also enclosed

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PLoS One. doi: 10.1371/journal.pone.0278332.r003

Decision Letter 1

Harapan Harapan

28 Oct 2022

PONE-D-22-08801R1PERCEPTION AND WILLINGNESS TO ACCEPT COVID-19 VACCINES: A CROSS-SECTIONAL SURVEY OF THE GENERAL POPULATION OF SOKOTO STATE, NIGERIAPLOS ONE

Dear Dr. Oche,

Please submit your revised manuscript by Dec 12 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

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Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

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Reviewer #1: (No Response)

Reviewer #3: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

Reviewer #1: Yes

Reviewer #3: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: No

Reviewer #3: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

Reviewer #1: Yes

Reviewer #3: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

Reviewer #1: Yes

Reviewer #3: Yes

**********

6. Review Comments to the Author

Reviewer #1: (No Response)

Reviewer #3: Authors may consider some minor technical issues before publication which could be done during proofreading process:

a. Please be mindful on the consistent use of COVID-19 vs Covid-19. Errors in punctuations still could be found; please check and revise.

b. Table 6. The OR and 95% CI columns can be combined >> OR (95% CI)

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Reviewer #1: Yes: EDMUND NDUDI OSSAI

Reviewer #3: Yes: Muhammad Iqhrammullah

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PLoS One. 2022 Dec 1;17(12):e0278332. doi: 10.1371/journal.pone.0278332.r004

Author response to Decision Letter 1

14 Nov 2022

These have been included in the response to reviewer Query

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PLoS One. doi: 10.1371/journal.pone.0278332.r005

Decision Letter 2

Harapan Harapan

15 Nov 2022

PERCEPTION AND WILLINGNESS TO ACCEPT COVID-19 VACCINES: A CROSS-SECTIONAL SURVEY OF THE GENERAL POPULATION OF SOKOTO STATE, NIGERIA

PONE-D-22-08801R2

Dear Dr. Oche,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Additional Editor Comments (optional):

Reviewers' comments:

PLoS One. doi: 10.1371/journal.pone.0278332.r006

Acceptance letter

Harapan Harapan

22 Nov 2022

PONE-D-22-08801R2

Perception and willingness to accept COVID-19 Vaccines: A Cross-Sectional Survey of the general population of Sokoto State, Nigeria

Dear Dr. Oche:

I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department.

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on behalf of

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Data Availability Statement

All relevant data are within the paper and its Supporting Information files.

[pone.0278332.ref001] 1.Cucinotta D, and Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Biomed. 2020;91(1): 157–160. doi: 10.23750/abm.v91i1.9397 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref002] 2.World Health Organization(WHO). WHO Coronavirus Disease (COVID-19) Dashboard, Geneva,Switzerland,: WHO; 2022. [Available from: https://covid19.who.int/]. [Google Scholar]

[pone.0278332.ref003] 3.Nigeria Center for Disease Control(NCDC). COVID-19 in Nigeria, Abuja, Nigeria: Nigeria Center for Disease Control; 2022. [Available from: https://covid19.ncdc.gov.ng/]. [Google Scholar]

[pone.0278332.ref004] 4.Neergaard L, Fingerhut H. AP-NORC poll: Half of Americans would get a COVID-19 vaccine: Associated Press; May 28, 2020. [cited 2020 December 14]. Available from: https://apnews.com/article/dacdc8bc428dd4df6511bfa259cfec44. [Google Scholar]

[pone.0278332.ref005] 5.Fisher KA, Bloomstone SJ, Walder J, Crawford S, Fouayzi H, Mazor KM. Attitudes Toward a Potential SARS-CoV-2 Vaccine: A Survey of U.S. Adults. Ann Intern Med. 2020. doi: 10.7326/M20-3569 ; PubMed Central PMCID: PMC7505019. [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref006] 6.Kwok K.O, Lai F,. Wei WI, Wong S.Y.S, Tang J.W.T. Herd immunity—Estimating the level required to halt the COVID-19 epidemics in affected countries. J. Infect. 2020, 80, e32–e33. doi: 10.1016/j.jinf.2020.03.027 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref007] 7.Palamenghi L, Barello S, Boccia S, Graffigna G. Mistrust in biomedical research and vaccine hesitancy: The forefront challenge in the battle against COVID-19 in Italy. Eur. J. Epidemiol. 2020;35: 785–788. doi: 10.1007/s10654-020-00675-8 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref008] 8.Machingaidze S and Wiysonge C S. Understanding COVID-19 vaccine hesitancy; A new study unpacks the complexities of COVID-19 vaccine hesitancy and acceptance across low-, middle- and high-income countries. Nature Medicine 2021;27:1338–1344. [DOI] [PubMed] [Google Scholar]

[pone.0278332.ref009] 9.Lazarus J.V, Ratzan S.C, Palayew A, Gostin L.O, Larson H.J, Rabin K, et al. global survey of potential acceptance of a COVID-19 vaccine. Nat. Med. 2020. [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref010] 10.Reuben R.C, Danladi M.M.A, Saleh D.A, Ejembi P.E, Knowledge, Attitudes and Practices TowardsCOVID-19: An Epidemiological Survey in North-Central Nigeria. J. Community Health 2020. [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref011] 11.French J, Deshpande S, Evans W, Obregon R. Key Guidelines in Developing a Pre-Emptive COVID-19 Vaccination Uptake Promotion Strategy. Int. J. Environ. Res. Public Health 2020, 17, 5893. doi: 10.3390/ijerph17165893 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref012] 12.Butler R, MacDonald N. Diagnosing the determinants of vaccine hesitancy in specific subgroups: The Guide to Tailoring Immunization Programmes (TIP). Vaccine 2015, 33, 4176–4179. doi: 10.1016/j.vaccine.2015.04.038 [DOI] [PubMed] [Google Scholar]

[pone.0278332.ref013] 13.World Health Organizatioin (WHO). Landscape of novel coronavirus candidate (COVID-19) vaccine development worldwide WHO: Geneva, Switzerland; 2021. [Available from: https://www.who.int/publications/m/item/draft-landscape-of-covid-19-candidate- vaccines. [Google Scholar]

[pone.0278332.ref014] 14.Noni E. MacDonald, The SAGE Working Group on Vaccine Hesitancy. Vaccine hesitancy: Definition, scope and determinants. Vaccine 33 (2015) 4161–4164. 2015. doi: 10.1016/j.vaccine.2015.04.036 [DOI] [PubMed] [Google Scholar]

[pone.0278332.ref015] 15.Gowda C, Dempsey A.F. The rise (and fall?) of parental vaccine hesitancy. Hum. Vaccines Immunother. 2013, 9, 1755–1762. [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref016] 16.Kumar D, Chandra R, Mathur M, Samdariya S, Kapoor N. Vaccine hesitancy: Understanding better to address better. Isr. J. Health Policy Res. 2016, 5, 2. doi: 10.1186/s13584-016-0062-y [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref017] 17.Daley M.F., Narwaney K.J., Shoup J.A., Wagner N.M., Glanz J.M. Addressing Parents ‘ Vaccine Concerns: A Randomized Trial of a Social Media Intervention. Am. J. Prev. Med. 2018, 55, 44–54. doi: 10.1016/j.amepre.2018.04.010 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref018] 18.Arede M, Bravo-Araya M, Bouchard E, Singh G.G, Plajer V, Shehraj A, et al. Combating Vaccine Hesitancy: Teaching the Next Generation to Navigate Through the Post Truth Era. Front. Public Health 2018, 6, 381. doi: 10.3389/fpubh.2018.00381 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref019] 19.Dube E, Vivion M, MacDonald N.E, Vaccine hesitancy, vaccine refusal and the anti-vaccine movement: Influence, impact and implications. Expert Rev. Vaccines 2015, 14, 99–117. doi: 10.1586/14760584.2015.964212 [DOI] [PubMed] [Google Scholar]

[pone.0278332.ref020] 20.Salmon D.A, Dudley M.Z, Glanz J.M, Omer S.B. Vaccine Hesitancy: Causes, Consequences, and a Call to Action. Am. J. Prev. Med. 2015, 49, S391–S398. doi: 10.1016/j.amepre.2015.06.009 [DOI] [PubMed] [Google Scholar]

[pone.0278332.ref021] 21.Larson H.J, Cooper L.Z, Eskola J, Katz S.L, Ratzan S. Addressing the vaccine confidence gap. Lancet 2011, 378, 526–535. doi: 10.1016/S0140-6736(11)60678-8 [DOI] [PubMed] [Google Scholar]

[pone.0278332.ref022] 22.Olson O, Berry C, Kumar N. Addressing Parental Vaccine Hesitancy towards Childhood Vaccines in the United States: A Systematic Literature Review of Communication Interventions and Strategies. Vaccines 2020, 8, 590. doi: 10.3390/vaccines8040590 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref023] 23.Lane S, MacDonald N.E, Marti M. Dumolard L. Vaccine hesitancy around the globe: Analysis of three years of WHO/UNICEF Joint Reporting Form data-2015–2017. Vaccine 2018, 36, 3861–3867. doi: 10.1016/j.vaccine.2018.03.063 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref024] 24.Wagner A.L, Masters N.B, Domek G.J, Mathew J.L, Sun X, Asturias E.J, et al. Comparisons of Vaccine Hesitancy across Five Low- and Middle-Income Countries. Vaccines 2019, 7, 155. doi: 10.3390/vaccines7040155 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref025] 25.The Lancet Child & Adolescent Health. Vaccine hesitancy: A generation at risk. Lancet Child Adolesc. Health 2019, 3, 281. [DOI] [PubMed] [Google Scholar]

[pone.0278332.ref026] 26.Karafillakis E, Larson H.J, Consortium A. The benefit of the doubt or doubts over benefits? A systematic literature review of perceived risks of vaccines in European populations. Vaccine 2017, 35, 4840–4850. doi: 10.1016/j.vaccine.2017.07.061 [DOI] [PubMed] [Google Scholar]

[pone.0278332.ref027] 27.Pelcic G, Karacic S, Mikirtichan G.L, Kubar O.I, Leavitt F.J, Cheng-Tek TM, et al. Religious exception for vaccination or religious excuses for avoiding vaccination. [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref028] 28.Karlsson L.C, Soveri A, Lewandowsky S, Karlsson L, Karlsson H, Nolvi S, et al. Fearing the disease or the vaccine: The case of COVID-19. Personal. Individ. Differ. 2021, 172, 110590. [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref029] 29.Olagoke A.A, Olagoke O.O, Hughes A.M, Intention to Vaccinate Against the Novel 2019 Coronavirus Disease: The Role of Health Locus of Control and Religiosity. J. Relig. Health 2020. doi: 10.1007/s10943-020-01090-9 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref030] 30.National Population Commission (NPopC) [Nigeria] and ICF. Demographic and Health Survey 2018. Abuja, Nigeria and Rockvile, Maryland USA: (NPopC) and ICF; 2018. [Google Scholar]

[pone.0278332.ref031] 31.Ibrahim T. Research methodology and dissertation writing for health and allied health professionals. Cress Global Link Limited Abuja; 2009.74. [Google Scholar]

[pone.0278332.ref032] 32.Pham K, Sharpe EC, Weiss WM,Vu A. The use of a lot quality assurance sampling methodology to assess and manage primary health interventions in conflict-affected West Darfur, Sudan. Popul Health Metrics; 2016:3–4. doi: 10.1186/s12963-016-0103-3 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref033] 33.CDC Africa COVID-19 Vaccine Perceptions 2020.

[pone.0278332.ref034] 34.Adejumo OA, Ogundele OA Madubuko CR, Oluwafemi RO, Okoye OC, Okonkwo KC. Perceptions of the COVID-19 vaccine and willingness to receive vaccination among health workers in Nigeria. Osong Public Health Res Perspect 2021;12(4):236–243. doi: 10.24171/j.phrp.2021.0023 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref035] 35.Islam MS, Siddique AS, Akter R, Tasnim R, Sujan MSH, Ward PR et al. Knowledge, attitudes and perceptions towards COVID-19 vaccinations: a community survey in Banglades. BMC Public Health (2021) 21:1851, 10.1186/s12889-021-11880-9. [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref036] 36.Al-Zalfawi S.M.; Rabbani S.I.; Asdaq S.M.B.; Alamri A.S.; Alsanie W.F.; Alhomrani M.; et al. Public Knowledge, Attitude, and Perception towards COVID-19 Vaccination in Saudi Arabia. Int. J. Environ. Res.Public Health 2021, 18, 10081. doi: 10.3390/ijerph181910081 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref037] 37.Lee H1, Noh EB, Park SJ, Hae Kweun Nam HK, Lee TH1, Ram Lee GR, et al. COVID-19 Vaccine Perception in South Korea: Web Crawling Approach. JMIR Public Health Surveill 2021. vol. 7 iss. 9 e31409 p. 1. doi: 10.2196/31409 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref038] 38.Soneji S, Beltrán-Sánchez H, Yang JW, Mann C Population-Level Mortality Rates from Novel Coronavirus (COVID-19) in South Korea. medRxiv 2020.03.23.20041814; 10.1101/2020.03.23.20041814 Asia Pacific Journal of Public Health doi: [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref039] 39.Park WB, Kwon N-J, Choi S-J, et al. Virus Isolation from the First Patient with SARS-CoV-2 in Korea. J Korean Med Sci. 2020;35(7). doi: 10.3346/jkms.2020.35.e84) [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref040] 40.Ritchie H, Mathieu E, Rodes-Gurao L, Appel C, Giattino C, Ortiz-Ospina E, et al. A global database of COVID-19 vaccinations. Nat Hum Behav (2021) 5, 947–953 (2021). 10.1038/s41562-021-01122-8. Accessed 15/01/2022. [DOI] [PubMed] [Google Scholar]

[pone.0278332.ref041] 41.NHS. Coronavirus (COVID-19) vaccine. Accessed 11thDecember 2020.

[pone.0278332.ref042] 42.Burki T. Vaccine misinformation and social media. The Lancet Digital Health 2019. Oct;1(6):e258–e259. doi: 10.1016/S2589-7500(19)30136-0 [DOI] [Google Scholar]

[pone.0278332.ref043] 43.Kishore J, Venkatesh U, Ghai G, Heena, Kumar P. Perception and attitude towards COVID-19 vaccination: A preliminary online survey from India. J Family Med Prim Care 2021;10:3116–21. doi: 10.4103/jfmpc.jfmpc_2530_20 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref044] 44.Reiter PL, Pennell ML, Katz ML. Acceptability of a COVID-19 vaccine among adults in the United States: How many people would get vaccinated? Vaccine 2020:6500–7. doi: 10.1016/j.vaccine.2020.08.043 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref045] 45.Salali GD, Uysal MS. COVID-19 vaccine hesitancy is associated with beliefs on the origin of the novel coronavirus in the UK and Turkey. Psychol Med 2020;1–3. doi: 10.1017/S0033291720004067 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref046] 46.Biasio LR, Bonaccorsi G, Lorini C, Pecorelli S. Assessing COVID-19 vaccine literacy: A preliminary online survey. Hum Vaccin Immunother 2021;1304–1312. doi: 10.1080/21645515.2020.1829315 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref047] 47.Peretti-Watel P, Seror V, Cortaredona S, Launay O, Raude J, Verger P, et al. A future vaccination campaign against COVID-19 at risk of vaccine hesitancy and politicisation. Lancet Infect Dis 2020:769–70. doi: 10.1016/S1473-3099(20)30426-6 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref048] 48.Nzaji MK, Ngombe LK, Mwamba GN, Ndala DBB, Miema JM, Lungoyo CL, et al. Acceptability of vaccination against COVID-19 among healthcare workers in the Democratic Republic of the Congo. Pragmat Obs Res 2020;11:103. doi: 10.2147/POR.S271096 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref049] 49.Adeniyi OV, Stead D, Singata-Madliki M, Batting J, Wright M, Jelliman E, et al. Acceptance of COVID-19 vaccine among the healthcare workers in the Eastern Cape, South Africa: a cross sectional study. Vaccines. 2021;9(6):666. doi: 10.3390/vaccines9060666 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref050] 50.El-Elimat T, AbuAlSamen MM, Almomani BA, Al-Sawalha NA, Alali FQ(2021) Acceptance and attitudes toward COVID-19 vaccines: A crosssectional study from Jordan. PLoS ONE 16(4): e0250555. doi: 10.1371/journal.pone.0250555 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref051] 51.Malik AA, McFadden SM, Elharake J, Omer SB. Determinants of covid-19 vaccine acceptance in the US. EClinicalMedicine. 2020. Aug 12; 26: 100495. doi: 10.1016/j.eclinm.2020.100495 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref052] 52.Di Gennaro F, Murri R, Segala FV, Cerruti L, Abdulle A, Saracino A, et al. Attitudes towards Anti-SARS-CoV2 Vaccination among Healthcare Workers: Results from a National Survey in Italy. Viruses 2021;13(3). doi: 10.3390/v13030371 . [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref053] 53.COVID-19 vaccination. BMC Public Al Halabi C.K.; Obeid S.; Sacre H.; Akel M.; Hallit R.; Salameh P.; et al. Attitudes of Lebanese adults regarding Health 2021, 21, 1–7. [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref054] 54.Mohamad O.; Zamlout A.; AlKhoury N.; Mazloum A.; Alsalkini M.; Shaaban R. Factors associated with the intention of Syrian adult population to accept COVID19 vaccination: A cross-sectional study. BMC Public Health 2021, 21, 1–10. [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref055] 55.Josiah B O Kantaris M. Perception of Covid-19 and acceptance of vaccination in Delta State Nigeria Nigerian Health Journal 2021;21(2):60–85. [Google Scholar]

[pone.0278332.ref056] 56.Cerda AA and García LY (2021) Hesitation and Refusal Factors in Individuals’ Decision- Making Processes Regarding a Coronavirus Disease 2019 Vaccination. Front. Public Health 9:626852 doi: 10.3389/fpubh.2021.626852 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref057] 57.Alqudeimat Y., Alenezi D, AlHajri B, Alfouzan H, Almokhaizeem Z, Altamimi S, et al. COVID-19 Vaccine Acceptability and Its Determinants among Adults in Kuwait. Med Princ Pract 2021;30:262–271 271 doi: 10.1159/000514636 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref058] 58.Solís Arce J S, Warren S S, Meriggi N F, Scacco A, McMurry N Voors M et al. (COVID-19 vaccine acceptance and hesitancy in low- and middle-income countries. Nature Medicine 2021; 27: 1385–1394. doi: 10.1038/s41591-021-01454-y [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref059] 59.Lazarus JV, Ratzan SC, Palayew A, Lazarus J.V, Ratzan S.C, Palayew A. et al. A global survey of potential acceptance of a COVID-19 vaccine. Nat Med 2021;27:225–8. doi: 10.1038/s41591-020-1124-9 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref060] 60.Yoda T, Katsuyama H. Willingness to receive COVID-19 vaccination in Japan. Vaccines 2021;9:48. doi: 10.3390/vaccines9010048 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref061] 61.Omer SB, Yildirim I, Forman HP. Herd Immunity and Implications for SARS-CoV-2 Control. JAMA. 2020; 324(20):2095–6. doi: 10.1001/jama.2020.20892 . [DOI] [PubMed] [Google Scholar]

[pone.0278332.ref062] 62.Fine P, Eames K, Heymann DL. “Herd Immunity”: A Rough Guide. Clin Infect Dis. 2011; 52(7):911–6. doi: 10.1093/cid/cir007 . [DOI] [PubMed] [Google Scholar]

[pone.0278332.ref063] 63.Coustasse A, Kimble C, Maxik K. COVID-19 and Vaccine Hesitancy: A Challenge the United States Must Overcome. J Ambul Care Manage. 2021; 44(1). doi: 10.1097/JAC.0000000000000360 . [DOI] [PubMed] [Google Scholar]

[pone.0278332.ref064] 64.Schoch-Spana M, Brunson EK, Long R, Ruth A, Ravi SJ, Trotochaud M, et al. The public’s role in COVID-19 vaccination: Human-centered recommendations to enhance pandemic vaccine awareness, access, and acceptance in the United States. Vaccine. 2020. doi: 10.1016/j.vaccine.2020.10.059 ; PubMed Central PMCID: PMC7598529. [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref065] 65.MacDonald NE. Vaccine hesitancy: Definition, scope and determinants. Vaccine. 2015; 33(34):4161–4. doi: 10.1016/j.vaccine.2015.04.036 . [DOI] [PubMed] [Google Scholar]

[pone.0278332.ref066] 66.Neumann-Bohme S, Varghese NE, Sabat I, Barros PP, Brouwer W, van Exel J, et al. Once we have it,will we use it? A European survey on willingness to be vaccinated against COVID-The European Journal of Health Economics. 2020; 21(7):977–82. 10.1007/s10198-020-01208-6 3259195718–20. [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref067] 67.World Health Organization (WHO). Ten threats to global health in 2019 [Internet]. Geneva: WHO; 2019. [cited 2020 Dec 20]. Available from: https://www.who.int/news-room/spotlight/ten-threats-to-global-health-in-2019. [Google Scholar]

[pone.0278332.ref068] 68.Sato R and Takasaki Y. Vaccine Hesitancy and Refusal: Behavioural evidence from Rural Northern Nigeria. Vaccines 2021;9(9): 1023. [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref069] 69.Ali M, Hossain A. What is the extent of COVID-19 vaccine hesitancy in Bangladesh? A cross-sectional rapid national survey. BMJ Open 2021;11:e050303. doi: 10.1136/bmjopen-2021-050303 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref070] 70.Aberese-Ako M, Doegah PT, Immurana M, Dalaba MA, Manyeh AK, Klu D, et al. COVID-19 vaccine hesitancy among the adult population in Ghana: evidence from a pre-vaccination rollout survey.Tropical Medicine and Health (2021) 49:96 10.1186/s41182-021-00357-5. [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref071] 71.Lazarus J.V.; Ratzan S.C.; Palayew A.; Gostin L.O.; Larson H.J.; Rabin K.; et al. A global survey of potential acceptance of a COVID-19 vaccine. Nat. Med. 2020. [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref072] 72.Sarasty O.; Carpio C.E.; Hudson D.; Guerrero-Ochoa P.A.; Borja I. The demand for a COVID-19 vaccine in Ecuador. Vaccine 2020, 38, 8090–8098. doi: 10.1016/j.vaccine.2020.11.013 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref073] 73.Trust Wellcome. Wellcome Global Monitor: How Does the World Feel about Science and Health? 2019. Available online: https://wellcome.ac.uk/sites/default/files/wellcome-global-monitor-questionnairedevelopment-report_0.pdf (accessed on 25 June 2021). [Google Scholar]

[pone.0278332.ref074] 74.Wellcome Global Monitor. How Does the World Feel about Science and Health? Available online: https://wellcome.org/sites/default/files/wellcome-global-monitor-2018.

[pone.0278332.ref075] 75.Sallam M.; Dababseh D.; Eid H.; Al-Mahzoum K.; Al-Haidar A.; Taim D.; et al. High rates of COVID-19 vaccine hesitancy and its association with conspiracy beliefs: A study in Jordan and Kuwait among other Arab countries. Vaccines 2021; 9: 42. doi: 10.3390/vaccines9010042 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref076] 76.Al-Mohaithef M.; Padhi B.K. Determinants of COVID-19 Vaccine Acceptance in Saudi Arabia: A Web-Based National Survey. J. Multidiscip. Health. 2020, 13, 1657–1663. doi: 10.2147/JMDH.S276771 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref077] 77.Schrading WA, Trent SA, Paxton JH et al. Vaccination Rates and Acceptnce of SARS-CoV2 CVaccination Among US Emergency Department Health Care Personnael. Acad Emerg Med. 2021. Mar 15: doi: 10.1111/acem.14236 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref078] 78.Seydou A. Who wants COVID-19 vaccination? In 5 West African countries, hesitancy is high, trust low. Afro barometer, 2021. Available: https://bit.ly/3hz1wZg. [Google Scholar]

[pone.0278332.ref079] 79.Solís Arce JS, Warren SS, Meriggi NF. COVID-19 vaccine acceptance and Hesitancy in low and middle income countries, and implications for messaging. Public and Global Health 2021;27. [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0278332.ref080] 80.Rogers EM. Diffusion of Innovations. 3rd ed New York, NY: The Free Press; 1983. [Google Scholar]

[pone.0278332.ref081] 81.Dzieciolowska S, Hamel D, Gadio S, Dionne M, Gagnon D, Robitaille L, et al. Covid-19 vaccine acceptance, hesitancy, and refusal among Canadian healthcare workers: A multicenter survey, American Journal of Infection Control 00 (2021) 1−6. doi: 10.1016/j.ajic.2021.04.079 [DOI] [PMC free article] [PubMed] [Google Scholar]

PERMALINK

Perception and willingness to accept COVID-19 Vaccines: A cross-sectional survey of the general population of Sokoto State, Nigeria

Oche Mansur Oche

Habibullah Adamu

Musa Yahaya

Hudu Garba Illo

Abdulaziz Mohammad Danmadami

Adamu Ijapa

Asmau Mohammad Wali

Hamza Yusuf

Hafsat Muhammad

Abba Aji

Roles

Abstract

Introduction

Materials and method

Results

Table 1. Sociodemographic characteristics of respondents.

Table 2. Perception of respondents regarding the COVID-19 vaccine.

Fig 1. Perception of respondents regarding COVID-19 vaccine.

Table 3. Willingness of respondents to accept COVID- 19 vaccine.

Fig 2. Willingness to accept COVID 19 vaccine according to gender.

Fig 3. Respondents’ reasons for not willing to accept COVID 19 vaccines.

Table 4. Factors influencing willingness to accept COVID-19 vaccine.

Table 5. Factors influencing the perception of respondents regarding the COVID-19 vaccine.

Table 6. Logistic regression analysis for predictors of willingness to take COVID 19 vaccine.

Discussion

Conclusion

Supporting information

Acknowledgments

Data Availability

Funding Statement

References

Decision Letter 0

Harapan Harapan

Roles

Author response to Decision Letter 0

Decision Letter 1

Harapan Harapan

Roles

Author response to Decision Letter 1

Decision Letter 2

Harapan Harapan

Roles

Acceptance letter

Harapan Harapan

Roles

Associated Data

Supplementary Materials

Data Availability Statement

ACTIONS

PERMALINK

RESOURCES

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