COVID-19 Vaccine hesitancy in Addis Ababa, Ethiopia: A mixed-methods study

Dereje, N.; Tesfaye, A.; Tamene, B.; Alemshet, D.; Abe, H.; Tesfa, N.; Gedion, S.; Biruk, T.; Lakew, Y.

Background: COVID-19 infection is a global pandemic threatening the public health. Due to the development and initiation of vaccination, currently significant difference upon vaccine acceptance is seen between developed and developing countries. However, there are no data on the level of COVID-19 vaccine hesitancy and its associated factors in Addis Ababa, Ethiopia. Methods: An embedded mixed method study [QUAN(quali)] was conducted among residents of Akaki Kality sub-city in Addis Ababa, Ethiopia. For the quantitative part, a multi-stage sampling technique was used to recruit the study participants (n = 422). Twenty four adults were included purposively for the qualitative in-depth interview. Data was collected by face-to-face interview by using a semi-structured questionnaire. Factors associated with COVID-19 vaccine hesitancy were identified by multivariable binary logistic regression model. Result: The mean age of the participants was 34.1 years (SD 12.9). Nearly half (46.7%) of the participants exhibited poor level of knowledge and 51.8% had negative attitude towards COVID-19 and its preventive measures. One out five (19.1%) participants were not willing to get vaccinated when it becomes available. In the multivariable analysis, vaccine hesitancy was significantly associated with being female (aOR=1.97; 95% CI: 1.10 - 3.89, p=0.03), negative attitude towards COVID-19 and its preventive measures (aOR=1.75; 95% CI: 1.08 - 3.02, p=0.04), and information source being social media (internet) (aOR=3.59; 95% CI: 1.75 - 7.37, P <0.0001). Conclusion: A considerable proportion of the people in Addis Ababa have concerns on COVID-19 vaccine and unwilling to accept once it is available. Several conspiracy theories were put forth to justify their stance and this was mainly due to the misconceptions distributed from the use of social media as source of information. Overall, providing the community with health education and consistent government efforts in uphold the prevention measures are of paramount importance to tackle this pandemic.