Covid-19 vaccine uptake, confidence and hesitancy in rural KwaZulu-Natal, South Africa between April 2021 and April 2022

A continuous cross-sectional surveillance study

Bibliographic Data

ID19594100
AuthorsRachael Piltch-Loeb (0000-0002-6813-1934, Harvard University), Lusanda Mazibuko (Africa Health Research Institute), Eva Stanton, Thobeka Mngomezulu (0000-0002-4142-2432, Africa Health Research Institute), Dickman Gareta (0000-0002-4004-5655, Africa Health Research Institute), Siyabonga Nxumalo (0000-0002-7900-8421, Africa Health Research Institute), John D Kraemer (0000-0002-8769-3393, Georgetown University), Kobus Herbst (0000-0002-5436-9386, Africa Health Research Institute), Mark J Siedner (0000-0003-3506-842X, Harvard University), Guy Harling (0000-0001-6604-491X, University of the Witwatersrand, corresponding author)
EditorsThu Anh Nguyen (0000-0002-2089-2902), Thu-Anh Nguyen
Year2023
Volume3
Issue6
Pagese0002033
Publication date2023-06-27
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0002033
PMID37368864
OpenAlexW4382345038
LanguageEN
Citations received3
References cited28

High COVID-19 vaccine hesitancy in South Africa limits protection against future epidemic waves. We evaluated how vaccine hesitancy and its correlates evolved April 2021-April 2022 in a well-characterized rural KwaZulu-Natal setting. All residents aged >15 in the Africa Health Research Institute’s surveillance area were invited to complete a home-based, in-person interview. We described vaccine uptake and hesitancy trends, then evaluated associations with pre-existing personal factors, dynamic environmental context, and cues to action using ordinal logistic regression. Among 10,011 respondents, vaccine uptake rose as age-cohorts became vaccine-eligible before levelling off three months post-eligibility; younger age-groups had slower uptake and plateaued faster. Lifetime receipt of any COVID-19 vaccine rose from 3.0% in April-July 2021 to 32.9% in January-April 2022. Among 7,445 unvaccinated respondents, 47.7% said they would definitely take a free vaccine today in the first quarter of the study time period, falling to 32.0% in the last. By March/April 2022 only 48.0% of respondents were vaccinated or said they would definitely would take a vaccine. Predictors of lower vaccine hesitancy included being male (adjusted odds ratio [aOR]: 0.70, 95% confidence interval [CI]: 0.65–0.76), living with vaccinated household members (aOR:0.65, 95%CI: 0.59–0.71) and knowing someone who had had COVID-19 (aOR: 0.69, 95%CI: 0.59–0.80). Mistrust in government predicted greater hesitancy (aOR: 1.47, 95%CI: 1.42–1.53). Despite several COVID-19 waves, vaccine hesitancy was common in rural South Africa, rising over time and closely tied to mistrust in government. However, interpersonal experiences countered hesitancy and may be entry-points for interventions

Confidence interval · Cross-sectional study · Environmental health · Geography · Logistic regression · Odds ratio · Vaccination · COVID-19 epidemiological studies · Demography · Medicine · SARS-CoV-2 and COVID-19 Research · Vaccine Coverage and Hesitancy · Immunology · Internal Medicine

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