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COVID-19 vaccine acceptance and hesitancy in low- and middle-income countries

Solís Arce, Julio S., Warren, Shana S., Meriggi, Niccolò F., Scacco, Alexandra, McMurry, Nina, Voors, Maarten, Syunyaev, Georgiy, Malik, Amyn Abdul, Aboutajdine, Samya, Adeojo, Opeyemi, Anigo, Deborah, Armand, Alex, Asad, Saher, Atyera, Martin, Augsburg, Britta, Awasthi, Manisha, Ayesiga, Gloria Eden, Bancalari, Antonella, Björkman Nyqvist, Martina, Borisova, Ekaterina, Bosancianu, Constantin Manuel, Cabra García, Magarita Rosa, Cheema, Ali, Collins, Elliott, Cuccaro, Filippo, Farooqi, Ahsan Zia, Fatima, Tatheer, Fracchia, Mattia, Galindo Soria, Mery Len, Guariso, Andrea, Hasanain, Ali, Jaramillo, Sofía, Kallon, Sellu, Kamwesigye, Anthony, Kharel, Arjun, Kreps, Sarah, Levine, Madison, Littman, Rebecca, Malik, Mohammad, Manirabaruta, Gisele, Mfura, Jean Léodomir Habarimana, Momoh, Fatoma, Mucauque, Alberto, Mussa, Imamo, Nsabimana, Jean Aime, Obara, Isaac, Otálora, María Juliana, Ouédraogo, Béchir Wendemi, Pare, Touba Bakary, Platas, Melina R., Polanco, Laura, Qureshi, Javaeria Ashraf, Raheem, Mariam, Ramakrishna, Vasudha, Rendrá, Ismail, Shah, Taimur, Shaked, Sarene Eyla, Shapiro, Jacob N., Svensson, Jakob, Tariq, Ahsan, Tchibozo, Achille Mignondo, Tiwana, Hamid Ali, Trivedi, Bhartendu, Vernot, Corey, Vicente, Pedro C., Weissinger, Laurin B., Zafar, Basit, Zhang, Baobao, Karlan, Dean, Callen, Michael, Teachout, Matthieu, Humphreys, Macartan, Mobarak, Ahmed Mushfiq and Omer, Saad B. (2021) COVID-19 vaccine acceptance and hesitancy in low- and middle-income countries. Nature Medicine, 27 (8). 1385 - 1394. ISSN 1078-8956

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Identification Number: 10.1038/s41591-021-01454-y


Widespread acceptance of COVID-19 vaccines is crucial for achieving sufficient immunization coverage to end the global pandemic, yet few studies have investigated COVID-19 vaccination attitudes in lower-income countries, where large-scale vaccination is just beginning. We analyze COVID-19 vaccine acceptance across 15 survey samples covering 10 low- and middle-income countries (LMICs) in Asia, Africa and South America, Russia (an upper-middle-income country) and the United States, including a total of 44,260 individuals. We find considerably higher willingness to take a COVID-19 vaccine in our LMIC samples (mean 80.3%; median 78%; range 30.1 percentage points) compared with the United States (mean 64.6%) and Russia (mean 30.4%). Vaccine acceptance in LMICs is primarily explained by an interest in personal protection against COVID-19, while concern about side effects is the most common reason for hesitancy. Health workers are the most trusted sources of guidance about COVID-19 vaccines. Evidence from this sample of LMICs suggests that prioritizing vaccine distribution to the Global South should yield high returns in advancing global immunization coverage. Vaccination campaigns should focus on translating the high levels of stated acceptance into actual uptake. Messages highlighting vaccine efficacy and safety, delivered by healthcare workers, could be effective for addressing any remaining hesitancy in the analyzed LMICs.

Item Type: Article
Official URL:
Additional Information: © 2021 The Authors
Divisions: International Growth Centre
Subjects: H Social Sciences > HV Social pathology. Social and public welfare. Criminology
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Date Deposited: 13 Dec 2021 11:21
Last Modified: 21 Jun 2024 07:00

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