Original Research

COVID-19 vaccine hesitancy in KwaZulu-Natal, South Africa: A survey of unvaccinated adults

Tanuja N. Gengiah, Donavan C. Naidoo, Nomcebo Maduma, Saien Govender, Sherishka Dhindayal, Lara Lewis
Health SA Gesondheid | Vol 29 | a2468 | DOI: https://doi.org/10.4102/hsag.v29i0.2468 | © 2024 Tanuja N. Gengiah, Donavan C. Naidoo, Nomcebo Maduma, Saien Govender, Sherishka Dhindayal, Lara Lewis | This work is licensed under CC Attribution 4.0
Submitted: 22 August 2023 | Published: 01 February 2024

About the author(s)

Tanuja N. Gengiah, Center for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa; and Discipline of Pharmaceutical Sciences, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
Donavan C. Naidoo, Discipline of Pharmaceutical Sciences, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
Nomcebo Maduma, Discipline of Pharmaceutical Sciences, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
Saien Govender, Center for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
Sherishka Dhindayal, Center for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
Lara Lewis, Center for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa

Abstract

Background: Concerns and misconceptions surrounding coronavirus disease 2019 (COVID-19) vaccines may account for vaccine hesitancy and low uptake.

Aim: To determine prevalence of COVID-19 vaccine hesitancy, vaccine-related misconceptions, and predictors of vaccine hesitancy among South Africans.

Setting: Community setting in five districts in KwaZulu- Natal province.

Methods: Between August 20, 2021, and September 27, 2021, we conducted a cross-sectional survey, interviewing 300 unvaccinated adults amid the national vaccination campaign. Predictors of hesitancy were identified through multivariable logistic regression analysis.

Results: Participants had a median age of 29 years (IQR: 23–39), 86.7% were Black African, 63.2% were male, 53.3% resided in rural communities, and 59.3% (95% CI: 53.8% – 64.9%) were classified as vaccine hesitant. The primary reason for not vaccinating was a lack of trust in the vaccine (62.1%). Factors associated with reduced vaccine hesitancy included age (participants aged 35–49 years: OR: 0.28, 95% CI: 0.18–0.64, p = 0.003; participants over 50 years: OR: 0.18, 95% CI: 0.07–0.47, p = 0.0004), previous COVID-19 infection (OR: 0.31, 95% CI: 0.11–0.87, p = 0.03), and receiving vaccine information from healthcare workers (OR: 0.32, 95% CI: 0.10–1.0, p = 0.05). Unemployed (OR: 2.14, 95% CI: 1.1–4.2, p = 0.03) and self-employed individuals (OR: 2.98, 95% CI: 1.27–7.02, p = 0.01) were more likely to be vaccine hesitant.

Conclusion: COVID-19 vaccine hesitancy rates are high in KwaZulu-Natal. Uptake could be enhanced by healthcare workers leading information campaigns with messages targeting younger individuals, the unemployed, and the self-employed.

Contribution: This survey provides evidence to improve COVID-19 vaccination uptake in South Africa.


Keywords

COVID-19; vaccine; hesitancy; vaccination; survey; South Africa.

Sustainable Development Goal

Goal 3: Good health and well-being

Metrics

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