Prevalence and factors associated with COVID-19 vaccine acceptance in Zambia: a web-based cross-sectional study

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Abstract
Introduction: vaccinations against COVID-19 have been instituted to contain the pandemic. However, information about the acceptability of COVID-19 vaccines in Zambia is lacking. Therefore, the study assessed the prevalence and factors associated with COVID-19 vaccine acceptance among the general population in Zambia. Methods: this was an online questionnaire-based cross-sectional study conducted from 13 th April to 21 5t May 2021. We included adult Zambians who had access to Facebook and WhatsApp. A multivariable logistic regression model was fitted to determine factors influencing vaccine acceptability. Data were analysed using Stata version 16.1. Results: of the 677 participants, only 33.4% (n = 226) would accept the vaccine if made available to them. In multivariable regression analysis, respondents who were older than 41 years compared to the 18 to 23 years age group (a0R: 2.77, 95% CI: 1.03-7.48), those who agreed (aOR; 22.85, 95% CI: 11.49-45.49) or did not know (aOR; 3.73, 95% CI: 2.296.07) compared to those who disagreed that the COVID-19 vaccine passed through all the necessary stages to ensure its safety and effectiveness, and those who were aware (aOR; 11.13, 95% CI: 5.31-23.35) compared to those who were not aware that the COVID-19 vaccine reduces virus transmission, were more likely to accept the vaccine. Conversely, entrepreneurs compared to government employees (aOR; 0.24, 95% CI: 0.07-0.79) were less likely to accept vaccination. Conclusion: awareness of the COVID-19 vaccine was high despite low acceptability levels. These findings are significant as they highlight the need to develop strategies for improving vaccine acceptability in Zambia.

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