Willingness to take COVID-19 vaccination in low-income countries: Evidence from Ethiopia.

Christoph Strupat,Zemzem Shigute,Matthias Rieger,Arjun S Bedi,Peter M Mugo

doi:10.1371/journal.pone.0264633

Christoph Strupat, Zemzem Shigute + Show 3 more

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https://doi.org/10.1371/journal.pone.0264633

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Abstract

BackgroundIn low-income countries, vaccination campaigns are lagging, and evidence on vaccine acceptance, a crucial public health planning input, remains scant. This is the first study that reports willingness to take COVID-19 vaccines and its socio-demographic correlates in Ethiopia, Africa’s second most populous country.MethodsThe analysis is based on a nationally representative survey data of 2,317 households conducted in the informal economy in November 2020. It employs two logistic regression models where the two outcome variables are (i) a household head’s willingness to take a COVID-19 vaccine or not, and (ii) if yes if they would also hypothetically pay (an unspecified amount) for it or not. Predictors include age, gender, education, marital status, income category, health insurance coverage, sickness due to COVID-19, chronic illness, trust in government, prior participation in voluntary activities, urban residence.ResultsWillingness to take the vaccine was high (88%) and significantly associated with COVID-19 cases in the family, trust in government and pro-social behavior. All other predictors such as gender, education, income, health insurance, chronic illness, urban residence did not significantly predict vaccine willingness at the 5% level. Among those willing to take the vaccine, 33% also answered that they would hypothetically pay (an unspecified amount) for it, an answer that is significantly associated with trust in government, health insurance coverage and income.ConclusionThe results highlight both opportunities and challenges. There is little evidence of vaccine hesitancy in Ethiopia among household heads operating in the informal economy. The role played by trust in government and pro-social behavior in motivating this outcome suggests that policy makers need to consider these factors in the planning of COVID-19 vaccine campaigns in order to foster vaccine uptake. At the same time, as the willingness to hypothetically pay for a COVID-19 vaccine seems to be small, fairly-priced vaccines along with financial support are also needed to ensure further uptake of COVID-19 vaccines.

Highlights

A growing body of research examines the willingness to take COVID-19 vaccinations in highand middle-income countries [1–7]
Willingness to take the vaccine was high (88%) and significantly associated with COVID-19 cases in the family, trust in government and pro-social behavior
There is little evidence of vaccine hesitancy in Ethiopia among household heads operating in the informal economy

Summary

Introduction

A growing body of research examines the willingness to take COVID-19 vaccinations in highand middle-income countries [1–7]. Our study contributes to closing this potential evidence gap by investigating the willingness to take COVID-19 vaccines based on a nationally representative in-person survey of the informal economy covering 2,317 households in Ethiopia. As 80% of all economic activities are part of the informal economy in Ethiopia [26], the survey covers the majority of the Ethiopian population. In low-income countries, vaccination campaigns are lagging, and evidence on vaccine acceptance, a crucial public health planning input, remains scant. This is the first study that reports willingness to take COVID-19 vaccines and its socio-demographic correlates in Ethiopia, Africa’s second most populous country

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