Abstract

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.

Rights

Copyright © The Author(s) 2021. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

Cite as

Solís Arce, J., Warren, S., Meriggi, N., Scacco, A., McMurry, N., Voors, M., Syunyaev, G., Malik, A., Aboutajdine, S., Adeojo, O., Anigo, D., Armand, A., Asad, S., Atyera, M., Augsburg, B., Awasthi, M., Ayesiga, G., Bancalari, A., Björkman Nyqvist, M., Borisova, E., Bosancianu, C., Cabra García, M., Cheema, A., Collins, E., Cuccaro, F., Farooqi, A., Fatima, T., Fracchia, M., Galindo Soria, M., Guariso, A., Hasanain, A., Jaramillo, S., Kallon, S., Kamwesigye, A., Kharel, A., Kreps, S., Levine, M., Littman, R., Malik, M., Manirabaruta, G., Mfura, J., Momoh, F., Mucauque, A., Mussa, I., Nsabimana, J., Obara, I., Otálora, M., Ouédraogo, B., Pare, T., Platas, M., Polanco, L., Qureshi, J., Raheem, M., Ramakrishna, V., Rendrá, I., Shah, T., Shaked, S., Shapiro, J., Svensson, J., Tariq, A., Tchibozo, A., Tiwana, H., Trivedi, B., Vernot, C., Vicente, P., Weissinger, L., Zafar, B., Zhang, B., Karlan, D., Callen, M., Teachout, M., Humphreys, M., Mobarak, A. & Omer, S. 2021, 'COVID-19 vaccine acceptance and hesitancy in low- and middle-income countries', Nature Medicine, 27, pp. 1385-1394. https://doi.org/10.1038/s41591-021-01454-y

Downloadable citations

Download HTML citationHTML Download BIB citationBIB Download RIS citationRIS
Last updated: 16 June 2022
Was this page helpful?