Perceptions and hesitancy towards the COVID-19 vaccination campaign among three vulnerable populations in the Democratic Republic of the Congo: A qualitative study

Main Article Content

Michael Bokolo
Adil Mansoori
Sarah Michaud

Keywords

Africa, Vulnerable Populations, Vaccination Hesitancy, COVID-19

Abstract

Background:  To deal with COVID-19, vaccination is a strategy adopted by many countries including the Democratic Republic of the Congo (DRC). The first phase of vaccination was conducted in 2021 as part of the country's Expanded Program on Immunization (EPI). To evaluate it, an intra-action review was conducted. It identified a low proportion of vaccinated vulnerable populations, namely health professionals (1.8%), chronically ill (0.09%), and older adults aged ≥ 55 (0.4%). The objective was to explore perceptions and barriers to acceptance of the COVID-19 vaccine in the DRC among the vulnerable populations targeted by the EPI.


Methodology: A qualitative study was conducted between September 2021 and June 2022 in Kinshasa, DRC.  Semi-structured focus groups were conducted with each group separately using a single interview guide. It included five categories: socio-demographic information, COVID-19 vaccine status, perceptions towards the COVID-19 vaccination, vaccine hesitancy and perceptions towards the COVID-19 vaccination campaign. 


Results: Three focus groups were conducted. In total, we had 16 participants with eight health professionals, four chronically ill participants, and four older adults. The majority were married (68.7%) and came from urban areas (68.7%). The sex ratio was at 1 and more than one-third had an education level equivalent to a master’s degree (37.5%). Half were vaccinated against the COVID-19 (50.0%). The main perceptions and hesitancy factors were the lack of trust and knowledge of the vaccine's properties, benefits, and risks. Adjustment of the information messages which, according to participants, were not clear and poorly adapted to the needs of each group is the main element to improve the vaccination campaign.


Conclusion: This study represents an important step to improve the COVID-19 vaccination campaign in the DRC. It showed the different barriers to the COVID-19 vaccines acceptance among vulnerable populations.  

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References

1. Mathieu E, Ritchie H, Ortiz-Ospina E, Roser M, Hasell J, Appel C, et al. A global database of COVID-19 vaccinations. Nat Hum Behav. 2021; 5(7):947–953.

2. Wilairatana P, Masangkay FR, Kotepui KU, Milanez GDJ, Kotepui M. Prevalence and characteristics of malaria among COVID-19 individuals: A systematic review, meta-analysis, and analysis of case reports. PLoSNegl Trop Dis. 2021; The 15-month-ago-100009766.

3. Nachega JB, Mbala-Kingebeni P, Otshudiema J, Mobula LM, Preiser W, Kallay O, et al. Responding to the Challenge of the Dual COVID-19 and Ebola Epidemics in the Democratic Republic of Congo—Priorities for Achieving Control. The American Journal of Tropical Medicine and Hygiene. 2020; 103(2):597–602.

4. Juma CA, Mushabaa NK, Abdu Salam F, Ahmadi A, Lucero-Prisno DE. COVID-19: The Current Situation in the Democratic Republic of Congo. The American Journal of Tropical Medicine and Hygiene. 2020; 103(6):2168–2170.

5. World Health Organization. Global COVID-19 Vaccination Strategy in a Changing World: July 2022 update. https://www.who.int/publications/m/item/global-covid-19-vaccination-strategy-in-a-changing-world--july-2022-update. Accessed on 1 August 2023.

6. Expanded Programme on Immunization, Democratic Republic of the Congo. EPI DRC - Expanded Programme on Immunization. PEV DRCongo. https://www.pevrdcongo.cd/. Accessed on 1 August 2023.

7. World Health Organization. Guide to conducting an intra-action review (RIA) of COVID-19. https://www.who.int/fr/publications-detail/WHO-2019-nCoV-Country_IAR-2020.1. Accessed on 1 August 2023.

8. TechNet-21. DRC - Country COVID-19 Intra-Action Review (IAR) Report. https://www.technet-21.org/fr/centre-de-connaissances/main/8308-drc_country-covid-19-intra-action-review-iar-report. Accessed on 1 August 2023.

9. Greyling T, Rossouw S. Positive attitudes towards COVID-19 vaccines: A cross-country analysis. PLoS ONE. 2022; The 17-day-to-300-day-to-300-day-to-300-day-to-30-day-on-day-of-the-

10. While A. Evidence-based strategies to promote vaccine acceptance. Br J Community Nurs. 2021; 26(7):338–343.

11. Sallam M. COVID-19 Vaccine Hesitancy Worldwide: A Concise Systematic Review of Vaccine Acceptance Rates. Vaccines. 2021; 9(2):160.

12. Ackah M, Ameyaw L, Gazali Salifu M, Afi Asubonteng DP, Osei Yeboah C, Narkotey Annor E, et al. COVID-19 vaccine acceptance among health care workers in Africa: A systematic review and meta-analysis. PLoS ONE. 2022; 17(5): 0268711.

13. Ngangue P, Pilabré AH, Barro A, Pafadnam Y, Bationo N, Soubeiga D. Public attitudes towards COVID-19 vaccines in Africa: A systematic review. J Public Health Afr. 2022; 13(1). doi:10.4081/jphia.2022.2181.

14. Kanyanda S, Markhof Y, Wollburg P, Zezza A. Acceptance of COVID-19 vaccines in sub-Saharan Africa: evidence from six national phone surveys. BMJ Open. 2021; The 11-month-ago-12-month-ago-2015 was the first to be 2015.

15. Ayenigbara IO, Adegboro JS, Ayenigbara GO, Adeleke OR, Olofintuyi OO. The challenges to a successful COVID-19 vaccination programme in Africa. Germs. 2021 ; 11(3):427–440.

16. Yin F, Ji M, Yang Z, Wu Z, Xia X, Xing T, et al. Exploring the determinants of global vaccination campaigns to combat COVID-19. Humanit Soc Sci Commun. 2022; 9(1):95.

17. Kalu ME, Oyinlola O, Ibekaku MC, Adandom II, Iwuagwu AO, Ezulike CJ, et al. A Mapping Review on the Uptake of the COVID-19 Vaccine among Adults in Africa Using the 5As Vaccine Taxonomy. The American Journal of Tropical Medicine and Hygiene. 2022; 106(6):1688–1697.

18. Lucero-Prisno DE, Adebisi YA, Lin X. Current efforts and challenges facing responses to 2019-nCoV in Africa. glob health res policy. 2020; 5(1):21.

19. MacDonald NE, Butler R, Dubé E. Addressing barriers to vaccine acceptance: an overview. Human Vaccines &Immunotherapeutics. 2018; 14(1):218–224.

20. Berihun G, Walle Z, Berhanu L, Teshome D. Acceptance of COVID-19 Vaccine and Determinant Factors Among Patients with Chronic Disease Visiting Dessie Comprehensive Specialized Hospital, Northeastern Ethiopia. PPA. 2021; Volume 15:1795–1805.

21. Privor-Dumm L, Excler J-L, Gilbert S, Abdool Karim SS, Hotez PJ, Thompson D, et al. Vaccine access, equity, and justice: COVID-19 vaccines and vaccination. BMJ Glob Health. 2023; It's not a good time to be in the world.