The Evolution of COVID-19 Vaccine Hesitancy in Sub-Saharan Africa : Evidence from Panel Survey Data

COVID-19 vaccination rates in Sub-Saharan Africa lag behind other world regions, with justover 20 percent of the population in Sub-Saharan Africa fully vaccinated. To reach widespread coverage, highwillingness to get vaccinated for COVID-19 among the population is considered an important prerequisite. Drawingon two years of panel survey data, this paper studies the dynamics of vaccine acceptance, its correlates, and reasonsfor hesitancy over time. The data come from multiple rounds of national High-Frequency Phone Surveys in five countriesin East and West Africa (Burkina Faso, Ethiopia, Malawi, Nigeria, and Uganda), covering the period between 2020 and2022. The surveys are cross-country comparable and draw their samples from nationally representative samplingframes. The paper finds that COVID-19 vaccine acceptance has been high throughout the study period (68 to 98 percent).However, acceptance levels were lower in 2022 than in 2020in three countries (Burkina Faso, Malawi, and Nigeria) and higher in one country (Uganda). Moreover, individuals areobserved to change their stated vaccine attitudes between survey rounds, to a limited extent in some countries(Ethiopia) and more frequently in others (Burkina Faso, Malawi, Nigeria, and Uganda). Vaccine hesitancy is higher inricher households and among those residing in urban areas, women, and the better educated. Conversely, hesitancy islower in larger households and among heads of the household. The main reasons for hesitancy are concerns about sideeffects of the vaccine, its safety and efficacy, as well as assessments of COVID-19 risk, although these reasonsfluctuate over time. The findings suggest that vaccine hesitancy is not the primary obstacle to reaching greatervaccine coverage in Sub-Saharan Africa. Instead, low coverage rates may be related to access and deliverybarriers as well as supply shortages. Nevertheless, vaccine attitudes appear malleable so that continued efforts areneeded to retain high levels of vaccine acceptance.