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Compulsory Vaccination Coverage in 12 Sub-Saharan African Countries Two Years Following the COVID-19 Pandemic

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Abstract

The coronavirus disease 2019 (COVID-19) pandemic is a global threat, challenging health services’ provision and utilization. This study aimed to assess compulsory vaccination coverage in 12 Sub-Saharan African countries two years following the COVID-19 pandemic using the Health Belief Model. A cross-sectional survey was conducted from November 1 to December 15, 2022. Multivariate logistic regression was conducted to identify the determinants of vaccination coverage. Among the 5032 respondents, 73.1% reported that their children received compulsory vaccination. The lowest coverage was observed in Ghana (36.5%), while the highest was in Burkina Faso and Congo (92.0%). Factors associated with non-vaccination included older mothers (adjusted odds ratio (AOR) = 1.04, 95%CI: 1.03–1.05), lower mothers’ education, older children (AOR = 0.76, 95%CI: 0.60–0.96), children with chronic illnesses (AOR = 0.55, 95%CI: 0.45–0.66), and difficult accessibility to healthcare facilities (AOR = 11.27, 95%CI: 9.48–13.44). Low perceived risk, in which non-vaccinated children were believed to be at no higher risk for infectious diseases and the disease severity would not worsen among non-vaccinated children, increased the likelihood of non-vaccination (AOR = 2.29, 95%CI: 1.75–2.99 and AOR = 2.12, 95%CI: 1.64–2.73, respectively). Perceiving vaccines as unnecessary, and needless for breastfed babies increased the probability of non-vaccination (AOR = 1.38, 95%CI: 1.10–1.73 and AOR = 1.69, 95%CI: 1.31–2.19, respectively). Higher odds of non-vaccination were found when the provision of vaccine information did not motivate parents to vaccinate their children (AOR = 4.29, 95%CI: 3.15–5.85). Conversely, believing that vaccines were safe for children decreased the odds of non-vaccination (AOR = 0.72, 95%CI: 0.58–0.88). Parental perceptions and concerns should be considered in interventions aiming to increase compulsory vaccine acceptance and coverage.

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Data Availability

Dataset is available upon request from the corresponding author.

Abbreviations

COVID-19:

The coronavirus disease 2019

HBM:

Health Belief Model

VPDs:

Vaccine-preventable diseases

SSA:

Sub-Saharan African

WHO:

The World Health Organization

SDGs:

Sustainable Development Goals

DRC:

Democratic Republic of Congo

ANC:

Antenatal care

OPV:

Oral polio vaccine

BCG:

Bacillus Calmette-Guérin vaccine

DPT:

Diphtheria, Tetanus, Pertussis vaccine

DHS:

Demographic and Health Survey

CI:

Confidence intervals

AOR:

Adjusted odds ratio

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Acknowledgements

The research team expresses their deep thanks to the study participants for providing their time and sharing in this study.

Funding

The underlying research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt

    Ramy Mohamed Ghazy

  2. Faculty of Medicine, Alexandria University, Alexandria, Egypt

    Assem Gebreal

  3. Public Health Institute, Faculty of Health, Liverpool John Moores University, Liverpool, UK

    Marina Raouf Abdelmessih Saleeb

  4. Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan

    Malik Sallam

  5. Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman, Jordan

    Malik Sallam

  6. Department of Physiology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt

    Ahmed El-Sayed Nour El-Deen

  7. Department of Basic Medical and Dental Sciences, Faculty of Dentistry, Zarqa University, PO Box 2000, Zarqa, 13110, Jordan

    Ahmed El-Sayed Nour El-Deen

  8. Sierra Leone Ministry of Health and Sanitation, Freetown, Sierra Leone

    Swaliho Dauda Sheriff

  9. College of Health Science, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia

    Eyerusalem Amossa Tessema

  10. Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda

    Salvias Ahurwendeire

  11. Motebang Hospital, Hlotse, Lesotho

    Nthabiseng Tsoeu

  12. Zomba Central Hospital, Zomba, Malawi

    Prince C. Chamambala

  13. Health Officer, Les Ailes du Coeur NGO, Congo, Democratic Republic of Congo

    Patrick B. Cibangu

  14. Department of Community Medicine, Federal Medical Centre Umuahia, Abia, Nigeria

    Debra Ukamaka Okeh

  15. Association Faso Civic, Ouagadougou, Burkina Faso

    Adama Sy Traoré

  16. Seventh-Day Adventist Hospital, Agona-Asamang, Ghana

    Gilbert Eshun

  17. Faculty of Medicine and Biomedical Sciences, University of Garoua, Garoua, Cameroun

    Nathan Ezie Kengo

  18. Saint Francis University College of health and allied Sciences, Ifakara, Morogoro, Tanzania

    Amos Elisha Kubuka

  19. Department of Health Promotion and Disability Studies, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

    Lydia Baffour Awuah

  20. Faculty of Medicine, Algiers University, Algiers, Algeria

    Assia Salah

  21. Department of Family and Community Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia

    Moath Aljohani

  22. Family Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt

    Noha Fadl

Authors
  1. Ramy Mohamed Ghazy
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  2. Assem Gebreal
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  3. Marina Raouf Abdelmessih Saleeb
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  4. Malik Sallam
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  5. Ahmed El-Sayed Nour El-Deen
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  6. Swaliho Dauda Sheriff
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  7. Eyerusalem Amossa Tessema
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  8. Salvias Ahurwendeire
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  9. Nthabiseng Tsoeu
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  10. Prince C. Chamambala
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  11. Patrick B. Cibangu
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  12. Debra Ukamaka Okeh
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  13. Adama Sy Traoré
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  14. Gilbert Eshun
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  15. Nathan Ezie Kengo
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  16. Amos Elisha Kubuka
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  17. Lydia Baffour Awuah
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  18. Assia Salah
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  19. Moath Aljohani
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  20. Noha Fadl
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Contributions

Conceptualization, Ramy Mohamed Ghazy, Noha Fadl.; Methodology, Ramy Mohamed Ghazy, Noha Fadl.; Data Collection and data cleaning: Assem Gebreal, Ahmed El-Sayed Nour El-Deen, Swaliho Dauda Sheriff, Eyerusalem Amossa Tessema, Salvias Ahurwendeire, Nthabiseng Tsoeu, Prince C. Chamambala, Patrick B. Cibangu, Debra Ukamaka Okeh, Adama Sy Traoré, Gilbert Eshun, Kengo Nathan Ezie, Amos Elisha Kubuka, Awuah Lydia Baffour,.; Data Analysis, Marina Raouf Abdelmessih Saleeb.; Data Curation, Ramy Mohamed Ghazy, Marina Raouf Abdelmessih Saleeb, Assem Gebreal.;Writing–Original Draft Preparation, Ramy Mohamed Ghazy, Noha Fadl, Ahmed El-Sayed Nour El-Deen, Assia Salah; Writing–Review & Editing, Ramy Mohamed Ghazy, Noha Fadl, Malik Sallam, Moath Aljohani; Visualization, Ramy Mohamed Ghazy and Noha Fadl. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Noha Fadl.

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Ghazy, R.M., Gebreal, A., Saleeb, M.R.A. et al. Compulsory Vaccination Coverage in 12 Sub-Saharan African Countries Two Years Following the COVID-19 Pandemic. J Community Health 49, 193–206 (2024). https://doi.org/10.1007/s10900-023-01261-1

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