COVID-19 Vaccine Hesitancy in a Medically-Challenged Context: A Cross-Sectional Study of Drivers, Dangers and Corrective Measures for Vaccine Hesitancy and Potential Penalties for Declining Vaccination among Adults in South-Eastern Nigeria.

BACKGROUND: COVID-19 vaccine hesitancy is a global public health problem. It is a complex and context-specific phenomenon that varies within and across nations. Despite COVID-19 vaccine programmes in Nigeria, there are possibilities that vaccine uptake and coverage among adult citizens will suffer setbacks amidst various interventions by the Federal Government of Nigeria. AIM: The study aimed to determine the drivers, dangers, and corrective measures for COVID-19 vaccine hesitancy and potential penalties for declining vaccination among adults in South-eastern Nigeria. METHODS: A descriptive study was carried out from March to April, 2021 on a cross section of 400 adults in South-eastern Nigeria. Data collection was done using a structured, pretested, and interviewer administered questionnaire. The questionnaire elicited information on drivers, dangers and corrective measures for COVID-19 vaccine hesitancy and potential penalties for declining vaccination. RESULTS: The study participants were aged 18-86 (51±14.2) years. There were 227(56.8%) females. The most common driver of refusal of COVID-19 vaccination was the safety of COVID-19 vaccines(100.0%). The most perceived dangers of refusing the COVID-19 vaccine were the risks of contracting COVID-19 infection(100.0%) and dying from its complications(100.0%). The most common corrective measure for refusal of the COVID-19 vaccine was public health information and education on vaccine safety(100.0%). The predominant potential penalty for declining the COVID-19 vaccine was restricting access to air travel (100.0%). CONCLUSION: This study has shown that the most common driver of vaccine hesitancy was vaccine safety while the most commonly perceived dangers were risks of contracting COVID-19 infection and dying from its complications. The most common corrective measure for refusal of the COVID-19 vaccine was public health information and education on vaccine safety. The most preeminent penalty for declining the COVID-19 vaccine was restricting access to air travel. There is a need to address these context-specific drivers and dangers that promote vaccine hesitancy. Public health information and education strategies to reduce vaccine hesitancy should be the focus of intervention to improve uptake of COVID-19 vaccination and safeguard the health of Nigerians.

CONTEXTE: L'hésitation à se faire vacciner contre le COVID-19 est un problème de santé publique mondial. Il s'agit d'un phénomène complexe et spécifique au contexte qui varie au sein d'une même nation et d'une nation à l'autre. Malgré les programmes de vaccination contre le COVID-19 au Nigeria, il est possible que l'adoption et la couverture vaccinale chez les adultes subissent des revers malgré les diverses interventions du gouvernement fédéral du Nigeria. OBJECTIF: L'étude visait à déterminer les moteurs, les dangers et les mesures correctives de l'hésitation à se faire vacciner contre le COVID- 19 et les sanctions potentielles en cas de refus de vaccination chez les adultes du sud-est du Nigeria. MÉTHODES: Une étude descriptive a été menée de mars à avril 2021 sur un échantillon de 400 adultes du sud-est du Nigeria. La collecte des données a été effectuée à l'aide d'un questionnaire structuré, testé au préalable et administré par un enquêteur. Le questionnaire a permis d'obtenir des informations sur les facteurs, les dangers et les mesures correctives de l'hésitation à se faire vacciner par le COVID-19 et les sanctions potentielles en cas de refus de la vaccination. RÉSULTATS: Les participants à l'étude étaient âgés de 18 à 86 ans (51±14,2). Il y avait 227 (56,8 %) femmes. Le motif le plus courant de refus de la vaccination par le COVID-19 était l'innocuité des vaccins COVID-19 (100,0 %). Les dangers les plus perçus du refus du vaccin COVID-19 étaient les risques de contracter une infection au COVID-19 (100,0%) et de mourir de ses complications (100,0%). La mesure corrective la plus courante pour le refus du vaccin COVID-19 était l'information et l'éducation en matière de santé publique sur la sécurité du vaccin (100,0%). La pénalité potentielle prédominante pour le refus du vaccin COVID-19 était la restriction de l'accès aux voyages aériens (100,0 %). CONCLUSION: Cette étude a montré que le facteur le plus courant de l'hésitation à se faire vacciner était la sécurité du vaccin, tandis que les dangers les plus couramment perçus étaient les risques de contracter l'infection au COVID-19 et de mourir de ses complications. La mesure corrective la plus courante pour le refus du vaccin COVID-19 était l'information et l'éducation de la santé publique sur la sécurité du vaccin. La sanction la plus prééminente pour le refus du vaccin COVID-19 était la restriction de l'accès aux voyages aériens. Il est nécessaire de s'attaquer à ces facteurs et dangers spécifiques au contexte qui favorisent l'hésitation à se faire vacciner. Les stratégies d'information et d'éducation en matière de santé publique visant à réduire l'hésitation à se faire vacciner devraient être au centre de l'intervention afin d'améliorer l'adoption de la vaccination par le COVID-19 et de préserver la santé des Nigérians. Mots clés: Vaccin COVID-19, Dangers, Facteurs d'incitation, Hésitation, Nigeria, Pénalités.

COVID-19 Biosecurity Protective Items Utilization at the Point of Care: A CrossSectional Study of Drivers, Barriers, Benefits and Perceived Dangers among Frontline Medical Doctors in Non-COVID-19 Hospitals in Abia State, Nigeria

BACKGROUND: Globally, COVID-19 is an emerging health problem. As the spread of COVID-19 infection continues worldwide, measures to protect frontline doctors have been in the spotlight on international biosecurity discussions especially in countries with weak health system and infrastructure. AIM: The study was aimed at describing the drivers, barriers, benefits and perceived dangers of utilization of COVID-19 biosecurity protective items at the point of care among frontline doctors in non-COVID-19 hospitals in Abia State. METHODS: This was a cross-sectional study on 220 frontline doctors in Abia State. Data were collected using self-administered questionnaire that elicited information on utilization of COVID-19 biosecurity items (face masks, face shields, hand sanitizers, disinfectant sprays, hand gloves). The drivers, barriers, benefits, and perceived dangers of utilization of biosecurity items were also studied. Utilization was assessed in the preceding 7 days and graded using utilization ordinal scoring system of 0-4 as follows: Always=4 points;most times=3 points;occasional=2 points, rarely=1 point and never=0 point. Those that scored 1 and above were graded as users while 0 score was graded as non-user. RESULTS: The study participants were aged 24-68 years (mean=32+/-8.4 years). There were 162(73.6%) males. All the respondents (100%) had used at least one of the biosecurity protective items in the previous 7 days. The most commonly used biosecurity items were face masks (100%) and hand-gloves (100%). Others included hand sanitizers (90.0%), face shields (55.5%) and disinfectant sprays (43.2%). The most common driver was availability of biosecurity items (100.0%). The commonest barrier was physical discomfort and fatigue (100.0%). The commonest benefits were self-protection from contracting COVID-19 (100.0%) and prevention of transmission to patients, colleagues and significant others (100.0%). The most commonly perceived dangers were suffocation (87.7%) and skin irritation (76.4%) for face masks and hand sanitizers respectively. CONCLUSION: The most commonly used biosecurity items were face masks and hand gloves while the least utilized was disinfectant sprays. The commonest driver was availability of biosecurity protective items. The most common barrier was physical discomfort and fatigue while the predominant benefits were protection from contracting COVID-19 and transmission to patients, colleagues, and significant others. The most commonly perceived dangers were suffocation and skin irritation for face masks and hand sanitizers respectively.

Drivers, barriers, benefits, and perceived dangers of the use of COVID-19 biosecurity protective items in a medically challenged environment of a rural hospital in Eastern Nigeria

INTRODUCTION: Coronavirus has infected and affected millions of life across the globe. As the burden of COVID-19 continues to rise, compliance with the use of COVID-19 biosecurity protective items by the public is critical in safeguarding interperson transmissions of the virus. MATERIALS AND METHODS: A descriptive study was carried out from April to May 2020 on a cross-section of 400 adult Nigerians in a rural hospital in eastern Nigeria. Data collection was done using structured, pretested, and researcher-administered questionnaire. The questionnaire elicited information on drivers, barriers, benefits, and perceived dangers of the use of biosecurity protective items (face masks and alcohol-based hand sanitizers). RESULTS: The study participants were aged 18-84 years with a mean age of 53 +/- 11.6 years. There were 214 (53.5%) females. The most common driver of use of COVID-19 biosecurity protective items was government public health legislative directives (400/400) (100.0%). The most common barrier was a denial of the existence of COVID-19 (359/400) (89.8%). The most common benefits were protection from contracting COVID-19 (400/400) (100.0%) and prevent spreading the infection to others (400/400) (100.0%). The most commonly perceived dangers were suffocation (400/400) (100.0%) and hand irritation (377/400) (94.3%) for face masks and hand sanitizers, respectively. CONCLUSION: The most common driver was government public health legislative directives. The most common barrier was a denial of the existence of COVID-19, while the predominant benefits were protection from contracting COVID-19 and prevent spreading the infection to others. The most commonly perceived dangers were suffocation and hand irritation for masks and sanitizers, respectively. There is a need to address the factors that constitute barriers and perceived dangers to the use of COVID-19 biosecurity items. Factors that drive the use of COVID-19 biosecurity items should be the focus of interest to contain the spread of COVID-19.