ABSTRACT
Vaccination is the most effective preventive measure against COVID-19 spread. While the WHO and other stakeholders fear vaccine nationalism, vaccine-hesitancy has become a topical issue among experts. Based on the evidence of vaccine hesitancy among Blacks, we explore the interrelatedness of psycho-social factors (personal health engagement, fear of COVID-19, perceived susceptibility, and vaccine-related attitude) likely to thwart vaccine acceptance in Africa. We sampled 1768 Ghanaian adults over 2 weeks from December 14, 2020, the first day a successful COVID-19 vaccine was administered in the US using an online survey. A higher level of personal health engagement was found to promote vaccine-related attitudes while reducing COVID-19 related fears, susceptibility, and vaccine hesitancy. Fear of COVID-19 and perceived vulnerability are significant contributors to the willingness to accept vaccination. This is an indication that health engagement alone will not promote vaccination willingness, but the fear and higher level of perceived susceptibility out of personal evaluation are essential factors in vaccination willingness. We recommend promoting health educational messages on COVID-19 vaccination ahead of any vaccination rollout in Africa, and such messages should contain some element of fear appeal.