Limited supply of COVID-19 vaccine, and a lack of confidence from the population could hamper immunization efforts in Sahelian Countries

Availability of vaccines is a serious issue, still when a vaccine is available, the roll-out is not effective, in part due to a lack of confidence from the population

The successful race to develop safe and effective vaccines, the tremendous pull from the COVAX facility to provide 2 billion doses for free to lower-income countries, and the fast mobilization of 12 billion US dollars of resources from the World Bank to finance the additional purchase of vaccines are contributing to making access to vaccines a reality. But in Africa in general, COVID-19 vaccination is experiencing a prolonged start, and countries in the Sahel, in particular, have mostly only received enough doses to cover their population. As of May 2nd, 2022, only 8.3 million people (approximatively 10% of people) in the Sahel have been vaccinated according to data from our world in Data. This includes 2.4 million people in Burkina Faso (11% of the population), 2.2 million people in Chad (13%),  1.5 million people in Mali (7%), and 2.2 million people in Niger (9%). However, the low vaccination rate in these countries cannot be explained simply by the very slow start and progress in the vaccine roll-out and the availability of vaccines. Negative perceptions resulting from little confidence in the vaccines' effectiveness and safety seem to play an essential part in the slow pace of vaccinations.

While some African countries struggle to secure COVID-19 vaccines, those who received vaccines are facing a difficult time getting people inoculated. In Africa, which is home to 1.3 billion people, only 22% of people have been vaccinated as of May 2nd, 2022 according to data from our world in Data. In Sahel countries, at least seven out of ten people are willing to get vaccinated, including eight out of ten people in Burkina Faso and Niger according to the results of the high-frequency survey. These acceptance rates are high compared to those available in other sources of data such as data from a Facebook survey run by Carnegie Mellon University and the University of Maryland in May that show that 62% and 45% of people in Mali and Burkina Faso, respectively, would get vaccinated once a vaccine is available and recommended. In each country, the poor are more likely to get vaccinated than the non-poor if the authorities provided them with free vaccines. In Chad, people who live in households with a more educated head are more likely to accept the vaccine, while in Burkina Faso, the same group of people is less likely to accept the vaccine compared to those who live in a household where the head is not educated (Table 1). But in general, people who are less likely to get vaccinated live in capital cities.  In Ouagadougou, only five out of ten people are willing to get vaccinated; the same applied to six out of ten people in Ndjamena and Bamako.  People in capital cities have more access to social media and are more susceptible to misinformation such as the rumors around AstraZeneca. In rural areas, the difficult access to the population can partially explain the slow uptake of the vaccination process. Figure 1 also presents some findings to better understand why Sahelian people are hesitating to get vaccinated against COVID-19.

Figure 1: Share of respondents who would agree to be vaccinated if an approved vaccine to prevent coronavirus were available now and at no cost.

Figure 2: Share of respondents who  would agree to be vaccinated if an approved vaccine to prevent coronavirus were available now and at no cost by gender and level of education of household head

Fear of vaccines or fear of “A” vaccine?

The debate on the effectiveness of some COVID-19 vaccines in developed countries has also negatively impacted populations and government trust in the vaccine. In particular, misinformation and rumors have made the fear of using AstraZeneca a particular issue in vaccine roll-out. On March 18th, the Minister of Public Health and National Solidarity of Chad announced that the country decided not to accept the AstraZeneca COVID-19 vaccine under the COVAX initiative until more evidence is available on the efficacy of this vaccine against the South African variant. At the population level, the fear of the “A” vaccine is put forward as the main reason for those who do not want to get vaccinated as 48.7% and 53.0% of them are worried about the safety net of the “A” vaccine in Niger and Chad, respectively. These proportions are relatively high compared to the share of people who do not want to be inoculated because of their lack of trust in vaccines in general which is 29.2% in Niger and 18.8% in Chad. In Mali and Burkina Faso, where the only vaccine received by the countries is AstraZeneca, 73.9% and 38.5% of people, respectively, who do not want to be vaccinated are worried about the safety net of the vaccine or feared about its side effects.

In addition to the fear and lack of trust in the vaccine, the lack of access to health care can also affect the vaccination process in these countries. In particular, Table 1 shows that people who have access to health care are more likely to get vaccinated compared to those who do not have access.
 

Figure 3: Reasons to not want to get vaccinated

Table 1: Results of logit regression of vaccine acceptance on some characteristics of the respondent and household head

Related Reading:

https://ourworldindata.org/coronavirus#coronavirus-country-profiles

https://www.bnnbloomberg.ca/china-suspicion-foreign-plot-fears-hamper-africa-vaccine-plan-1.1592543