Introduction: The COVID-19 Pandemic has affected critical sectors of human development. To curtail these effects, vaccines are being approved for human trials. It is, therefore, important to know the possible vaccine coverage expected in each country. This study determined the willingness of Nigerians to accept and pay for COVID-19 vaccine. Methods: A cross-sectional web-based survey across all states of Nigeria was conducted via a structured e-questionnaire. Descriptive statistics, ANOVA and multinomial logistic regression were conducted. Result: A total of 502 responses were obtained from all six geopolitical zones of Nigeria, comprising 67.3% males (n = 338) and 32.7% females (n = 164). The results indicated that 34.7% (n = 167) are willing to accept the vaccine when given for free, 33.9% (n = 163) are not willing, and up to 31.4% (n = 151) are indifferent in their decision. Univariate analysis indicated the likelihood that education level could influence willingness to accept the vaccine (F = 2.408, p = 0.049). Rollout strategies may have an impact (p < 0.0001) on the willingness to accept the vaccine. These strategies include providing incentives, making it compulsory and paying for the vaccine with F = 186.983 and eta = 0.657, F =71.620 and Eta = 0.476, F = 108.696 and Eta = 0.552, respectively. Conclusion: The study revealed a possibility of the low willingness of Nigerians to accept COVID-19 vaccine. Providing incentives is likely to improve coverage, while making the vaccine compulsory may increase rejection. This study, therefore, serves as a gateway for government and policymakers on how best to prime and penetrate the society to achieve massive COVID-19 vaccine coverage in Nigeria.
References
[1]
WHO (2020) Timeline: WHO’s COVID-19 Response.
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/interactive-timeline
[2]
Nnama-Okechukwu, C.U., Chukwu, N.E. and Nkechukwu, C.N. (2020) COVID-19 in Nigeria: Knowledge and Compliance with Preventive Measures. Social Work in Public Health, 35, 590-602. https://doi.org/10.1080/19371918.2020.1806985
[3]
Zhu, N., et al. (2020) A Novel Coronavirus from Patients with Pneumonia in China, 2019. New England Journal of Medicine, 382, 727-733.
https://doi.org/10.1056/NEJMoa2001017
[4]
Hassan, Z., Hashim, M.J. and Khan, G. (2020) Population Risk Factors for COVID-19 Deaths in Nigeria at Sub-National Level. The Pan African Medical Journal, 35, Article No. 131.
[5]
Worldometer (2021) Coronavirus Update (Live): 99,520,105 Cases and 2,134,070 Deaths from COVID-19 Virus Pandemic.
https://www.worldometers.info/coronavirus/#countries
NCDC (2020) Nigeria Centre for Disease Control. https://ncdc.gov.ng/
[8]
World Bank (2020) Annual Report 2020.
https://www.worldbank.org/en/about/annual-report
[9]
IMF (2020) IMF Annual Report 2020: A Year Like No Other.
https://www.imf.org/external/pubs/ft/ar/2020/eng/
[10]
Breuer, E., Lee, L., De Silva, M. and Lund, C. (2016) Using Theory of Change to Design and Evaluate Public Health Interventions: A Systematic Review. Implementation Science, 11, Article No. 63. https://doi.org/10.1186/s13012-016-0422-6
[11]
De Silva, M.J., et al. (2014) Theory of Change: A Theory-Driven Approach to Enhance the Medical Research Council’s Framework for Complex Interventions. Trials, 15, Article No. 267. https://doi.org/10.1186/1745-6215-15-267
[12]
Ling, T. (2012) Evaluating Complex and Unfolding Interventions in Real Time. Evaluation, 18, 79-91. https://doi.org/10.1177/1356389011429629
[13]
Mackenzie, M., O’Donnell, C., Halliday, E., Sridharan, S. and Platt, S. (2010) Do Health Improvement Programmes Fit with MRC Guidance on Evaluating Complex Interventions? British Medical Journal, 340, c185. https://doi.org/10.1136/bmj.c185
[14]
Mookherji, S. and LaFond, A. (2013) Strategies to Maximize Generalization from Multiple Case Studies: Lessons from the Africa Routine Immunization System Essentials (ARISE) Project. Evaluation, 19, 284-303.
https://doi.org/10.1177/1356389013495212
[15]
Ningthoujam, R. (2020) COVID 19 Can Spread through Breathing, Talking, Study Estimates. Current Medicine Research and Practice, 10, 132-133.
https://doi.org/10.1016/j.cmrp.2020.05.003
[16]
Feikin, D.R., Flannery, B., Hamel, M.J., Stack, M. and Hansen, P.M. (2016) Vaccines for Children in Low- and Middle-Income Countries. In: Black, R.E., Laxminarayan, R., Temmerman, M. and Walker, N., Eds., Reproductive, Maternal, Newborn, and Child Health: Disease Control Priorities, The International Bank for Reconstruction and Development/The World Bank, Washington DC, 187-204.
https://doi.org/10.1596/978-1-4648-0348-2_ch10
[17]
WHO (2021) Draft Landscape and Tracker of COVID-19 Candidate Vaccines.
https://www.who.int/publications/m/item/draft-landscape-of-covid-19-candidate-vaccines
[18]
Farge, E. (2021) Vaccine Nationalism Puts World on Brink of ‘Cata-strophic Moral Failure’: WHO Chief. Reuters.
[19]
Baker, H. and Murdoch, I.E. (2008) Can a Public Health Intervention Improve Awareness and Health-Seeking Behaviour for Glaucoma? British Journal of Ophthalmology, 92, 1671-1675. https://doi.org/10.1136/bjo.2008.143537
[20]
Seymour, J. (2017) The Impact of Public Health Awareness Campaigns on the Awareness and Quality of Palliative Care. Journal of Palliative Medicine, 20, S30-S36.
https://doi.org/10.1089/jpm.2017.0391
[21]
World Americas (2021) COVID-19: Vaccine Rollout Hits Snag in US as Health Workers Balk at Shots.
https://gulfnews.com/world/americas/covid-19-vaccine-rollout-hits-snag-in-us-as-health-workers-balk-at-shots-1.1610173961760
[22]
The News (2021) Dubai Restaurants Announce Exciting Incentive for Vaccinating against COVID-19.
https://www.thenews.com.pk/latest/779616-dubai-restaurants-announce-exciting-incentive-for-vaccinating-against-covid-19
[23]
Seth, R., et al. (2018) Mobile Phone Incentives for Childhood Immunizations in Rural India. Pediatrics, 141, e20173455. https://doi.org/10.1542/peds.2017-3455
[24]
AP News (2020) Can Employers Make COVID-19 Vaccination Mandatory?
https://apnews.com/article/can-employers-covid-19-vaccine-mandatory-ba22c99f01f24ea3be7631ff751f0d82
[25]
Fujiwara, S. (2006) Is Mandatory Vaccination Legal in Time of Epidemic? AMA Journal of Ethics, 8, 227-229.
https://doi.org/10.1001/virtualmentor.2006.8.4.hlaw1-0604
[26]
Savulescu, J. (2021) Good Reasons to Vaccinate: Mandatory or Payment for Risk? Journal of Medical Ethics, 47, 78-85. https://doi.org/10.1136/medethics-2020-106821
[27]
Hassan, Z., Sa’id, A.S. and Mohammed, H.A. (2021) Is Distance E-Learning Option Acceptable by Nigerians amidst COVID-19 Pandemic? African Journal of Education and Practice, 7, 11-25.
[28]
CDC (2020) COVID-19 and Your Health. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations.html
Weintraub, R. and Mohta, N.S. (2021) Covid-19 Vaccine Distribution: One of the Most Complex Tasks in American Public Health History. NEJM Catalyst.
[31]
DoH Louisiana (2021) Louisiana Joins Federal Retail Pharmacy Program to Expand COVID Vaccine Distribution. Department of Health, State of Louisiana.
https://ldh.la.gov/index.cfm/newsroom/detail/6011
[32]
Estrin, D. (2021) Vaccines for Data: Israel’s Pfizer Deal Drives Quick Rollout—And Privacy Worries. NPR.
https://www.npr.org/2021/01/31/960819083/vaccines-for-data-israels-pfizer-deal-drives-quick-rollout-and-privacy-worries
[33]
Barrett, A.D.T. (2016) Vaccinology in the Twenty-First Century. npj Vaccines, 1, Article No. 16009. https://doi.org/10.1038/npjvaccines.2016.9
[34]
Bangura, J.B., Xiao, S.Y., Qiu, D., Ouyang, F.Y. and Chen, L. (2020) Barriers to Childhood Immunization in Sub-Saharan Africa: A Systematic Review. BMC Public Health, 20, Article No. 1108. https://doi.org/10.1186/s12889-020-09169-4
[35]
Pollard, A.J. and Bijker, E.M. (2020) A Guide to Vaccinology: From Basic Principles to New Developments. Nature Reviews Immunology, 21, 83-100.
[36]
WHO (2021) Raising Awareness of Immunization.
https://www.who.int/westernpacific/activities/raising-awareness-of-immunization
[37]
Henao-Restrepo, A.M., et al. (2015) Efficacy and Effectiveness of an rVSV-Vectored Vaccine Expressing Ebola Surface Glycoprotein: Interim Results from the Guinea Ring Vaccination Cluster-Randomised Trial. The Lancet, 386, 857-866.
https://doi.org/10.1016/S0140-6736(15)61117-5
[38]
Kanapathipillai, R., et al. (2014) Ebola Vaccine—An Urgent International Priority. The New England Journal of Medicine, 371, 2249-2251.
https://www.nejm.org/doi/10.1056/NEJMp1412166
[39]
Lurie, N., Saville, M., Hatchett, R. and Halton, J. (2020) Developing Covid-19 Vaccines at Pandemic Speed. New England Journal of Medicine, 382, 1969-1973.
https://doi.org/10.1056/NEJMp2005630
[40]
Jeyanathan, M., Afkhami, S., Smaill, F., Miller, M.S., Lichty, B.D. and Xing, Z. (2020) Immunological Considerations for COVID-19 Vaccine Strategies. Nature Reviews Immunology, 20, 615-632. https://doi.org/10.1038/s41577-020-00434-6
[41]
Geddes, L. (2021) Who Can’t Have a COVID-19 Vaccine? Gavi.
https://www.gavi.org/vaccineswork/who-cant-have-covid-19-vaccine
[42]
CDC (2020) COVID-19 Vaccination. Centers for Disease Control and Prevention.
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/older-adults.html
[43]
Lazarus, J.V., et al. (2021) A Global Survey of Potential Acceptance of a COVID-19 Vaccine. Nature Medicine, 27, 225-228. https://doi.org/10.1038/s41591-020-1124-9
[44]
Al-Qerem, W.A. and Jarab, A.S. (2021) COVID-19 Vaccination Acceptance and Its Associated Factors among a Middle Eastern Population. Frontiers in Public Health, 9, Article ID: 632914. https://doi.org/10.3389/fpubh.2021.632914
[45]
WHO (2020) Coronavirus Disease (COVID-19): Herd Immunity, Lockdowns and COVID-19.
https://www.who.int/news-room/q-a-detail/herd-immunity-lockdowns-and-covid-19
[46]
NPHCDA (2021) COVID-19 Vaccination Update for May 6th 2021, in 36 States+the FCT. Is Your State Still Vaccinating? #YesToCOVID19Vaccine.
https://twitter.com/NphcdaNG/status/1390560529018724352
[47]
McMillan, A. (2021) Mandatory Vaccination: Legal, Justified, Effective? IBA.
https://www.ibanet.org/Article/NewDetail.aspx?ArticleUid=70e1f93e-a23b-4f1a-a596-aeef84750241
[48]
Gravagna, K., et al. (2020) Global Assessment of National Mandatory Vaccination Policies and Consequences of Non-Compliance. Vaccine, 38, 7865-7873.
https://doi.org/10.1016/j.vaccine.2020.09.063
[49]
Al Amir, K. (2021) Saudi Arabia: Vaccination required to Perform Umrah. World Gulf. https://gulfnews.com/world/gulf/saudi/saudi-arabia-vaccination-required-to-perform-umrah-1.78350195
[50]
Hassan, R. (2021) Saudi Arabia: Vaccine Required to Enter Prophet’s Mosque, Permit Needed for Umrah. Arab News. https://arab.news/pb9re
[51]
Fisher, K.A., Bloomstone, S.J., Walder, J., Crawford, S., Fouayzi, H. and Mazor, K.M. (2020) Attitudes toward a Potential SARS-CoV-2 Vaccine: A Survey of U.S. Adults. Annals of Internal Medicine, 173, 964-973.
https://doi.org/10.7326/M20-3569
[52]
Neumann-Bohme, S., et al. (2020) Once we Have It, Will We Use It? A European Survey on Willingness to be Vaccinated against COVID-19. The European Journal of Health Economics, 21, 977-982. https://doi.org/10.1007/s10198-020-01208-6
[53]
Wang, J., et al. (2020) Acceptance of COVID-19 Vaccination during the COVID-19 Pandemic in China. Vaccines, 8, Article No. 482.
https://doi.org/10.3390/vaccines8030482
[54]
Moore, T. (2021) COVID-19 Vaccine Blood Clot Fears: Under-40s to Be Offered Alternative to AstraZeneca Jab as Advice Changes. Sky News.
https://news.sky.com/story/under-40s-to-be-offered-alternative-to-oxford-jab-over-blood-clot-fears-12299219
[55]
Pinho, A.C. (2021) AstraZeneca’s COVID-19 Vaccine: EMA Finds Possible Link to Very Rare Cases of Unusual Blood Clots with Low Platelets. European Medicines Agency.
https://www.ema.europa.eu/en/news/astrazenecas-covid-19-vaccine-ema-finds-possible-link-very-rare-cases-unusual-blood-clots-low-blood
[56]
Mahase, E. (2021) Covid-19: AstraZeneca Vaccine Is Not Linked to Increased Risk of Blood Clots, Finds European Medicine Agency. British Medical Journal, 372, n774. https://doi.org/10.1136/bmj.n774
[57]
WHO (2021) Interim Recommendations for Use of the ChAdOx1-S [Recombinant] Vaccine against COVID-19 (AstraZeneca COVID-19 Vaccine AZD1222, SII COVI-SHIELD, SK Bioscience).
https://www.who.int/publications-detail-redirect/WHO-2019-nCoV-vaccines-SAGE_recommendation-AZD1222-2021.1
[58]
Lucero-Prisno, D.E., Ogunkola, I.O., Imo, U.F. and Adebisi, Y.A. (2021) Who Will Pay for the COVID-19 Vaccines for Africa? The American Journal of Tropical Medicine and Hygiene, 104, 794-796. https://doi.org/10.4269/ajtmh.20-1506
[59]
World Bank (2020) World Bank Approves $12 Billion for COVID-19 Vaccines.
https://www.worldbank.org/en/news/press-release/2020/10/13/world-bank-approves-12-billion-for-covid-19-vaccines