COVID-19 vaccine uptake, confidence and hesitancy in rural KwaZulu-Natal, South Africa between April 2021 and April 2022: A continuous cross-sectional surveillance study.
COVID-19 vaccine uptake, confidence and hesitancy in rural KwaZulu-Natal, South Africa between April 2021 and April 2022: A continuous cross-sectional surveillance study.
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DOI：
10.1371/journal.pgph.0002033
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发表时间：
2023
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南非对COVID-19疫苗的高度犹豫限制了对未来疫情的保护。我们评估了2021年4月至2022年4月在特征鲜明的夸祖鲁-纳塔尔农村环境中疫苗犹豫及其相关因素的演变情况。邀请非洲卫生研究所监测地区所有15岁以上的居民完成一次以家庭为基础的面对面访谈。我们描述了疫苗接种和犹豫的趋势，然后使用有序逻辑回归评估与预先存在的个人因素，动态环境背景和行动线索的关联。在10，011名受访者中，疫苗接种率随着年龄组在合格后三个月内达到接种资格而上升;年轻年龄组的接种速度较慢，稳定速度更快。终生接种任何COVID-19疫苗的比例由2021年4月至7月的3. 0%上升至2022年1月至4月的32. 9%。在7,445名未接种疫苗的受访者中，47.7%的人表示他们肯定会在研究时间段的第一季度今天接种免费疫苗，最后下降到32.0%。到2022年3月/4月，只有48.0%的受访者接种了疫苗或表示肯定会接种疫苗。较低疫苗犹豫的预测因素包括男性（调整后的比值比[aOR]：0.70，95%置信区间[CI]：0.65-0.76），与接种疫苗的家庭成员一起生活（aOR：0.65，95%CI：0.59-0.71）和知道有人患有COVID-19（aOR：0.69，95%CI：0.59-0.80）。对政府的不信任预测了更大的犹豫（aOR：1.47，95%CI：1.42-1.53）。尽管有几次COVID-19浪潮，但疫苗犹豫在南非农村很常见，随着时间的推移而上升，并与对政府的不信任密切相关。然而，人际交往的经验反击犹豫，可能是切入点的干预措施。
High COVID-19 vaccine hesitancy in South Africa limits protection against future epidemic waves. We evaluated how vaccine hesitancy and its correlates evolved April 2021-April 2022 in a well-characterized rural KwaZulu-Natal setting. All residents aged >15 in the Africa Health Research Institute’s surveillance area were invited to complete a home-based, in-person interview. We described vaccine uptake and hesitancy trends, then evaluated associations with pre-existing personal factors, dynamic environmental context, and cues to action using ordinal logistic regression. Among 10,011 respondents, vaccine uptake rose as age-cohorts became vaccine-eligible before levelling off three months post-eligibility; younger age-groups had slower uptake and plateaued faster. Lifetime receipt of any COVID-19 vaccine rose from 3.0% in April-July 2021 to 32.9% in January-April 2022. Among 7,445 unvaccinated respondents, 47.7% said they would definitely take a free vaccine today in the first quarter of the study time period, falling to 32.0% in the last. By March/April 2022 only 48.0% of respondents were vaccinated or said they would definitely would take a vaccine. Predictors of lower vaccine hesitancy included being male (adjusted odds ratio [aOR]: 0.70, 95% confidence interval [CI]: 0.65–0.76), living with vaccinated household members (aOR:0.65, 95%CI: 0.59–0.71) and knowing someone who had had COVID-19 (aOR: 0.69, 95%CI: 0.59–0.80). Mistrust in government predicted greater hesitancy (aOR: 1.47, 95%CI: 1.42–1.53). Despite several COVID-19 waves, vaccine hesitancy was common in rural South Africa, rising over time and closely tied to mistrust in government. However, interpersonal experiences countered hesitancy and may be entry-points for interventions.