Vaccine hesitancy among healthcare workers in low- and middle-income countries during the COVID-19 pandemic: Results from facility surveys across six countries.

Publication date: Jul 07, 2023

Vaccine hesitancy remains a critical barrier in mitigating the effects of the ongoing COVID-19 pandemic. The willingness of health care workers (HCWs) to be vaccinated, and, in turn, recommend the COVID-19 vaccine for their patient population is an important strategy. This study aims to understand the uptake of COVID-19 vaccines and the reasoning for vaccine hesitancy among facility-based health care workers (HCWs) in LMICs. We conducted nationally representative phone-based rapid-cycle surveys across facilities in six LMICs to better understand COVID-19 vaccine hesitancy. We gathered data on vaccine uptake among facility managers, their perceptions of vaccine uptake and hesitancy among the HCWs operating in their facilities, and their perception of vaccine hesitancy among the patient population served by the facility. 1,148 unique public health facilities participated in the study, with vaccines being almost universally offered to facility-based respondents across five out of six countries. Among facility respondents who have been offered the vaccine, more than 9 in 10 survey respondents had already been vaccinated at the time of data collection. Vaccine uptake among other HCWs at the facility was similarly high. Over 90% of facilities in Bangladesh, Liberia, Malawi, and Nigeria reported that all or most staff had already received the COVID-19 vaccine when the survey was conducted. Concerns about side effects predominantly drive vaccine hesitancy in both HCWs and the patient population. Our findings indicate that the opportunity to get vaccinated in participating public facilities is almost universal. We find vaccine hesitancy among facility-based HCWs, as reported by respondents, to be very low. This suggests that a potentially effective effort to increase vaccine uptake equitably would be to channel promotional activities through health facilities and HCWs. However, reasons for hesitancy, even if limited, are far from uniform across countries, highlighting the need for audience-specific messaging.

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Concepts Keywords
Bangladesh Based
Managers Countries
Nigeria Covid
Pandemic Facilities
Vaccinated Facility


Type Source Name
disease VO vaccine
disease MESH COVID-19 pandemic
disease IDO facility
disease VO vaccinated
disease VO COVID-19 vaccine
disease VO population
drug DRUGBANK Tropicamide
disease VO time
drug DRUGBANK Etoperidone
disease VO effective
pathway REACTOME Reproduction
disease VO vaccination
disease MESH infections
disease VO immunization
disease VO organization
drug DRUGBANK Pentaerythritol tetranitrate
disease MESH vaccine preventable diseases
disease MESH measles
pathway KEGG Measles
disease IDO infection
disease MESH influenza
disease VO document
disease IDO country
disease VO dose
drug DRUGBANK Coenzyme M
disease VO USA
disease VO unvaccinated
disease VO Imovax ID
disease MESH thrombosis
drug DRUGBANK Trestolone
disease IDO process
disease VO efficient
disease IDO intervention
disease VO Equity
disease VO vaccination coverage
disease MESH Infectious Diseases
disease VO effectiveness
disease VO Canada
disease VO frequency

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