Determinants of COVID-19 Vaccine Acceptance and Hesitance Among Adolescents and Youths in Sub-Saharan African Countries: A Systematic Review and Meta-analysis

Abstract

Abstract The COVID-19 pandemic has overwhelmed health systems especially sub-Saharan African countries. Vaccination is one of the easily accessible interventions that can help reduce the burden on the health system. However, vaccination coverage remains low in sub-Saharan African countries. The determinants of vaccine acceptance and hesitance among adolescents and youths remain unknown. Therefore, this study explored the prevalence and determinants of COVID-19 Vaccine Acceptance and Hesitance among Adolescents and Youths in Sub-Saharan African Countries. A systematic literature search of Scopus, PubMed Central, PubMed, Embase, African Journal Online, Research 4 Life, Embase, and Google Scholar was performed from 6th to 9th May 2023, using developed keywords. Studies conducted in sub-Saharan African countries between 20th February 2020 and 14th June 2023 were considered for the study. Twenty-three (N = 23) studies were finally selected for analysis. The prevalence of vaccine acceptance among adolescents and youths was (n = 23) 38.7% in sub-Saharan African countries. The subgroup analysis indicated that the prevalence of acceptance among adolescents was (n = 13), 36.1% while youths (n = 10), 42%. At the region level West Africa (n = 13) 42.2%, East Africa (n = 6), 39.8%, Central Africa (n = 1), 33%, and Southern Africa (n = 3), 24.2%. The prevalence of vaccine hesitance was (n = 23), 25.3%. The subgroup analysis indicated that the prevalence of acceptance among adolescents was n = 13, 30.7% while youths (n = 10), 41.6%. At the region level Central Africa (n = 1), 67.2, Southern Africa (n = 3), 41.7%, East Africa (n = 6), 34.7% and 3%, and West Africa (n = 13, 31.9%. The meta-regression analysis of determinants of acceptance was self-immunity p < 0.05, health officer p < 0.001, effectiveness p < 0.05, while hesitance was the source of information 0.05. The findings indicate that there is a low level of COVID-19 vaccine acceptance and high levels of hesitance among adolescents and youths in Sub-Saharan African countries. Therefore, there is a need to ensure that extensive research is undertaken into age-appropriate health promotion messages and strategies to encourage uptake of the vaccines. Educating individuals on the benefit of vaccination and the expected side effect should be addressed as well as the basic process of vaccine development.