The colonial effect: Language, trust and attitudes to science as predictors of vaccine hesitancy across Africa

Abstract

Perceptions of vaccine safety, importance and effectiveness are at the core of vaccine hesitancy around the world, and Africa has had its own share of vaccine revolts. This study uses the 2018 Wellcome Global Monitor on public perceptions of vaccines in 40 African countries to examine the predictors of vaccine hesitancy. It examines levels of hesitancy from a language perspective, comparing French speakers with others, mostly English speakers. Results show that French speakers were significantly more hesitant about importance and safety, while English speakers and others were more hesitant about effectiveness. This reflects the continuing influence of colonial ties on African countries. Respondents with high levels of trust in social actors (such as national government, journalists, people neighborhood, doctors and nurses) were also more hesitant about the safety and effectiveness of vaccines, indicating the importance of non-scientists in influencing vaccine hesitancy. Those with high levels of education were more likely to be hesitant about vaccines in general, indicating that having more education may have an opposite effect. Perception of science as progress was significant for all three hesitancy types, indicating that Africans with more progressive attitudes were less likely to worry about the importance, safety and effectiveness of vaccines. At the country level, there was no overarching predictor, indicating the strong role of local social and cultural factors. These findings improve our understanding of the drivers of vaccine hesitancy in Africa and provide valuable input for future vaccine policy and health-awareness campaigns.