Scientific article
Open access

Determinants of COVID-19 vaccine hesitancy and uptake in sub-Saharan Africa: a scoping review

Published inBMJ Open, vol. 12, no. 11, e066615
Publication date2022-11-18
First online date2022-11-18


To identify, describe and map the research tools used to measure COVID-19 vaccine hesitancy, refusal, acceptance and access in sub-Saharan Africa (SSA).


Scoping review


In March 2022, we searched PubMed, Scopus, Web of Science, Cochrane, Academic Search Premier, MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Health Source Nursing, Africa Wide and APA PsychInfo for peer-reviewed literature in English related to COVID-19 vaccine hesitancy, refusal, acceptance and access in SSA. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews to guide evidence gathering and as a template to present the evidence retrieval process.


In the studies selected for review (n=72), several measurement tools were used to measure COVID-19 vaccine hesitancy, acceptance and refusal. These measurements were willingness and intent to vaccinate from the perspectives of the general population, special population groups such as mothers, students and staff in academic institutions and healthcare workers and uptake as a proxy for measuring assumed COVID-19 vaccine acceptance. Measurements of access to COVID-19 vaccination were cost and affordability, convenience, distance and time to travel or time waiting for a vaccine and (dis)comfort. Although all studies measured COVID-19 vaccine hesitancy, acceptance and refusal, relatively few studies (n=16, 22.2%) included explicit measurements of access to COVID-19 vaccination.


Based on the gaps identified in the scoping review, we propose that future research on determinants of COVID-19 vaccination in SSA should further prioritise the inclusion of access-related variables. We recommend the development and use of standardised research tools that can operationalise, measure and disentangle the complex determinants of vaccine uptake in future studies throughout SSA and other low- and middle-income country (LMIC) settings.

  • COVID-19
  • Infection control
  • Public health
  • Epidemiology
  • Ministry of Science, Education and Sports of the Republic of Croatia (MSES) - Znanstveni centar izvrsnosti za integrativnu bioetiku [N/A]
Citation (ISO format)
DEML, Michael, GITHAIGA, Jennifer Nyawira. Determinants of COVID-19 vaccine hesitancy and uptake in sub-Saharan Africa: a scoping review. In: BMJ Open, 2022, vol. 12, n° 11, p. e066615. doi: 10.1136/bmjopen-2022-066615
Main files (1)
Article (Published version)
ISSN of the journal2044-6055

Technical informations

Creation11/21/2022 8:00:00 AM
First validation11/21/2022 8:00:00 AM
Update time03/16/2023 9:07:29 AM
Status update03/16/2023 9:07:28 AM
Last indexation02/12/2024 12:27:49 PM
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