Analysis of Perception, Reasons, and Motivations for COVID-19 Vaccination in People with Diabetes across Sub-Saharan Africa: A Mixed-Method Approach

Diabetes mellitus (DM) is associated with severe COVID-19 infection and complications. This study assessed COVID-19 vaccine acceptance and hesitancy in diabetes and explored reasons for nonvaccinating. A web-based cross-sectional survey using a mixed method approach was distributed to participants aged ≥18 years with self-reported DM in 11 Sub-Saharan African (SSA) countries from March–May 2021 corresponding to the early vaccine roll out period in most SSA countries. Responses to comments were analyzed for reasons for vaccine hesitancy and facilitators for vaccine uptake. Of the 73 participants with DM, 65.8% were males, older than 35 years (86.3%), had a post-secondary education (90%) and a significant proportion were from South Africa (39.7%), Nigeria (28.8%) and Ghana (13.7%). 64.4% had COVID-19 symptoms, 46.6% were tested for COVID-19 of which 19.2% tested positive. Few participants (6.8%) had taken COVID-19 vaccination, 65.8% were willing to take the vaccine, while 26.0% either refused or hesitated to take the vaccines. The main reasons identified for not taking the vaccine were: concerns about the vaccine safety, its effects, and efficacy, mistrust of the pharmaceutical companies, the conspiracy theories around the vaccines, the process of production, and personal belief of the participants. However, participants stated they would take the vaccine if given more education about it, receive positive feedback from those vaccinated, are rewarded for taking the vaccine or if vaccination becomes a condition for travel and employment. The findings of this study showed that uptake of COVID-19 vaccine was very low in this high-risk group. It is imperative that efforts to increase uptake of vaccine such as provision of education and relevant information, are made.