Factors Driving COVID-19 Vaccine Hesitancy in Cameroon and Their Implications for Africa: A Comparison of Two Cross-Sectional Studies Conducted 19 Months Apart in 2020 and 2022.

Many efficacious COVID-19 vaccines have been approved for general use but their ability to control the disease is being undermined by slow uptake. Resources are needed to persuade people to obtain a COVID-19 vaccine. Here we compare this present study and a previous one to assess the impact of the Cameroon government's policy and efforts to reduce COVID-19 vaccine hesitancy after one year of implementation. After obtaining ethical clearance and informed consent, 6732 participants completed a questionnaire about COVID-19 vaccine hesitancy and acceptance. It was observed that the government's policies and efforts reduced COVID-19 vaccine hesitancy significantly, but this was not enough to ensure the herd immunity necessary to control the disease. The risk factors associated with vaccine hesitancy were the consumption of traditional herbal remedies; living in an urban setting; being female, jobless or a student; working in the education sector; being a politician/policy maker/administrator, engineer or technician; medium income; no education/primary school/secondary/high school/professional training; and working in the informal sector. In contrast, people who were male, healthcare personnel, high-income earners, participants who do not consume traditional herbal remedies, infected or knowing someone who has been infected by COVID-19, and having a chronic illness or comorbidity, were associated with COVID-19 vaccine acceptance. Participants also gave several reasons they were either hesitant or willing to take the vaccine. A more rigorous surveillance system is needed to systematically monitor drivers of vaccine hesitancy, establish tailored interventions promoting vaccine acceptance, and evaluate the impact of these interventions.