A Mapping Review on the Uptake of the COVID-19 Vaccine among Adults in Africa Using the 5A’s Vaccine Taxonomy

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  • 1 Emerging Researchers and Professionals in Ageing–African Network, Hamilton, Ontario, Canada;
  • | 2 School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada;
  • | 3 Medical Social Services Department, University College Hospital, Ibadan;
  • | 4 University of Benin Teaching Hospital, Benin, Nigeria;
  • | 5 Cedarcrest Hospitals, FCT-Abuja, Nigeria;
  • | 6 Department of Social Work, University of Nigeria, Nsukka, Nigeria;
  • | 7 Department of Social and Behavioral Sciences, City University of Hong Kong, Kowloon, Hong Kong;
  • | 8 Physiotherapy Department, Enugu State University of Science and Technology Teaching Hospital, Parklane-Enugu;
  • | 9 Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus

Uptake of a vaccine is complete if individuals are aware of the associated risks of the vaccine, accept the vaccine, and respond positively to the nudges (activation) to increase the uptake, and respond when the vaccine is made accessible and affordable. We mapped systematically the existing literature concerning the 5As—acceptability, accessibility, affordability, awareness, and activation—of COVID-19 vaccination among adults and, specifically, older adults (55 years and older) in Africa. We searched multiple databases from 2020 to December 2021. Using predefined inclusion and exclusion criteria, two reviewers screened citations, conducted title and abstract screening, and extracted data independently. We included 68 articles conducted in 33 African countries, primarily cross-sectional studies (n = 49, 72%). None of the articles focused on older adults only, but 22 articles (32%) included at least one older adult (55 years and older) in their sample size. Acceptance (n = 58, 85%) was the most commonly researched aspect of vaccine uptake, followed by accessibility (n = 17, 25%), awareness (n = 13, 19%), and affordability (n = 5, 7.0%). We found only one report on activation. Factors affecting acceptance of the COVID-19 vaccine in Africa were grouped into sociodemographic factors; knowledge-, attitude-, and belief-related factors; a COVID-19 vaccine efficacy and safety concern factor; and trust in government and public health authorities. The governments of African nations should focus on strategies to influence the modifiable factors identified in this review. More studies are needed to evaluate the impact of nudges (activation) to improve COVID-19 vaccine uptake in African nations.

Author Notes

Address correspondence to Michael E. Kalu, School of Rehabilitation Science, McMaster University, Hamilton Ontario, Canada. E-mail: kalum@mcmaster.ca

Authors’ addresses: Michael E. Kalu, Emerging Researchers and Professionals in Ageing–African Network and School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada, E-mail: kalum@mcmaster.ca. Oluwagbemiga Oyinlola, Emerging Researchers and Professionals in Ageing–African Network and 3Medical Social Services Department, University College Hospital, Ibadan, E-mail: gsticks2@gmail.com. Michael C. Ibekaku, Emerging Researchers and Professionals in Ageing–African Network and University of Benin Teaching Hospital, Benin, Nigeria, E-mail: michael.ibekaku.192311@unn.edu.ng. Israel I. Adandom, Emerging Researchers and Professionals in Ageing–African Network and Cedarcrest Hospitals, FCT-Abuja, Nigeria, E-mail: israeladandom@gmail.com. Anthony O. Iwuagwu, Emerging Researchers and Professionals in Ageing–African Network and Department of Social Work, University of Nigeria, Nsukka, Nigeria, E-mail: anthony.iwuagwu@unn.edu.ng. Chigozie Ezulike, Emerging Researchers and Professionals in Ageing–African Network, Department of Social Work, University of Nigeria, Nsukka, Nigeria, and Department of Social and Behavioral Sciences, City University of Hong Kong, Kowloon, Hong Kong, E-mail: julietezulike@gmail.com. Ernest C. Nwachukwu, Emerging Researchers and Professionals in Ageing–African Network and Physiotherapy Department, Enugu State University of Science and Technology Teaching Hospital, Parklane-Enugu, E-mail: ernest.nwachukwu.196200@unn.edu.ng. Ekezie Uduonu, Emerging Researchers and Professionals in Ageing–African Network and Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, E-mail: ekezie.uduonu@unn.edu.ng.

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