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Investigating Non-Compliance with COVID-19 Vaccination through Hesitancy, Refusal, and Access Limitation: A Community-Based Survey from the Democratic Republic of the Congo

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Journal of Biosciences and Medicines 2024年第9期12卷 280-306页

作者： Nestor Kalala-Tshituka Alain Cimuanga-Mukanya Alain Yamba Mukendi Faustin Ndjibu Mpoji Ghislain Disashi-Tumba Joris Losimba Likwela nadine kayiba kalenda Evariste Tshibangu-Kabamba Department of Public Health Faculty of Medicine Pharmacy and Public Health University of Mbujimayi Mbuji-Mayi Democratic Republic of the Congo Department of Public Health Faculty of Medicine and Pharmacy University of Kisangani Kisangani Democratic Republic of the Congo Department of Internal Medicine Faculty of Medicine Pharmacy and Public Health University of Mbujimayi Mbuji-Mayi Democratic Republic of the Congo Department of Environmental and Preventive Medicine Faculty of Medicine Oita University Oita Japan Research Institute of Health and Society Catholic University of Louvain Brussels Belgium

Introduction: Vaccination plays a pivotal role in mitigating the repercussions of the COVID-19 pandemic. However, vaccination campaigns encounter obstacles, especially in developing countries like the Democratic Republic of the Congo (DRC). This study aimed at investigating the roles of vaccine hesitancy, refusal, and access barriers, while identifying individual-level factors associated with non-vaccination in Mbujimayi, DRC. Methods: A community-based cross-sectional survey was conducted in three health districts and included 1496 residents. Attitudes and behaviors related to seeking COVID-19 vaccination were assessed using a standardized questionnaire. Hierarchical logistic regression modeling was used to assess factors potentially affecting non-compliance with vaccination. Results: Among participants (median age = 33, IQR = 23.3, M/F sex ratio = 0.7), 60% displayed misconceptions about COVID-19 or its vaccine, while only 35.2% perceived COVID-19 as a significant health threat. Vaccination coverage was estimated at 49.1% (95% CI: 47.5;52.6), with 71.8% of vaccinated individuals having received one dose. Among the unvaccinated individuals, 50.9% expressed no intention to be vaccinated in the future, citing hesitation (30.4%) or refusal (39.6%) mainly due to side effects or distrust of vaccines. Conversely, 32.7% of the unvaccinated persons expressed access barriers despite willingness to be vaccinated. Misconceptions about COVID-19 and its vaccines were the main drivers of vaccination non-compliance. Conclusion: These findings demonstrate significant vaccine non-compliance driven by hesitancy, refusal, and access barriers. Strategies to enhance vaccination coverage and pandemic preparedness should address misconceptions, sociodemographic barriers, and geographic disparities.

关键词： COVID-19 Vaccination Non-Observance Community Democratic Republic of the Congo

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