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Willingness to Accept a Potential COVID-19 Vaccine in Nigeria

Article  in  American Journal of Medical Sciences and Medicine · January 2021

DOI: 10.12691/ajmsm-9-1-1

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American Journal of Medical Sciences and Medicine, 2021, Vol. 9, No. 1, 1-5
Available online at http://pubs.sciepub.com/ajmsm/9/1/1
Published by Science and Education Publishing
DOI:10.12691/ajmsm-9-1-1

Willingness to Accept a Potential

COVID-19 Vaccine in Nigeria
Amakiri Paschal Chiedozie1,*, Ogbodo Jude Chukwuebuka2, Chude Florence Chidimma3,
Offor Vivian Onyinyechi3, Anoka Kennedy Chijioke4, Olisakwe Sandra Chibuzor5,
Obi Chidera Gabriel6, Ukazu Bethel Chioma7
1
Chester Medical School University of Chester United Kingdom
2
Department of Parasitology and Entomology, Nnamdi Azikiwe University Awka, Anambra State, Nigeria
3
Department of Zoology, Nnamdi Azikiwe University Awka, Anambra State, Nigeria
4
University of Koblenz Landau, Germany
5
Nigeria Centre for Diseases Control Abuja, Nigeria
6
Uwani Health Center, Enugu, Enugu State, Nigeria
7
Madras University Chennai, India
*Corresponding author:

Received December 31, 2020; Revised January 13, 2021; Accepted January 22, 2021
Abstract Background: Vaccine hesitancy is a potential threat to global public health including Nigeria.
Since there is an unprecedented global effort to develop a vaccine against the COVID-19 virus, there are
questions regarding the probability in acceptance of the vaccine in Nigeria. Understanding key determinants that
influence the preferences and demands of a future vaccine in Nigeria may help to develop a vaccination program. The
purpose of this survey study is to access the level of willingness of Nigerians to accept a potential COVID- 19 vaccine.
Method: Using a multi-choice and open-ended questions with predefined answers, this survey was conducted
among 499 respondents and analyzed to access their level of willingness to accept a potential COVID-19
vaccine when available and statistical differences in willingness to accept a potential COVID-19 vaccine based on age
and gender were also determined. Result: And the result revealed that a very high percentage of respondents (98%) have
prior knowledge of what a vaccine is. 51.1% were willing to take a COVID-19 vaccine, 30.5% were not willing as
18.4% were indecisive. Concerning the acceptance of vaccines for other vaccine-preventable illnesses in the country
apart from COVID-19; 79.56% of respondents were willing, 7.82% were unwilling while 12.62% were indecisive.
However, 52% of the respondents at different degrees rejected a mandatory vaccination of the population using a
potential COVID-19 vaccine in Nigeria. Conclusion: This survey sheds light on the willingness to take a potential
COVID-19 vaccine in Nigeria. Upon realizing the percentages of individuals willing to take a potential COVID-19
vaccine and individuals unwilling to accept the vaccine, the survey identified rumoured conspiracy theory, lack
of confidence in a novel vaccine and safety doubts as the major underlying factors for unwillingness to accept a
potential COVID-19 vaccine in Nigeria.

Cite This Article: Amakiri Paschal Chiedozie, Ogbodo Jude Chukwuebuka, Chude Florence Chidimma,
Offor Vivian Onyinyechi, Anoka Kennedy Chijioke, Olisakwe Sandra Chibuzor, Obi Chidera Gabriel, and
Ukazu Bethel Chioma, “Willingness to Accept a Potential COVID-19 Vaccine in Nigeria.” American Journal of
Medical Sciences and Medicine, vol. 9, no. 1 (2021): 1-5. doi: 10.12691/ajmsm-9-1-1.

COVID-19 however, Remdesivir and Dexamethasone

1. Introduction
COVID-19 is a viral disease that was first discovered in
pneumonia cases in the Wuhan province of China [1,2].
This virus is highly infectious and has spread to over
100 countries globally [3]. There are over 18 million
COVID-19 cases globally with the death rate of about
650000 [4]. Nigeria as a west African country has about
62,964 COVID-19 cases with about 1,146 deaths due to
the Pandemic [5]. Currently, there is no cure for
have shown promising efficacy in clinical trials thus
suggesting the need for more research [6,7]. Vaccines
have been used as a viable tool to curb some outbreaks
and pandemics [8]. There is no approved vaccine for
COVID-19 however, there are over 100 vaccines in
clinical trials with about 25 in the late stage of the clinical
trial [9]. There is hope that a vaccine might be ready by
2021. Approving a vaccine without people’s willingness
to accept it detriments the aim of vaccine development.
This research aims to determine the willingness of
Nigerians to accept a potential COVID-19 vaccine.
2 American Journal of Medical Sciences and Medicine

2. Methodology was used to identify if there is a statistical difference in

The survey contained sixteen [16] general questions
and was designed to elicit the response on the willingness
of people to accept a potential COVID-19 vaccine in
Nigeria. The questionnaire combined multiple-choice and
open-ended questions with predefined answers offering
respondents to choose and rank among several options or
the possibility to grade on a “strongly agree” to “strongly
disagree” scale.
The questionnaire was prepared and evaluated to ensure
that the respondents understanding of the question and the
questions itself was in line with our goal and targeted the
objectives of the research. The data preparation was
collected online. The evaluation of the data was based on
content validity. The Analysis was done using R studio
statistical package and Excel. The gender and the average
age of the respondent were analysed. A bar chat was used
to show the age distribution of the participants. The
willingness of people to accept a potential COVID-19
vaccine in Nigeria was analysed based on the respondent’s
response and rated in percentage. The Fishers exact test
willingness to take COVID-19 vaccine based on gender
and age.
3. Results
3.1. Sample Characteristics
The survey presented a sample of 499 valid responses.
Regarding gender, there were 242 males and 257 females
who participated in the study. Majority of the respondents
were between the ages of 19-35. The age distribution is
shown in the graph below
3.2. Educational Level
A total number of 345 participants had a bachelor’s
degree remaining participants which accounted for more
than half of the total participants with 88, 58 and 8
participants having A level, Masters and PhD
qualifications respectively.

Figure 1. Age distribution ofparticipants

Figure 2. Educational Level of participants

Table 1. Display of Frequency distribution based on the percentage

Questions Yes No Indecisive
Knowledge of a Vaccine 98% 2%
Vaccination in the past 95% 2% 3%
Willingness to take COVID-19 Vaccine 51.1% 30.5% 18.4%
Willingness to take other Vaccines aside the COVID-19 Vaccine 79.56% 7.82% 12.62%
 American Journal of Medical Sciences and Medicine
Table 2. Frequency percentage distribution of Likert scale questions
Question
Agreement to COVID-19 Vaccine implementation in Nigeria
Do you think other Vaccines are necessary
View on compulsory usage of COVID-19 Vaccine in Nigeria
Belief in COVID-19 effectiveness
3.3. Frequency Analysis
98% of respondents expressed knowledge of a vaccine
while 2% did not. 95% have been vaccinated in the past,
2% have never been while 3% were indecisive. 51% were
willing to take a COVID-19 vaccine with 30% were not
willing and 18% were indecisive. 79% were willing to
take a vaccine for other illnesses aside the COVID-19
vaccine, 7% were unwilling to take the vaccine for other
illnesses and 12% were indecisive. Below is a summary of
all responses.
3.4. Hypothesis Testing
We used the Fisher exact test to study if there is a
statistical difference in willingness to take the COVID-19
vaccine based on Gender and Age. The significance level
is p < 0.05. Below is the table showing the information.
Table 3. Display of p-value results using the Fisher exact test
Groups P-value
Gender 0.6769
Age group 0.6956
From the results above, both p values are below a
significant level. Therefore, there is no significant
difference based on Gender and Age group in the
willingness to take the COVID- 19 vaccine in Nigeria.
4. Discussion
COVID-19 pandemic will remain a serious public
health problem until a valid vaccine is produced and
distributed throughout the world. The development of a
COVID-19 vaccine has been identified as a key factor in
ending the pandemic and returning to normal activities
[10]. The availability of a vaccine without the adequate
willingness of the populace to use it is tantamount to zero
effort [11].
The willingness of Nigerians to accept a potential
COVID-19 vaccine was determined using Google
document online questionnaire in which about 533
responses were received. 517 participants gave their
consent but only 499 participants gave valid responses to
the questions relevant to the survey comprising of 242
males and 257 females, this suggests that females have
higher internet presence than males, although recent
studies revealed that in recent times, there is no significant
difference of importance between males and females in
terms of internet usage; gender differences based on
internet usage have been narrowed greatly [12].
Most respondents were between the age brackets of
19-35 as seen in sample characteristics (Figure 1). The
reason for this high percentage of young people of this age
bracket could be due to their frequent use of the internet as
3
Strongly Agree Agree Disagree Strongly Disagree Neutral
37.7% 33.7% 9% 9% 10.6%
48.5% 45.5% 1% 1% 4%
19% 21% 32% 20% 8%
23% 42% 13% 6% 16%
the questionnaire was distributed online using social
media platforms of which youths of this age bracket are
heavily present. This finding aligns with the report of
Clement (2020) that people between the ages of 24 and 35
were the highest internet users in the world. In the study,
participants between the ages of (46-65) account for a
very low percentage of participants in the survey (less
than 4%) which may be due to their low online presence
and are the group most vulnerable to COVID-19 disease
[13].
On the educational level of the respondents as seen in
Figure 2, 345 participants had a bachelor's degree which
accounts for 69% of the total participants in the survey,
the reason for this may be attributed to the fact that
majority of bachelor's degree holders (81.2%) are
constantly present on the internet desperately seeking for
white-collar jobs after their tertiary education [14]. As the
unemployment rate in the country hits 27.1% [15] while
17.6% of the respondents are A-level certified and PhD
degree holders were the least, accounting for only 1.6%.
This may be attributed to their busy schedule in their
places of work and other activities of concern such as
attention to Family which may result in their low internet
presence to attend to an online questionnaire.
Table 1 shows that 51.1% of the respondents were
willing to take a potential COVID-19 vaccine, their basic
reason was that they are aware of the preventive effect of
other vaccines in curbing infectious disease spread and
burden. This corresponds with the findings of [16]
showing significant signs of positive responses towards
accepting a COVID-19 vaccine in Australia, and the
findings of [17] where over two-third of the participants
were willing to take a COVID-19 vaccine when one
becomes available in Canada provided it's safe for use. It
also corresponds with the results found in Europe with
73.9% of the participants willing to take a potential
COVID-19 vaccine [18].
Although, the willingness to take a potential COVID-19
vaccine in Australia (85.8%), in Europe (73.9%) and
Canada (57.5%) are much higher than the results from this
survey in Nigeria (51.1%). This may be due to a higher
literacy level in these countries, 99% in Canada, Australia
and Italy [19,20,21] as compared to 62% in Nigeria [22].
As displayed in Table 1, 98% of the respondents
affirmed that they have prior knowledge of vaccine, this
shows that many Nigerians are aware of vaccine and
Vaccination programs and 95% of the respondents have
been previously vaccinated for other vaccine-preventable
ailments in the past. This could have buttressed their
willingness to accept a potential COVID-19 vaccine
having experienced the preventive effects of vaccines for
other ailments.
Table 1 also revealed that 30.5% of the respondents in
Nigeria were unwilling to accept the potential COVID-19
vaccine. The two top reasons were anchored on rumoured
conspiracy theory, that through a potential COVID-19
4 American Journal of Medical Sciences and Medicine
vaccination, humans could be chipped which may fulfil a
mythical end-time prophecy. It's similar to what is
obtainable in a survey in America which suggests that
28% of Americans believe that Bill Gates wants to use
vaccines to implant microchips in people - with the figure
rising to 44% among Republicans [23].
The unwillingness to take up vaccines against vaccine-
preventable ailments is the common situation around the
world and has led to the measles crisis in the Philippines
with over 4000 cases and 70 new deaths, this unwillingness
in Philippians was fed by conspiracy theories associated
with measles vaccine program in the area [24]. Some
unwilling respondents, lack confidence in the safety of a
potential novel vaccine. These findings correspond with
the studies carried out in Canada which showed that 9%
were very unlikely to take the vaccine for COVID-19; half
of these group's reason was their lack of confidence in the
safety of a novel vaccine while the other half were
concerned about the side effects that may be associated
with a novel vaccine. This result suggest that fewer
Nigerians (51.1%) are likely going to accept a potential
COVID-19 vaccine than Australians (85.0%). This may
also be due to the low health literacy reported in Nigeria
[25]. While others who are unwilling term it "unnecessary
and irrelevant”, as this corresponds to the findings of [26]
were it was reported that People, often do not receive
vaccinations because they think them unnecessary, or
rather, they do not know how to obtain free vaccination.
As observed in Table 2: The result also showed 71.4%
of the respondents were positive about implementing a
potential COVID-19 Vaccine in Nigeria when available, if
the vaccine would be effective against the virus and safe
for human use. 18% of the participants disagree with
Implementation of a potential novel COVID-19 vaccine,
this may be due to their doubt on the burden of COVID-19
disease in Nigeria as worldwide opinions which suggest
exaggeration of Corona virus outbreak [27] while 10.6%
of the participants were indifferent on the vaccine
implementation.
A Strong Belief in the effectiveness of a vaccine is the
strongest predictor of people's willingness to take a
vaccine [28]. From a psychological point of view, an
important aspect of people's behaviour towards
vaccination is their confidence in the vaccine, the vaccine
benefits, safety of vaccines, vaccine providers, such as
trust on healthcare workers, health authorities, and
policymakers [29]. Table 1 also showed that 79.56% of
the respondents were willing to take existing vaccines for
another vaccine-preventable ailment aside a potential
COVID-19 vaccine, this level of willingness was still tied
to their confidence on those existing vaccines having
experienced their effectiveness and safety. 7.82% were
unwilling to take other vaccines as 12.62% were
indecisive about being vaccinated for other vaccine-
preventable ailments.
Table 2 revealed that 65% agree that a potential
COVID-19 vaccine would be effective against the disease.
This level of confidence could be attributed to the high
percentage of young people (19 - 35 years) on the survey
which made up a high percentage (69%) of participants
with at least a Bachelor's degree from a university
showing a considerably high rate of adult literacy, which
is 62% in Nigeria [22].
Another group of participants (18.4%) were indifferent
about accepting a potential COVID-19 vaccine, they
believed that their future decision would be based on the
outcome i.e. the effectiveness of the COVID-19 vaccine
when implemented. Basically, these group of people
believe they will take the potential vaccine only if it's safe
for use and effective as other vaccines in the past. This
finding is similar to what was obtained in Europe, where
18.9% were not sure of taking the vaccine [18] and in
Canada 5.1% [30] basically due to lack of confidence in a
novel vaccine.
However, 52% of the respondents at different degrees
rejected a mandatory vaccination of the populace using a
potential COVID-19 vaccine in Nigeria. This may be due
to the following reasons: the aforementioned belief in a
conspiracy theory, their doubt on the public health
importance of COVID-19 disease in Nigeria and the
general lack of vaccine confidence. This group believe
that the vaccine should be administered with the consent
of the people.
Anti-vaccine movements have been boosted in America
because of the idea of mandatory vaccination against
infectious diseases including COVID-19 [31]. This result
also revealed that if a potential COVID-19 vaccine is
made mandatory in Nigeria as a bill on that is been passed
[32], it would further confirm the people's belief in a
conspiracy theory and more resistance would be met thus
truncating the goal of eradicating COVID-19 using
vaccines. If this vaccine resistance is allowed to linger
without a solution, it may even affect the people's
confidence in other existing vaccines programs. Table 2
also revealed that 94% of the respondents agree at
different degrees that vaccines generally are necessary for
the prevention and control of infectious diseases.
As displayed in Table 3: The result showed that there
was no significant difference in the willingness of
Nigerians to take a potential COVID-19 vaccine based on
age group and gender.
In conclusion, vaccines are an effective tool available
for prevention of infectious diseases with their associated
morbidities and mortalities [33] on the average, Nigerians
are willing to accept a potential COVID-19 vaccine if the
vaccine is shown to be effective with less side effect and
would be administered with the consent of the people.
5. Recommendations
There is a dare need to intensify vaccine education
among the people with lower education level as well those
with little health literacy. An awareness campaign
emphasizing on the social benefits of COVID-19
vaccination could increase the willingness to be
vaccinated not just for COVID-19 but for other vaccine-
preventable ailments.
6. Shortcoming
During this survey, one of the shortcomings
encountered was the unwillingness of people to click on
external URL links to the online questionnaire, this is
because of their fear of being scammed or hacked by
 American Journal of Medical Sciences and Medicine
internet fraudsters, and this shortcoming reduced the total
number of willing participants.
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