Factors associated with COVID-19 vaccine compliance and reasons for hesitancy among adults in Benin: A cross-sectional survey

Introduction: Immunization is one of the most effective public health measures for preventing cases and deaths related to infectious diseases. However, vaccine hesitancy and non-compliance have recently been observed worldwide, particularly in Africa, especially during the COVID-19 emergency. The study aimed to investigate the factors associated with COVID-19 vaccine compliance and reasons for hesitancy in Cotonou, Benin. Methods: A cross-sectional survey was carried out in Cotonou in December 2022. Respondents were at least 18 years of age. A three-stage stratified random sampling method was used. Vaccination coverage and reasons for hesitancy were assessed. The factors associated with COVID-19 vaccination compliance were identified using a binary logistic regression. Results: Among the 815 respondents, 53% were vaccinated. The most cited reasons for non-compliance were “fear adverse events” (42.4%), the “rumours” (37.2%), and the “lack of knowledge or confidence in the health system” (10.4%). The COVID-19 vaccination compliance demonstrated spatial heterogeneity with rates increasing from the youngest to the oldest age groups (p=0.0005), from the lowest to the highest education levels (p=0.0021), with a good habit of accessing health care and vaccination, the perception of the risk of contracting the COVID-19 (p=0.0271), and decreased with the fear of adverse effects of the vaccines (p< 0.0001). Conclusion: The Government and donors should invest in debunking misinformation and disinformation related to all vaccines in Africa to ensure effective routine vaccination and outbreak response.