An unmet global agenda : COVID-19 vaccine hesitancy in northern Ghana

Abstract

Background: Despite the availability of COVID-19 vaccinations, 52.2% of Ghanaians exhibit vaccine hesitancy. This research aimed to investigate the factors associated with vaccine hesitancy among farmers and to identify strategies for improving the uptake of the coronavirus vaccine in northern Ghana. Methods: The study employed a concurrent embedded mixed-methods design, allowing for the simultaneous collection of qualitative and quantitative data. Participants were purposively sampled from five farmer-based organizations, resulting in a total of 41 participants. Twenty-four farmers were interviewed for 30 to 45 minutes via telephone calls through WhatsApp and in person, while 17 health stakeholders were interviewed using Zoom. The transcripts were imported into NVivo version 14 and analyzed using Braun and Clarke's reflexive thematic analysis. Results: The interviews with farmers revealed five themes related to vaccine hesitancy: availability and access, misconceptions regarding the COVID-19 virus, preference for a single- dose vaccine, concerns about the safety of the COVID-19 vaccine, and the belief in the non- existence of COVID-19 in northern Ghana. The farmers' perspectives on the COVID-19 vaccine varied within the quantitative findings. Approximately 37.5% (n = 9) indicated a willingness to postpone vaccination, and 16.7% (n = 4) expressed an intention to decline the COVID-19 vaccination. In contrast, about 12.5% (n = 3) demonstrated a positive attitude toward the vaccines, while 58.3% (n = 14) asserted that COVID-19 was currently of little significance. The uptake of the vaccine among farmers in northern Ghana appears to be hindered by a lack of information and the perception that the virus is no longer a threat. The stakeholders' interviews identified five additional themes: 1) organizing community-based vaccination programs; 2) organizational support for vaccination initiatives; 3) proposed strategies to enhance vaccine uptake; 4) logistical challenges in vaccination programs; and 5) exploration of herbal medicine as an alternative option. Conclusion: The findings underscore the multifaceted reasons underlying vaccine hesitancy, ranging from logistical barriers to social and cultural beliefs. To effectively address these issues, it is imperative to enhance the availability of single-dose vaccines, implement sustained public health campaigns, and prioritize farmers as a vulnerable population during health emergencies.