Attitudes toward COVID-19 Vaccines among Patients with Complex Non-Communicable Disease and Their Caregivers in Rural Malawi

Moses Banda Aron; Emilia Connolly; Kaylin Vrkljan; Haules Robbins Zaniku; Revelation Nyirongo; Bright Mailosi; Todd Ruderman; Dale A Barnhart; On Behalf Of The Partners In Health Cross-Site Covid-Cohort Research Network

doi:10.3390/vaccines10050792

Attitudes toward COVID-19 Vaccines among Patients with Complex Non-Communicable Disease and Their Caregivers in Rural Malawi

Vaccines (Basel). 2022 May 17;10(5):792. doi: 10.3390/vaccines10050792.

Affiliations

¹ Partners In Health/Abwenzi Pa za Umoyo (PIH/APZU), Neno P.O. Box 56, Malawi.
² Division of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH 45267, USA.
³ Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45529, USA.
⁴ Harvard College, Harvard University, Cambridge, MA 02138, USA.
⁵ Ministry of Health, Neno District Health Office, Neno P.O. Box 52, Malawi.
⁶ Partners In Health/Inshuti Mu Buzima (PIH/IMB), Kigali P.O. Box 3432, Rwanda.
⁷ Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02138, USA.

Abstract

Current low COVID-19 vaccination rates in low- and middle-income countries reflect an inequitable global vaccine distribution; however, local attitudes towards the COVID-19 vaccine are an important factor to meet vaccination benchmarks. We describe attitudes toward the uptake of the COVID-19 vaccine and perceptions among patients with NCDs and their caregivers using cross-sectional data collected through telephone interviews in Neno, Malawi. Out of 126 survey respondents, 71% were patients, and 29% were caregivers. Twenty-two percent of respondents had received at least one dose at the interview (95% CI: 15-30%), with 19% being fully vaccinated. Only 24% (95% CI: 12-40%) of unvaccinated respondents reported that they would accept an approved vaccine if it were offered today. Vaccines were perceived as unsafe or designed to harm and commonly associated with death, severe disability, infertility, and evil. However, over two-thirds reported high levels of trust in health care workers (73%) and community health workers (72%) as sources of information for the COVID-19 vaccine. Although the uptake of COVID-19 vaccine in this vulnerable population was three times than the national average, a low intention to be vaccinated persists among the unvaccinated. Strong trust in health care workers suggests that community engagement could help increase vaccine acceptance.

Keywords: COVID-19; COVID-19 vaccine; intention to vaccinate; non-communicable diseases; vaccination hesitancy.

Grants and funding

This research was funded by PIH/country unrestricted funds. Dale A Barnhart is supported by the Harvard Medical School Global Health Equity Research Fellowship, funded by Jonathan M. Goldstein and Kaia Miller Goldstein. Special thanks to Wagner Foundation who provided open access to this research by supporting the article processing charge for this paper. The data collection, analysis, interpretation, and writing of the manuscript were conducted independently by authors.