Determinants of COVID-19 vaccine acceptance among residents of Ilorin metropolis, Nigeria, 2023: A community-based cluster survey

Introduction: At least 70% of the eligible population in Nigeria must be vaccinated for the country to achieve herd immunity against COVID-19. Suboptimal vaccine acceptance could delay the timely achievement of this objective. We investigated to determine the prevalence of COVID-19 acceptance, the factors influencing COVID-19 vaccine acceptance and the determinants of incomplete COVID-19 vaccination among residents of Ilorin metropolis, Nigeria. Methods: Adopting a community-based cluster design, we collected data from a representative sample of 861 respondents in 30 enumeration areas of Ilorin metropolis selected proportionally to their estimated population. We used a questionnaire adapted from the 7C vaccination readiness scale which includes dimensions of confidence, complacency, constraints, calculation, collective responsibility, compliance and conspiracy. We performed descriptive and bivariate analyses. We used the chi-square test to evaluate associations between dependent and independent variables and conducted multivariate logistic regression to predict acceptance of a COVID-19 vaccine at a p-value of < 0.05. Results: COVID-19 vaccine acceptance was 61% (n = 524/861, 95% CI: 0.58 to 0. 64). Of these, 339 (67.3%) had been completely vaccinated. The most common reason for non-completion of primary vaccine series was ´I have enough immunity. Multivariate logistic regression showed that COVID-19 vaccine acceptance was higher in individuals aged 40-49 years (AOR: 2.62, 95% CI: 1.37 – 5.00). Other predictive variables included belief in the existence of COVID-19 (AOR: 3.04, 95% CI: 1.72 – 5.36), confidence (AOR: 0.78, 95% CI: 0.72-0.85), collective responsibility (AOR: 0.73, 95% CI: 0.67-0.80); complacency (AOR: 1.43, 95% CI: 1.26 – 1.61) and calculations (AOR: 0.88, 95% CI: 0.80-0.96) Conclusion: The prevalence of COVID-19 vaccine acceptance was sub-optimal, with age and belief in the existence of COVID-19 being significant predictors. We recommend targeted interventional strategies to increase vaccine acceptance among middle-aged individuals, address misconceptions about immunity to optimize vaccination completion, and enhance evidence-based public health campaigns to inform the public.