Determinants of persistent COVID-19 vaccine hesitancy: a preliminary study among healthcare providers in Lubumbashi, DR Congo

Abstract Introduction : Vaccine hesitancy is one of the ten threats to global health. In DR Congo, COVID-19 vaccine hesitancy among healthcare providers has resulted in one of the lowest vaccination coverage rates in the world. In 2025, four years after the rollout of vaccines, the persistence of this mistrust remains poorly documented. This study aims to identify the determinants of persistent hesitancy among healthcare providers in the city of Lubumbashi. Methods : A cross-sectional analytical study was conducted via an online questionnaire (from 5 to 9 May 2025) among healthcare providers in the city of Lubumbashi, DR Congo. The reasons for hesitancy were analysed via flat sorting, followed by logistic regression to identify the factors independently associated with vaccine hesitancy. Results : Amongthe 86 participants (sex ratio M/F: 3.1; 86.1% doctors), the median age and duration of experience were 28 and 2 years, respectively. The vaccine hesitancy rate was 80.23% (n=69). The main reasons for hesitancy included mistrust of the speed of clinical trials (83.72%), low perception of individual risk of developing a severe form of the disease (83.72%) and no history of COVID-19 (81.40%). In the multivariate analysis, two factors were independently associated with vaccine hesitancy: geopolitical influence and limited professional experience (≤ 2 years). Conclusion : COVID-19 Vaccine hesitancy remains prevalent among healthcare professionals in Lubumbashi. In this exploratory study, geopolitical issues and limited professional experience were independently associated with this hesitancy. These findings suggest the potential value of transparent, context-specific institutional communication and targeted educational support for less experienced healthcare providers, which hospital administrators should consider strengthening.