Vaccines are vital to the prevention and control of infectious-disease outbreaks. They protect us from the time we are children into adulthood. Today there are vaccines available to protect against at least 20 diseases, such as diphtheria, tetanus, influenza and measles. Together, these vaccines save the lives of up to 3 million people every year.

Stopping a pandemic requires using all the tools we have available. While wearing masks and physical distancing helps reduce our chances of being exposed to the virus or spreading it to others, these measures are not enough. The COVID-19 vaccine is a critical tool in the battle against the COVID-19 pandemic.

Several factors contribute to the public acceptance of vaccines including concerns about safety and efficacy, as well as the spread of misinformation — which is particularly rampant in the context of the COVID-19 pandemic. Misinformation about vaccines is not new in Nigeria. For example, during the monkeypox outbreak in 2017, there was a widespread rumour that the military was injecting school children with the monkeypox virus. This fake news led to the closure of schools, low immunisation rates for other vaccine-preventable diseases during the period, and general widespread panic.

In March 2021, Nigeria received 3.94 million doses of the Oxford-AstraZeneca COVID-19 vaccine to stop the spread of the coronavirus and save lives. Acceptance of the vaccine is instrumental to ending the pandemic, especially in the face of prevailing conspiracies and myths about the vaccine. To guide needed communications and engagement strategies to support the rollout of the vaccine, in February 2021, Nigeria Health Watch conducted a COVID-19 Household Vaccine survey.

Understanding COVID-19 perception to drive vaccine acceptance advocacy
The survey sought to investigate public knowledge and perception of both the vaccine and its acceptance. The overarching goal was to understand the behavioural and cultural insights of the public on COVID-19 vaccines and to use the findings to guide advocacy and social mobilisation interventions towards the acceptance of vaccines in Nigeria.

The survey was carried out in Bauchi, Bayelsa, Ebonyi, Kebbi, Lagos and Niger states as well as the Federal Capital Territory (FCT). Two Local Government Areas were randomly selected per state, one urban and one rural to fully represent both rural and urban perceptions. A total of 1,089 respondents participated in the survey — 730 respondents in the urban areas and 359 in the rural areas. This was a cross-sectional study design with mixed methodology that adopted both qualitative and quantitative research methodologies which included face to face household interviews, in-depth interviews and focus group discussions.

The survey sought to determine the respondents’ general attitude when faced with health challenges. Quantitative results revealed that about three out of four respondents indicated that the first thing they do when they or a family member is unwell, is visit the General Hospital. Urban dwellers are however twice more likely to take a family member to a General Hospital compared to rural dwellers who are more likely to go to a local health clinic. But in-depth interviews revealed that some respondents prefer to drink local herbs or visit traditional healers, others prefer to go to a chemist or pharmacy first. Most respondents agreed that they would eventually go to the hospital when their conditions get worse.