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2021 (4)

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Acceptance of COVID-19 Vaccines in Sub-Saharan Africa : Evidence from Six National Phone Surveys
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Year: 2021 Publisher: Washington, D.C. : The World Bank,

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Abstract

Recent debates surrounding the lagging COVID-19 vaccination campaigns in low-income countries center around vaccine supply and financing. Yet, relatively little is known about attitudes toward COVID-19 vaccines in these countries and in Africa in particular. This paper provides cross-country comparable estimates of the willingness to accept a COVID-19 vaccine in six Sub-Saharan African countries. It uses data from six national high-frequency phone surveys in countries representing 38 percent of the Sub-Saharan African population (Burkina Faso, Ethiopia, Malawi, Mali, Nigeria, and Uganda). Samples were drawn from large, nationally representative sampling frames providing a rich set of demographic and socioeconomic characteristics which are used to disaggregate the analysis. The findings show acceptance rates to be generally high, with at least four in five people willing to be vaccinated in all but one country. Vaccine acceptance ranges from nearly universal in Ethiopia (97.9 percent) to below what would likely be required for herd immunity in Mali (64.5 percent). Safety concerns about the vaccine in general and its side effects emerge as the primary reservations toward a COVID-19 vaccine across countries. These findings suggest that limited supply, not inadequate demand, likely presents the key bottleneck to reaching high COVID-19 vaccine coverage in Sub-Saharan Africa.


Book
Addressing Vaccine Hesitancy : Survey and Experimental Evidence from Papua New Guinea
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Year: 2021 Publisher: Washington, D.C. : The World Bank,

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This paper examines the drivers of COVID-19 vaccine hesitancy and tests various means of increasing people's willingness to receive a COVID-19 vaccine. The study draws on data collected through a broadly representative phone survey with 2,533 respondents and an online randomized survey experiment with 2,392 participants in Papua New Guinea. Both surveys show that less than 20 percent of the respondents who were aware a vaccine existed were willing to be vaccinated. The main reason respondents stated for their hesitancy regarding the vaccine was concern about side effects; however, the majority also said health workers could change their mind, particularly if information was communicated in person. The phone survey illustrated that people's level of trust in the vaccine and their beliefs about the behavior of others are strongly associated with their intention to get a COVID-19 vaccine. In contrast, people's concern about COVID-19, most trusted source of information (including social media), and vaccination history were unrelated to their intention to get vaccinated. The online experiment showed that a message that emphasized the relative safety of the vaccine by highlighting that severe side effects are rare, while also emphasizing the dangers of COVID-19, increased intention to get vaccinated by around 50 percent. Collectively, these results suggest that policy makers would be well placed to direct their efforts to boosting the general population's trust that getting vaccinated substantially reduces the risk of severe illness or death from COVID-19.


Book
How to End The COVID-19 Pandemic by March 2022
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Year: 2021 Publisher: Washington, D.C. : The World Bank,

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How can the world reach herd immunity against COVID-19 before the second anniversary of the pandemic, or March 2022? A study of vaccine demand and supply answers this question. A target of vaccinating 60 percent of the population in each country by March 2022 is likely sufficient to achieve worldwide herd immunity under a baseline scenario with limited mutation. Achieving this target appears feasible given stated production capacity of vaccine manufacturers and the pace of current and historical vaccination campaigns. Considering existing pre-purchase contracts for vaccines, achieving this target requires addressing a procurement gap of just 350 million vaccine courses in low- and middle-income countries. Immediate additional donor funding of about USD 4 billion or in-kind donations of excess orders by high-income countries would be sufficient to close this gap. There are additional challenges along the path to achieving world-wide herd immunity-including supply chain issues, trade restrictions, vaccine delivery, and mutations. Overall however, this analysis suggests multilateral action now can bring an end to the acute phase of the pandemic early next year.


Book
The Covid-19 Vaccine Production Club : Will Value Chains Temper Nationalism?
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Year: 2021 Publisher: Washington, D.C. : The World Bank,

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In the first two months of 2021, the production of COVID-19 vaccines has suffered setbacks delaying the implementation of national inoculation strategies. These delays have revealed the concentration of vaccine manufacture in a small club of producer nations, which in turn has implications for the degree to which cross-border value chains can deter more aggressive forms of Vaccine Nationalism, such as export curbs. This paper documents the existence of this club, taking account of not just the production of final vaccines but also the ingredients of and items needed to manufacture and distribute COVID-19 vaccines. During 2017-19, vaccine producing nations sourced 88 percent of their key vaccine ingredients from other vaccine producing trading partners. Combined with the growing number of mutations of COVID-19 and the realization that this coronavirus is likely to become a permanent endemic global health threat, this finding calls for a rethink of the policy calculus towards ramping up the production and distribution of COVID-19 vaccines, its ingredients, and the various items needed to deliver them. The more approved vaccines that are safely produced, the smaller will be the temptation to succumb to zero-sum Vaccine Nationalism.

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