Publications

Vaccination adherence involves the expected benefit of a vaccine and the perceived risk of the disease. To develop an evidence-based communication strategy aimed at improving vaccination coverage in Niger, we conducted a mixed socio-anthropological study of the perceptions among the population on the benefit and the risk of the childhood (Expanded Program on Immunization) and the COVID-19 vaccines. Our results show that negative rumors are not a significant driver of vaccine refusal. The insufficient level of fully vaccinated, compared with partially vaccinated, children might be explained by misunderstandings around the side effects of vaccines and the necessity for full vaccination. Approximately one-fourth of the population is vaccinated against COVID-19, whereas 73.3% think that vaccines against the disease are a “good thing,” and 83% of those who have heard messages promoting the vaccination approve of them. This apparent contradiction is explained by a low perception of the risks of COVID-19. More than half of the population surveyed believe that the disease is not present in the country. A large majority believe that only ill people can transmit the disease, whereas only 12.8% think they know anybody who has ever been sick with COVID-19. Three-fourths of the interviewees have seen images from around the world of persons sick or deceased from COVID-19; the same proportion has not seen any such images of affected patients in Niger. Communication to improve COVID-19 uptake should focus on the reality of the disease presence and its transmission and not on rumors surrounding the vaccines.

Since the beginning of the COVID-19 pandemic, there has been a profusion of studies and webinars on the infodemic (the rapid diffusion of information on the internet). The infodemic is often cited as a key factor in the lack of adherence to COVID-19 preventive measures, including vaccination. A study we conducted in West Africa questions the reality of this impact: the majority of people who do not adhere to the preventive measures draw their opinion from their own experience, not from what they have viewed or read on social networks. Historically, resistance to public health messages and interventions, including vaccination, existed before the advent of the Internet. Studying the perceptions of the population and not only the circulation of information is necessary to fully understand the lack of adherence to the COVID-19 preventive measures and to build an effective communication strategy.

Adherence to protective measures is a major component of COVID-19 epidemic control. COVID-19 health literacy is a major driver of this adherence, and the evaluation of health literacy levels is the basis for designing an effective communication strategy. We conducted a quantitative socio-anthropological study of the knowledge of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and perception of the prevention messages in Burkina Faso, Cabo Verde, Guinea-Bissau, Ivory Coast, and Sierra Leone. There are widespread erroneous ideas regarding the transmission of and the protection against COVID-19. The majority of people are unaware that asymptomatic individuals can transmit the virus. Knowledge of the risk factors for severe disease is not sufficient, and the majority of individuals fear contracting COVID-19 by visiting a health center. Our study also shows the achievements of communication campaigns on several aspects: almost everybody has heard of the virus and heard or read the messages on the protective measures and a large majority of people think that these measures are effective against COVID-19. Based on these results, we propose a communication strategy that will emphasize that asymptomatic individuals can transmit the virus, emphasize the risk factors, reassure individuals regarding the safety of frequenting health centers, and design specific messages targeting young populations.