Misunderstanding poor adherence to COVID-19 vaccination in Africa.

Although I can only applaud the call to action in favour of COVID-19 vaccination in Africa by Polydor Ngoy Mutombo and colleagues (March, 2022), their analysis of so-called COVID-19 vaccine hesitancy is questionable.

Their first assessment that vaccine hesitancy in low-income and middle-income countries is caused by a dearth of knowledge about the fact that vaccines are the most effective public health interventions is contradicted by the evidence: 80% of infants in the WHO African region received a first diphtheria-tetanus-pertussis vaccine dose in 2019. The reference supporting their second argument on the historical, structural, and other systemic dynamics is a study done in the USA. Their third assertion that no firm commitment from the global community to expedite vaccine deployment to the African continent perpetuates vaccine hesitancy is based on two references that do not address this specific topic and don't include any African country.

I and colleagues have done a quantitative socioanthropological study in five west African countries that revealed what appear to be the main drivers of the absence of adherence to COVID-19 preventive measures. For example, although very few people in our study wore a mask, 73·8–98·0% thought that a mask is useful to protect against COVID-19. Only 3·2–39·7% of the interviewees knew that asymptomatic people can transmit the coronavirus and the qualitative part of our study revealed that many people believe COVID-19 is not present in their country. These results confirm previous studies that showed that adherence to COVID-19 preventive measures is linked to risk perception.

Therefore, besides the delivery of vaccines, the point is not to call for efforts to monitor and combat fake news, but to communicate the fact that COVID-19 is present in Africa, how the virus is transmitted, and who is at risk of the disease.

I declare no competing interests.