Factors associated with acceptance of COVID-19 vaccination among women in Guinea: Analysis of the first vaccination phase in March 2021

Vaccination remains the primary strategy for ending the COVID-19 pandemic. However, vaccination rates are still low in low-income countries. The primary goal of this study was to describe the status of COVID-19 vaccine acceptance and hesitancy among women in Guinea and to identify associated predictors.Weconducted a cross-sectional study in five Guinean cities (Conakry, Mamou, Kindia, Kankan and N’zérékoré) across the four natural regions between Mar 22 and Aug 25 2021. Participants aged 18 were randomly recruited from the healthcare workers (HCWs) and the general population (GP). We used multivariate logistic regression to identify facilitators and barriers to acceptance of COVID-19 vaccination and a classification and regression tree (CART) to extract the profile of predictors.We included2,208 women among the HCWs and 1,121 in the GP. Most HCWs (63%) were already vaccinated, compared to only 28% of GP. The main factors associated with acceptance of a COVID-19 vaccine in the HCWs were an absence of pregnancy ORA = 4.46 [CI95%: 3.08, 6.52] and positive subjective norms ORA = 2.34 [CI95%: 1.92, 2.84].Regarding the GP, the main factors were the ability to receive the vaccine ORA = 5.20 [CI95%: 3.45, 8.01] and being adult ORA = 2.25 [CI95%: 1.34, 3.79] associated with acceptance of vaccination. Vaccination rates were higher in the HCWs. Favourable subjective norms and ability to receive the vaccine were facilitators of acceptance of COVID-19 vaccination, while youth and pregnancy were barriers to the approval of the COVID-19 vaccine.