Understanding COVID-19 vaccination intention among healthcare workers in N’Djamena, Chad: insights for enhanced immunization strategies in Africa

Although COVID-19 cases and mortality are declining, vaccination remains essential for the World Health Organization (WHO) as it shifts from managing a global emergency to implementing long-term disease control strategies. Sub-Saharan Africa requires particular attention due to low vaccination coverage and the risk of variants. Chad ranks among the countries with the lowest vaccination rates globally. Healthcare workers’ (HCWs) vaccine hesitancy may influence patient uptake, making it essential to understand their intentions and underlying reasons to inform context-specific public health strategies. A cross-sectional survey, adapted from the WHO Strategic Advisory Group of Experts (SAGE) vaccine hesitancy tool, was conducted among 632 HCWs in N’Djamena, Chad, between April 30 and May 14, 2021, before the national COVID-19 vaccination rollout. Approximately 60% of HCWs expressed willingness to be vaccinated. Positive attitudes were associated with older age, presence of chronic conditions, and greater fear of the disease. Vaccine refusal was linked to beliefs that vaccines are dangerous, prior rejection of all vaccines, or perception of COVID-19 vaccines as a strategy to benefit Western pharmaceutical companies. These findings can support the adaptation of global vaccination initiatives to local contexts in Sub-Saharan Africa by addressing HCWs’ concerns to improve vaccine uptake.