COVID-19 vaccine acceptance and hesitancy among the general population of Pakistan: a population-based survey

Objectives This study aims to determine the COVID-19 vaccination coverage and the factors associated with vaccine acceptance and hesitancy in the general population of Pakistan. Setting This population-based study covers all major areas of Pakistan, including Sindh, Punjab, Khyber Pakhtunkhwa and Baluchistan provinces and the capital Islamabad. Participants A total of 541 male and female Pakistani adults above 18 years were interviewed to determine the COVID-19 vaccination coverage and understand the factors associated with vaccine acceptance and hesitancy. Outcome The outcome was COVID-19 vaccination status (not vaccinated or vaccinated). Results Of 541 participants, 227 (41.96%) were non-vaccinated and 314 (58.04%) were vaccinated. Two-thirds of the participants from both the non-vaccinated and vaccinated groups (185 (81.50%) vs 236 (75.16%), p=0.008) reside in Sindh. Nearly one-third of participants from both groups were ever infected with COVID-19 (77 (33.92%) and 90 (28.66%)). The odds of COVID-19 vaccination among the age group 34-42 years were 1.75 times higher (95% CI 1.35 to 2.09, p=0.008) than the other age groups. The odds of COVID-19 vaccination among those with COVID-19 ever-infected family members were 1.87 times higher (95% C11.56 to 2.34, p=0.032) than those with uninfected family members. Conclusions Targeted interventions for subsets of populations reluctant to vaccination can improve vaccine coverage. Moreover, advocacy and explaining the public health benefits of vaccination can enhance the coverage in Pakistan.