Barriers to Immunity: Understanding COVID-19 Vaccine Uptake in Africa

Abstract

This thesis examines the factors influencing COVID-19 vaccine uptake across African countries, with a focus on structural, informational, and behavioral barriers to immunization. Drawing on cross-country data, the study analyzes how access to transportation, reliable information, and healthcare resources shape vaccination rates, alongside the effect of demographics and institutional factors in shaping individual perceptions of risk and vaccine safety. The findings emphasize that the broader strength and preparedness of national health systems strongly influence vaccine uptake. Countries that demonstrated higher coverage of routine childhood immunizations, such as polio and hepatitis B, also tended to perform better in COVID-19 uptake efficiency and overall vaccination coverage. In addition to health system capacity, broader socioeconomic and institutional factors also influenced vaccine distribution and efficiency. Indicators such as healthcare spending, logistics performance, human development levels, and access to basic infrastructure positively influenced vaccine receipt and vaccine coverage, while percent of the population with access to electricity and GDP contributed to efficient COVID vaccine uptake. These results suggest that successful vaccination campaigns depend not only on the availability of vaccines during emergencies, but also on the long-term capacity of countries to manage and sustain immunization programs, highlighting the importance of investing in routine vaccination infrastructure. Further, these findings emphasize the interconnected nature of infrastructure and public health: transportation systems, reliable utilities, and functioning institutions all contribute to the ability of a country to receive and deliver vaccines effectively to their populations. As global disparities in vaccine access persist, with Africa continuing to lag behind much of the world, it is critical to identify the key barriers to vaccine uptake in order to effectively begin closing this gap. By highlighting the interaction between systemic barriers and individual decision-making, this research underscores the importance of targeted public health strategies that improve access while addressing misinformation. The study contributes to a deeper understanding of vaccine uptake in developing contexts and offers policy-relevant insights for increasing immunization coverage in future public health initiatives