{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T10:15:09Z","timestamp":1768644909318,"version":"3.49.0"},"reference-count":49,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T00:00:00Z","timestamp":1646265600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005846","name":"Friedrich-Ebert-Stiftung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005846","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006456","name":"Bundesministerium f\u00fcr Wirtschaftliche Zusammenarbeit und Entwicklung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006456","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>In low-income countries, vaccination campaigns are lagging, and evidence on vaccine acceptance, a crucial public health planning input, remains scant. This is the first study that reports willingness to take COVID-19 vaccines and its socio-demographic correlates in Ethiopia, Africa\u2019s second most populous country.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>The analysis is based on a nationally representative survey data of 2,317 households conducted in the informal economy in November 2020. It employs two logistic regression models where the two outcome variables are (i) a household head\u2019s willingness to take a COVID-19 vaccine or not, and (ii) if yes if they would also hypothetically pay (an unspecified amount) for it or not. Predictors include age, gender, education, marital status, income category, health insurance coverage, sickness due to COVID-19, chronic illness, trust in government, prior participation in voluntary activities, urban residence.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Willingness to take the vaccine was high (88%) and significantly associated with COVID-19 cases in the family, trust in government and pro-social behavior. All other predictors such as gender, education, income, health insurance, chronic illness, urban residence did not significantly predict vaccine willingness at the 5% level. Among those willing to take the vaccine, 33% also answered that they would hypothetically pay (an unspecified amount) for it, an answer that is significantly associated with trust in government, health insurance coverage and income.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The results highlight both opportunities and challenges. There is little evidence of vaccine hesitancy in Ethiopia among household heads operating in the informal economy. The role played by trust in government and pro-social behavior in motivating this outcome suggests that policy makers need to consider these factors in the planning of COVID-19 vaccine campaigns in order to foster vaccine uptake. At the same time, as the willingness to hypothetically pay for a COVID-19 vaccine seems to be small, fairly-priced vaccines along with financial support are also needed to ensure further uptake of COVID-19 vaccines.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0264633","type":"journal-article","created":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T18:57:57Z","timestamp":1646333877000},"page":"e0264633","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":23,"title":["Willingness to take COVID-19 vaccination in low-income countries: Evidence from Ethiopia"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5545-3627","authenticated-orcid":true,"given":"Christoph","family":"Strupat","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zemzem","family":"Shigute","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arjun S.","family":"Bedi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Rieger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,3,3]]},"reference":[{"key":"pone.0264633.ref001","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1038\/s41591-020-1124-9","article-title":"A global survey of potential acceptance of a COVID-19 vaccine","volume":"27","author":"J.V. 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Dias-God\u00f3i","journal-title":"Expert Review of Pharmaeconomics & Outcomes Research"},{"key":"pone.0264633.ref021","doi-asserted-by":"crossref","unstructured":"Brubaker, J.M., Kilic, T., Wollburg, P.R., 2021. Representativeness of Individual-Level Data in COVID-19 phone surveys: findings from Sub-Saharan Africa. World Bank Policy Research Working Paper No. 9660. http:\/\/documents.worldbank.org\/curated\/en\/131501620912712969\/Representativeness-of-Individual-Level-Data-in-COVID-19-Phone-Surveys-Findings-from-Sub-Saharan-Africa","DOI":"10.1596\/1813-9450-9660"},{"key":"pone.0264633.ref022","article-title":"Exploring the behavioral determinants of COVID-19 vaccine acceptance among an urban population in Bangladesh: Implications for behavior change interventions","author":"Md. A. Kalam","year":"2021","journal-title":"PLoS ONE"},{"key":"pone.0264633.ref023","article-title":"COVID-19 Vaccine hesitancy in Addis Ababa, Ethiopia: A mixed methods study","author":"N. Dereje","year":"2021","journal-title":"medRxiv"},{"issue":"9","key":"pone.0264633.ref024","doi-asserted-by":"crossref","first-page":"e0257109","DOI":"10.1371\/journal.pone.0257109","article-title":"Health care workers intention to accept COVID-19 vaccine and associated factors in southwestern Ethiopia","volume":"16","author":"A.T. Angelo","year":"2021","journal-title":"PLoS ONE"},{"key":"pone.0264633.ref025","doi-asserted-by":"crossref","first-page":"1795","DOI":"10.2147\/PPA.S324564","article-title":"Acceptance of COVID-19 Vaccine and Determinant Factors Among Patients with Chronic Disease Visiting Dessie Comprehensive Specialized Hospital, Northeastern Ethiopia","volume":"15","author":"G. Berihun","year":"2021","journal-title":"Patient Preference and Adherence"},{"key":"pone.0264633.ref026","unstructured":"Verick, S. (2006). The impact of globalization on the informal sector in Africa. Economic and Social Policy Division, United Nations Economic Commission for Africa (ECA) and Institute for the Study of Labor (IZA)."},{"key":"#cr-split#-pone.0264633.ref027.1","unstructured":"ILO (2002): Effect to be given to resolutions adopted by the International Labour Conference at its 90th Session (2002), (b) Resolution concerning decent work and the informal economy"},{"key":"#cr-split#-pone.0264633.ref027.2","unstructured":"Geneva, November 2002 (doc. GB.285\/7\/2)"},{"key":"#cr-split#-pone.0264633.ref027.3","unstructured":"ILO (2002): Effect to be given to resolutions adopted by the International Labour Conference at its 90th Session (2002),"},{"key":"#cr-split#-pone.0264633.ref027.4","unstructured":"(b) Resolution concerning decent work and the informal economy; Governing Body, 285th Session, Seventh item on the agenda; Geneva, November 2002 (doc. GB.285\/7\/2)"},{"issue":"10263","key":"pone.0264633.ref028","doi-asserted-by":"crossref","first-page":"1614","DOI":"10.1016\/S0140-6736(20)32318-7","article-title":"Challenges in creating herd immunity to SARS-CoV-2 infection by mass vaccination","volume":"396","author":"R.M. Anderson","year":"2020","journal-title":"The Lancet"},{"key":"pone.0264633.ref029","unstructured":"WHO (2021): COVID-19 in the African region, https:\/\/who.maps.arcgis.com\/apps\/opsdashboard\/index.html#\/0c9b3a8b68d0437a8cf28581e9c063a9 [Accessed 12 March 2021]"},{"key":"pone.0264633.ref030","unstructured":"Ethiopian Public Health Institute, COVID-19 Weekly Bulletin, https:\/\/ephi.gov.et\/images\/novel_coronavirus\/EPHI_PHEOC_COVID-19_Weekly_Bulletin_42_English_02232021.pdf [Accessed 12 March 2021]"},{"key":"pone.0264633.ref031","unstructured":"WHO (2021): Ethiopia introduces COVID-10 vaccine in a national launching ceremony, https:\/\/www.afro.who.int\/news\/ethiopia-introduces-COVID-19-vaccine-national-launching-ceremony [Accessed 20 March 2021]"},{"key":"pone.0264633.ref032","unstructured":"Afrobarometer Questionnaire Ethiopia round 5 (2013) https:\/\/afrobarometer.org\/sites\/default\/files\/questionnaires\/Round%205\/eth_r5_questionnaire.pdf"},{"issue":"C","key":"pone.0264633.ref033","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1016\/j.socscimed.2019.05.037","article-title":"The impact of the Ethiopian health extension program and health development army on maternal mortality: A synthetic control approach","volume":"232","author":"M. Rieger","year":"2019","journal-title":"Social Science & Medicine"},{"key":"pone.0264633.ref034","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1038\/s41591-020-0962-9","article-title":"Age-dependent effects in the transmission and control of COVID-19 epidemics","volume":"26","author":"CMMID COVID-19 working group","year":"2020","journal-title":"Nature Medicine"},{"key":"pone.0264633.ref035","article-title":"Factors explaining the fear of being infected with COVID-19","author":"A. A. Cerda","year":"2021a","journal-title":"Health Expectations"},{"key":"pone.0264633.ref036","doi-asserted-by":"crossref","DOI":"10.3389\/fpubh.2021.626852","article-title":"Hesitation and Refusal Factors in Individuals\u2019 Decision-Making Processes Regarding a Coronavirus Disease 2019 Vaccination","volume":"9","author":"A. A. Cerda","year":"2021b","journal-title":"Frontiers in Public Health"},{"key":"pone.0264633.ref037","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1027\/1016-9040\/a000169","article-title":"The role of public trust during pandemics: implications for crisis communication","volume":"19","author":"M. Siegrist","year":"2014","journal-title":"Eur. Psychol"},{"issue":"26","key":"pone.0264633.ref038","doi-asserted-by":"crossref","first-page":"14890","DOI":"10.1073\/pnas.1919666117","article-title":"Vaccination as a social contract","volume":"117","author":"L. Korn","year":"2020","journal-title":"Proceedings of the National Academy of Sciences"},{"key":"pone.0264633.ref039","unstructured":"Leininger, J., Burchi, F., Fiedler, C., Mross, K., Nowack, D., von Schiller, A., et al. (2021). Social cohesion: A new definition and a proposal for its measurement in Africa (Discussion Paper 31\/2021). Bonn: German Development Institute \/ Deutsches Institut f\u00fcr Entwicklungspolitik (DIE)."},{"key":"pone.0264633.ref040","doi-asserted-by":"crossref","first-page":"0056","DOI":"10.1038\/s41562-017-0056","article-title":"On the benefits of explaining herd immunity in vaccine advocacy","volume":"1","author":"C. Betsch","year":"2017","journal-title":"Nature Human Behavior"},{"issue":"9","key":"pone.0264633.ref041","doi-asserted-by":"crossref","first-page":"2132","DOI":"10.1016\/j.vaccine.2020.01.029","article-title":"Association between health insurance coverage and uptake of seasonal influenza vaccine in Brazos County, Texas","volume":"38","author":"Y. Akpalu","year":"2020","journal-title":"Vaccine"},{"issue":"1","key":"pone.0264633.ref042","doi-asserted-by":"crossref","first-page":"197","DOI":"10.3982\/ECTA9508","article-title":"Short-run subsidies and long-run adoption of new health products: Evidence from a field experiment","volume":"82","author":"P. 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