Vaccine · 2026
Global misinformation, local consequences: conspiracy theory endorsement and a graded association with COVID-19 vaccine refusal across Nigeria.
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Asaga Peter Mac, Kroeger Axel, Yako Andrew, Makpo James
Аннотация
BACKGROUND: Conspiracy theories about COVID-19 vaccines circulated widely during the pandemic, yet their prevalence and association with vaccine refusal in sub-Saharan Africa remain poorly quantified. Understanding how global misinformation narratives shape vaccination acceptance in low- and middle-income settings is relevant to future pandemic preparedness.
METHODS: We conducted a cross-sectional survey between October 2023 and April 2024, recruiting 870 adults through convenience sampling across Nigeria's six geopolitical regions. COVID-19 vaccines had been available in the country since 2021, but national uptake remained low throughout this period. Structured face-to-face interviews assessed vaccine intentions, endorsement of specific conspiracy beliefs, information sources, and trust networks. Multivariable logistic regression identified factors independently associated with conspiracy endorsement and vaccine refusal.
RESULTS: Of 870 participants, 742 (85.3%) were vaccine-hesitant, and 89.4% of these endorsed at least one conspiracy theory. Microchip or tracking device theories were the most frequently cited concern (32.1%). Overall vaccine acceptance was 14.7%. A graded inverse association was observed: each additional conspiracy theory endorsed was associated with an average 69% lower odds of vaccine acceptance (aOR 0.31, 95% CI 0.25-0.39; p for trend <0.001). In multivariable analysis, conspiracy endorsement was the factor most strongly associated with refusal (aOR 0.11, 95% CI 0.06-0.21). Its inclusion in the model substantially attenuated the coefficients for education and region, which suggests that these sociodemographic associations with refusal may be partly accounted for by differential conspiracy endorsement.
CONCLUSIONS: COVID-19 vaccine conspiracy theories were widespread in Nigerian communities well into the national vaccination campaign, at a time of persistently low uptake, and represented the factor most strongly associated with refusal. The graded association between conspiracy endorsement and refusal, and the attenuation of sociodemographic predictors after adjustment for conspiracy beliefs, suggest that counter-misinformation strategies could be a high-yield component of future pandemic vaccine campaigns.
METHODS: We conducted a cross-sectional survey between October 2023 and April 2024, recruiting 870 adults through convenience sampling across Nigeria's six geopolitical regions. COVID-19 vaccines had been available in the country since 2021, but national uptake remained low throughout this period. Structured face-to-face interviews assessed vaccine intentions, endorsement of specific conspiracy beliefs, information sources, and trust networks. Multivariable logistic regression identified factors independently associated with conspiracy endorsement and vaccine refusal.
RESULTS: Of 870 participants, 742 (85.3%) were vaccine-hesitant, and 89.4% of these endorsed at least one conspiracy theory. Microchip or tracking device theories were the most frequently cited concern (32.1%). Overall vaccine acceptance was 14.7%. A graded inverse association was observed: each additional conspiracy theory endorsed was associated with an average 69% lower odds of vaccine acceptance (aOR 0.31, 95% CI 0.25-0.39; p for trend <0.001). In multivariable analysis, conspiracy endorsement was the factor most strongly associated with refusal (aOR 0.11, 95% CI 0.06-0.21). Its inclusion in the model substantially attenuated the coefficients for education and region, which suggests that these sociodemographic associations with refusal may be partly accounted for by differential conspiracy endorsement.
CONCLUSIONS: COVID-19 vaccine conspiracy theories were widespread in Nigerian communities well into the national vaccination campaign, at a time of persistently low uptake, and represented the factor most strongly associated with refusal. The graded association between conspiracy endorsement and refusal, and the attenuation of sociodemographic predictors after adjustment for conspiracy beliefs, suggest that counter-misinformation strategies could be a high-yield component of future pandemic vaccine campaigns.