Publication date: Feb 04, 2025

While African countries, in general, experienced a milder COVID-19 impact compared to Western nations, they faced challenges with vaccine uptake. Specifically, Zimbabwe and Sierra Leone saw vaccine acceptance rates below global averages. This research delves into the underlying factors that influenced these disparities in vaccine acceptance in these two countries, using the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB) as guiding frameworks. This study utilized data from a cross-sectional survey encompassing 2,312 participants from areas where the Africa Christian Health Associations Platform (ACHAP) operates in Zimbabwe and Sierra Leone. The survey assessed respondents’ views in line with core HBM and TPB constructs, in addition to their levels of vaccine acceptance. We then employed adjusted logistic regression models to investigate the correlation between health behavior change theory constructs and vaccine uptake, taking into account variables like gender, age, education, and country of residence. Several associations were identified, including high vaccine uptake correlated with a heightened perceived threat of COVID-19 (OR = 2. 674; p 

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