Factors influencing influenza vaccine uptake among adults in Johannesburg, South Africa: A qualitative study

• DOI: 10.1016/j.vaccine.2025.127133
• Publication Date: 2025-05-07T09:10:21Z
• Authors: Mulalo Mashamba; Tshepiso Msibi; Gugulethu Tshabalala; Lerato Tsotetsi; Stefanie Vermaak; Nellie Myburgh; Sarah Malycha; Isabella Goldstein; Elliot Grainger; Maatla Dave Temane; Takwanisa Machemedze; Kimberley Gutu; Heidi J. Larson; Catherine Hill; Ziyaad Dangor; Janan J. Dietrich

Influenza vaccination coverage in South Africa is less than 3 % among the general adult population. We explored factors associated with influenza vaccine uptake using World Health Organization's Strategic Advisory Group on Immunization (SAGE) 3C (confidence, complacency, convenience) model of hesitancy. The present study forms part Bambisana project, a mixed-methods pre-test-post-test intervention conducted from 29 April 2023 to 15 2024. Participants ≥18 years were enrolled six Focus Discussions (FGDs), stratified by age (≥18-34 and ≥ 35 years). FGDs audio-recorded, transcribed verbatim, coded Dedoose framework analysis. Among 48 participants, most (66.7 %, n = 30) aged 18-34 years, 65.9 (n 29) had completed high school, 70.2 33) unemployed. Overall, was three key factors: low confidence, lack convenience. Low confidence negative experiences COVID-19 vaccines, fear side effects, misconceptions, needles, mistrust public health institutions, concerns about effectiveness. Complacency included reliance upon traditional alternative medicines, knowledge minimising seriousness illness. Convenience perceived costs promotion. Addressing complacency convenience important increase acceptance Africa.