Factors affecting equitable access and uptake of COVID-19 vaccines in Ghana: a scoping review

The coronavirus disease (COVID-19) emerged as one of the most serious pandemics that impacted health systems and world economies. Vaccination against the pandemic was considered as an effective tool for the prevention and containment of the virus. Following the outbreak of the Coronavirus pandemic, efforts were made to enhance procurement and distribution of vaccines across countries with the view to containing the pandemic. However, evidence suggested that several factors hindered access, acceptance and use of the COVID-19 vaccines across the globe. This scoping review, thus, explored factors that influenced access, acceptance and use of the COVID-19 vaccines among Ghanaians and strategies that were needed to improve vaccine uptake especially for the vulnerable populations.

We adopted the five-stage analytic framework developed by Arksey and O'Malley to map existing literature on what has been done and documented on the subject. We searched various electronic databases such as PubMed, Cochrane, African journal online (AJOL), and Google Scholar for relevant articles for the review.

In all, fifty-four (54) articles retrieved met our eligibility criteria and were included in this review. Health system factors including untimely payment of vaccinators allowances, shortfalls in logistics and vaccines, lack of transport and long queues at vaccination centers affected access and uptake of the COVID-19 vaccines in Ghana. Additionally, beliefs and perceptions including myths, misconceptions and misinformation around the virus and the vaccines affected people's decision-making to participate in the vaccination exercise. Also, negative reportage through social media platforms created mistrust in COVID-19 vaccine intensions.

Even though Ghana made significant progress in addressing the Coronavirus pandemic, hesitancy factors played a crucial role in diminishing Ghana's effort towards meeting global targets in containing the virus and reducing its impact. Strengthening Ghana's public health preparedness and response strategy, through a community-based approach and multi-stakeholder engagement, could improve immunization programs and vaccines uptake in addressing future pandemics.