The role of social influence on COVID-19 vaccination hesitancy and acceptance in Tanzania.

Background: COVID-19 vaccination hesitancy and acceptance remain critical public health concerns, influenced by socio-cultural factors globally. Social influence - particularly conformity, compliance and obedience - influence vaccination intentions, decisions and behaviours based on the information circulated by the people already vaccinated. Understanding these dynamics is essential for promotion vaccine uptake through reassuring the hesitant about the safety and effectiveness of the vaccine.

Aim: We explored the influence of social influence on COVID-19 vaccination hesitancy and acceptance in Tanzania.

Setting: Our study was conducted in eight regions of Mainland Tanzania: Arusha, Morogoro, Mtwara, Njombe, Mbeya, Tabora, Singida and Shinyanga, to represent eight zones of Mainland Tanzania.

Methods: We adopted a mixed-methods research approach, to collect data from 3098 respondents for a quantitative part, and 336 key informants as well as 376 participants for focus group discussions. Data analysis involved both descriptive and inferential statistics for quantitative data as well as thematic analysis for qualitative data.

Results: There was regional variation in vaccination rates, with Mtwara and Singida showing high acceptance at 50% and 49.7%, respectively, while Morogoro (22.5%) and Mbeya (26.2%) showed lower rates. Social influence, especially friends, family, and community discussions, and trust in the government as a reliable source of information regarding the COVID-19 vaccination were key. Changes in the Tanzanian government's political will also contributed to positive attitudes regarding COVID-19 vaccination acceptance.

Conclusion: Social influence influenced COVID-19 vaccination acceptance in Tanzania, requiring tailored public health strategies involving the government, trusted community figures and considering social ties and social interaction to boost vaccination rates.

Contribution: Our study offers insights on the critical role of social influence on COVID-19 vaccination hesitancy and acceptance; hence, a necessity for socio-cultural context-specific and participatory interventions in a quest to reduce COVID-19 vaccination hesitancy and improve acceptance in the Tanzanian context.