Research, Maternal, Child and Reproductive Health

How Perceptions of COVID-19 Vaccines Affect Health-Seeking Behaviours In Sierra Leone

The IPERVAC-SL study provides new socio-anthropological insights based on the narratives around the pandemic in the country

02.01.2023
Photo: World Bank / Vincent Tremeau

Phenomena like vaccine hesitancy and decreased health-seeking practices are often rooted in social dynamics and historical events. IPERVAC-SL (Impact of perceptions of COVID-19 vaccines on health-seeking behaviours in Sierra Leone), a study coordinated by ISGlobal, sought to explore these questions in Sierra Leone, in the context of the COVID-19 pandemic. The study results were recently presented to the funders – the Glòria Soler Foundation.

“When the COVID-19 vaccines were initially being deployed in African countries, there was very little evidence of the social perceptions and attitudes toward vaccines. Moreover, little was known about how these perceptions could impact health service utilisation in certain communities,” explains Cristina Enguita, the project co-coordinator. “This study, with a socio-anthropological approach, was envisioned to shed light on the impact of COVID-19 perceptions, social imaginaries on epidemics, and the collective epidemiological memory on COVID-19 vaccination in Sierra Leone.”

The study adopted qualitative methodologies including a literature review, focus group discussions, in-depth interviews, and participant observation. Under the umbrella of the ICARIA project, the IPERVAC team collected data from two districts in northern Sierra Leone – Port Loko and Bombali.

Results of the study being presented

The main findings from the study point to the legacy of the Ebola epidemic in West Africa between 2014 and 2016, especially in Sierra Leone, which continues to shadow people’s experiences even during the COVID-19 pandemic. This epidemiological memory has been shaping social perceptions of risk in relation to the pandemic. The initial fear of contagion and diagnosis of COVID-19 reproduced the traumas from the Ebola outbreak, resulting in decreased use of health services during the period. With time, these perceptions evolved and COVID-19 was considered an ‘invisible disease’ due to its lower severity and incidence as compared to Ebola.

In several cases, vaccine hesitancy had spillover effects in the Expanded Program on  Immunisation, which ensures essential childhood vaccinations, because people feared being vaccinated against COVID-19 if they visited the health centre.

Vaccine acceptance in the community can be attributed to two factors – encouragement from trusted and influential community members, and the practical benefits of obtaining a vaccine certificate such as traveling for work. The study also showed that the use of health services seemed to be gradually resuming, together with an increase in COVID-19 vaccine uptake.


“IPERVAC provided some rich insights into understanding the relevance of the epidemiological memory in shaping social responses to the COVID-19 pandemic and perceptions of vaccines. These lessons will be valuable across vaccination programmes and will encourage further research along these lines in new contexts,” concludes Yara Alonso, project co-coordinator.