Citation: Naidoo, D.; Meyer-Weitz, A.; Govender, K. Factors Influencing the Intention and Uptake of COVID-19 Vaccines on the African Continent: A Scoping Review. Vaccines 2023, 11, 873. https:// doi.org/10.3390/vaccines11040873 Academic Editor: Pedro Plans-Rubió Received: 5 March 2023 Revised: 31 March 2023 Accepted: 11 April 2023 Published: 20 April 2023 Copyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). Systematic Review Factors Influencing the Intention and Uptake of COVID-19 Vaccines on the African Continent: A Scoping Review Damian Naidoo 1,2, * , Anna Meyer-Weitz 1 and Kaymarlin Govender 3 1 Discipline of Psychology, School of Applied Human Sciences, Howard College, University of KwaZulu-Natal, Durban 4041, South Africa 2 Health Promotion Unit, KwaZulu-Natal Department of Health, Pietermaritzburg, Private Bag X9051, Pietermaritzburg 3200, South Africa 3 HEARD, College of Law and Management Studies, University of KwaZulu-Natal, Durban 4041, South Africa * Correspondence: naidoo.damian@outlook.com Abstract: The COVID-19 pandemic is a severe concern worldwide, particularly in Africa. Vaccines are crucial in the fight against the COVID-19 pandemic. This scoping review examined existing literature from 2020 to 2022 on individual, interpersonal, and structural barriers and facilitators to COVID-19 vaccination within Africa to facilitate more informed health promotion interventions to improve vaccine uptake. This review was conducted using Arksey and O’Malley’s five-stage methodological framework. A comprehensive search was undertaken from 2021 to 2022 using six electronic databases: EBSCOhost, PubMed, Web of Science, ProQuest, WorldCat Discovery, and Google Scholar. Data was collected, charted into themes, and summarized using a standard data extraction sheet in Microsoft Excel. A total of forty (n = 40) published academic articles were reviewed, with many conducted in Nigeria (n = 10), followed by Ethiopia (n = 5) and Ghana (n = 4) and the rest elsewhere in Africa. Thematic narratives were used to report data into six themes: attitudes and perceptions about COVID-19 vaccines, intention to uptake COVID-19 vaccines; factors and barriers associated with COVID-19 vaccine uptake; socio-demographic determinants affecting the intention and uptake; and information sources for COVID-19 vaccines. The intention for uptake ranged from 25% to 80.9%, resulting in a suboptimal uptake intention rate (54.2%) on the African continent. Factors that promoted vaccine acceptance included confidence in the COVID-19 vaccines and the desire to protect people. Age, education, and gender were the most common factors significantly associated with vaccine acceptance. Most studies revealed that considerable barriers to vaccine uptake exist in Africa. Concerns about potential side effects, vaccine ineffectiveness, a perceived lack of information, and inaccessibility were among the individual, interpersonal, and structural barriers to COVID-19 vaccine uptake. The unwillingness to receive the COVID-19 vaccine was strongly correlated with being female. Mass and social media were the main sources of information regarding COVID-19 vaccines. To encourage vaccine uptake, governments should pay attention to refuting misinformation through integrated community-based approaches, such as creating messages that convey more than just information. Keywords: intention; barriers; uptake; facilitators; COVID-19 vaccines; Africa; scoping review 1. Introduction The novel coronavirus 2019, termed COVID-19, is a highly transmissible and pathogenic viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1–3], and COVID-19 vaccines are seen as an effective public health tool in mitigating the spread of SARS-CoV-2. The COVID-19 pandemic has raised many direct and indirect health problems [3]. Although most people experience upper respiratory tract and pulmonary symptoms, those with severe COVID-19 may also experience widespread small and large vessel thrombosis, microvascular injury, cardiac conduction abnormalities, neurologic Vaccines 2023, 11, 873. https://doi.org/10.3390/vaccines11040873 https://www.mdpi.com/journal/vaccines