Uncovering COVID-19 vaccine acceptance and intent in 15 developing countries: a multi-level, clustered analysis of six months of repeated, cross-sectional data

Background COVID-19 vaccination hesitancy is antithetical to preventing communicable disease. The study's aim was to determine social ecological factors associated with vaccination acceptance / intent in select developing countries.Methods To examine vaccine acceptance / intent in fifteen developing countries, data was sourced from the Global COVID-19 Trends and Impacts Survey and analyzed with a multi-level, clustered, cross-sectional design. Weighted Generalized Additive Modeling (GAM) with 1,000 stratified cluster bootstraps mitigated intra-cluster correlation and temporal dependencies.Results Statistically significant linear variables included those age 55 + (OR = 1.204, 95% CI [1.095, 1.324], p Conclusions Vaccine decision-making complexities are associated with cultural and individual influences. Such findings could inform future vaccine campaign strategies.