Conspiracy theories and misinformation about COVID-19 in Nigeria: Implications for vaccine demand generation communications

Introduction: COVID-19 vaccine hesitancy is a worldwide phenomenon and a serious threat to pandemic control efforts. Until recently, COVID-19 vaccine hesitancy was not the cause of low vaccine coverage in Nigeria; vaccine scarcity was the problem. As the global supply of COVID-19 vaccines improves in the second half of 2021 and more doses are deployed in Nigeria, the supply/demand dynamic will switch. Vaccine acceptance will become a key driver of coverage; thus, amplifying the impact of vaccine hesi-tancy. Conspiracy theories and misinformation about COVID-19 are rampant and have been shown to drive vaccine hesitancy and refusal. This study systematically elicits the misinformation and conspiracy theories circulating about COVID-19 among the Nigerian public to understand relevant themes and potential message framing for communication efforts to improve vaccine uptake. Methods: From February 1 to 8, 2021, we conducted 22 focus group discussions and 24 key informant interviews with 178 participants from six states representing the six geopolitical zones. Participants were purposively selected and included sub-national program managers, healthcare workers, and community members. All interviews were iteratively analyzed using a framework analysis approach. Results: We elicited a total of 33 different conspiracy theories or misinformation that participants had heard about the COVID-19 virus, pandemic response, or vaccine. All participants had heard some misin-formation. The leading claim was that COVID-19 was not real, and politicians took advantage of the sit-uation and misused funds. People believed certain claims based on distrust of government, their understanding of Christian scripture, or their lack of personal experience with COVID-19. Conclusions: Our study is the first to report a thematic analysis of the range of circulating misinformation about COVID-19 in Nigeria. Our findings provide new insights into why people believe these theories, which could help the immunization program improve demand generation communication for COVID-19 vaccines by targeting unsubstantiated claims. (c) 2022 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).