From the start of the epidemic in March 2020 until October 2021, 79,861 confirmed cases of COVID-19 were recorded in the national database. The median age was 35 years with an interquartile range of 23 to 40 years. They were mostly adults with the most represented age group 30 to 49 years old with 38.3% followed by that of 50 years and over (Table 1).

On a total of 76,434 confirmed cases in which the sex was known, it appears that the men were more affected than the women with a 50.3% and 45.4% respectively yielding a sex ratio of 1.1. Among affected women with COVID-19, 0.4% were pregnant.

Out of 50,580 cases whose evolution was recorded, 1,232 deaths were notified with a case fatality rate of 2.4%. The risk of death was slightly higher in women than in men with an OR of 1.135 (CI: 1.012-1.274). Regarding age, 71.4% of deaths occurred in people aged 50 and over. The probability of death was 4.6 times higher in the elderly and this difference was statistically significant (p = 0.000). Case confirmation could be made in 482 people who died at the time of notification, accounting for 0.8% (Table 2).

Some informants identified themselves as being anti-COVID vaccines and therefore explained several reasons, including doubts about the quality or safety of the vaccines: “You must first know if the content of the vial is really a vaccine against COVID”; the fact that COVID remains a disease of the “white”; “That they should not force Africans to get vaccinated when the disease kills white people much more”; the fact that the vaccine is perceived or presented as being an obligation: “I am against an imposed vaccine”.

The fact that there are a multitude of vaccines on the market: “The covid-19 pandemic is real but the real problem arises with the variety of vaccines”; “The efficacy difference in percentage of vaccines and different names generally creates doubt in people, especially women”. According to them, women are more insightful than men: “We women have much more wisdom in decision-making. One problem already has several vaccine proposals in such a short time, why? Let the people in charge of those vaccines first agree on one, do some testing and release the results over time, and then we’ll see”. Other informants finally suggest that there are alternatives to the vaccine: “It would be better to use naturopathy, to overcome this pandemic:” Do not take any vaccine, take Ekouk and Mfol, it is effective”.

A few participants had no suggestions to share, either because they had no idea about it or because they felt it was a personal decision: “I have no advice for them. Everyone is free to engage in it or not”. Others, because they themselves, are against the vaccine: “For common vaccines, I can agree. But for COVID-19 I cannot encourage people even less women because, they are responsible for lives and their security”.

The COVID pro-vaccines thought that the vaccination of women should be obvious because: “For me, women are more vulnerable because of their fragility”; “She must protect herself and those around her since women remain at the center of many activities”. One respondent, however, underlined the incongruity of the question because according to him: “There is no difference for me, the same actions must be carried out in both sexes”.

While some informants refrained from contributing to the topic, others were able to offer suggestions for raising the vaccination rate among women. Respondents believe that the solution could come from vaccines, for example by ensuring their reliability, by involving African companies in the manufacture of the COVID-19 vaccine or by manufacturing vaccines for young people and pregnant women. But we could also: “Distribute the same vaccine throughout the country. Through:” Introduction of routine vaccine”. Which means, “We can take advantage of pregnancy to let them be vaccinated”. Without forgetting to “Bring the vaccine closer to the population, that is to say more vaccination centers even in the neighbourhoods. “Because:” The vaccination team does not cover a tenth of health areas”.

Support vaccination, that is: “Provide financial motivation for vaccination. “Or also think about:” Make compensation commitments in case the side effects exist”.

To improve women’s adherence to the COVID-19 vaccination, some informants believed that it was necessary to: “First gain men’s confidence in the admissibility of globally credible and acceptable vaccines”. The majority see in: “Awareness. “or” Communication.” as the appropriate solutions to implement. Upstream: “We must first identify the reasons for their refusal and after that it will be easier to carry out campaigns to raise their awareness. “. In order for women to be more receptive, it would be necessary to: “Engage female leaders at all social levels. “. So: “We need to develop better communication on COVID. “. This can be presented in several ways: “Proximity awareness. “; “Targeted awareness. “; “Door to door awareness. “; “Community sensitization “; “Educational meeting. “; “Put the posters everywhere. “.

More specifically, it is: “th need to make them understand that the vaccine is for both sexes and has no negative effects on women.”; “That, famous women who received the vaccine communicate strongly about it. » and « They need role models. “; “Make videos with more actresses that show the benefits of the vaccine and develop messages that contradict the fake news about vaccination. “;” Raise awareness, testify, remind people of the benefits of vaccination, give the right information on the risks on fertility, procreation, breastfeeding, etc. »; “I have published my photos of the vaccine action in associations and meeting, I do with my neighbourhood comrades. I made them aware of vaccination benefits. “;” Get closer to women’s associations, community meetings for women, put women at the front of the business. “; “Good communication and essential messages with community leaders, religious, influencers and extend to all women layers.”;” Focused sensitization and health education. Encouragement and no attempt at all at coercion or obligation. Government has to increase opportunities for sensitization of women and general public. But also, we have to be honest and produce very credible and convincing reports on how we have used COVID-19 funds, because this issue of mismanagement of COVID funds has come to embolden earlier suspicion that there is no COVID and that government is using it to get money from Europe and America and from monetary organizations. “; “Raise awareness of the importance of the vaccine and reduce beliefs that the vaccine is harmful or lethal. “;” Organize sensitization sessions in health facilities, in places of gathering (places of worship, markets, etc.), explain to men the need to have their girlfriends, wives, sisters, mothers, etc. vaccinated. “; “deny fake news from the social media. “;” Strengthen pre and post vaccination counselling “.

“We recognize the good tree by the sweetness of its fruits, if we realize that the vaccine really protects with contamination drop in vaccinated countries like Israel, sensitization will be easy and convincing. “. Statistics from good student countries such as Israel might just as well be convincing. However, the most drastic advocate: “Make vaccination compulsory. “. On the second question of how to use social media to improve vaccine confidence and vaccine uptake, a few informants had no knowledge to share. Other respondents shared their doubts about the feasibility of this project: “Very difficult because we find too many rumours in social media. “.

Some people thought that social networks were not suitable for impacting the population: “The media and Radio Stations are great sources of manipulation. The population has already understood it, that is why you will always see thousands of likes but few acts. “But according to some people,” Social networks should rather help to sensitize people on the respect of barrier measures. “. To improve confidence in vaccines and vaccine uptake, it is important to: “Do not avoid the mistakes of scientists. One dose, two doses, three doses. Vaccinated people who still get contaminated by the disease etc. “.

Social networks are important channels of communication and networking between communities, for informants, their use in improving confidence in vaccines and vaccines uptake can be defined as: “Communicate regularly on: the role of vaccines, the advantages of prevention over treatment, the quality of the vaccine, the possible side effects and their management in Cameroon, indicate the vaccination points, schedules etc. “; “Post the comparative reports of a country affected by covid19 before and after taking the vaccine. “; “By posting videos of people who have received the vaccines, videos that explain the types of vaccine “; “Aggressively invest social networks with messages, videos and images on the benefits of vaccination. “; “Encourage more social groups to create their accounts such as on Facebook, WhatsApp, Telegram and let the leaders of such groups share their pics on how they already took the jab. “; “Make videos from theatres to illustrate the benefits of COVID-19 vaccination and the harms of not doing so. “; “By live sessions during the vaccination sessions in the sites and share them. “; “Invite vaccinated and infected people to speak at a round table or a health program. “; “By using our status to share positive images. “; “Take pictures showing people who get vaccinated and who give good testimonials. “; “By sending messages to our contacts informing them about the importance of the vaccine, by advertising through leaflets on the benefits of the vaccine. “; “The government itself should have their own specific social media platform, whose duty will be to scan social media for all the COVID vaccine negative propaganda, and elaborate simple, clear, objective and convincing messages, reports, short videos or audios, brief social media slots to disperse the propaganda. To make info available to everybody. Social media is the most followed media today and we must be serious to get on with it”.

It emerges from the respondents that all communication through social media should be done transparently and by professionals, people who have been vaccinated, or opinion leaders, influencers trained for this purpose.

The respondents wish to point out that social networks, although important for information dissemination, professionals should take a closer look at the said information circulating: “A lot of rumours and fake-news are disseminated through social networks”; They offer several solutions to this, including: “Set up at all levels, monitoring / listening committees for social networks.”; “Strengthen the information system and rumour management. “; “To counter information, that is to say deny what has been said with the help of experts in the field. “; “prevent doctors and other health personnel who are against the vaccine to give their opinions on TV channels to discourage others. “; “The state needs to control all the sterile information that can create social psychosis, if possible, completely suppress social media. “; “why not even punish those who spread fake news of the vaccines. “.