As COVID-19 vaccines have become more widely available in Sub-Saharan Africa, vaccination campaigns in the region have struggled to pick up pace and trail the rest of the world. This paper presents new evidence on vaccine hesitancy, uptake, last-mile delivery barriers, and potential strategies to reach those who remain unvaccinated. The data come from high-frequency phone surveys in five countries in East and West Africa (Burkina Faso, Kenya, Malawi, Nigeria, and Tanzania). The surveys were conducted by countries' national statistical agencies, have national scope, are cross-country comparable, and draw their samples from nationally representative sampling frames. The findings show that across the study countries, a majority is willing to get vaccinated. Still, vaccine hesitancy is non-negligible among those pending vaccination. Concerns about side effects of the vaccine are the primary reason for hesitancy. At the same time, many who are willing to get vaccinated are deterred by a lack of easy access to vaccines at the local level. Radio broadcasts have widespread reach and medical professionals have good rapport among the unvaccinated population. Furthermore, social ties and perceptions as well as intrahousehold power relations matter for vaccine take-up. Based on the findings, the paper elaborates policy options to boost vaccination campaigns in Sub-Saharan Africa.