COVID-19 vaccine hesitancy: Vaccination intention and attitudes of community health volunteers in Kenya

Abstract

In Kenya, community health volunteers link the formal healthcare system to urban and rural communities and advocate for and deliver healthcare interventions to community members. Therefore, understanding their views towards COVID-19 vaccination is critical to the country’s successful rollout of mass vaccination. The study aimed to determine vaccination intention and attitudes of community health volunteers and their potential effects on national COVID-19 vaccination rollout in Kenya. This cross-sectional study involved community health volunteers in four counties: Mombasa, Nairobi, Kajiado, and Trans-Nzoia, representing two urban and two rural counties, respectively. COVID-19 vaccination intention among community health volunteers was 81% (95% CI: 0.76–0.85). On individual binary logistic regression level, contextual influence: trust in vaccine manufacturers (adjOR = 2.25, 95% CI: 1.06–4.59; p = 0.030); individual and group influences: trust in the MoH (adjOR = 2.12, 90% CI: 0.92–4.78; p = 0.073); belief in COVID-19 vaccine safety (adjOR = 3.20, 99% CI: 1.56–6.49; p = 0.002), and vaccine safety and issues: risk management by the government (adjOR = 2.46, 99% CI: 1.32–4.56; p = 0.005) and vaccine concerns (adjOR = 0.81, 90% CI: 0.64–1.01; p = 0.064), were significantly associated with vaccination intention. Overall, belief in COVID-19 vaccine safety (adjOR = 2.04, 90% CI: 0.92–4.47 p = 0.076) and risk management by the government (adjOR = 1.86, 90% CI: 0.94–3.65; p = 0.072) were significantly associated with vaccination intention. Overall vaccine hesitancy among community health volunteers in four counties in Kenya was 19% (95% CI: 0.15–0.24), ranging from 10.2−44.6% across the counties. These pockets of higher hesitancy are likely to negatively impact national vaccine rollout and future COVID-19 vaccination campaigns. The determinants of hesitancy arise from contextual, individual and group, and vaccine or vaccination specific concerns, and vary from county to county.

Influence of conspiracy theories and distrust of community health volunteers on adherence to COVID-19 guidelines and vaccine uptake in Kenya

“…The trust in the vaccination initiative can be associated with the quicker opening of the economy and normal lifestyle. This finding is in agreement with Osur et al’s [ 6 ] study, that reported a significant association between intention to accept COVID-19 vaccines and trust in MoH (national government) decisions on COVID-19 vaccination. As of the time of writing this paper, Kenya’s government was struggling to vaccinate 10 million adult Kenyans by the end of December 2021.…”

“…Inadequate resources and remunerations may hinder the CHVs from serving their clients well and especially attending to households within their areas of jurisdiction at odd hours. They need to be facilitated with resources to improve their performances and increase trust in the ministry of health messaging [ 6 ] and they need further training to enable them effectively perform their roles.…”

“…This cross-sectional study collected data between 25 May –27 June 2021. It involved all registered community health volunteers (CHVs) who had participated in the COVID-19 vaccine hesitancy study [ 6 ], whose database was used as the sampling unit.…”

“…As demonstrated by Osur et al ., [ 6 ] CHVs play a significant role in building trust and convincing communities in Kenya to accept COVID-19 vaccination and treatment. It is therefore crucial to understand how they relate to official guidelines.…”

Exploring COVID-19 vaccine hesitancy and uptake in Nairobi’s urban informal settlements: an unsupervised machine learning analysis of a longitudinal prospective cohort study from 2021 to 2022

“…To increase vaccine uptake, it is important to address hesitancy by identifying sources of information, perceived trustworthiness of sources and how messaging can be adapted to drive positive behaviour change. Studies have shown that individuals who report receiving COVID-19 information from social media, primarily Facebook, have the highest rates of vaccine hesitancy 6 26. An Africa CDC report found that among those surveyed in Kenya, 65% reported having seen or heard at least some misinformation about COVID-19 from social media 29.…”