Differential COVID-19 Vaccination Uptake and Associated Factors among the Slum and Estate Communities in Uganda: A Cross-Sectional Population-Based Survey

Abstract

Vaccination against COVID-19 remains one of the ultimate solutions to the ongoing pandemic. This study examined and compared the completion of primary COVID-19 vaccination series and associated factors in the slum and estate communities of Uganda. This was a cross-sectional survey conducted among 1025 slum and estate residents. Logistic regression models were fitted. Of the 1025 participants, 511 were slum residents and 514 were estate residents. Completion of COVID-19 vaccination was 43.8% in the slum community and 39.9% in the estate community (p = 0.03). Having more knowledge about COVID-19 was positively associated with completing COVID-19 vaccination in both communities. Perceived benefits and cues to action also had a positive association, but only among the slum residents. However, perceiving people infected with COVID-19 as having a high death rate, perceived barriers such as serious side effects and long distances, and depressive symptoms had negative associations with vaccine uptake among the slum community, but not in the estate community. Addressing barriers to vaccination, strengthening and utilizing the various cues to action, engagement of religious and cultural leaders, and continued community education and sensitization tailored to the needs of each community are potentially vital strategies in raising vaccination rates. Consideration of socioeconomic impact-alleviation strategies, especially among the urban poor, would also be beneficial.

COVID-19 Vaccine Acceptance, Attitude and Perception among Slum and Underserved Communities: A Systematic Review and Meta-Analysis

“…On further screening, 42 articles remained for eligibility assessment after excluding those which were not original studies and not done in slum/underserved communities. The final assessment yielded 24 articles for further analysis [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ].…”

“…Seventeen (17) studies reported on the factors associated with COVID-19 vaccination (acceptance/hesitancy and uptake), Table 5 . Older age was a strong predictor reported in nine studies, with some reporting a positive association with acceptance and uptake [ 28 , 30 , 35 , 38 , 41 , 42 , 47 ] and a negative association in others [ 27 , 29 ]. High education level and good health literacy were also positive correlates of vaccine acceptance and uptake [ 25 , 29 , 37 , 39 , 42 ], though some studies reported a negative association [ 32 , 38 ].…”

“…Ethnicity/race was a strong predictor in the USA and reported in five studies, with more vaccine hesitancy among ethnic minorities, mostly among Blacks and Hispanics [ 25 , 33 , 35 , 45 , 47 ]. Ethnicity/tribe was also a strong predictor in Uganda [ 41 ]. Being employed and having higher SES had a positive association with acceptance and uptake [ 29 , 39 ], while occupation had a varying effect on vaccination [ 29 , 37 , 38 , 42 ].…”

Assessing Willingness to receive COVID-19 Vaccines, associated factors and reasons for hesitancy among persons aged 13-80 years in Central Uganda. A population-based surveillance Cohort

“…Furthermore, a study done among residents of South Western Ethiopia reported that only 29% of the participants were willing to receive the vaccine (19). The relatively high willingness to accept the vaccine could be attributed to the vigorous campaigns by the government of Uganda to promote COVID-19 vaccination (20).…”

Association between recent COVID-19 diagnosis, depression and anxiety symptoms among slum residents in Kampala, Uganda

“…For example, approximately 15% of individuals quarantined due to SARS epidemic in the Canadian city of Toronto showed signs of depression and post-traumatic stress disorder [ 20 ]. Economic-related mental distress has been reported to have a negative impact on COVID-19 vaccine uptake [ 21 ]. Similarly, higher prevalence of psychological effects such as fear, anxiety and depression were reported during the 2013–2016 West Africa Ebola outbreak [ 22 ].…”