Factors Associated with COVID-19 Vaccine Hesitancy in Uganda: A Population-Based Cross-Sectional Survey

Abstract

Purpose Vaccination toward coronavirus disease (COVID-19) has been recommended and adopted as one of the measures of reducing the spread of this novel disease worldwide. Despite this, vaccine uptake among the Ugandan population has been low with reasons surrounding this being unknown. This study aimed to investigate the factors associated with COVID-19 vaccine hesitancy in Uganda. Methods A cross-sectional study was conducted on a total of 1042 adults in the districts of Mukono, Kiboga, Kumi, Soroti, Gulu, Amuru, Mbarara and Sheema from June to November 2021. Data were analyzed using STATA v.15. Barriers to vaccination were analyzed descriptively, while a binary logistic regression model was used to establish the factors associated with COVID-19 vaccine hesitancy. Results Overall, COVID-19 vaccine hesitancy was 58.6% (611). Respondents from urban areas and those in the eastern or northern region had increased odds of vaccine hesitancy. Further, higher education level and having knowledge on how COVID-19 is transmitted significantly reduced the odds of vaccine hesitancy. The study also noted individual perception such as COVID-19 kills only people with underlying medical conditions, as well as limited awareness on vaccine types or vaccination areas as the main reasons to vaccine hesitancy. Relatedly, other misconceptions like the ability of the vaccine to cause infertility, or spreading the virus into the body, and acknowledgment of alcohol as a possible cure were other reasons for vaccine hesitancy. Conclusion The proportion of COVID-19 vaccine hesitancy is still high among the population with this varying across regions. This is driven by low education level and limited awareness on the vaccination as well as perceived myths and misconceptions. The study recommends mass sensitization of the population on the benefits of vaccination using various channels as well as rolling out community-based outreach vaccination campaigns across the country.

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

“…Regarding the factors associated with completing the primary COVID-19 vaccination series, having more knowledge of COVID-19 was positively associated with vaccination uptake among the slum and estate communities. The finding is in line with previous studies that have also reported positive associations [ 9 , 11 ]. This is partly because individuals with good knowledge of the disease tend to be more aware of the importance of getting vaccinated and where to get the vaccine.…”

“…The low uptake of COVID-19 vaccination has been attributed to concerns about the adverse effects and effectiveness of the vaccines [ 9 , 10 ]. Intriguingly, the inaccessibility of vaccination centers, global vaccine supply chain dynamics, and perceived misconceptions have been linked to low vaccine uptake, especially in low-income countries [ 11 , 12 , 13 ]. Nonetheless, vaccination remains the most effective intervention for curtailing communicable disease pandemics [ 14 ], and most countries have implemented COVID-19 vaccination programs [ 7 , 15 ].…”

“…For a more comprehensive evaluation, this study used the socioecological model, as it considers individual and interpersonal level factors. From previous studies, at the individual level, age, gender, education level, income, adequate knowledge and positive perceptions about the COVID-19 virus and vaccines, and history of COVID-19 infection, among others, have been reported to increase the uptake of COVID-19 vaccines in Africa [ 9 , 11 , 13 , 15 ]. Interpersonal factors such as place of residence and occupation, among others, have also shown associations with COVID-19 vaccine uptake [ 13 , 15 ].…”

“…Despite the evident vulnerability of the urban poor to the pandemic and the documented associations of COVID-19 vaccine uptake with sociodemographic dynamics, few studies have explored vaccination uptake among this special group. In Uganda, most of the COVID-19 vaccination studies have focused on the general community [ 11 , 29 , 30 , 31 ], health-care workers [ 32 , 33 ] and other groups [ 10 ], with uncertainty whether the findings apply equally to the disadvantaged urban poor. To our knowledge, only one study has explored COVID-19 vaccination among slum-dwellers, and this reported on the progress of the COVID-19 vaccination rollout in Kampala slums [ 16 ].…”

Enablers and Barriers to Handwashing and Vaccine Uptake in Kenya, Uganda, and Tanzania in Relation to COVID-19 Prevention and Control: A Systematic Review

“…A study (30) focusing Kenya indicated that misinformation and lack of public sensitization about the vaccines had led to vaccine hesitancy. A study (31) focusing Uganda noted that due inadequate awareness on vaccination sites, the overall Covid-19 hesitancy was 58.6%. A study (32) focusing Kenya and other countries highlighted that Covid-19 acceptance rates ranged between 6.9 to 97.9%.…”