Is it COVID-19 vaccine hesitancy or inquisitiveness? Factors associated with COVID-19 vaccine acceptance among the adult population in Northern Uganda. A cross-sectional study.

Abstract

Background When the COVID-19 vaccines arrived in Uganda in early March of 2021, there was a lack of information on the vaccine acceptance in the population due to many factors, mainly misinformation and disinformation circulating in the Ugandan social and mainstream media. This study aimed to determine factors associated with COVID-19 vaccine acceptance among the adult population in northern Uganda. Methods We conducted a cross-sectional study among the 723-adult population in northern Uganda. Participants were selected randomly from the nine districts of the Acholi sub-region. Ethical approval was obtained from a local IRB, and SPSS version 20.0 was used for data analysis at a multivariable logistic regression. A p-value less than 0.05 was considered significant. Results The most significant finding was that COVID-19 vaccine acceptance among the adult population in northern Uganda was at 580/723(80.22%) and was significantly associated with those with comorbidities AoR = 0.397, 95%CI: 0.233,0.674; p = 0.001; those who agreed that vaccines in health facilities in northern Uganda were safe AoR = 0.724, 95%CI:0.597,0.878;p = 0.001; graduates AoR = 2.781,95%CI:1.278,6.052;p = 0.010; females AoR = 0.616, 95%CI:0.396,0.957; p = 0.031; Catholics AoR = 1.703,95%CI:1.048,2.765;p = 0.032; Baganda tribe AoR = 3.829,95%CI:1.170,7.790;p = 0.026; non-smokers AoR = 7.349,95%CI:1.767,30.566;p = 0.006; ex-smokers AoR = 8.687,95%CI:1.052,71.734;p = 0.045; Agago district AoR = 2.950,95%CI: 1.118,7.789; p = 0.029, and Lamwo district AoR = 2.781, 95%CI:1.278,6.052; p = 0.010. Conclusion COVID-19 vaccine acceptance among the study population was encouragingly high despite the disinformation and misinformation in the Ugandan media. The independent determinants of COVID-19 vaccine acceptance were among females, those who agreed that vaccines in health facilities were safe, those with comorbidities, graduates, Catholics, Baganda tribe, ex-smokers and non-smokers, and participants from Agago and Lamwo districts. The fear of contracting the coronavirus and the fear of death if not vaccinated contributed significantly to the COVID-19 vaccine acceptance in northern Uganda. There is a need for health managers to engage, sensitize and mobilize the population on the COVID-19 vaccine and vaccination using the VHTs and the catholic church structures, which remain critically important for the vaccination campaign if the high COVID-19 vaccine acceptance in the sub-region is to be maintained or improved.

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“…Similar to findings from Nigeria and Uganda [28,29], our study found that identification with certain ethnic groups was associated with COVID-19 vaccination status. Specifically, we found that those who identified as Akan were significantly more likely to be vaccinated while those who identified with other ethnic groups (Gour, Krou, and Mandé) were less likely to be vaccinated, although these findings were not significant.…”

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“…It was also revealed that religious beliefs and use of religious leaders for promoting vaccination effort is an important acts of reducing vaccination effort. For instance, in the study by Oloya et al (2022) findings indicate that when the Archbishop in a Catholic dominated region communicated the need to vaccinate most Catholics that vaccinated yet government messages had not yielded much. It was also revealed that Muslims did not belief in vaccination as their belief was the vaccine was manufactured and did not evolve naturally.…”

“…Yet a randomized study by Ssanyu, Kiguba, Olum, Kiguli & Kitutu (2022) in Uganda, validates misinformation as a major contributor of vaccine hesitancy. Another study in Uganda indicates that the lack of trust in public health systems and post vaccination effects were responsible for up to 40% vaccinate hesitancy rate in a randomized study in Northern Uganda (Oloya et al,2022). It was also revealed that religious beliefs and use of religious leaders for promoting vaccination effort is an important acts of reducing vaccination effort.…”

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“…24,25 In addition, district task forces set up by the Government of Uganda along the layers of administrative structures (national, districts, and communities) to support the management, prevention, and control of COVID-19 pandemic in communities met weekly to discuss new developments and plans of action. 24,25 Further, the President of Uganda had announced new methods of work in public settings, whereby only 30% of staff in public and private organizations were allowed physically in offices. 24,25 These COVID-19 control measures were intended to disrupt day-to-day contact between management, administration, and the community to interrupt the cycle of physical person-to-person contacts to break the transmission cycle of COVID-19.…”

“…24,25 Further, the President of Uganda had announced new methods of work in public settings, whereby only 30% of staff in public and private organizations were allowed physically in offices. 24,25 These COVID-19 control measures were intended to disrupt day-to-day contact between management, administration, and the community to interrupt the cycle of physical person-to-person contacts to break the transmission cycle of COVID-19. 24,25 Study participants and sampling techniques: We sampled five hundred and eighty-seven adult respondents recruited by a single stage stratified and systematic sampling techniques, and data was collected using a questionnaire.…”