Sociodemographic inequity in COVID-19 vaccine uptake among youth in Zimbabwe

Abstract

Introduction COVID-19 vaccine acceptance research has mostly originated from high-income countries and reasons why youth may not get vaccinated may differ in low-income settings. Understanding vaccination coverage across different population groups and the sociocultural influences in healthcare delivery is important to inform targeted vaccination campaigns. Methods A population-based survey was conducted in 24 communities across three provinces (Harare, Bulawayo and Mashonaland East) in Zimbabwe between October 2021 and June 2022. Youth aged 18 - 24 years were recruited using random sampling. Data on sociodemographic information and COVID-19 vaccination uptake and reasons for non-uptake were collected. Results A total of 17,682 youth were recruited (n=10,743, 60.8% female). The median age of survey participants was 20 (IQR: 19-22) years. Almost two thirds (n=10,651, 60.2%) of participants reported receiving at least one dose of COVID-19 vaccine. A higher proportion of men than women had been vaccinated (68.9% vs 54.7%), and vaccination prevalence increased with age (<19 years: 57.5%, 20-22: 61.5%, >23: 62.2%). Lack of time to get vaccinated, belief that the vaccine was unsafe and anxiety about side effects (particularly infertility) were the main reasons for not getting vaccinated. Factors associated with vaccination were male sex (OR=1.69, 95%CI:1.58-1.80), increasing age (>22 years: OR=1.12, 95%CI:1.04-1.21), education level (post-secondary: OR=4.34, 95%CI:3.27-5.76), and socioeconomic status (least poor: OR=1.32, 95%CI:1.20-1.47). Conclusion This study found vaccine inequity across age, sex, educational attainment and socioeconomic status among youth. Strategies should address these inequities by understanding concerns and tailoring vaccine campaigns to specific groups.

The Feasibility and Acceptability of Using Mobile Applications for HIV Testing, Prevention, and Treatment Among Adolescent Girls and Young Women in Cameroon: A Cross-Sectional Study

“…This was confirmed in our study where, in addition to privacy concerns, these factors were barriers to AGYW's willingness to use mobile apps for HIV testing, prevention, and treatment. The use of mobile technology for health service delivery should be based on a thorough assessment of logistics and operationalization, including target users' digital literacy and access to a device and the internet (Larsson et al, 2023) In this study, we also found that compared with AGYW aged 21-25 years, those aged 18-20 years were less likely to accept mobile apps for HIV testing, prevention, and treatment. This could be because of privacy concerns, particularly in home settings where despite having phones, these younger AGYW need to share their phones with other family members or submit to parental control which could lead to coercive disclosure of access to HIV-related services (Larsson et al, 2023).…”