Determinants of Covid-19 Vaccine Uptake Among Adults in Mwala Sub County, Machakos County, Kenya

Abstract

COVID-19 has had immense negative effects on different populations both economically and socially. Since the pandemic started in 2019, it has caused numerous deaths and lowered quality of life among various victims and survivors. In efforts to contain the pandemic, virologists and vaccine manufacturers have worked and invented different COVID-19 vaccine variants with diverse but remarkably good levels of efficacy against the disease. Despite the Kenyan government’s efforts to make the vaccines available to the eligible population, vaccine hesitancy and refusal has brought about poor uptake hence slowing down the vaccination process. In this regard, the broad objective was to investigate the determinants of COVID-19 vaccine uptake among adults. The specific objectives were to identify the individual, administrative, social, and demographic factors that influence COVID-19 vaccine uptake among adults in Mwala Sub-county. It engaged the adult population residing in Mwala sub-county, Machakos County, Kenya as the study participants only. Analytical cross-sectional study design was used to achieve these objectives. Ethical clearance was issued by Mount Kenya University Ethical Review Committee and NACOSTI before data collection. The study targeted residents of Mwala Sub-county aged above 18 years of age. Data collection was carried out by means of structured questionnaires administered to 384 respondents and key informant interview guides that engaged six informants. The questionnaire respondents were sampled using systematic random sampling method from individuals visiting the six vaccination centres in the Sub-county. The process adhered to ethical considerations of informed consent, confidentiality, and anonymity. Data analysis was done with the aid of the SPSS software version 26. Descriptive analysis was conducted to describe the socio-demographic findings of the study as well as COVID-19 vaccine uptake of the respondents. Uptake of the first dose was 46.60% while fully vaccinated individuals were 11.70% of the total number of respondents. The association between some variables was identified through Chi-square test of association at significance level p=0.05. There were statistically significant associations between the outcome variable (COVID-19 vaccine uptake) and demographic predictors of age (χ2=15.524, df=3, P=0.001), sex (χ2=5.250, df=1, P=0.022), education level (χ2=107.556, df=3, P<0.001), and marital status (χ2=35.328, df=3, P<0.001). Additionally, social factors such as dependence on unreliable sources of information (χ2=32.904, df=3, P<0.001), collective responsibility of getting vaccinated to protect others (χ2=292.931, df=3, P<0.001), and religious teachings (χ2=11.763, df=1, p=0.001) also exhibited significant associations. Among predictors of low vaccine uptake was individual factors of susceptibility perception (χ2=189.471, df=1, p<0.001), severity perception (χ2=234.515, df=3, P<0.001), safety concerns (χ2=277.624, df=3, P<0.001), and perception that the vaccine benefits did not outdo associated side effects (χ2=277.624, df=3, P<0.001). Administrative factors of vaccine stock-outs (OR = 0.86, 95% CI 0.82 – 0.90) and long queues (OR=0.87, CI 95% 0.83–0.90) were not significantly related to the outcome variable. The study concludes that the vaccine uptake in Mwala is generally low. To overcome the low vaccine uptake, the government should incorporate COVID-19 vaccination into the existing routine vaccination schedule and address conspiracy theories revolving around the vaccine in various social media sites during health education and awareness vaccination campaigns.