Determinants of COVID-19 vaccine uptake among adults in Mwala Sub-county, Machakos County, Kenya

Abstract

Background: Despite the available evidence on benefits of COVID-19 vaccine, its low uptake and hesitancy remain a challenge. This study assessed individual, administrative, social, and demographic factors associated with COVID-19 vaccine uptake. Methods: Analytical cross-sectional study design was used. The data was collected using structured questionnaires administered to 384 respondents and key informant interview guides that engaged six informants. Results: Uptake of the first dose was 46.60% while fully vaccinated respondents were 11.70% of the total. There were significant associations between 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). Some social factors such as dependence on unreliable sources of information (χ2=32.904, df=3, p<0.001) and collective responsibility of getting vaccinated to protect others (χ2=292.931, df=3, p<0.001) also exhibited significant associations. However, religious teachings did not influence vaccine uptake (df=1, R2=0.099, p=0.997). Individual factors of susceptibility perception (p<0.001, R2=0.525, df=1), 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 side effects (χ2=277.624, df=3, p<0.001) determined vaccine uptake. Administrative factors of vaccine stock-outs (R2=0.091, df=1, p=0.997) and long queues (R2=0.061, df=1, p=0.997) had no influence on vaccine uptake. Conclusions: With the findings indicating poor 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.