Factors associated with willingness to receive the COVID-19 vaccine among residents of Hoima District, Mid-western Uganda

Abstract

Background: The development and use of COVID-19 vaccine has been a global target to effectively control the pandemic. Since March 2021, Uganda has been publicizing and implementing COVID-19 vaccination. However, little is known on the willingness to receive the vaccine particularly in rural areas of Uganda. This study aimed to determine the willingness to receive the COVID 19 vaccine, associated factors, and barriers or motivators to willingness in Uganda. Methods: This was a mixed-methods cross-sectional study conducted between January and April 2022, among residents in Hoima district, Uganda. We used multi-stage sampling to survey 379 randomly selected adult participants from 13 systematically sampled villages in two rural sub-counties in Hoima district. Also, we interviewed 8 purposively selected key informants who were health workers at Hoima regional referral Hospital, where vaccination was being conducted. A participant who was voluntarily willing to receive COVID-19 vaccination was categorized as willing. We also interviewed eight purposively selected key informants who were healthcare workers actively involved in vaccination services. We used descriptive statistics and then conducted multivariable-modified Poisson regression model to generate prevalence ratios(PR)for the quantitative data while a thematic approach was used for qualitative data analysis. Results: All (379) participants had heard about COVID-19 vaccination and commonest sources of information were radios(58.8%),friends(28.8%),and health workers(12.5%). Overall, 79%(301/379) of the participants were willing to receive the COVID-19 vaccination. Willingness to receive COVID-19 vaccination was significantly higher among participants with tertiary level of education(adj.PR=1.2;95%CI:1.1,1.4); those who received information about COVID-19 vaccination from healthcare workers(adj.PR=1.3; 95%CI:1.2,1.6);, and those who resided within 5 Kilometers from a vaccination site(adj.PR=1.2;95%CI:1.1,1.6). From the qualitative analysis perceived fear for loss of libido among men and infertility among women was a major concern across the interviews, which barred willingness. In addition, some faith-healing religion believed and propagated information that this vaccine attached evil intentions and should be avoided. Conclusion. Willingness to receive COVID-19 vaccination was high in rural settings but safety concerns were main barrier. Strategies to improve COVID-19 vaccination programs, in such settings, may focus on health education messages through local radio stations to counter fears on reproduction and misconceptions about the vaccine. Key words: COVID-19, willingness, vaccination, Rural Uganda.