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. We determined willingness to receive COVID-19 vaccination, associated factors, and barriers to willingness in rural Uganda.
Methods
We conducted a mixed-methods cross-sectional study, between January and April 2022, among residents in Hoima district, Uganda. We used multi-stage sampling to survey a random sample of 379 adult participants from 13 systematically sampled villages in two rural sub-counties in Hoima. 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 conducted multivariable-modified Poisson regression analysis to generate prevalence ratios(PR). 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 counseling about COVID-19 vaccination from healthcare workers(adj.PR=1.3; 95%CI:1.2,1.6); and those who resided within five kilometers from a vaccination site(adj.PR=1.2;95%CI:1.1,1.6). Perceived fear of loss of libido and infertility 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.