Assessment of covid-19 vaccine hesitancy amongst health care workers in Dokolo district; a cross-sectional study.

Abstract

Background: The World Health Organization (WHO) declared COVID-19 a pandemic on 11th March 2020, and as of the 3rd May 2022, the total cumulative cases and death globally stood at 511,965,711 and 6,240,619, respectively. In Uganda, as of the 3rd May 2022, the total number of COVID-19 deaths were 3,597. In response, WHO recommended several vaccines, which significantly averted the tide in high-income countries, with a drastic decline in new COVID-19 infections. Subsequently, Uganda adopted a rigorous nationwide vaccination campaign which was characterized by a low uptake of COVID-19 vaccines in the initial phases. One of the hypothesized reasons for the low uptake of COVID-19 vaccines was vaccine hesitancy. However, there is a paucity of information on vaccine hesitancy among health workers. This study aimed to examine COVID-19 vaccine hesitancy amongst healthcare workers in the Dokolo district. Methods: This was a cross-sectional study that adopted a mixed-methods sequential explanatory design, consisting of two distinct phases: a quantitative phase, followed by a qualitative phase. Structured questionnaires and a key informant interview guide were used to collect quantitative and qualitative data respectively from the targeted healthcare workers. Quantitative data analysis was performed using Stata version 15.0 software, and the qualitative analysis was performed using NVIVO software. I conducted a multivariable logistic regression model to determine factors associated with vaccine hesitancy. We defined vaccine hesitancy as an Individual’s unwillingness to get vaccinated despite the availability of the vaccine. Results: Almost all the 350 registered health workers (from public and private health facilities) in Dokolo district were recruited in this study [346/350 (99%)]. The mean age ± standard deviation of the participants was 31.4±6.9 years. Participants’ cadres were nurses [225/346 (60.6%)] clinicians [31/346 (9%)], environmental health officers [49/346 (14.3%)], laboratory technicians [26/346 (6.7%)], and doctors [15/346 (4.4%)]. We found that [46/346 (13.3%)] were vaccine-hesitant. In the multivariable analysis, fear of side effects (AOR: 3.5; 95% CI: 1.3-9.3) and health workers’ lack of trust in the information provided by health authorities (AOR: 5.2; 95% CI: 1.6-16.1) were associated with vaccine hesitancy among the health workers. Qualitative findings identified fear of side effects, distrust in vaccine stakeholders, and lack of trust in the vaccine as key barriers to COVID-19 vaccination uptake among health workers. Conclusion and recommendations: Vaccine hesitancy among health workers was low, at 13.3%. This was associated with fear of side effects, and the lack of trust in the information provided by the health authorities. The study recommends health stakeholders, including the Ministry of Health, the World Health Organisation, and non-state actors, explain COVID-19 vaccine safety and embark on rigorous information dissemination on the known side effects and management strategies, to restore vaccine confidence among health workers and the public and also accurately packaging the information on COVID-19 vaccine from the national and sub-national level, and use correct and reliable channels to disseminate the information to erase distrust in the information passed out on COVID-19 vaccine. Keywords: COVID-19, vaccine hesitancy, health workers, SARS-CoV-2, unwillingness