Prevalence and individual level enablers and barriers for COVID-19 vaccine uptake among adult tuberculosis patients attending selected clinics in Nairobi County, Kenya

Abstract

Background Although vaccination is impactful public health intervention in curbing the spread of infectious disease, low uptake is a significant concern, especially among high-risk population groups. Nearly half of the population is unvaccinated in Nairobi with highest TB and COVID-19 burden, yet there is dearth of vaccination information on tuberculosis patients. The interplay of several factors influences uptake, and protecting this vulnerable group and the general population from severe disease, hospitalization, and deaths is worthy. The study sought to determine the prevalence and individual level enablers and barriers for COVID-19 vaccine uptake among adult Tuberculosis patients attending selected clinics in Nairobi County, Kenya. Methods This cross-sectional mixed-method study was conducted at Tuberculosi clinics across six sub-counties in Nairobi County. It included 388 participants sampled from each clinic’s Tuberculosis register. Quantitative data was collected using a questionnaire, and qualitative data was collected through key informant interviews and focus group discussions. Quantitative data was analyzed using descriptive statistics (frequencies and percentages for categorical variables and mean standard deviation for continuous variables) and inferential statistics (logistic regression). Qualitative data was analyzed through deductive coding and thematic analysis. Results The prevalence of COVID-19 vaccination was 46.1%, with 38.1% receiving complete vaccination. Mistrust in vaccine management (adjusted odds ratio (aOR)= 0.075, 95% confidence interval (CI): 0.025-0.229, p <0.001) was a significant barrier to COVID-19 vaccine uptake. Perceived covid-19 susceptibility (aOR = 2.901, 95% CI: 1.258-6.688, p = 0.012) and perceived covid-19 seriousness (aOR = 3.294, 95% CI: 1.130-9.604, p = 0.029) were significant enablers of COVID-19 vaccine uptake. Qualitative themes related to individual-level barriers (were fear of side effects, stigma, myths, and mistrust) and enablers (desire to protect others and risk perception). Conclusions Low COVID-19 vaccine prevalence, mistrust as barrier and risk perception as enablers for COVID-19 uptake among TB patients in Nairobi, Kenya.