Factors associated with COVID-19 vaccine uptake among people with type 2 diabetes in Kenya and Tanzania: a mixed-methods study.

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  • Additional Information
    • Source:
      Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE
    • Publication Information:
      Original Publication: [London] : BMJ Publishing Group Ltd, 2011-
    • Subject Terms:
      Diabetes Mellitus, Type 2* ; COVID-19*/epidemiology ; COVID-19*/prevention & control; Adult ; Humans ; Aged ; COVID-19 Vaccines ; Kenya/epidemiology ; Tanzania/epidemiology ; Vaccination
    • Abstract:
      Background: People with type 2 diabetes (T2D) are at increased risk of poor outcomes from COVID-19. Vaccination can improve outcomes, but vaccine hesitancy remains a major challenge. We examined factors influencing COVID-19 vaccine uptake among people with T2D in two sub-Saharan Africa countries that adopted different national approaches to combat COVID-19, Kenya and Tanzania.
      Methods: A mixed-methods study was conducted in February-March 2022, involving a survey of 1000 adults with T2D (500 Kenya; 500 Tanzania) and 51 in-depth interviews (21 Kenya; 30 Tanzania). Determinants of COVID-19 vaccine uptake were identified using a multivariate logistic regression model, while thematic content analysis explored barriers and facilitators.
      Results: COVID-19 vaccine uptake was lower in Tanzania (26%) than in Kenya (75%), which may reflect an initial political hesitancy about vaccines in Tanzania. People with college/university education were four times more likely to be vaccinated than those with no education (Kenya AOR=4.25 (95% CI 1.00 to 18.03), Tanzania AOR=4.07 (1.03 to 16.12)); and people with health insurance were almost twice as likely to be vaccinated than those without health insurance (Kenya AOR=1.70 (1.07 to 2.70), Tanzania AOR=1.81 (1.04 to 3.13)). Vaccine uptake was higher in older people in Kenya, and among those with more comorbidities and higher socioeconomic status in Tanzania. Interviewees reported that wanting protection from severe illness promoted vaccine uptake, while conflicting information, misinformation and fear of side-effects limited uptake.
      Conclusion: COVID-19 vaccine uptake among people with T2D was suboptimal, particularly in Tanzania, where initial political hesitancy had a negative impact. Policy-makers must develop strategies to reduce fear and misconceptions, especially among those who are less educated, uninsured and younger.
      Competing Interests: Competing interests: None declared.
      (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.)
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    • Grant Information:
      United Kingdom MRC_ Medical Research Council
    • Contributed Indexing:
      Keywords: COVID-19; health policy; health services accessibility; public health
    • Accession Number:
      0 (COVID-19 Vaccines)
    • Publication Date:
      Date Created: 20231227 Date Completed: 20231228 Latest Revision: 20240124
    • Publication Date:
      20240124
    • Accession Number:
      PMC10711896
    • Accession Number:
      10.1136/bmjopen-2023-073668
    • Accession Number:
      38149426