Factors associated with COVID-19 vaccine uptake among people with type 2 diabetes in Kenya and Tanzania: a mixed-methods study
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...
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BMJ Publishing Group
2023-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/12/e073668.full |
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| author | Irene Mashasi Gershim Asiki Shukri F Mohamed Cindy M Gray Frances S Mair Sally M Mtenga Peter Binyaruka Caroline H Karugu |
| author_facet | Irene Mashasi Gershim Asiki Shukri F Mohamed Cindy M Gray Frances S Mair Sally M Mtenga Peter Binyaruka Caroline H Karugu |
| author_sort | Irene Mashasi |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-e5f029dbcdd0493280964f6de34981cd |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-e5f029dbcdd0493280964f6de34981cd2025-08-20T01:47:32ZengBMJ Publishing GroupBMJ Open2044-60552023-12-01131210.1136/bmjopen-2023-073668Factors associated with COVID-19 vaccine uptake among people with type 2 diabetes in Kenya and Tanzania: a mixed-methods studyIrene Mashasi0Gershim Asiki1Shukri F Mohamed2Cindy M Gray3Frances S Mair4Sally M Mtenga5Peter Binyaruka6Caroline H Karugu7Department of Health System, Impact Evaluation and Policy, Ifakara Health Institute, Dar es Salaam, TanzaniaMedical Research Council/Uganda Virus Research Institute, Entebbe, UgandaChronic Disease Management Unit, African Population and Health Research Center, Nairobi, KenyaSchool of Social and Political Sciences, University of Glasgow, Glasgow, UKPrimary Care, University of Glasgow, Glasgow, UKDepartment of Health System, Impact Evaluation and Policy, Ifakara Health Institute, Dar es Salaam, TanzaniaDepartment of Health System, Impact Evaluation and Policy, Ifakara Health Institute, Dar es Salaam, TanzaniaChronic Disease Management Unit, African Population and Health Research Center, Nairobi, KenyaBackground 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.https://bmjopen.bmj.com/content/13/12/e073668.full |
| spellingShingle | Irene Mashasi Gershim Asiki Shukri F Mohamed Cindy M Gray Frances S Mair Sally M Mtenga Peter Binyaruka Caroline H Karugu Factors associated with COVID-19 vaccine uptake among people with type 2 diabetes in Kenya and Tanzania: a mixed-methods study BMJ Open |
| title | Factors associated with COVID-19 vaccine uptake among people with type 2 diabetes in Kenya and Tanzania: a mixed-methods study |
| title_full | Factors associated with COVID-19 vaccine uptake among people with type 2 diabetes in Kenya and Tanzania: a mixed-methods study |
| title_fullStr | Factors associated with COVID-19 vaccine uptake among people with type 2 diabetes in Kenya and Tanzania: a mixed-methods study |
| title_full_unstemmed | Factors associated with COVID-19 vaccine uptake among people with type 2 diabetes in Kenya and Tanzania: a mixed-methods study |
| title_short | Factors associated with COVID-19 vaccine uptake among people with type 2 diabetes in Kenya and Tanzania: a mixed-methods study |
| title_sort | factors associated with covid 19 vaccine uptake among people with type 2 diabetes in kenya and tanzania a mixed methods study |
| url | https://bmjopen.bmj.com/content/13/12/e073668.full |
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