Knowledge and perceptions of COVID-19 vaccine uptake among adults: A community-based cross-sectional survey in the Kilimanjaro region, Tanzania

Background: Vaccination remains the most effective measure to prevent and control infectious diseases, including pandemics like COVID-19. Ensuring widespread vaccine uptake is critical for achieving herd immunity and curbing disease transmission. Despite the availability of COVID-19 vaccines, resistance to uptake, particularly among adults, poses a public health challenge. This study assessed knowledge and perceptions of COVID-19 vaccine uptake among adults in the Kilimanjaro Region, Tanzania. A community-based cross-sectional survey was conducted in Hai and Siha districts of the Kilimanjaro Region, Tanzania. A total of 434 adults were randomly selected from community household listings. Data were collected using a structured interview guide translated into Swahili, the local language, and back-translated to ensure validity. Knowledge and perceptions were assessed, and data were analyzed using IBM SPSS version 21. Results: Among the 434 participants, the majority were female (58%), and nearly a quarter (24%) reported a history of COVID-19 infection. Mass media (42%) and interpersonal communication (40%) were the primary sources of vaccine-related information, followed by social media (18%). Overall, 78% of participants demonstrated poor knowledge regarding COVID-19 vaccines. Poor knowledge was more prevalent among older adults, individuals with lower education levels, and unemployed participants. Concerns about vaccine safety and efficacy were most common among participants who relied on social media as their primary information source. Conclusions: Knowledge about COVID-19 vaccines among adults in Kilimanjaro was generally low, and misconceptions were prevalent, particularly among social media users. There is an urgent need to enhance public education campaigns through trusted mass media and address misinformation on social media platforms to improve vaccine uptake and acceptance.