Assessing the Level and Determinants of COVID-19 Vaccine Confidence in Kenya

  1. Stacey Orangi
  2. Jessie Pinchoff
  3. Daniel Mwanga
  4. Timothy Abuya
  5. Mainga Hamaluba
  6. George Warimwe
  7. Karen Austrian
  8. Edwine Barasa

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Abstract

The government of Kenya has launched a phased rollout of COVID-19 vaccination. A major barrier is vaccine hesitancy; the refusal or delay of accepting vaccination. This study evaluated the level and determinants of vaccine hesitancy in Kenya. We conducted a cross-sectional study administered through a phone-based survey in February 2021 in four counties of Kenya. Multilevel logistic regression was used to identify individual perceived risks and influences, context-specific factors and vaccine-specific issues associated with COVID-19 vaccine hesitancy. COVID-19 vaccine hesitancy in Kenya was high: 36.5%. Factors associated with vaccine hesitancy included: Rural regions, perceived difficulty in adhering to government regulations on COVID-19 prevention, no perceived COVID-19 infection risk, concerns regarding vaccine safety and effectiveness, and religious and cultural reasons. There is a need for the prioritization of interventions to address vaccine hesitancy and improve vaccine confidence as part of the vaccine roll-out plan. These messaging and/or interventions should be holistic to include the value of other public health measures, be focused and targeted to specific groups, raise awareness on the risks of COVID-19 and effectively communicate the benefits and risks of vaccines.

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  1. Version published to 10.3390/vaccines9080936
  2. ScreenIT

    SciScore for 10.1101/2021.06.11.21258775: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: Ethical Approval: Ethical approval for this study was obtained from both Population Council Institutional Review Board (p936) and AMREF Ethics and Scientific Review Committee (P803/2020).
    IACUC: Ethical Approval: Ethical approval for this study was obtained from both Population Council Institutional Review Board (p936) and AMREF Ethics and Scientific Review Committee (P803/2020).
    Consent: Before data collection, verbal informed consent was obtained from all participants 18 years and over.
    Sex as a biological variableSample size and sampling procedure: Households with available phone numbers were randomly sampled from the four existing cohorts using a ratio of 1:3 for male to female interviews.
    RandomizationSample size and sampling procedure: Households with available phone numbers were randomly sampled from the four existing cohorts using a ratio of 1:3 for male to female interviews.
    Blindingnot detected.
    Power Analysisnot detected.
    Cell Line AuthenticationAuthentication: The data collection tool was designed using validated measures where possible such as the WHO SAGE vaccine hesitancy tool, existing COVID-19 vaccine hesitancy tools [21,22], and was also informed by local Kenyan researchers.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Further, this study has several limitations. First, the sample was drawn from existing Population Council cohorts whose households all have adolescents. Therefore, the sample is not representative of the four counties included in this study and the results are not generalizable to the full population. Second, the study was cross-sectional and reflects the level and determinants of vaccine hesitancy, as of February 2021. This was before the actual COVID-19 vaccine rollout in Kenya that started in March 2021. Conducting a longitudinal study would have provided more information on the change in vaccine hesitancy and its drivers, which could also inform the tailoring of messages over time. Third, there is also a need for qualitative studies to further explore the drivers and deterrents of COVID-19 vaccine uptake and the factors that may improve or compound COVID-19 vaccine acceptance. Despite these reported weaknesses, the study provides important insights on the COVID-19 vaccine hesitancy in certain locations of Kenya and provides implications to policymakers on possible avenues of improving vaccine hesitancy in Kenya.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  3. Version published to 10.1101/2021.06.11.21258775v1 on medRxiv