An Exploration Of Drivers Of Covid-19 Vaccine Hesitancy In Kenya

• By: ORANGI, Stacey (Kemri-wellcome Trust Research Program, Kenya)
• Co-author(s): Mrs Stacey Orangi (Kemri-Wellcome Trust Research Program, Nairobi, Kenya)
  Mr Daniel Waweru Mbuthia (Kemri-Wellcome Trust Research Program, Nairobi, Kenya)
  Prof Edwine Barasa (Kemri-Wellcome Trust Research Program, Nairobi, Kenya / University of Oxford, Oxford, United Kingdom)
  
• Abstract:

  Background: COVID-19 vaccination rates have been low among adults in Kenya (37% as of mid-February 2023) with vaccine hesitancy posing a threat to the COVID-19 vaccination program. Ensuring equitable access to the COVID-19 vaccine is important, however, the novelty of vaccinating the adult population in Kenya has been riddled with challenges.
  
  Purpose: This study sought to examine public attitudes and behavioural influences towards COVID-19 vaccine hesitancy.
  
  Methods: We conducted a qualitative cross-sectional study in two purposively selected counties in Kenya. We collected data through 8 focus group discussions with 80 community members and in-depth interviews (n=8) with health care managers and providers. The data was analyzed using a framework approach focusing on determinants of vaccine hesitancy and their influence on psychological constructs.
  
  Results: Reported perceived barriers to COVID-19 vaccine uptake were influenced by individual characteristics (males, younger age, perceived health status, religion, and belief in herbal medicine), contextual influences (the lack of autonomy among women in decision making and cultural beliefs-more predominant in rural settings, lifting of bans, myths), medical mistrust (towards the government and pharmaceutical companies) and COVID-19 vaccine related factors (fear of unknown consequences, side-effects after first dose, and the lack of understanding of the rationale and number of boosters). These drivers of vaccine hesitancy mainly related to psychological constructs including confidence, complacency and constraints. Respondents also reported strategies that would promote COVID-19 vaccine uptake including their trusted information sources (community health workers and community leaders), preferred messaging content (e.g. transparency on long-term side effects and clarity on number of boosters), preferred delivery strategies (mixed approach, including door-to-door campaigns).
  
  Conclusions: Vaccine hesitancy in Kenya is driven by multiple and interconnected factors. These factors are likely to inform targeted strategies to address vaccine hesitancy among adults. These strategies could include transparent and consistent communication that target fear, misconceptions and information gaps as well as increased individual sensitization through community health workers and community leaders.