Prevalence and individual level enablers and barriers for COVID-19 vaccine uptake among adult tuberculosis patients attending selected clinics in Nairobi County, Kenya

Although vaccination is a cost-effective, equitable, and impactful public health intervention in curbing the spread of infectious disease, low uptake is a significant concern, especially among high-risk population groups. Nearly half of the population is unvaccinated in Nairobi, yet there is a shortage of vaccination information on vulnerable tuberculosis (TB) patients. The interplay of factors influences uptake, and protecting this vulnerable group and the general population from severe disease, hospitalization, and deaths is worthy. The purpose of this study is to determine the prevalence and individual-level enablers and barriers to COVID-19 vaccine uptake among adult TB patients attending selected clinics in Nairobi County, Kenya. This cross-sectional mixed-method study was conducted at TB clinics across six sub-counties in Nairobi County. It included 388 participants sampled from each clinic’s TB register. Quantitative data was collected using a questionnaire, and qualitative data was collected through key informant interviews and focus group discussions. Quantitative data was analyzed using descriptive statistics (frequencies and percentages for categorical variables and mean standard deviation for continuous variables) and inferential statistics (logistic regression). Qualitative data was analyzed through deductive coding and thematic analysis. The prevalence of COVID-19 vaccination was 46.1%, with 38.1% receiving complete vaccination. Mistrust in vaccine management (adjusted odds ratio (aOR)= 0.075, 95% confidence interval (CI): 0.025-0.229, p <0.001) was a significant barrier to COVID-19 vaccine uptake. Perceived covid-19 susceptibility (aOR = 2.901, 95% CI: 1.258-6.688, p = 0.012) and perceived covid-19 seriousness (aOR = 3.294, 95% CI: 1.130-9.604, p = 0.029) were significant enablers of COVID-19 vaccine uptake. Qualitative themes related to individual-level barriers and enablers of COVID-19 vaccine uptake were fear of side effects, stigma, myths, and mistrust in the messaging for barriers and desire to protect others and risk perception as enablers. The study revealed critical individual-level factors related to COVID-19 vaccine uptake.