Determinants of COVID-19 Vaccine Uptake and Hesitancy among Healthcare Workers in Tanzania: A Mixed-Methods Study
Maryam A. Amour,
Innocent B. Mboya,
Harrieth P. Ndumwa,
James T. Kengia,
Emmy Metta,
Belinda J. Njiro,
Kasusu Klint Nyamuryekung’e,
Lwidiko E. Mhamilawa,
Elizabeth H. Shayo,
Frida Ngalesoni,
Ntuli Kapologwe,
Bruno Sunguya,
Sia E. Msuya,
Albino Kalolo
Affiliations
Maryam A. Amour
Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania
Innocent B. Mboya
Department of Translational Medicine, Lund University, 202 13 Malmö, Sweden
Harrieth P. Ndumwa
Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania
James T. Kengia
President’s Office Regional Administration and Local Government, Dodoma P.O. Box 1923, Tanzania
Emmy Metta
Department of Behavioural Sciences, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania
Belinda J. Njiro
Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania
Kasusu Klint Nyamuryekung’e
Department of Community Dentistry, School of Dentistry, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65014, Tanzania
Lwidiko E. Mhamilawa
Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania
Elizabeth H. Shayo
National Institute for Medical Research, Dar es Salaam P.O. Box 9653, Tanzania
Frida Ngalesoni
Amref Health Africa in Tanzania, Dar es Salaam P.O. Box 2773, Tanzania
Ntuli Kapologwe
President’s Office Regional Administration and Local Government, Dodoma P.O. Box 1923, Tanzania
Bruno Sunguya
Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania
Sia E. Msuya
Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi P.O. Box 2240, Tanzania
Albino Kalolo
Department of Public Health, St. Francis University College of Health, and Allied Sciences, Morogoro P.O. Box 175, Tanzania
The novel Coronavirus disease 2019 (COVID-19) presents a major threat to public health but can be prevented by safe and effective COVID-19 vaccines. Vaccine acceptance among healthcare workers (HCWs) is essential to promote uptake. This study, aimed to determine the COVID-19 vaccination uptake and hesitancy and its associated factors among HCWs in Tanzania. We employed a convergent-parallel mixed-methods design among 1368 HCWs across health facilities in seven geographical zones in Tanzania in 2021. We collected quantitative data by using an interviewer-administered questionnaire and qualitative data, using in-depth interviews and focus group discussions. Participants in the quantitative aspect were conveniently selected whereas those in the qualitative aspect were purposively selected based on their role in patient care, management, and vaccine provision. Stata software version 16.1 was used in the analysis of quantitative data and thematic analysis for the qualitative data. Multiple logistic regression was used to assess the determinants of COVID-19 vaccine uptake. The median age of 1368 HCWs was 33, and the interquartile range was 28–43 years; 65.6% were aged 30+ years, and 60.1% were females. Over half (53.4%) of all HCWs received the COVID-19 vaccine, 33.6% completely refused, and 13% chose to wait. HCWs aged 40+ years, from lower-level facilities (district hospitals and health centers), who worked 6+ years, and with perceived high/very high risk of COVID-19 infection had significantly higher odds of vaccine uptake. The qualitative data revealed misinformation and inadequate knowledge about COVID-19 vaccine safety and efficacy as the key barriers to uptake. Nearly half of all HCWs in Tanzania are still unvaccinated against COVID-19. The predominance of contextual influence on COVID-19 vaccine uptake calls for interventions to focus on addressing contextual determinants, focusing on younger HCWs’ population, short working duration, those working at different facility levels, and providing adequate vaccine knowledge.
