Vaccines (Dec 2022)

Near-Complete SARS-CoV-2 Seroprevalence among Rural and Urban Kenyans despite Significant Vaccine Hesitancy and Refusal

  • Carolyne Nasimiyu,
  • Isaac Ngere,
  • Jeanette Dawa,
  • Patrick Amoth,
  • Ouma Oluga,
  • Carol Ngunu,
  • Harriet Mirieri,
  • John Gachohi,
  • Moshe Dayan,
  • Nzisa Liku,
  • Ruth Njoroge,
  • Raymond Odinoh,
  • Samuel Owaka,
  • Samoel A. Khamadi,
  • Samson L. Konongoi,
  • Sudi Galo,
  • Linet Elamenya,
  • Marianne Mureithi,
  • Omu Anzala,
  • Robert Breiman,
  • Eric Osoro,
  • M. Kariuki Njenga

DOI
https://doi.org/10.3390/vaccines11010068
Journal volume & issue
Vol. 11, no. 1
p. 68

Abstract

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Considering the early inequity in global COVID-19 vaccine distribution, we compared the level of population immunity to SARS-CoV-2 with vaccine uptake and refusal between rural and urban Kenya two years after the pandemic onset. A population-based seroprevalence study was conducted in the city of Nairobi (n = 781) and a rural western county (n = 810) between January and February 2022. The overall SARS-CoV-2 seroprevalence was 90.2% (95% CI, 88.6–91.2%), including 96.7% (95% CI, 95.2–97.9%) among urban and 83.6% (95% CI, 80.6–86.0%) among rural populations. A comparison of immunity profiles showed that >50% of the rural population were strongly immunoreactive compared to 75%), inadequate information (26%), and concern about vaccine effectiveness (9%). Less than 2% of vaccine refusers cited religious or cultural beliefs. These findings indicate that despite vaccine inequity, hesitancy, and refusal, herd immunity had been achieved in Kenya and likely other African countries by early 2022, with natural infections likely contributing to most of this immunity. However, vaccine campaigns should be sustained due to the need for repeat boosters associated with waning of SARS-CoV-2 immunity and emergence of immune-evading virus variants.

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