ABSTRACT
Background: Recognising the importance of attaining high vaccine coverage to mitigate the COVID-19 impact, a Vaccine Pass scheme was implemented during and after the first large Omicron wave in Hong Kong in early 2022 requiring three doses by June 2022. We evaluated the impact of the Vaccine Pass policy on vaccine uptake in adults. Methods: We analyzed patterns in vaccine uptake and hesitancy using local data from the population vaccine registry and 32 cross-sectional surveys conducted from October 2021 to December 2022. We examined the association of Vaccine Pass phases with vaccine uptake, taking into account covariables including self-risk perception, perceived self-efficacy in preventing COVID-19 and trust in government in pandemic control as well as physical distancing measures and demographics. Findings: The uptake of primary series and third doses was significantly associated with stages of Vaccine Pass implementation, and other statistically significant drivers included age group, chronic condition, higher perceived personal susceptibility to COVID-19, higher trust in government, and higher educational attainment. Older adults ([≥]65y) were less likely to be vaccinated against COVID-19, compared to adults aged 18-44 years. Interpretation: Vaccine uptake in older adults was observed to have increased by a greater extent after the policy announcement and implementation, which occurred during and after a large Omicron wave with high mortality in older ages in early 2022. Since the policy withdrawal the uptake of further booster doses has been very low in all ages. Improving voluntary booster uptake in older adults should be prioritized.
Subject(s)
COVID-19ABSTRACT
Background-misinformation and mistrust often undermines community vaccine uptake, yet information in rural communities, especially of developing countries, is scarce. This study aimed to identify major challenges associated with coronavirus disease 2019 (COVID-19) vaccine clinical trials among healthcare workers and staff in Uganda. Methods-a rapid exploratory survey was conducted over 5 weeks among 260 respondents (66% male) from healthcare centers across the country using an online questionnaire. Twenty-seven questions assessed knowledge, confidence, and trust scores on COVID-19 vaccine clinical trials from participants in 46 districts in Uganda. Results-we found low levels of knowledge (i.e., confusing COVID-19 with Ebola) with males being more informed than females (OR = 1.5, 95% CI: 0.7-3.0), and mistrust associated with policy decisions to promote herbal treatments in Uganda and the rushed international clinical trials, highlighting challenges for the upcoming Oxford-AstraZeneca vaccinations. Knowledge, confidence and trust scores were higher among the least educated (certificate vs. bachelor degree holders). We also found a high level of skepticism and possible community resistance to DNA recombinant vaccines, such as the Oxford-AstraZeneca vaccine. Preference for herbal treatments (38/260; 14.6%, 95% CI: 10.7-19.3) currently being promoted by the Ugandan government raises major policy concerns. High fear and mistrust for COVID-19 vaccine clinical trials was more common among wealthier participants and more affluent regions of the country. Conclusion-our study found that knowledge, confidence, and trust in COVID-19 vaccines was low among healthcare workers in Uganda, especially those with higher wealth and educational status. There is a need to increase transparency and inclusive participation to address these issues before new trials of COVID-19 vaccines are initiated.