Determinants of Covid-19 Vaccine Uptake among Adult Tuberculosis Patients Attending Selected Clinics in Nairobi County, Kenya

Abstract

Vaccination is a cost-effective public health strategy for controlling infectious diseases, yet low uptake of the coronavirus disease 2019 (COVID-19) vaccine remains a concern, particularly among high-risk groups such as tuberculosis (TB) patients. Coronavirus disease 2019 poses a significant threat to vulnerable populations, with bidirectional interactions between COVID-19 and TB exacerbating disease progression and outcomes due to compromised immunity and sustained community transmission. In Nairobi County, Kenya, nearly 47% of the population remains unvaccinated, with limited data on vaccine uptake among TB patients. This study aimed to investigate the facilitators and barriers to COVID-19 vaccine uptake among adult TB patients attending selected clinics in Nairobi County. To assess the determinants of COVID-19 vaccine uptake among adult TB patients in selected health facilities in Nairobi County, Kenya. A mixed-methods cross-sectional analytical study was conducted in six purposively selected health facilities offering TB services in Nairobi County. A total of 388 adult TB patients were recruited using simple random sampling. Data were collected via a KoBo Collect questionnaire and analyzed using SPSS version 25. Associations were assessed using logistic regression, with p < 0.05 as the threshold for statistical significance. All 388 participants responded (response rate: 100%). As of October 2023, the COVID-19 vaccination rate was 46.1%, with 38.1% fully vaccinated. Factors significantly associated with higher vaccine uptake included age >35 years (adjusted odds ratio (aOR) = 1.89, 95% CI: 1.185–3.427, p = 0.030), employment (aOR = 2.8, 95% CI: 1.191–6.705, p = 0.018), perceived susceptibility to COVID-19 (aOR = 2.901, 95% CI: 1.258–6.688, p = 0.012), perceived disease severity (aOR = 3.294, 95% CI: 1.130–9.604, p = 0.029), consistent and accurate messaging (aOR = 3.380, 95% CI: 1.217–9.384, p = 0.019), emphasis on social benefits (aOR = 3.786, 95% CI: 1.204–11.908, p = 0.023), and sufficient public awareness (aOR = 2.86, 95% CI: 1.689–8.254, p = 0.028). Barriers included mandatory registration requirements (aOR = 0.687, 95% CI: 0.270–0.743, p = 0.029) and mistrust in government pandemic management (aOR = 0.076, 95% CI: 0.025–0.229, p < 0.001). COVID-19 vaccine uptake among adult TB patients in Nairobi County was low at 46.1%. Older age, employment, heightened risk perception, effective communication, and adequate awareness facilitated uptake, while registration requirements and mistrust in government acted as significant barriers. Targeted interventions addressing these barriers and leveraging enablers are essential to increase vaccination rates in this high-risk group, thereby reducing severe COVID-19-related morbidity and mortality.