Uganda plans to vaccinate an eligible population of 22 million people representing 49.8% of the population as a means of optimal control of the pandemic and full opening up of the economy. As at 16th September, 2021, a total of 2,799,920 doses of the Covid 19 vaccines comprising of AstraZeneca, Sinovac and Moderna had been received in the country. The vaccination status of the 4.8 million priority population who are fully vaccinated stood as follows as at 22nd/9/2021. Teachers – 17.6%; 50 years>4.1%, comorbidities -2.1%, Health workers- 37.8% and Security- 19.4%. The numbers of people fully vaccinated in each category of the priority group is still below 50% in the seventh month after the government kicked started the vaccination process of the priority groups.
Although there has been a limited supply of the vaccines in the country, one can say that there has been enough for the priority group but the level of vaccine hesitancy is still high. Vaccine hesitancy, which is defined by WHO as a “delay in acceptance or refusal of vaccines despite availability of vaccination services”, has been evidenced in Uganda among the priority groups to such extend that the vaccination on several occasions had to be opened to any person aged 18 years and above to avoid wastage through expiry. More to that, during the presidential address as of 22nd/9/21, the President called for Covid-19 vaccination efforts to be ramped up and warned that in any district where vaccines expire, the Resident District Commissioner, Chief Administrative Officer and District Health Officer will be dismissed.
TIU through its project titled “Enhancing Equitable access to Covid 19 vaccines” being implemented in 10 districts documented the following causes for Covid 19 vaccine hesitancy in Uganda; Limited responses from the health workers on alleged side effects and misconceptions on the vaccines reported especially through the social media; Cropping herbal “medicine” alternatives -Since these are being promoted by some health workers, some persons see no need for the vaccines when the herbal medicine is an alternative. Long distances to and long queues at the vaccination centers discourage some beneficiaries from obtaining the vaccines, and Having to sign a consent form for this particular vaccine which has not been the case with other vaccines creates a lot of doubt on safety of the vaccine.
Uganda is currently in the process of fully opening up the economy and as such a number of sector specific guidelines have been put in place. For example; a target of 65% of teachers have to be vaccinated as announced by the Ministry of Education so as to reopen schools, Fully vaccinated and asymptomatic individuals with negative PCR tests taken 72 hours before travel didn’t need mandatory testing at entry points. These guidelines somewhat create pressure for people to comply in order to return to work. As such, this may crop risks of corruption especially for categories of people whose level of vaccine hesitancy is still high. For example; at the vaccination center, people may bribe to obtain the vaccination cards and also have their details uploaded onto the Ministry of Health Covid 19-vaccination certification portal without necessarily being vaccinated. There is also a risk of people bribing the health facilities to obtain negative PCR test results without taking the test. Such scenarios undermine the efforts of the Ministry of Health in trying to curb the spread of Covid 19.
TIU therefore recommends that the Ministry of health and partners should;
Enhance sensitization on the safety of the Covid 19 vaccines. In addition to the mass media campaigns by the Ministry of Health and others partners on the safety of Covid 19 vaccines, leaders to include; government, religious, traditional, local community or other influential leaders (male and female) should have dialogues with their communities aimed at increasing awareness on the safety of the vaccines. This will somewhat reduce doubts among people with high levels of vaccine hesitancy and in-turn prompt them to obtain their jabs rather than paying a bribe in an attempt to comply with the set guidelines.
Increase the number of vaccination sites in each sub county. This will improve convenience and access to vaccination which will also reduce beneficiary fatigue in search of the vaccine. This in turn will reduce the temptation of offering a bribe to “shortcut” the vaccination process.
Impose stringent measures for the health workers aiding the irregularities in the vaccination process and conduct refresher training on ethical standards for some health workers.