The sample included 665 youths (60.30% male) and (30.70% females) among which 45.35% were from urban counties, 26.36% and 28.29% are from peri-urban and rural counties respectively. Majority (55.34%) of the youth interviewed were aged 18 to 23 years, 41.03% are from urban counties, 31.25% are from rural counties and minority 27.72% are from peri urban counties. Among the youth surveyed, majority 48.88% of them were protestants and lived in urban counties. The education level of the majority of the youths interviewed were college/university where 64.21% of them came from urban counties. See Table 1
4.2 Behavior Intentions
Overally, 52% of the youths surveyed reported that they will wait and see how people who were vaccinated would react to COVID-19 vaccine before they can get it, 42 % reported that they will be among the first people to take it (Fig. 1). In contrast, 6% of the youths stated they will not take the vaccine.
Disaggregating by gender, the study revealed that majority 60.85% of the females will wait and see how other people react to the vaccine before they can get it while majority 47.38% of male participants will be among the first people to get the vaccine. Statistically there was a significant difference between gender and uptake of COVID 19 vaccine (Chi square P Value 0.004 < 0.05 at 95% C.I). Further test shows a moderate association between gender and uptake of COVID 19 vaccine (Cramer’s V = 0.1080). The study also revealed a significant relationship between religion and vaccine uptake (Chi square P Value 0.001 < 0.05 at 95% C.I). See Table 2.
The results revealed that there was a widening gap in access to the COVID vaccine among females and males, sometimes men tending to access the vaccine more than the women. The reasons behind gender inequality were stated as follows;
Toxic masculinity
The youths in the focused group discussions reported that the society esteem men more compared to women, and this makes women feel that men should always be at the forefront in everything. Some women are not able to make independent choices and decisions and therefore they have to consult their partners, that is they can’t do anything without being allowed by their partners.
Society generally holds men in higher regard than women, the society has made women feel men should be at the forefront. some women can’t make independent choices and therefore have to consult partner. (FGD)
patriarchal society so women can't do something without being allowed by husbands or fathers despite being of legal decision making age
Health reasons
The COVID-19 vaccine is contraindicated for pregnant women and breastfeeding mothers, and therefore they cannot be vaccinated. The women are more cautious when it comes to their health and they think they are not exposed to the virus, hence they don’t need to be vaccinated.
if a woman is breast feeding or pregnant, vaccine is contraindicated; shouldn't take ~ FGD
I would say are from women in terms of maybe more women have more reservations in taking the vaccine perhaps most of my colleagues would is say does it have an effect on fertility on my immune system, I think women take more caution when it comes to their health and in their lives so the easier way is that so long as they do not feel like they are exposed to the virus they are more likely to stay home than get the virus.~FGD
Men have weak immunity and suffer from the disease more compared to women:
Men were perceived to have weak immunity compared to women, thus if they contract the disease, if not vaccinated they would die easily. When the women receive this kind of information from the media, they tend to be reluctant to take up the vaccine as they think they are safer compared to men. Also, men are more affected by the disease more compared to the women.
“many people have said that more men when they get this COVID they can easily die from it as compared to women, I think it's because of immune system, and that's why most women they just like ignore, I don't think it's ignoring because most women they don't choose to just go for the vaccine because of what is said by the media that women are not highly affected to the point of death as compared to men.”~FGD
“The male gender the suffering the virus a big deal more than the female and it's also surprising that the females are also getting the vaccine So much than the male gender and that's not working out because it's not logical, whereby the men are the gender that is suffering, mostly from the virus but they are getting the least supplies.”~FGD
Access to COVID-19 vaccine information
The men were reported to have high access to COVID-19 vaccine information compared to women because most men go outside their houses to clubs where they meet with their peers where they share more information on the COVID-19 vaccine. Women most of the times remain at home doing house chores and have less access to information about the COVID-19 vaccine, thus will not go for the vaccine as they lack the right information.
Women tend to be busier than men - work and attend to matters at home so getting time to go for vaccine is harder.
More women work at home and so access to information is less giving men a higher chance to also get vaccinated as the access info easily and can pass by the hospital and get vaccinated. women go home to do household chores in the evening while men go to bars, hotels, etc to chill hence have access to information.~FGD
Occupation
The type of occupation exposes people to risks of contracting COVID-19 disease, and people at risk are encouraged to take up the vaccine. Men most of the time are the bread winners for their families and will always go out to work so that they can provide for their families. Thus will access information about the vaccine and get the vaccine compared to women who don’t go out to search for the bread. Due to the exposure to the risks of contracting the disease, men will be more likely to be vaccinated compared to women.
I know of households where the men are the main breadwinners, so they go to work every single day. So that's why more of them are getting the vaccine cause they're out there, they're traveling a lot, they have to do that every single day, so they go get the vaccine first before some women do not all but some.~FGD
In Kenya you find that we have more men who go out to hustle or work and we have a section of women who are left behind, the people who go out have a higher risk of being infected and the wives will push for the men to be vaccinated because they feel like it is through the person who is going out that they will get the virus.~FGD
Nature of men Vs women
Women feel that their bodies are more complicated to men’s and need to be protected from any complications associated with the vaccine, and since men’s body is not complicated, they can risk to get the vaccine.
The body set up the female body is more complicated than the men and they say let them protect themselves first and not go for the vaccine. And the men are not complicated and they would take the risk.~FGD
Perceived behavior control
Men were perceived to be more careless than women in adherence to COVID-19 guidelines, and hence will be more exposed to risks of contracting the disease compared to women. Therefore, for proper protection they require to be vaccinated. Women are more skeptical and will need more information to help them make the right decisions compared to men who are risk takers. Men will make decision to take up the vaccine without consulting their wives but women have to consult.
“Men tend to be more careless when it comes to the covid guidelines. Men are risk takers but women are more skeptical so need more information to make decisions and men make decisions without having to consult with their wives, but women keep consulting.”~FGD
you find that it’s the male who are actually exposed as compared to women, and I would look at it in the, I think it’s the not to judge on it or rather a different perspective, but I would look at it, it's the simple behaviors that women are exposed to, and men are exposed to, like you would look at it in the sense that a woman would wash their hands as many times as compared to how meals wash their hands, so that that would bring it down to like the chances of being exposed.~FGD
Accessibility of the COVID-19 vaccine / Lack of transport
Women’s duty of house chores and taking care of the children make them unable to access the COVID-19 vaccine. Lack of transport/ enough money to take their children to daycare and to facilitate their transport to vaccination centers hinder them from accessing the COVID-19 vaccine.
“The vaccine is not really that easily accessible, so for a woman who's taking care of her kids at home.”~FGD
“I think that Maybe there are challenges that the women are facing that is preventing them from being vaccinated, maybe I can say transport, may be taking care of children, so to make this equal, I think they should be provided with the transport or like maybe building daycares for taking their children to be looked after there as they go for the vaccine. so that can make it for them to be equal, yeah, that is my view.”~FGD
Fear of becoming infertile
Women hesitate to take the vaccine because they fear their hormones will be suppressed and may make them get few children. Men are less concerns about the effects of the vaccine and will prefer to take it despite the effects.
“I think most females have that fear, like a woman would have that fear and it will be like the their hormones will be suppressed when they get access to the vaccine as compared to a male who will be like I would rather just take it, the male won’t look at it in a deeper perspective considering the myths that are there that women there is a chance that you will get less children, there is a chance that this might happen it will affect your hormones and everything, so I think that would bring it down to why most males are getting the vaccine as compared to females, yeah that's my opinion, thank you.”~FGD
Myths and misinformation
Myths which target women, that the vaccine could be more harmful after taking it compared to when not taken, hence the hesitancy among women. They also belief that COVID-19 disease is not real and God can protect them from any disease.
“Existing myths target ladies more hence their hesitance towards uptake of vaccine. They belief that it could be more harmful when taken than without taking it.”~FGD
“Belief that corona isn't real; and that God would protect them from any disease.”~FGD
Rumours that the vaccine will interfere with the menstrual cycle of the women. That the vaccine is likely to cause missed periods or even affect their health. This results to low uptake of the vaccine among the women.
“According to the here say of women who have taken the vaccine before, there is something going around that they missed their periods, something like that, so when the rest of the gender gets to here that they tend to hold back on taking the vaccine.”~FGD
“Generally, people have started being skeptical about the vaccines due to their effects on the woman's body as evidenced by the HPV vaccine which also experienced very low turnout. So, all the misconceptions and myths plus side effects could cause low uptake”~FGD
Table 1
Variable
|
General Sample
n(%)
|
Urbanization
|
|
Urban Counties
n(%)
|
Peri-Urban Counties n(%)
|
Rural Counties
n(%)
|
|
Gender
Female
Male
Prefer not to say
|
258(38.80)
401(60.30)
6(0.90)
|
117(45.35)
179(44.64)
3(50.0)
|
68(26.36)
110(27.43)
2(33.33)
|
73(28.29)
112(27.93)
1(16.67)
|
|
Age
18 to 23 years
24 to 29 years
30–35 years
|
368(55.34)
249(37.44)
48(7.22)
|
151(41.03)
125(50.5)
23(7.69)
|
102(27.72)
61(24.50)
17(35.42)
|
115(31.25)
63(25.30)
8(16.67)
|
|
Religion
Catholic
Islam
No Religion
Protestant
|
289(43.46)
15(2.26)
3(0.45)
358(53.83)
|
112(38.75)
10(66.67)
2(66.67)
175(48.88)
|
83(28.72)
3(20.00)
1(33.33)
93(25.98)
|
94(32.54)
2(13.33)
0(0.00)
90(25.14)
|
|
Education Level
College/university
Primary
Secondary
|
417(62.71)
19(2.86)
229(34.44)
|
192(45.93)
8(42.11)
99(43.42)
|
104(24.88)
8(42.11)
68(29.83)
|
122(29.19)
3(15.79)
62(26.75)
|
|
Table 2
Socio demographic factors by intention to get CoVID-19 vaccine
Variable
|
I want to be among the first people to get it n(%)
|
I will not get the vaccine n (%)
|
I will wait to see how other people react to it before I can get it n (%)
|
P-Value(Cramer's V)
|
Age
18 to 23 years
24 to 29 years
30–35 years
|
150(40.76)
110(44.18)
18(37.50)
|
15(4.08)
22(8.84)
2(4.17)
|
203(55.16)
117(46.99)
28(58.33)
|
0.064
|
Gender
Female
Male
Prefer not to say
|
87(33.72)
190(47.38)
1(16.67)
|
14(5.43)
24(5.99)
1(16.67)
|
157(60.85)
187(46.63)
4(66.67)
|
0.004***(0.1080)
|
Religion
Catholic
Islam
No Religion
Protestant
|
148(51.21)
4(26.67)
2(66.67)
126(34.64)
|
10(3.48)
1(6.67)
0(.00)
28(7.82)
|
131(45.33)
10(66.67)
1(33.33)
206(57.54)
|
0.001***(0.1301)
|
Education Level
College/university
Primary
Secondary
|
149(35.65)
8(42.11)
121(53.07)
|
29(6.94)
1(5.26)
9(3.95)
|
239(57.42)
10(52.63)
99(42.98)
|
0.001****(0.1172)
|
County Category
Peri Urban Counties
Rural Counties
Urban Counties
|
84(46.67)
85(45.70)
109(36.45)
|
8(4.44)
10(5.38)
21(7.02)
|
88(48.89)
91(48.92)
169(56.52)
|
0.139
|
Stratified by education level, the study revealed a significant relationship between educational level and COVID 19 vaccine uptake (Chi square P Value 0.001 < 0.05 at 95% C.I). Further analysis showed a moderate association between education level and COVID 19 vaccine uptake (Cramer’s v = 0.1172).
The multinomial logistic regression model for predicting the uptake of COVID-19 vaccine is shown in Table 3. The results suggest that male predictor are 0.5538 less likely to wait to see how other people react to the vaccine before they can get it and are more likely to be among the first people to get the vaccine compared to females (b=-.5538, s.e.=.1730, p = .0.001) (see Fig. 2).
The youths with primary level of education are 0.6405 more likely to get the vaccine and more likely to be among the first people to get the vaccine compared to respondents with tertiary/University level of education (b=-0.473, s.e.=1.1047, p = .024). In addition, the respondents with secondary level of education are less likely to wait and see how people react to the vaccine before they can get it but are more likely to be among the first people to get the vaccine compared to compared to respondents with tertiary/University level of education (b=-0.6405, s.e.=0.31754, p = .0.00) see Fig. 3. In summary, respondents with lower level of education are willing to get vaccinated compared to counterparts with higher level of education.
On the other hand, protestants are 1.1485 less likely to get vaccinated and more likely to wait to see how other people react to it before they can get it (b = 1.1485, s.e.=.3905, p = .0.003). In addition, they are also 0.5853 less likely to be among the first people to get the vaccine compared to Catholic (b = 0.5853, s.e = 0.1689, p = 0.001) see Fig. 4.
The surveyed youths were asked if their friends and relatives are ready to receive the COVID 19 vaccine and the majority 59.9% thinks that their relatives are friends are ready to receive the COVID 19 vaccine as shown in Fig. 5.
Table 3
Associated factors of uptake of COVID-19 using a multivariable multinomial regression
Variable
|
I will not get the vaccine n (%)
|
I will wait to see how other people react to it before I can get it n (%)
|
Coefficient
|
Standard error
|
P-value
|
Coefficient
|
Standard error
|
P-value
|
Gender
(reference Predictor-Female
Male
Prefer not to say
|
-0.1600
1.5445
|
0.3655
1.4650
|
0.662
0.292
|
-0.5538
0.5979
|
0.1730
1.1355
|
0.001***
0.599
|
Religion
(reference predictor- Catholic)
Islam
No Religion
Protestant
|
1.3392
-10.6582
1.1485
|
1.1772
489.341
30.3905
|
0.253
0.983
0.003***
|
1.0352
-0.6089
0.5853
|
0.6138
1.2348
0.1689
|
0.092
0.622
0.001***
|
Education Level
(Reference Predictor-College/university)
Secondary
Primary
|
-0.9131
-0.473
|
0.4046
1.1047
|
0.670
0.024***
|
-0.6405
-0.1769
|
0.1754
0.4990
|
0.000***
0.723
|
65% of the youths correlated the rejection of COVID 19 vaccine to inadequate information, effectiveness of the drug and safety was 42% and 45% respectively. Only 7% of the youths reported that their reason for rejecting the COVID 19 vaccine was due to conflict with culture or religion see Fig. 6.
From Fig. 6 above, Majority reported that the main reason for rejecting the COVID 19 vaccine was due to inadequate information. The study further revealed that majority of the youths 29.61% reported to strongly agree with the reason for rejecting COVID_19 vaccines. See Fig. 7
The most common source of information about COVID-19 vaccines was reliance on social media 40.30%. This was followed by TV programs and radio, 31.43% and 23.91% respectively, word of mouth was 2.56%, while IEC material from MOH was the main source of information for 1.35% of the youth see Fig. 8
Chi square test was used to determine the relationship between socio-demographic factors and the main source of COVID 19 information, gender, educational level and county of residence was found to be associated with the main source of information with (P-value < 0.05 at 95% CI). Social media platforms were the main source of information about COVID-19 among the female youths, respondents residing in urban counties and respondents with college/university educational levels. The male respondents preferred radio as the source of COVID 19 information compared to female. On the hand, the female respondents preferred TV compared to male respondents. Age and religion were not associated with the main source of COVID 19 information. See Table 4.
Table 4
Socio demographic factors by sources of COVID 19 Information
Variable
|
Community Meeting
n(%)
|
IEC Materials from MOH
n (%)
|
Radio
n (%)
|
Social Media
n(%)
|
TV
n(%)
|
Word of Mouth n(%)
|
P-Value(Cramer's V)
|
Age
18 to 23 years
24 to 29 years
30–35 years
|
2(0.54)
1(0.40)
0(0.00)
|
4(1.09)
4(1.61)
1(2.08)
|
90(24.46)
59(23.69)
10(20.83)
|
147(39.95)
100(40.16)
21(43.75)
|
119(32.34)
75(30.12)
15(31.25)
|
6(1.63)
10(4.02)
1(2.08)
|
0.905
|
Gender
Female
Male
Prefer not to say
|
0(0.00)
3(0.75)
0(0.00)
|
6(2.33)
3(0.75)
0(0.00)
|
41(15.89)
116(29.93)
2(33.33)
|
105(40.70)
160(39.90)
3(50.00)
|
96(37.21)
112(27.93)
1(16.67)
|
10(3.88)
7(1.75)
0(0.00)
|
0.007***(0.1348)
|
Religion
Catholic
Islam
No Religion
Protestant
|
2(0.69)
0(0.0)
0(0.0)
1(0.28)
|
4(1.38)
0(0.00)
0(0.00)
5(1.40)
|
74(25.61)
2(13.33)
1(33.33)
82(22.91)
|
108(37.37)
8(53.33)
2(66.67)
150(41.90)
|
95(32.87)
4(26.67)
0(0.00)
110(30.73)
|
6(2.08)
1(6.67)
0(0.00)
10(2.79)
|
0.959
|
Education Level
College/university
Secondary
Primary
|
3(0.72)
0(0.00)
0(0.00)
|
7(1.67)
0(0.00)
2(0.88)
|
80(19.14)
10(52.63)
69(30.26)
|
188(44.98)
4(21.05)
76(33.33)
|
127(30.38)
5(26.32)
77(33.77)
|
13(3.11)
0(0.00)
4(1.75)
|
0.004***(0.1402)
|
County Category
Peri Urban Counties
Rural Counties
Urban Counties
|
0(0.0)
1(0.54)
2(0.67)
|
2(1.11)
2(1.08)
5(1.67)
|
56(31.11)
55(29.57)
48(16.05)
|
59(32.78)
69(37.10)
140(46.82)
|
61(33.89)
53(28.49)
95(31.77)
|
2(1.11)
6(3.23)
9(3.01)
|
0.006***(0.1364)
|
Multinomial logistic regression was carried out to determine significant predictors in gender, religion, level of education and county of residence; the ‘Male’ predictor was positive and significant (b = .5737, s.e.=.2267 p = .011). This predictor revealed that the male youths were more likely to access information on COVID-19 vaccine on radio and less likely on social media as compared to female.
Both primary and secondary predictors were positive and significant (b = 1.7472, s.e.=.6260 p = .005), (b = 0.7232, s.e.=.2183 p = .0.001) respectively. The positive slope suggests that the youth participants with primary and secondary level of education are more likely to access information on COVID 19 on Radio and less likely on social media as compared to participants with tertiary/ University level of education. Comparing the accessibility of COVID 19 information on TV and social media, participants with secondary level of education were more likely to access information on COVID 19 on TV and less likely on social media.
The ‘urban category’ predictor was negative and significant (b=-0.9023, s.e.=.2517 p = .00), The negative slope indicates that participants from urban counties were less likely to access information on COVID 19 on Radio and more likely to access the same information on social media as compared with participants from rural counties. See table 5.
Disaggregating by education level, the youths with primary level of education relied on radio as the source of COVID 19 information. The rural youth with primary level of education depicted the highest dependence on radio as the source of information. On the other hand, the youths with college/university level of education relied majorly on social media, the youths residing in urban counties and with college/university level of education depicted the highest dependence on social media as the source of information on COVID 19. See Fig. 9.
Table 5: Multinomial logistic regression on socio demographic factors and vaccine uptake
Sources of Information
|
Radio
|
TV
|
Coefficient
|
Standard error
|
P-value
|
Coefficient
|
Standard error
|
P-value
|
Gender
Female
Male
Prefer not to say
|
0.5737
.439246
|
.2268706
.9793025
|
0.011
0.654
|
− .2882506
-1.037774
|
.1890588
1.174332
|
0.127
0.377
|
Education Level
University/Tertiary
Primary
Secondary
|
1.7470
0.7232
|
0.6260
0.2183
|
0.005
0.001
|
0.6596
0.4119
|
0.6872
0.1998
|
0.337
0.039***
|
Urban_Category
Rural
Peri urban
urban
|
0.08369
-0.9023
|
0.2665
0.2518
|
0.753
0.000***
|
0.2755
-0.1322
|
0.2600
0.2274
|
0.289
0.561
|
Similarly, the male youths with primary level of education majorly depend on radio as the source of COVID 19 information compared to female with same level of education. There was no substantial difference on the reliance on social media across the gender. Female with secondary level of education relied on majorly on TV as the source of information on COVID 19 compared with female with same level of education. See Fig. 10.
60.33% of the youths feel that the information on COVID 19 is being shared openly, a chi square test revealed that there a relationship between the uptake of COVID 19 vaccine and the feeling that the information on vaccine was being shared openly (Chi square P Value 0.001 < 0.05 at 95% C.I) and the association.
Despite the fact that majority of the respondents believe that the information is being shared openly the youths believe that these information is not sufficient see Fig. 9 above. Furthermore, 55.32% of the youth have heard information on social media that will make them reconsider the uptake of COVID 19 vaccine and the relationship with uptake of COVID 19 vaccine was statistically significant (Chi square P Value 0.005 < 0.05 at 95% C.I).
Majority of the youths surveyed thinks that political leader’s sentiments on COVID-19 vaccine can trigger doubts on the vaccine amongst the youths/ the community, this factor showed a statistically significant relationship with the uptake of COVID 19 Vaccine (Chi square P Value 0.005 < 0.05 at 95% C.I). There was no relationship between the uptake of vaccine and culture. See Table 6.
Multinomial logistic regression was carried out to determine significant predictors in the uptake of COVID 19 vaccine. The ‘Do you feel that information on COVID 19 vaccine is being openly shared’ predictor is negative and significant (b=-2.4899, s.e.=.4183, p = 0.000). This suggests that participants who feel that information on COVID 19 vaccine is being shared openly are more likely to get vaccinated and more likely to be the first people to get vaccinated as compared to participants who feel that information on COVID 19 vaccine is not shared openly. They are also less likely to wait and see how people react to the vaccine. (b=-12788, s.e.=.1880, p = 0.000).
Table 6
Contextual Influences by intention to get COVID-19 vaccine
Variable
|
I want to be among the first people to get it n(%)
|
I will not get the vaccine n (%)
|
I will wait to see how other people react to it before I can get it n (%)
|
P-Value(Crammers V)
|
Do you feel that information on COVID 19 vaccine is being openly shared?
No
Yes
|
57(8.57)
221(33.23)
|
30(4.51)
9(1.35)
|
176(26.47)
172(25.86)
|
< 0.000****(0.3526)
|
Have you heard/ read in the media/ on social media any information that would make you reconsider not to take COVID-19 vaccine?
No
Yes
|
144(21.65)
134(20.15)
|
18(2.71)
21(3.16)
|
135(20.30)
213(32.03)
|
0.005***(0.1263)
|
Do you think political leader’s sentiments on COVID-19 vaccine can trigger doubts on the vaccine amongst the youths/ the community?
No
Yes
|
82(12.33)
196(29.47)
|
5(0.75)
34(5.11)
|
63(9.47)
285(42.86)
|
0.001***(0.1437)
|
Do you know people in your community who oppose COVID-19 vaccine on cultural grounds?
No
Yes
|
193(29.02)
85(12.78)
|
29(4.36)
10(1.50)
|
269(40.45)
79(11.88)
|
0.083
|
base outcome is “I want to be among the first people to get the Vaccine
Looking at ‘Have you heard/ read in the media/ on social media any information that would make you reconsider not to take COVID-19 vaccine’ and the uptake of CIVID 19 vaccine, this predictor is positive and significant (b = 0.3744, s.e.=.0.1714, p = .0.029). This indicates that participants who have heard/ read in the social media any information that would make them reconsider not to take COVID-19 vaccine are more likely to wait to see how other people react to it before they can get it and less likely to be among the first people to get vaccinated as compared to those who had not heard/ read in the media/ on social media any information that would make them reconsider not to take COVID-19 vaccine. See Table 7.
Table 7
Multinomial logistic regression on socio Contextual Influences and vaccine uptake
Variable
|
I will not get the vaccine n (%)
|
I will wait to see how other people react to it before I can get it n (%)
|
Coefficient
|
Standard error
|
P-value
|
Coefficient
|
Standard error
|
P-value
|
Do you feel that information on COVID 19 vaccine is being openly shared?
Reference Predictor-No
Yes
|
-2.4899
|
0.4183
|
0.000***
|
-1.2788
|
0.1880
|
0.000***
|
Have you heard/ read in the media/ on social media any information that would make you reconsider not to take COVID-19 vaccine?
Reference Predictor-No
Yes
|
-0.6106
|
0.3594
|
0.865
|
0.3744
|
0.1714
|
0.029***
|
Do you think political leader’s sentiments on COVID-19 vaccine can trigger doubts on the vaccine amongst the youths/ the community?
Reference Predictor-No
Yes
|
0.4130
|
0.5218
|
0.429
|
0.2982
|
0.2026
|
1.47
|
Sharing of relevant vaccine information is key and the youths surveyed reported that the most trusted source of information was health care providers 26.32% followed by TV and Radio at 20.66% and 18.59% respectively and the least trusted source of information was word of mouth 55.19%. See Fig. 11.
Individual and Group Influences
The study revealed that majority of the youths 30.73% reported to influence their parents or the vulnerable groups not to receive the vaccine at an average extent. See Fig. 13.
64.21 % of the youths surveyed believe that once there were vaccinated with COVID-19 vaccine, other people in the community will be protected as well. A statistically significant relationship was obtained between ‘do you believe that once you are vaccinated with COVID-19 vaccine, other people in the community will be protected as well believe that once you are vaccinated with COVID-19 vaccine, other people in the community will be protected as well’ and uptake of COVID 19 vaccine (Chi square P Value 0.000 < 0.05 at 95% C.I). The study further showed that 71.72% of the youth support mass vaccination, this was also statistically significant (Chi square P Value 0.000 < 0.05 at 95% C.I) and the association is moderate .See Table 8.
Table 8
Group influences by intention to get COVID-19 vaccine
Variable
|
I want to be among the first people to get it n(%)
|
I will not get the vaccine n (%)
|
I will wait to see how other people react to it before I can get it n (%)
|
P-Value(Crammers V)
|
Do you believe that once you are vaccinated with COVID-19 vaccine, other people in the community will be protected as well?
No
Yes
|
66(9.92)
212(31.88)
|
28(4.21)
11(1.65)
|
144(21.65)
204(30.68)
|
P < 0.000****(0.2581)
|
Do you support mass vaccination (vaccinating everyone) with COVID-19 vaccine?
No
Yes
|
27(4.06)
251(37.74)
|
32(4.81)
7(1.05)
|
129(19.40)
219(32.93)
|
< 0.001****(0.4179)
|
Multinomial logistic regression to determine youths uptake of COVID 19 vaccine, the study revealed that the youths believe that once they are vaccinated with COVID-19 vaccine, other people in the community will be protected as well’ are more likely to get vaccinated (b=-1.4466, s.e.=.0.4085, p = .0.000) and less likely to wait and see how people react to the vaccine before they can get it (b=-05585, s.e.=.1882, p = .0.003) as compared to those who do not believe that once you are vaccinated with COVID-19 vaccine, other people in the community will be protected as well.
In addition the youths who support mass vaccination (vaccinating everyone) with COVID-19 vaccine are more likely to be among the first people to get vaccinated (b=-3.4201, s.e.=0.4728, p = .0.000) and are less likely to wait and see how people react to the vaccine before they can get it (b=-1.5765, s.e = 0.2347,p = 0.000) as compared to those who do not support mass vaccination (vaccinating everyone) with COVID-19 vaccine. See Table 9.
Table 9
Multinomial logistic regression on Individual and Group Influences and vaccine uptake Vaccine safety and vaccination specific Determinants
Variable
|
I will not get the vaccine n (%)
|
I will wait to see how other people react to it before I can get it n (%)
|
Coefficient
|
Standard error
|
P-value
|
Coefficient
|
Standard error
|
P-value
|
Do you believe that once you are vaccinated with COVID-19 vaccine, other people in the community will be protected as well?
Reference Predictor-No
Yes
|
-1.4466
|
0.4085
|
0.000***
|
-0.5585
|
0.1882
|
0.003***
|
Do you support mass vaccination (vaccinating everyone) with COVID-19 vaccine?
Reference Predictor-No
Yes
|
-3.4201
|
0.4728
|
0.000***
|
-1.5765
|
0.2347
|
0.000***
|
59.99% of the youths surveyed believe that our Country is not able to manage risks associated with COVID-19 vaccine side effects, a chi square test was carried out to determine if this relationship with uptake of COVID 19 vaccine was significant a P Value = 0.000 < 0.05 at 95% C.I was obtained. This implies that there is a relationship between country’s readiness to manage the risk associate with COVID 19 vaccine and the uptake of the vaccine is statistically significant. Moreover, majority 35.73% of the youths are somewhat confident on the safety of CIVID 19 vaccine and this relationship with the uptake of vaccine was found to be statistically significant with P Value = 0.000 < 0.05 at 95% C.I and the association was high. In addition, majority 29.78% are concerned that they can develop serious side effects from the COVID-19 vaccine, the relationship with uptake of COVID 19 vaccine was statistically significant with P Value = 0.000 < 0.05 at 95% C.I. On the other hand, 78.65% of the youths trust the health system to deliver COVID-19 vaccine to their communities and somewhat agree that the benefits of being vaccinated with COVID-19 vaccine exceeds the risks of not being vaccinated. These relationships were statistically significant with (chi-square test P-value = 0.00 < 0.05, 95% CI) and (chi-square test, P-value = 0.00 < 0.05, 95% CI) respectively. See Table 10.
Table 10
Vaccine safety and vaccination specific Determinants
Question asked
|
Answer
|
I want to be among the first people to get it n(%)
|
I will not get the vaccine n (%)
|
I will wait to see how other people react to it before I can get it n (%)
|
P-Value(Crammers V)
|
Do you feel our country is able to manage risks associated with COVID-19 vaccine side effects?
|
No
Yes
|
115(17.29)
163(24.51)
|
30(4.51)
9(1.35)
|
234(35.19)
114(17.14)
|
< 0.000***(0.2712)
|
Can the health system be trusted to deliver COVID-19 vaccine to your communities?
|
No
Yes
|
26(3.91)
252(37.89)
|
21(3.16)
18(2.71)
|
95(14.29)
253(38.05)
|
< 0.000***(0.2894)
|
How confident are you in the safety of COVID-19 vaccine?
|
Very confident
Confident
Somehow confident
Not confident
Not confident at all
Don’t know
|
113(16.99)
90(13.53)
65(9.77)
7(1.05)
0(0.00)
3(0.45)
|
3(0.45)
3(0.45)
2(0.30)
13(1.95)
15(2.26)
3(0.45)
|
28(4.21)
53(7.97)
168(25.26)
67(10.08)
14(2.21)
18(2.71)
|
< 0.000***(0.4853)
|
Do you remember any vaccine associated health problems in the past that may prevent you from getting the COVID-19 vaccine?
|
No
Yes
|
228(34.29)
50(7.52)
|
27(4.06)
12(1.80)
|
281(42.26)
67(10.08)
|
0.167
|
How concerned are you that you can develop serious side effects from the COVID-19 vaccine?
|
Don’t Know
Not at all
Not too much
Somewhat
Very Much
|
29(4.36)
71(10.53)
81(12.18)
54(8.12)
44(6.62)
|
4(0.60)
1(0.15)
1(0.15)
5(0.75)
28(4.21)
|
29(4.36)
19(2.86)
73(10.98)
101(15.19)
126(18.95)
|
< 0.000***(0.2942)
|
How much do you agree that benefits of being vaccinated with COVID-19 vaccine exceeds the risks of not being vaccinated?
|
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
|
84(12.63)
58(8.72)
53(7.97)
37(5.56)
46(6.92)
|
6(0.90)
2(0.30)
7(1.05)
11(1.65)
13(1.95)
|
43(6.47)
78(11.73)
128(19.25)
66(9.92)
33(4.96)
|
< 0.000***(0.2321)
|
Multinomial logistic regression was carried out to determine significant predictors in the uptake of COVID 19 vaccine. The ‘Can the health system be trusted to deliver COVID-19 vaccine to your communities?’ predictor is negative and significant (b=-1.4831, s.e.=.4866, p = .0.002). The negative slope indicates that participants who trust that the health system can deliver COVID-19 vaccine to their communities are more likely to get vaccinated and less likely to wait and see how people react to the vaccine before they can get it (b=-0.5388, s.e.=.2745, p = .0.050) as compared to those who do trust that the health system to deliver COVID-19 vaccine to their communities.
The ‘How confident are you in the safety of COVID-19 vaccine?’ predictor is positive and significant (b = 3.4989, s.e.=.7926, p = .000). The positive slope indicates that participants who are not confident in the safety of COVID-19 vaccine are more likely not to get vaccinated and more likely to wait and see how people react to the vaccine before they can get it (b = 2.4461, s.e.=.44565, p = .0.000) as compared to those who are confident in the safety of COVID-19 vaccine.
The ‘How much do you agree that benefits of being vaccinated with COVID-19 vaccine exceeds the risks of not being vaccinated?’ predictor is positive and significant (b = 1.7319, s.e.=.0.8850, p = .0.050). The positive slope indicates that participants who strongly disagree that benefits of being vaccinated with COVID-19 vaccine exceeds the risks of not being vaccinated are more likely not to get vaccinated and less likely to be among the first people to get vaccinated as compared to those who strongly agree that benefits of being vaccinated with COVID-19 vaccine exceeds the risks of not being vaccinated. See Table 11.
Table 11
Multinomial logistic regression on Vaccine safety and vaccination specific Determinants and vaccine uptake
Variable
|
I will not get the vaccine n (%)
|
I will wait to see how other people react to it before I can get it n (%)
|
Coefficient
|
Standard error
|
P-value
|
Coefficient
|
Standard error
|
P-value
|
Do you feel our country is able to manage risks associated with COVID-19 vaccine side effects?
Reference Predictor-No
Yes
|
-0.4284
|
0.5174
|
0.408
|
-0.3836
|
0.2034
|
0.059
|
Can the health system be trusted to deliver COVID-19 vaccine to your communities?
Reference Predictor-No
Yes
|
-1.4831
|
0.4866
|
0.002***
|
-0.5388
|
0.2745
|
0.050***
|
How confident are you in the safety of COVID-19 vaccine?
Reference Predictor- Confident
Very confident
Somehow confident
Not confident
Not confident at all
Don’t know
|
-0.3256
-0.2544
3.4989
18.0808
3.5272
|
0.8549
0.9400
0.7926
585.3956
1.0341
|
0.703
0.787
0.000***
0.975
0.001
|
-0.7059
1.3098
2.4461
15.6067
2.1140
|
0.2872
0.2345
0.4456
585.3953
0.6583
|
0.014***
0.000***
0.000***
0.979
0.001***
|
How much do you agree that benefits of being vaccinated with COVID-19 vaccine exceeds the risks of not being vaccinated?
Strongly Agree
Neutral
Disagree
Strongly Disagree
|
0.7667
0.3004
1.6277
1.7319
|
0.9146
0.8795
0.8706
0.8850
|
0.402
0.733
0.062
0.050***
|
-0.5532
0.2830
0.4772
-0.1375
|
0.2906
0.302
0.3093
0.3457
|
0.057
0.302
0.123
0.691
|
Vaccine Knowledge Questions
Majority of the respondents 86.17% do not know what the COVID-19 vaccine contains and 46.92% of them do not know the effectiveness of COVID-19 vaccines in preventing infection as shown in Table 12
Table 12
COVID 19 Vaccine knowledge
Variable
|
Frequency
|
Percent(%)
|
Do you know what the COVID-19 vaccine contains?
No
Yes
|
573
92
|
86.17
13.1.83
|
Do you know the effectiveness of COVID-19 vaccines in preventing infection?
a. Is quite high in vaccines that have been approved
b. It will be known once the COVID-19 vaccines are in use for a while
c. I do not know
|
226
127
312
|
33.98
19.10
46.92
|