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. 2023 Jul;8(7):e012268.
doi: 10.1136/bmjgh-2023-012268.

Addressing sociodemographic disparities in COVID-19 vaccine uptake among youth in Zimbabwe

Leyla Larsson  1   2 , Chido Dziva Chikwari  3   4 , Victoria Simms  3   5 , Mandikudza Tembo  3   6 , Agnes Mahomva  7 , Owen Mugurungi  8 , Richard J Hayes  4 , Constance R S Mackworth-Young  3   9 , Sarah Bernays  10   11 , Constancia Mavodza  3   12 , Tinotenda Taruvinga  3   13 , Tsitsi Bandason  3 , Ethel Dauya  3 , Rashida Abbas Ferrand  3   14 , Katharina Kranzer  2   13
Affiliations

Addressing sociodemographic disparities in COVID-19 vaccine uptake among youth in Zimbabwe

Leyla Larsson et al. BMJ Glob Health. 2023 Jul.

Abstract

Introduction: COVID-19 vaccine acceptance research has mostly originated from high-income countries and reasons why youth may not get vaccinated may differ in low-income settings. Understanding vaccination coverage across different population groups and the sociocultural influences in healthcare delivery is important to inform targeted vaccination campaigns.

Methods: A population-based survey was conducted in 24 communities across three provinces (Harare, Bulawayo and Mashonaland East) in Zimbabwe between October 2021 and June 2022. Youth aged 18-24 years were randomly selected using multistage sampling. Sociodemographic characteristics, COVID-19 vaccination uptake and reasons for non-uptake were collected, and odds of vaccination was investigated using logistic regression.

Results: 17 682 youth were recruited in the survey (n=10 742, 60.8% female). The median age of participants was 20 (IQR: 19-22) years. Almost two thirds (n=10 652, 60.2%) reported receiving at least one dose of COVID-19 vaccine. A higher proportion of men than women had been vaccinated (68.9% vs 54.7%), and vaccination prevalence increased with age (<19 years: 57.5%, 20-22: 61.5%, >23: 62.2%). Lack of time to get vaccinated, belief that the vaccine was unsafe and anxiety about side effects (particularly infertility) were the main reasons for not getting vaccinated. Factors associated with vaccination were male sex (OR=1.69, 95% CI 1.58 to 1.80), increasing age (>22 years: OR=1.12, 95% CI 1.04 to 1.21), education level (postsecondary: OR=4.34, 95% CI 3.27 to 5.76) and socioeconomic status (least poor: OR=1.32, 95% CI 1.20 to 1.47).

Conclusion: This study found vaccine inequity across age, sex, educational attainment and socioeconomic status among youth. Strategies should address these inequities by understanding concerns and tailoring vaccine campaigns to specific groups.

Keywords: COVID-19; epidemiology; health services research; public health; vaccines.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Proportion of young people aged 18-24 who reported being vaccinated by month of the CHIEDZA prevalence survey stratified by province.
Figure 2
Figure 2
Reasons for not receiving the COVID-19 vaccine stratified by sex and grouped based on the 5C’s of vaccine hesitancy delineated by Razai et al. shown as proportions (%).
See this image and copyright information in PMC

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