Prevention of cholera and COVID-19 pandemics in Uganda: understanding vaccine coverage survey Plus

Abstract

Abstract Background Between March, 2020 and December, 2021, Uganda experienced high prevalence of cholera and Coronavirus Disease 2019 (COVID-19) leading to 1,534 cholera cases with 14 deaths and 136,065 COVID-19 cases with 3,285 deaths reported respectively. This study investigated mass vaccination campaigns for the prevention of the two pandemics namely Oral Cholera Vaccine (OCV) and COVID-19 vaccine coverages; Adverse Events Following Immunization (AEFI); barriers and enablers for the vaccine uptake and the feasibility of incorporating Water, Sanitation and Hygiene (WASH) assessments into vaccine coverage surveys. Methods A household survey was conducted between January and February, 2022 in the six districts of Uganda which had recently conducted OCV mass vaccination campaigns or had ongoing COVID-19 mass vaccination campaigns. The survey randomly enrolled 900 households with 4,315 persons of whom 2,085 were above 18 years. Data were collected and analysed using STATA statistical package. Frequencies, percentages, Odds ratios, confidence intervals and maps were generated and interpreted. Results The OCV coverage for dose one and two were 85% (CI: 84.2–86.4) and 67% (CI: 65.6–68.4) respectively. Among the 4,315 OCV recipients, 2% reported mild AEFI, 0.16% reported moderate AEFI and none reported severe AEFI. The COVID-19 vaccination coverage for dose one and two were 69.8% (CI: 67.8–71.8) and 18.8% (CI: 17.1–20.5) respectively. Approximately, 23% (478/2,085) of COVID-19 vaccine recipient reported AEFI; 94% were mild, 0.6% were moderate and 2 cases were severe. The commonest reason for missing COVID-19 vaccine was fear of the side effects. For most districts (5/6), sanitation (latrine/toilet) coverages were low at 7.4% − 37.4%. Conclusion There were high OCV coverages but low COVID-19 vaccine and sanitation coverages with high number of moderate cases of AEFI recorded due to COVID-19 vaccines. The low COVID-19 coverage could indicate vaccine hesitancy for COVID-19 vaccines. Furthermore, incorporation of WASH assessment in the OCV coverage surveys is recommended for similar settings to generate data for better planning. However, more studies are required on COVID-19 vaccine hesitancy.