Factors associated with willingness to receive the COVID-19 vaccine among residents of Hoima District, Mid-Western Uganda

Introduction: For the effective control of the COVID-19 pandemic, the development and use of vaccines was a global target. Since March 2021, Uganda publicized and implemented COVID-19 vaccination activities. Reports from other parts of the world indicate mixed results in relation to willingness to receive the vaccine and little information is available from rural settings. We assessed the willingness to receive the COVID-19 vaccine and associated factors among adult residents in Hoima District, Western Uganda. Methods: A cross-sectional study that employed concurrent mixed-methods comprising a survey and key informant interviews. The study was conducted between January and April 2022, among residents of Hoima District, Uganda. We used multi-stage sampling to randomly select 379 adult participants from 13 systematically sampled villages in two rural sub-counties in Hoima District. We also interviewed 8 purposively selected key informants who were health workers at Hoima Regional Referral Hospital (HRRH), where vaccination was being conducted. We used descriptive statistics and then conducted multivariable-modified Poisson regression to generate adjusted prevalence ratios (adj.PRs) and confidence intervals (CIs) for the quantitative data, while a thematic approach was used for qualitative data analysis. Results: More than three quarters 79 % (301/379) of the participants were willing to receive the COVID-19 vaccination.Willingness to receive COVID-19 vaccination was significantly higher among participants with tertiary level of education (adj.PR=1.26, 95% CI: 1.12-1.47); those who received information about COVID-19 vaccination from healthcare workers (adj.PR=1.37, 95% CI: 1.21-1.64); and those who resided within five Kilometers from a vaccination site (adj.PR=1.22, 95% CI: 1.18-1.37). Perceived fear of losing libido among men and infertility among women was a major concern across the interviews. Conclusion. Willingness to receive COVID-19 vaccination was high in rural settings but safety concerns were the main barrier. Strategies to improve COVID-19 vaccination programs, in such settings, may focus on health education messages through local radio stations to counter fears of reproduction and misconceptions about the vaccine.