Predictors of COVID-19 vaccination status among youth in eThekwini, South Africa: results from the AYAZAZI RIGHTS study

BACKGROUND: Understanding which factors impact vaccine uptake is important for supporting ongoing and future vaccine programmes among youth. OBJECTIVE: This study examined predictors of COVID-19 vaccination uptake among South African youth in the eThekwini District. METHODS: Cross-sectional data from an online survey (AYAZAZI RIGHTS: December 2021-May 2022) of youth aged 18-24 in the eThekwini district, South Africa, were analyzed using a gender-stratified logistic regression of vaccination status on candidate predictors of interest (k = 14). A full model with backwards selection using Akaike's Information Criterion was employed to remove predictors that did not add to the model's explanatory power. RESULTS: = 525) of participants had received a COVID-19 vaccine, 58.6% of whom were women. In this cross‑sectional, observational analysis, the most consistent predictors of vaccination status were older age, living with seniors in the home, and personal proximity to severe pandemic outcomes, specifically knowing people who had been hospitalized or died due to COVID-19. Gender‑specific predictors included ethnicity, having children for women, employment, and relationship status. CONCLUSION: Socio-demographic as well as community factors predicted receiving a COVID-19 vaccination, varying by gender. Better understanding of modifiable factors to support vaccine uptake, and curbing vaccine hesitancy related to mistrust and misinformation, will help support South Africa's immunization programs among youth, and can help inform targeted, inclusive, and equity-oriented public-health strategies.