Abstract:

The desire to control Covid 19 pandemic has continued to exist in the Mbala district of Zambia, with the latest trend showing a significant increase in a number of people testing positive, with a corresponding increase in vaccines (AZ, JJ) hesitancy resulting in a low (2.8 %) vaccination rate in the district. Thus, the need to probe further on covert factors under acceptability (myths, AEFs) and accessibility (vaccines availability, adequacy of vaccination sites) that could be reducing Covid 19 vaccine uptake in Mbala district. The study used a cross-sectional survey, a mixed (quantitative & qualitative) method in eliciting information from data sources covering a period of six months (April – September 2021). In all, 341 research respondents were interviewed through self-administered questionnaires. Data were analysed using descriptive statistics and binary logistic regression under SPSS v16. Study findings provide sufficient evidence that high myth (89.8%) reduced acceptability levels, while a low number of vaccination sites (59%) reduced accessibility, resulting in a low uptake rate in Mbala district. Therefore, the study recommended; building up of well-financed District Covid 19 task forces with educational aims on acceptability and accessibility, Governments to introduce specific funding lines for Covid 19 vaccination campaign and enshrine it into monthly grants for routine-outreach Covid 19 vaccination services, and Local Governments through the directorate of Public Health to introduce by-laws on mandatory Covid 19 vaccination passports for the public. With proper implementation of all these study recommendations, Covid 19 vaccination coverage rates can increase drastically across all districts of northern Zambia.

References:

[1] Mbala HIMS. (2021). District Health Information Management System. Mbala district health office.

[2] Luca Steardo, Luca Steardo Jr. Et al. (2020). Neuroinfection may contribute to the pathophysiology and clinical manifestations of COVID‐19: PMC, Public Health Emergency. Acta Physiol (Oxf). 2020 Apr 11: e13473. Doi: 10.1111/apha.13473 [Epub ahead of print].

[3] Guan W-j, Ni Z-y, et al. (2020). Clinical Characteristics of Coronavirus Disease 2019 in China. New England Journal of Medicine: NEJMoa2002032-NEJMoa. https://www.nejm.org/doi/full/10.1056/nejmoa2002032.

[4] Chen N, Zhou M, et al. (2020). Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet. 2020; 395 (10223):507.

https://pubmed.ncbi.nlm.nih.gov/32007143/.

[5] Wang D, Hu B, et al. (2020). Clinical Characteristics of 138 Hospitalized Patients with 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China. JAMA: 323(11):1061. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7042881/.

[6] David J Cennimo. (2021). Coronavirus Disease 2019 (COVID-19) Clinical Presentation: Infectious Diseases. Medscape.

https://emedicine.medscape.com/article/2500114-clinical.

[7] Chirumbolo. S. (2021). Vaccination hesitancy and the “myth” on mRNA-based vaccines in Italy in the COVID-19 era: Does urgency meet major safety criteria? Journal of Medical Virology. https://doi.org/10.1002/jmv.26922.

[8] Melissa Couto Zuber. (2021). How J&J and AstraZeneca differ from the mRNA vaccines from Pfizer and Moderna. The Canadian Press. https://www.bnnbloomberg.ca/how-j-j-and-astrazeneca-differ-from-the-mrna-vaccines-from-pfizer-and-moderna-1.1589765.

[9] Lauer SA, Grantz KH, Bi Q, et al. (2020). The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application. Annals of internal medicine.

https://www.acpjournals.org/doi/10.7326/m20-0504.

[10] Amanna I, Slifka MK. (2005). Public fear of vaccination: separating fact from fiction. Viral Immunol; 18(2): 307- 315. https://pubmed.ncbi.nlm.nih.gov/16035942/.

[11] Mbala IDSR. (2021). Incidence Disease Surveillance Report. DHO. Pg. 8-20.

[12] Nature News. (2021). Trial hints that Pfizer vaccine could curb covid transmission. www.nature.com/articles/d41586-020-00502-w.

[13] Centers for Disease Control and Prevention. (2021). Vaccination considerations for people who are pregnant. www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html.

[14] AstraZeneca. (2021). Covid-19 vaccine AstraZeneca confirms 100% protection against severe disease, hospitalization, and death in the primary analysis of phase III trials. www.astrazeneca.com/media-centre/press-releases/2021/Covid-19-vaccine-astrazeneca-confirms-protection-against-severe-disease-hospitalisation-and-death-in-the-primary-analysis-of-phase-iii-trials.html.

[15] WHO. (Sept. 2021). What Needs to Change to Enhance Covid-19 Vaccine Access: Statement from the Independent Allocation of Vaccines Group of COVAX. https://www.who.int/news/item/24-09-2021-what-needs-to-change-to-enhance-Covid-19-vaccine-access.

[16] Kaddar M. (2020). Economic characteristics of vaccines and immunizations. World Health Organization. www.who.int/influenza_vaccines_plan/resources/session_2_kaddar.pdf.

[17] Nuffield Council on Bioethics. (2020). Rapid policy briefing: Covid-19 antibody testing and “immunity certification” www.nuffieldbioethics.org/publications/Covid-19-antibody-testing-and-immunity-certification.

[18] Hassoun N. (2021). How to make “immunity passports” more ethical. Scientific American. www.scientificamerican.com/article/how-to-make-immunity-passports-more-ethical.

[19] European Patient Forum, Editorial. (2021). Covid-19 vaccine passports: access, equity, and ethics. BMJ https://doi.org/10.1136/bmj.

[20] Scientific Advisory Group for Emergencies. (2021). Factors influencing Covid-19 vaccine uptake among minority ethnic groups. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/952716/s0979-factors-influencing-vaccine-uptake-minority-ethnic-groups.pdf.

[21] Sinkala. D. (2021). Factors associated with the distribution of Preeclampsia and Eclampsia among Rural and Urban Women in Childbearing Age – A case of Mbala General Hospital, Northern Province, Zambia. Texila International Journal of Public Health. DOI No. 10.21522/TIJPH.2013.09.03. Art008. https://www.texilajournal.com/public-health/article/1912-factors-associated-with.