Abstract:
The novel Coronavirus disease 2019 (COVID-19) presents a major threat to public health
but can be prevented by safe and effective COVID-19 vaccines. Vaccine acceptance among healthcare
workers (HCWs) is essential to promote uptake. This study, aimed to determine the COVID-19
vaccination uptake and hesitancy and its associated factors among HCWs in Tanzania. We employed
a convergent-parallel mixed-methods design among 1368 HCWs across health facilities in seven
geographical zones in Tanzania in 2021. We collected quantitative data by using an intervieweradministered questionnaire and qualitative data, using in-depth interviews and focus group discussions. Participants in the quantitative aspect were conveniently selected whereas those in the
qualitative aspect were purposively selected based on their role in patient care, management, and vaccine provision. Stata software version 16.1 was used in the analysis of quantitative data and thematic
analysis for the qualitative data. Multiple logistic regression was used to assess the determinants of
COVID-19 vaccine uptake. The median age of 1368 HCWs was 33, and the interquartile range was
28–43 years; 65.6% were aged 30+ years, and 60.1% were females. Over half (53.4%) of all HCWs
received the COVID-19 vaccine, 33.6% completely refused, and 13% chose to wait. HCWs aged 40+
years, from lower-level facilities (district hospitals and health centers), who worked 6+ years, and
with perceived high/very high risk of COVID-19 infection had significantly higher odds of vaccine
uptake. The qualitative data revealed misinformation and inadequate knowledge about COVID-19
vaccine safety and efficacy as the key barriers to uptake. Nearly half of all HCWs in Tanzania are still
unvaccinated against COVID-19. The predominance of contextual influence on COVID-19 vaccine
uptake calls for interventions to focus on addressing contextual determinants, focusing on younger
HCWs’ population, short working duration, those working at different facility levels, and providing
adequate vaccine knowledge
