Factors associated with COVID-19 vaccine receipt among mobile phone users in Malawi: Findings from a national mobile-based syndromic surveillance survey, July 2021-April 2022

Lucky Makonokaya; Lester Kapanda; Thulani Maphosa; Louiser Upile Kalitera; Rhoderick Machekano; Harrid Nkhoma; Rachel Chamanga; Suzgo B Zimba; Annie Chauma Mwale; Alice Maida; Godfrey Woelk

doi:10.1371/journal.pgph.0002722

Factors associated with COVID-19 vaccine receipt among mobile phone users in Malawi: Findings from a national mobile-based syndromic surveillance survey, July 2021-April 2022

PLOS Glob Public Health. 2024 Jan 11;4(1):e0002722. doi: 10.1371/journal.pgph.0002722. eCollection 2024.

Affiliations

¹ Elizabeth Glaser Pediatric AIDS Foundation, Lilongwe, Malawi.
² Elizabeth Glaser Pediatric AIDS Foundation, Washington, DC, United States of America.
³ Public Health Institute, Ministry of Health, Lilongwe, Malawi.
⁴ Centers for Disease Control and Prevention, Lilongwe, Malawi.

Abstract

Malawi recommended COVID-19 vaccines for adults aged ≥18 years in March 2021. We assessed factors associated with receiving COVID-19 vaccines in Malawi as part of a telephone-based syndromic surveillance survey. We conducted telephone-based syndromic surveillance surveys with questions on COVID-19 vaccine receipt among adults (≥18 years old) upon verbal consent from July 2021 to April 2022. We used random digit dialing to select mobile phone numbers and employed electronic data collection forms on secure tablets. Survey questions included whether the respondent had received at least one dose of a COVID-19 vaccine. We used multivariable analysis to identify factors associated with COVID-19 vaccine receipt. Of the 51,577 participants enrolled; 65.7% were male. Males were less likely to receive the COVID-19 vaccine than females (AOR 0.83, 95% CI 0.80-0.86). Compared to those aged 18-24 years, older age had increased odds of vaccine receipt: 25-34 years (AOR 1.32, 95% CI 1.24-1.40), 35-44 years (AOR 2.00, 95% CI 1.88-2.13), 45-54 years (AOR 3.02, 95% CI 2.82-3.24), 55-64 years (AOR 3.24, 95% CI 2.93-3.57) and 65 years+ (AOR 3.98, 95% CI 3.52-4.49). Respondents without formal education were less likely to receive vaccination compared to those with primary (AOR 1.30, 95% CI 1.14-1.48), secondary (AOR 1.76, 95% CI 1.55-2.01), and tertiary (AOR 3.37, 95% CI 2.95-3.86) education. Respondents who thought COVID-19 vaccines were unsafe were less likely to receive vaccination than those who thought it was very safe (AOR 0.26, 95% CI 0.25-0.28). Residents of the Central and Southern regions had reduced odds of vaccine receipt compared to those in the North (AORs 0.79, (95% CI 0.74-0.84) and 0.55, (95% CI 0.52-0.58) respectively). Radio (72.6%), health facilities (52.1%), and social media (16.0%) were the more common self-reported sources of COVID-19 vaccine information. COVID-19 vaccine receipt is associated with gender, age, education, and residence. It is important to consider these factors when implementing COVID-19 vaccination programs.

Copyright: © 2024 Makonokaya et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Grants and funding

This surveillance work and the study was fully supported by the President's Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention (CDC) under the terms of Cooperative Agreement Number U2UGH002010. TM was the principal investigator and recipient of the funding. LM, LK, LUK, HN, SZ, RC, and TM got salaries from the funding. Its contents are solely the authors' responsibility and do not necessarily represent the official views of PEPFAR or CDC. The findings and conclusions in this paper are those of the authors and do not necessarily represent the views of their supporting or funding agencies.