# Vaccine uptake, barriers and enhancers of COVID-19 vaccination among healthcare workers from high-burden cities in Ethiopia

## TL;DR

This study examines how healthcare workers in Ethiopia responded to the COVID-19 vaccine, identifying barriers and ways to improve uptake.

## Contribution

The study provides insights into vaccine hesitancy and motivators among healthcare workers in high-burden cities in Ethiopia.

## Key findings

- Only 39.2% of healthcare workers were fully vaccinated, with safety concerns being the main barrier.
- Older healthcare workers and those in health centres were more likely to be vaccinated.
- Improving confidence in vaccine safety and efficacy could increase vaccination rates.

## Abstract

Coronavirus disease 2019 (COVID-19) vaccination is crucial for healthcare workers (HCWs) to protect themselves and promote public health.

This study assessed COVID-19 vaccination uptake, barriers and enhancers among HCWs in high-burden cities in Ethiopia.

A cross-sectional survey among 600 randomly selected HCWs from 30 health facilities (May 2023 to July 2023).

Interviewer-administered questionnaires assessed vaccination status, concerns and motivators. Descriptive statistics and modified Poisson regression identified factors associated with vaccination.

Overall, 70.3% (n = 422) received at least one dose, and 39.2% (n = 235) were fully vaccinated. Safety concerns (51.9%) were the main barrier. More information on safety and efficacy (53.1%) and regulatory approval (27.3%) were key motivators. Those not recommending vaccination were less likely to be vaccinated (prevalence ratio [PR] = 0.59, 95% confidence interval [CI]: 0.41–0.85). Professionals such as radiographers (PR = 0.78), pharmacists (PR = 0.79) and laboratory personnel (PR = 0.85) were less likely compared to physicians. Older HCWs (> 25 years) were twice as likely to be vaccinated. HCWs in health centres were more likely to be vaccinated than those in hospitals (PR = 1.201, 95% CI: 1.076–1.341).

A significant proportion of HCWs were not fully vaccinated. Targeting hospital workers and younger age groups and improving HCWs confidence in recommending vaccination can increase uptake.

This study reveals COVID-19 vaccine safety, efficacy and confidence concerns of HCWs, highlighting the need for targeted awareness to strengthen national vaccination efforts against pandemics.