Gov’t asked to boost vaccine confidence among people living with HIV

Health researchers have appealed to the Ministry of Health to develop tailored messaging on the benefits of vaccination to people living with HIV and their concerns over vaccine safety.

The call was made by Richard Muhindo, a health expert from the Makerere University-based Infectious Disease Institute during the presentation of a research report that discovered that some people living with HIV declined to get vaccinated because doubted the vaccine's efficacy because they fear the side effects and have misconceptions that one’s body systems weaken if the vaccine interacts with HIV and HIV medications.

“Additionally, older people living with HIV suffering from hypertension, and diabetes were reluctant to vaccinate,” Muhindo, the lead researcher in the project, said during the dissemination of the findings at Fairway Hotel in Kampala recently (July 29).

The research project was titled: Fighting COVID-19: Tackling coronavirus disease - Vaccine Hesitancy among People Living with HIV in Kampala, Uganda.

“The project was conceived on the premise that people living with HIV have a higher risk of severe acute respiratory syndrome coronavirus to infection and mortality from COVID-19, making them a priority group for vaccination,” Muhindo said.

The study was done on 767 individuals, 12 focus group discussions among people living with HIV and 24 key informant interviews among expert clients, health professionals, and community leaders.

The study examined vaccine acceptability among people living with HIV in Kampala Metropolitan area.

The study was carried out in Antiretroviral Therapy clinics in Kitebi Health Centre III, Kiswa Health Centre III, Kisenyi Health Centre III and Kawaala Health Centre III in Kampala. The others are Komamboga Health Centre III and Kasangati Health Centre IV in Wakiso district.

“Of the respondents, 485 (63%) were women and 282 (37%) were men. Over two-thirds (69.6%) reported receiving at least one vaccine dose, with women more likely than men to be vaccinated (73% against 63%). Among the unvaccinated, 64 (27.3%) were unwilling to accept vaccination,” he said.

The other researchers that were part of the study are Dr Barbara Castelnuovo, Dr Agnes Kiragga, Dr Rachel King, Dr Stephen Okoboi and Walter Joseph Arinaitwe. The research was supported by IDI with funding from the National Institute for Health and Fogarty International Centre. Data collection was between January and April 2022. 

People’s concerns about the vaccine

According to the research, a number of people living with HIV thought the vaccine would harm their health.

“People out there talk a lot about the vaccines…some say the vaccines are meant to reduce the African population, others say they cause loss of libido in men, abortion and infertility in women. But for us PLWH our bodies are already weak, and some people say with ART, getting vaccinated will make us weaker or even cause death,” a male respondent at Kisenyi Health Centre III said.

Health workers said people living with HIV had been told that people who get vaccinated die.

“To be sincere PLWH are not into vaccination because even those who vaccinate is because we (health workers) emphasize they should get vaccinated…they have been misinformed that they will die or experience serious side effects if they vaccinate,” a nurse at Kisenyi told the researchers.

Some clinics told the researchers that they had already rolled out sensitization session to assure people living with HIV that the vaccines are safe.

“Vaccines are now available, and we now provide health education talks to patients in the waiting area. The only problem is that some clients arrive after the sessions in the morning, and also the long lines at the vaccination site given that the client mainly come for ART,” a doctor at Kisenyi Health Centre III told the researchers.

Other people cited delays in the administering of vaccines as a hindrance to exercise.

“Vaccines are now available at many facilities in Uganda…the only problem is long waiting hours at the vaccination site…  a week ago we waited for over four hours before the vaccination team arrived yet we had been referred from the ART clinic,” a male person living with HIV told researchers at Komamboga Health Centre in Wakiso district.

Recommendations

The researchers recommended that the Ministry of Health and its partners strengthen training programmes that empower health professionals to be more explicit in advising people living with HIV for vaccination

“Health professionals should periodically provide information regarding vaccination, and booster doses during client consultation,” the research report concluded.

This was because it was discovered that most health workers were not confident enough to sensitise people about vaccination.

“Clients have many questions like difference between vaccine types, vaccine type suitable for a particular individual or blood group, and vaccine-HIV/ART interactions but sometimes I am not confident to answer all,” a doctor at Kisenyi Health Centre said.

“One area that remains grey is screening in vaccination for COVID19…it is not clear for even health workers to explain to patients…we are vaccinating people but there are those who are asymptomatic…how do we proceed…do we first screen them…if we screen you, and you are positive, should we vaccinate you or not…for example we can not vaccinate someone who tests positive for hepatitis B…so what do we do for COVID-19,” doctor at Kisenyi Health Centre said.