Abstract
BACKGROUND: People with chronic illnesses such as Human Immunodeficiency Virus (HIV), hypertension, and Diabetes Mellitus (DM) are a priority for Coronavirus disease (COVID-19) vaccination due to elevated risk of severe disease. We explored the perspectives and experiences of COVID-19 vaccination among these priority populations in Southwestern and Southcentral Uganda. METHODS: Between January and April 2023, we conducted in-depth interviews with adult (≥18 years) persons living with HIV (PLWH), hypertension and/or DM (n = 30) and key informant interviews with healthcare providers and managers (n = 12) at Mbarara and Masaka Regional Referral Hospitals. We used the Behavioral and Social Drivers model to explore the factors that influenced COVID-19 vaccination. We coded the data using Dedoose software and analyzed them using thematic deductive analysis. RESULTS: Motivations to take the COVID-19 vaccine included fear of COVID-19, observing the effect of COVID-19 or the vaccine on others, vulnerability from underlying illnesses, family and social support, health worker recommendation, vaccine benefits and trust in the vaccine. Fear of side effects and vaccine interactions with antiretroviral, antihypertensive or antidiabetic medications, misinformation, rapid vaccine development and rollout, inadequate sensitization, and healthcare providers' hesitancy hindered uptake. Furthermore, health system challenges like stockouts and long queues hindered uptake or dose completion. CONCLUSION: Fear of COVID-19, trust in the vaccine, family and social support facilitated COVID-19 vaccination uptake. Conversely, fear of side effects, vaccine and medication interaction, misinformation and inadequate sensitization hindered vaccine uptake. Effective communication strategies involving health workers and community leaders and sustained vaccine supply are crucial to improve COVID-19 vaccine uptake. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s44155-025-00199-0.