Community-Reported Postvaccination Experiences and Their Influence on COVID-19 Vaccine Uptake and Acceptance in Rural Southwestern Uganda: A Qualitative Cross-Sectional Study.

backgroundThe COVID-19 pandemic had profound global health and socioeconomic impacts, necessitating rapid vaccine deployment to reduce morbidity and mortality. However, perceptions regarding vaccine safety have influenced vaccine confidence and uptake in many communities. This study explored community-reported experiences of adverse events following COVID-19 vaccination and their implications for vaccine acceptance, uptake, and public perceptions in Mitooma District, Southwestern Uganda.

methodsA qualitative cross-sectional study was conducted using focus group discussions (FGDs) among community members and leaders from seven randomly selected villages in Katenga Subcounty, Mitooma District, Southwestern Uganda. Participants were purposively selected based on their involvement, influence, or knowledge of COVID-19 vaccination-related issues. Data were collected on reported experiences following vaccination, perceptions regarding vaccine safety, and factors influencing vaccine acceptance and uptake.

resultsA total of 52 participants (male-to-female ratio, 1:1) participated in the FGDs. The median age (range) of participants was 45 (23-82) years. Most participants were Banyankole (n = 45, 86.5%), married (n = 46, 88.5%), and engaged in subsistence farming (n = 26, 50%). More than half (n = 28, 53.8%) had attained primary education as their highest level of education. Participants commonly reported experiencing symptoms after COVID-19 vaccination, ranging from mild and expected local or systemic reactions to severe or unusual experiences that they perceived as vaccine-related. The most frequently reported experiences included injection-site symptoms, fever, dizziness, and gastrointestinal symptoms. Some participants also described rare and alarming events, including perceived nerve-related problems, impotence, and deaths occurring after vaccination; however, these reports were based on participant accounts and were not clinically verified or confirmed to be causally related to COVID-19 vaccination. Concerns regarding reported adverse events, amplified by misinformation and anti-vaccine messages in local media, negatively influenced willingness among some individuals to receive additional vaccine doses. Nevertheless, overall vaccine acceptance and uptake remained high, largely attributed to fear of severe COVID-19 outcomes and previous positive experiences with immunization programs. CONCLUSION AND RECOMMENDATIONS: Community perceptions of vaccine safety were shaped by both personal experiences and information circulating within communities. Engagement of community leaders and participatory approaches were important in supporting vaccination efforts. Strengthening pharmacovigilance systems, improving mechanisms for reporting and evaluating adverse events following immunization, and implementing proactive risk communication strategies are essential for addressing vaccine safety concerns and maintaining public trust.