COVID-19 Vaccine Uptake: Prevalence, Health Facility Enablers and Barriers among Adult Tuberculosis Patients across Nairobi County Clinics, Kenya.

Patients with tuberculosis (TB) are at increased risk of developing severe forms of novel coronavirus 2019 (COVID-19), and COVID-19 coinfection aggravates active TB progression through immunosuppression. Despite the availability of COVID-19 vaccines to prevent and reduce COVID-19 transmission, COVID-19 vaccine uptake levels remain low worldwide. In Kenya, an African country with high TB prevalence and TB-HIV coinfection, 47% of the population had received the COVID-19 vaccine by 2023. This study determined health-system enablers and barriers to the COVID-19 vaccine among adult TB patients across Nairobi County TB clinics in Kenya. An analytical cross-sectional study was used. Three hundred eighty-eight TB patients from six TB clinics across six sub-counties in Nairobi were recruited. The participants completed the study questionnaire. After confounding for age, employment status perceived COVID-19 susceptibility, and perceived COVID-19 seriousness, health system enablers of COVID-19 vaccine uptake were consistent and positive messaging on COVID-19 (adjusted odds ratio (aOR) = 4.498; 95% CI: 1.953 - 10.36, p < 0.001), the feeling that the vaccination had significant social benefits was (aOR = 2.632; 95% CI: 1.108 - 6.257, p = 0.028), and enough public awareness about the vaccine (aOR = 2.619; 95% CI: 1.099 - 6.239, p = 0.03). A significant barrier was vaccine preference (aOR = 0.387, 95% CI: 0.179 - 0.838, p = 0.016). This study confirmed health facility factors that enable and hinder COVID-19 vaccine uptake among TB patients. We recommend policy actions to improve TB clinics' infrastructure and resources to support the enablers and address the barriers.