Nasimiyu Carolyne, Ngere Isaac, Dawa Jeanette, Amoth Patrick, Oluga Ouma, Ngunu Carol, Mirieri Harriet, Gachohi John, Dayan Moshe, Liku Nzisa, Njoroge Ruth, Odinoh Raymond, Owaka Samuel, Khamadi Samoel A, Konongoi Samson L, Galo Sudi, Elamenya Linet, Mureithi Marianne, Anzala Omu, Breiman Robert, Osoro Eric, Njenga M Kariuki
Global Health Program, Washington State University (WSU), Nairobi 00100, Kenya.
Paul G. Allen School of Global Health, Washington State University (WSU), Pullman, WA 99163, USA.
Vaccines (Basel). 2022 Dec 28;11(1):68. doi: 10.3390/vaccines11010068.
Considering the early inequity in global COVID-19 vaccine distribution, we compared the level of population immunity to SARS-CoV-2 with vaccine uptake and refusal between rural and urban Kenya two years after the pandemic onset. A population-based seroprevalence study was conducted in the city of Nairobi (n = 781) and a rural western county (n = 810) between January and February 2022. The overall SARS-CoV-2 seroprevalence was 90.2% (95% CI, 88.6−91.2%), including 96.7% (95% CI, 95.2−97.9%) among urban and 83.6% (95% CI, 80.6−86.0%) among rural populations. A comparison of immunity profiles showed that >50% of the rural population were strongly immunoreactive compared to <20% of the urban population, suggesting more recent infections or vaccinations in the rural population. More than 45% of the vaccine-eligible (≥18 years old) persons had not taken a single dose of the vaccine (hesitancy), including 47.6% and 46.9% of urban and rural participants, respectively. Vaccine refusal was reported in 19.6% of urban and 15.6% of rural participants, attributed to concern about vaccine safety (>75%), inadequate information (26%), and concern about vaccine effectiveness (9%). Less than 2% of vaccine refusers cited religious or cultural beliefs. These findings indicate that despite vaccine inequity, hesitancy, and refusal, herd immunity had been achieved in Kenya and likely other African countries by early 2022, with natural infections likely contributing to most of this immunity. However, vaccine campaigns should be sustained due to the need for repeat boosters associated with waning of SARS-CoV-2 immunity and emergence of immune-evading virus variants.
考虑到全球新冠肺炎疫苗分配早期存在的不平等现象，我们比较了疫情爆发两年后肯尼亚城乡人群对新冠病毒的免疫水平以及疫苗接种率和拒绝接种情况。2022年1月至2月期间，在内罗毕市（n = 781）和西部一个农村县（n = 810）开展了一项基于人群的血清流行率研究。新冠病毒总体血清流行率为90.2%（95%置信区间，88.6−91.2%），其中城市人群为96.7%（95%置信区间，95.2−97.9%），农村人群为83.6%（95%置信区间，80.6−86.0%）。免疫情况比较显示，超过50%的农村人口具有强免疫反应性，而城市人口中这一比例不到20%，这表明农村人口近期感染或接种疫苗的情况更多。超过45%符合疫苗接种条件（≥18岁）的人未接种过一剂疫苗（犹豫未接种），城市和农村参与者中这一比例分别为47.6%和46.9%。报告称，19.6%的城市参与者和15.6%的农村参与者拒绝接种疫苗，原因主要是担心疫苗安全（>75%）、信息不足（26%）以及担心疫苗有效性（9%）。不到2%的拒绝接种者提到宗教或文化信仰。这些发现表明，尽管存在疫苗不平等、犹豫未接种和拒绝接种的情况，但到2022年初肯尼亚以及其他非洲国家可能已实现群体免疫，自然感染可能是这种免疫力的主要来源。然而，由于需要重复接种加强针以应对新冠病毒免疫力下降和免疫逃逸病毒变种的出现，疫苗接种活动应持续开展。
