Background: Coronavirus disease 2019 (Covid-19) pandemic has affected more than 200 million people causing loss of life and livelihood across the entire world. This accelerated the development of Covid-19 vaccines. Data from various scholars has it that, Covid-19 vaccines are both safe and efficacious. Despite this fact, low uptake has been reported as a serious issue in normal and humanitarian settings. Therefore, this research investigated levels of Covid-19 vaccine uptake and factors associated with low Covid-19 vaccine uptake among adult refugees towards the Covid-19 vaccine in Kyangwali, Kikuube District. Aim: To assess the level of Covid-19 vaccine uptake among adult refugees (18 years and above) in Kyangwali refugee settlement -Kikuube district mid-western Uganda. Methods: It was a mixed methods cross sectional study where 538 respondents were interviewed in June 2022. Multi-stage sampling was used to select respondents of 18 years and above at the time of the visit. A questionnaire was used to collect information on factors that are associated with low Covid-19 vaccine uptake and uptake levels. A key informant interview guide was used to collect information on the interventions to uptake of Covid-19 vaccine. Quantitative data was entered into an excel sheet and later analysed using SPSS software whereas qualitative data was transcribed and later coded into meaningful information. Chi-square tests were done at bivariate analysis to establish if there was a significant relationship between all independent variables and the dependent variable. Multivariate binary logistic regression was done at multivariate level of analysis for all those factors that had shown an association at bivariate level. Odds ratios were used as the measure of association with corresponding 95% confidence intervals. Results: About 39.2% of adults in Kyangwali had not taken Covid-19 vaccine. Findings confirm adverse events following immunization (AEFI), mistrust of authority and perceived severity of Covid-19 symptoms are factors which were statistically significantly associated with refugees not taking the Covid-19 vaccine in Kyangwali refugee settlement. The main vaccine uptake interventions identified through key informant interviews included, proper dissemination of data in line with Covid-19 vaccination, maximized awareness creation across the refugee settlement, continued mobilization, stocking vaccines, stocking vaccine cards and routine vaccination, facilitation of health workers and health education. Conclusion. A relatively big proportion (39.2%) of adult refugees in Kyangwali refugee settlement had not vaccinated against Covid-19 and factors, adverse effects following vaccination, mistrust in Authority and perceived severity of Covid-19 symptoms were the factors associated to low Covid -19 vaccine uptake in Kyangwali refugee settlement. Keywords: Factor, Corona Virus 2019, Vaccine, uptake, Refugee

show more