Oral cholera vaccine uptake, acceptance and confidence among residents of a high-risk township in Zambia : key insights for future vaccination programs

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Miti, Ernest and Mukosha, Moses and Mwaba, John and Mulavu, Malala and Meyer, Johanna C and Mudenda, Steward and Godman, Brian and Mwila, Chiluba and Hamachila, Audrey and Kalungia, Aubrey C (2026) Oral cholera vaccine uptake, acceptance and confidence among residents of a high-risk township in Zambia : key insights for future vaccination programs. International Health, 18 (2). pp. 254-263. ISSN 1876-3405 (https://doi.org/10.1093/inthealth/ihaf087)

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Abstract

Background: Oral cholera vaccines (OCVs) prevent cholera and save lives. Given the recent 2024 country-wide cholera epidemic in Zambia, we determined self-reported OCV uptake, acceptance and confidence among adults living in a high-risk, cholera-prone township in Zambia. Methods: A descriptive cross-sectional study was conducted from April to August 2024, involving 385 randomly selected adult participants residing in the Kanyama township of Lusaka, Zambia. Data were collected using an interviewer-administered questionnaire and statistically analysed. Results: Self-reported uptake of at least one dose of the OCV was 18%, with the majority (315 [82%]) reporting being unvaccinated against cholera. Among those who were unvaccinated, vaccine acceptance was <10% (95% confidence interval [CI] 6.8 to 13.7), with higher rates reported among women than men (p=0.002). Despite this, the majority (210 [84.3%]) expressed confidence in the vaccination program. Those knowledgeable about the OCV were twice as likely to get vaccinated (adjusted odds ratio 2.60 [95% CI 1.19 to 5.68]). Knowledge, attitudes and perceptions were associated with OCV uptake. Conclusions: Self-reported OCV uptake and acceptance were low in a high-risk cholera-prone township in Zambia. Community education on the benefits of the vaccine is urgently needed to enhance confidence and attitudes towards the OCV and improve vaccination rates in the future.

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