{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T18:04:32Z","timestamp":1778695472307,"version":"3.51.4"},"reference-count":41,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health Security"],"published-print":{"date-parts":[[2025,4,1]]},"abstract":"<jats:p>In this study, we identify facilitators and barriers to COVID-19 vaccination in Nairobi, Kenya, using the modified 5 Cs model for vaccine hesitancy. We conducted 33 in-person interviews in Nairobi, Kenya. Participants were recruited using convenience sampling by a member of the research team who resides in Nairobi and speaks Swahili. Interviews were audio recorded and transcripts were analyzed using thematic analysis. The modified 5 Cs model for vaccine hesitancy was applied to create a codebook prior to analysis. Participants cited misinformation, lack of trust in the science behind the vaccine, and concerns about side effects as reasons for not receiving the COVID-19 vaccine. Facilitators for choosing to receive the vaccination included concerns about the severity of COVID-19, vaccination requirements for school and employment, and communication from the government. This study is the first to organize facilitators and barriers to COVID-19 vaccine uptake in Kenya using the 5 Cs model of vaccine hesitancy. Our findings suggest that to improve vaccine uptake in Kenya, interventions should inform the public about the vaccine\u2019s safety and reduce misinformation.<\/jats:p>","DOI":"10.1089\/hs.2024.0049","type":"journal-article","created":{"date-parts":[[2025,3,3]],"date-time":"2025-03-03T04:30:55Z","timestamp":1740976255000},"page":"102-109","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Examining COVID-19 Vaccine Hesitancy in Nairobi, Kenya, Using the Modified 5 Cs Model"],"prefix":"10.1177","volume":"23","author":[{"given":"Christine Crudo","family":"Blackburn","sequence":"first","affiliation":[{"name":"Christine Crudo Blackburn, PhD, is an Assistant Professor, Department of Health Policy &amp; Management and USA Center for Rural Public Health Preparedness; and Jessica Hernandez, MPH, was an MPH Student at time of research, Department of Health Behavior; both in the School of Public Health, Texas A&amp;M University, College Station, TX. Leila H. Abdullahi, PhD, is a Senior Researcher and Policy Analyst, African Institute for Development Policy, Nairobi, Kenya. Tim Callaghan, PhD, is an Associate Professor, Department of Health Law, Policy &amp; Management, School of Public Health, Boston University, Boston, MA. Brian Colwell, PhD, is a Professor, and Tasmiah Nuzhath, DrPH, is an Assistant Professor; both in the Department of Global Health and Population, T.H. Chan School of Public Health, Harvard University, Cambridge, MA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leila H.","family":"Abdullahi","sequence":"additional","affiliation":[{"name":"Christine Crudo Blackburn, PhD, is an Assistant Professor, Department of Health Policy &amp; Management and USA Center for Rural Public Health Preparedness; and Jessica Hernandez, MPH, was an MPH Student at time of research, Department of Health Behavior; both in the School of Public Health, Texas A&amp;M University, College Station, TX. Leila H. Abdullahi, PhD, is a Senior Researcher and Policy Analyst, African Institute for Development Policy, Nairobi, Kenya. Tim Callaghan, PhD, is an Associate Professor, Department of Health Law, Policy &amp; Management, School of Public Health, Boston University, Boston, MA. Brian Colwell, PhD, is a Professor, and Tasmiah Nuzhath, DrPH, is an Assistant Professor; both in the Department of Global Health and Population, T.H. Chan School of Public Health, Harvard University, Cambridge, MA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Callaghan","sequence":"additional","affiliation":[{"name":"Christine Crudo Blackburn, PhD, is an Assistant Professor, Department of Health Policy &amp; Management and USA Center for Rural Public Health Preparedness; and Jessica Hernandez, MPH, was an MPH Student at time of research, Department of Health Behavior; both in the School of Public Health, Texas A&amp;M University, College Station, TX. Leila H. Abdullahi, PhD, is a Senior Researcher and Policy Analyst, African Institute for Development Policy, Nairobi, Kenya. Tim Callaghan, PhD, is an Associate Professor, Department of Health Law, Policy &amp; Management, School of Public Health, Boston University, Boston, MA. Brian Colwell, PhD, is a Professor, and Tasmiah Nuzhath, DrPH, is an Assistant Professor; both in the Department of Global Health and Population, T.H. Chan School of Public Health, Harvard University, Cambridge, MA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Colwell","sequence":"additional","affiliation":[{"name":"Christine Crudo Blackburn, PhD, is an Assistant Professor, Department of Health Policy &amp; Management and USA Center for Rural Public Health Preparedness; and Jessica Hernandez, MPH, was an MPH Student at time of research, Department of Health Behavior; both in the School of Public Health, Texas A&amp;M University, College Station, TX. Leila H. Abdullahi, PhD, is a Senior Researcher and Policy Analyst, African Institute for Development Policy, Nairobi, Kenya. Tim Callaghan, PhD, is an Associate Professor, Department of Health Law, Policy &amp; Management, School of Public Health, Boston University, Boston, MA. Brian Colwell, PhD, is a Professor, and Tasmiah Nuzhath, DrPH, is an Assistant Professor; both in the Department of Global Health and Population, T.H. Chan School of Public Health, Harvard University, Cambridge, MA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tasmiah","family":"Nuzhath","sequence":"additional","affiliation":[{"name":"Christine Crudo Blackburn, PhD, is an Assistant Professor, Department of Health Policy &amp; Management and USA Center for Rural Public Health Preparedness; and Jessica Hernandez, MPH, was an MPH Student at time of research, Department of Health Behavior; both in the School of Public Health, Texas A&amp;M University, College Station, TX. Leila H. Abdullahi, PhD, is a Senior Researcher and Policy Analyst, African Institute for Development Policy, Nairobi, Kenya. Tim Callaghan, PhD, is an Associate Professor, Department of Health Law, Policy &amp; Management, School of Public Health, Boston University, Boston, MA. Brian Colwell, PhD, is a Professor, and Tasmiah Nuzhath, DrPH, is an Assistant Professor; both in the Department of Global Health and Population, T.H. Chan School of Public Health, Harvard University, Cambridge, MA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Christine Crudo Blackburn, PhD, is an Assistant Professor, Department of Health Policy &amp; Management and USA Center for Rural Public Health Preparedness; and Jessica Hernandez, MPH, was an MPH Student at time of research, Department of Health Behavior; both in the School of Public Health, Texas A&amp;M University, College Station, TX. Leila H. Abdullahi, PhD, is a Senior Researcher and Policy Analyst, African Institute for Development Policy, Nairobi, Kenya. Tim Callaghan, PhD, is an Associate Professor, Department of Health Law, Policy &amp; Management, School of Public Health, Boston University, Boston, MA. Brian Colwell, PhD, is a Professor, and Tasmiah Nuzhath, DrPH, is an Assistant Professor; both in the Department of Global Health and Population, T.H. Chan School of Public Health, Harvard University, Cambridge, MA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,4,14]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"US Centers for Disease Control and Prevention. Fast facts on global immunization. Accessed December 2 2024. https:\/\/www.cdc.gov\/global-immunization\/fast-facts"},{"key":"e_1_3_2_3_2","unstructured":"World Health Organization (WHO). Ten threats to global health in 2019. Accessed December 2 2024. https:\/\/www.who.int\/news-room\/spotlight\/ten-threats-to-global-health-in-2019"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(23)00063-3"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-022-07486-0"},{"key":"e_1_3_2_6_2","unstructured":"Menezes NP Simuzingili M Debebe ZY Pivodic F Massiah E. What is driving COVID-19 vaccine hesitancy in sub-Saharan Africa? World Bank\u2026Blogs. Published August 11 2021. Accessed November 5 2023. https:\/\/blogs.worldbank.org\/africacan\/what-driving-covid-19-vaccine-hesitancy-sub-saharan-africa"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040073"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m734"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.3390\/diseases11010032"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2020-004206"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1080\/14760584.2021.1899819"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines10071008"},{"key":"e_1_3_2_13_2","unstructured":"Johns Hopkins University & Medicine Coronavirus Resource Center. COVID-19 Dashboard. Updated March 10 2023. Accessed April 3 2024. https:\/\/coronavirus.jhu.edu\/map.html"},{"key":"e_1_3_2_14_2","unstructured":"US Central Intelligence Agency. Kenya \u2013 country factsheet. The World Factbook. Updated February5 2025. Accessed February11 2025. https:\/\/www.cia.gov\/the-world-factbook\/countries\/kenya\/factsheets\/"},{"key":"e_1_3_2_15_2","unstructured":"Ministry of Health. COVID-19 outbreak in Kenya: daily situation report no 940. Published April 22 2021. Accessed December 2 2024. https:\/\/www.health.go.ke\/sites\/default\/files\/2023-05\/COVID-19-Outbreak-in-Kenya-Daily-Report-SITREP-940-22-April-2021.pdf"},{"key":"e_1_3_2_16_2","unstructured":"Africa Centres for Disease Control and Prevention. COVID-19 vaccination. Updated December 2 2024. Accessed December 2 2024. https:\/\/africacdc.org\/covid-19\/covid-19-vaccination\/"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines9080936"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2022.02.035"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-071032"},{"key":"e_1_3_2_20_2","article-title":"Determinants of COVID-19 vaccine behaviour intentions among the youth in Kenya: a vaccine pre-introduction study","volume":"80","author":"Osur JO","year":"2021","unstructured":"Osur JO, , Chengo R, , Muinga E, , Kemboi J, , Sidibe M, , Rarieya M. Determinants of COVID-19 vaccine behaviour intentions among the youth in Kenya: a vaccine pre-introduction study. Arch Public Health. 2021; 80.","journal-title":"Arch Public Health"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines10050705"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2023.115695"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2023.2297490"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2023.307274"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20021561"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0208601"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2022.2138047"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000003499"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1177\/1525822X16640447"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-018-0594-7"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-69909-7_3470-2"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2021.1944743"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2021.1894896"},{"key":"e_1_3_2_34_2","first-page":"2468","article-title":"COVID-19 vaccine hesitancy in KwaZulu-Natal, South Africa: a survey of unvaccinated adults","volume":"29","author":"Gengiah TN","year":"2024","unstructured":"Gengiah TN, , Naidoo DC, , Maduma N, , Govender S, , Dhindayal S, , Lewis L. COVID-19 vaccine hesitancy in KwaZulu-Natal, South Africa: a survey of unvaccinated adults. Health SA. 2024; 29:2468.","journal-title":"Health SA"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-052432"},{"key":"e_1_3_2_36_2","first-page":"37","article-title":"Willingness to take COVID-19 vaccine among people most at risk of exposure in Southern Ethiopia","volume":"12","author":"Zewude B","year":"2021","unstructured":"Zewude B, , Habtegiorgis T. Willingness to take COVID-19 vaccine among people most at risk of exposure in Southern Ethiopia. Pragmat Obs Res. 2021; 12:37-47.","journal-title":"Pragmat Obs Res"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1364225"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1186\/s41256-022-00255-1"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2018.03.073"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1080\/713851971"},{"key":"e_1_3_2_41_2","unstructured":"Muranda M. Social media helps boost vaccine coverage in Kenya. Gavi: The Vaccine Alliance. Published February 21 2022. Accessed December 2 2024. https:\/\/www.gavi.org\/vaccineswork\/social-media-helps-boost-vaccine-coverage-kenya"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1177\/1049732310367498"}],"container-title":["Health Security"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/hs.2024.0049","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/hs.2024.0049","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/hs.2024.0049","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T08:41:29Z","timestamp":1777452089000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/hs.2024.0049"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,1]]},"references-count":41,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,4,1]]}},"alternative-id":["10.1089\/hs.2024.0049"],"URL":"https:\/\/doi.org\/10.1089\/hs.2024.0049","relation":{},"ISSN":["2326-5094","2326-5108"],"issn-type":[{"value":"2326-5094","type":"print"},{"value":"2326-5108","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,1]]}}}