Publication date: Jul 29, 2025

The coronavirus disease 2019 (COVID-19) pandemic exposed global public health preparedness challenges. In Ethiopia, healthcare workers (HCWs) faced barriers to vaccination despite widespread availability. Here, we describe severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and vaccine uptake among HCWs in Addis Ababa after the national vaccine rollout. A prospective cohort study enrolled 469 HCWs with baseline and 5 follow-up visits over 6 months (January 2022-July 2022). Nasopharyngeal swabs were tested using real-time reverse transcription polymerase chain reaction. Associations among participant characteristics, vaccination status, and SARS-CoV-2 infection were assessed using the Fisher exact test and odds ratios (ORs) with 95% confidence intervals (CIs). At baseline, 57% (267 of 469) of participants were fully vaccinated, with physicians having higher uptake than other HCWs (82% vs 52%; P < .001). Vaccination was not associated with perceived risk (P = 1. 00) or workplace exposure (P = .08). Over 6 months, 11% (53 of 469) experienced SARS-CoV-2 infection, all with mild symptoms and no hospitalizations. Infection was not associated with vaccination (P = .66) or occupational characteristics but was more likely in HCWs who felt safe from infection (OR = 2. 05; 95% CI, 1. 11-3. 81; P = .02). Despite vaccine availability, uptake remained suboptimal among Ethiopian HCWs. Misalignment between perceived risk and vaccination decisions suggests the need for targeted interventions. Educational campaigns and community leader engagement may improve vaccine acceptance. The association between perceived safety and infection risk highlights the need for continued infection prevention measures.

Semantics

Original Article