Scoping review of COVID-19 vaccines access, equity, hesitancy, and uptake in Kenya: lessons for the next pandemic

Abstract

Introduction: The global rollout of COVID-19 vaccines was hampered by hesitancy, even as the pandemic intensified, underscoring the urgent need to strengthen vaccination efforts to reach most of the population. The primary objective of this review was to identify the critical barriers to equitable and timely access to and uptake of vaccines in Kenya with a view to mitigating the impacts of future pandemics, such as COVID-19. Methods: A digital search was conducted between February and March 17, 2024, and between December 2025 and February 2026, using four databases: PUBMED, Google Scholar, Cochrane Library, and Africa Journals Online. The search was limited to peer-reviewed articles only. The keywords used in the search were: COVID-19 vaccine + Access +Kenya; COVID-19 vaccine +Uptake+ Kenya; COVID-19 vaccine +Equity+ Kenya; COVID-19 vaccine +Hesitancy+ Kenya. The search was restricted to studies published from 2020, when the first vaccines were rolled out. Three researchers independently reviewed articles for inclusion and exclusion. Results: A total of 60 articles were included in the review. The main themes identified include geographic access, socio-demographic factors, economic and political determinants, and distrust in government systems. Among the critical determinants of COVID-19 vaccine uptake, confidence in the vaccine's efficacy and safety was a significant consideration. Geographic access to vaccination sites hindered uptake; for example, only 9.7% were vaccinated in a hard-to-reach county, compared to 53% in an urban county. Sociodemographic factors, including age, gender, level of education, occupation, and co-morbidity, significantly influenced vaccine uptake in Kenya. Above all, the Ministry of Health's failure to mount a convincing response to myths and misconceptions about the COVID-19 vaccine ultimately affected vaccination coverage nationwide. Conclusion: Future preparedness must ensure inclusive vaccine strategies led by governments with clear policies and tailored outreach. Communication should address vulnerable groups and reduce hesitancy. Improving access and engaging communities are key to equity. Social workers help build trust and local relevance.