IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v382y2025ics0277953625006045.html

Did COVID-19 vaccine enforcement work? Evidence from northwestern and northern Uganda

Author

Listed:
  • Parker, Melissa
  • Okello, Bob
  • Kermundu, Peter
  • Ozunga, Bono E.
  • Baluku, Moses
  • Akello, Grace
  • MacGregor, Hayley
  • Leach, Melissa
  • Allen, Tim

Abstract

During the COVID-19 pandemic, vaccination programmes were shaped by diverse approaches to enforcement. Yet, little is known about how public authority influenced modes of enforcement on the ground or their ramifications for governance and public health more broadly. This article focuses on the Ugandan mandatory COVID-19 vaccination programme in two contrasting geographical and socio-political spaces: rural Dei and peri-urban Gulu. Ethnographic and survey research demonstrated that enforcement occurred in different ways and by diverse public authorities, with ostensibly contrasting results. In Dei, self-reported vaccine uptake and coverage was 77 % and 73 % respectively; while in Gulu, it was 46 % and 23 %, and below the national target of 70 %.

Suggested Citation

  • Parker, Melissa & Okello, Bob & Kermundu, Peter & Ozunga, Bono E. & Baluku, Moses & Akello, Grace & MacGregor, Hayley & Leach, Melissa & Allen, Tim, 2025. "Did COVID-19 vaccine enforcement work? Evidence from northwestern and northern Uganda," Social Science & Medicine, Elsevier, vol. 382(C).
    • Handle: RePEc:eee:socmed:v:382:y:2025:i:c:s0277953625006045
    DOI: 10.1016/j.socscimed.2025.118273
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953625006045
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2025.118273?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to

    for a different version of it.

    References listed on IDEAS

    as
    1. Parker, Melissa & Allen, Tim, 2011. "Does mass drug administration for the integrated treatment of neglected tropical diseases really work?: assessing evidence for the control of schistosomiasis and soil-transmitted helminths in Uganda," LSE Research Online Documents on Economics 44291, London School of Economics and Political Science, LSE Library.
    2. Leach, Melissa & MacGregor, Hayley & Akello, Grace & Babawo, Lawrence & Baluku, Moses & Desclaux, Alice & Grant, Catherine & Kamara, Foday & Nyakoi, Marion & Parker, Melissa & Richards, Paul & Mokuwa,, 2022. "Vaccine anxieties, vaccine preparedness: Perspectives from Africa in a Covid-19 era," Social Science & Medicine, Elsevier, vol. 298(C).
    3. David Musoke & Sarah Nalinya & Grace Biyinzika Lubega & Kevin Deane & Elizabeth Ekirapa-Kiracho & David McCoy, 2023. "The effects of COVID-19 lockdown measures on health and healthcare services in Uganda," PLOS Global Public Health, Public Library of Science, vol. 3(1), pages 1-16, January.
    4. Vanderslott, Samantha & Enria, Luisa & Bowmer, Alex & Kamara, Abass & Lees, Shelley, 2022. "Attributing public ignorance in vaccination narratives," Social Science & Medicine, Elsevier, vol. 307(C).
    5. Mylan, Sophie, 2024. "Suspicious business: COVID-19 vaccination in Palabek refugee settlement, northern Uganda," Social Science & Medicine, Elsevier, vol. 346(C).
    6. Greenough, Paul, 1995. "Intimidation, coercion and resistance in the final stages of the South Asian Smallpox Eradication Campaign, 1973-1975," Social Science & Medicine, Elsevier, vol. 41(5), pages 633-645, September.
    7. Melissa Parker & Tim Allen & Georgina Pearson & Nichola Peach & Rachel Flynn & Nicholas Rees, 2012. "Border parasites: schistosomiasis control among Uganda's fisherfolk," Journal of Eastern African Studies, Taylor & Francis Journals, vol. 6(1), pages 98-123.
    8. Parker, Melissa & Baluku, Moses & Ozunga, Bono E. & Okello, Bob & Kermundu, Peter & Akello, Grace & MacGregor, Hayley & Leach, Melissa & Allen, Tim, 2022. "Epidemics and the Military: Responding to COVID-19 in Uganda," Social Science & Medicine, Elsevier, vol. 314(C).
    9. Akello, Grace & Reis, Ria & Richters, Annemiek, 2010. "Silencing distressed children in the context of war in northern Uganda: An analysis of its dynamics and its health consequences," Social Science & Medicine, Elsevier, vol. 71(2), pages 213-220, July.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Mylan, Sophie, 2024. "Suspicious business: COVID-19 vaccination in Palabek refugee settlement, northern Uganda," Social Science & Medicine, Elsevier, vol. 346(C).
    2. Tim Allen & Melissa Parker, 2024. "In the line of duty: Militarising African epidemics," Global Policy, London School of Economics and Political Science, vol. 15(S4), pages 97-108, July.
    3. Parker, Melissa & Baluku, Moses & Ozunga, Bono E. & Okello, Bob & Kermundu, Peter & Akello, Grace & MacGregor, Hayley & Leach, Melissa & Allen, Tim, 2022. "Epidemics and the Military: Responding to COVID-19 in Uganda," Social Science & Medicine, Elsevier, vol. 314(C).
    4. Carolina Bueno & Rafael Macharete & Clarice Araújo Rodrigues & Felipe Kamia & Juliana Moreira & Camila Rizzini Freitas & Marco Nascimento & Carlos Grabois Gadelha, 2025. "Global Knowledge Asymmetries in Health: A Data-Driven Analysis of the Sustainable Development Goals (SDGs)," Sustainability, MDPI, vol. 17(14), pages 1-21, July.
    5. Panter-Brick, Catherine & Eggerman, Mark, 2018. "The field of medical anthropology in Social Science & Medicine," Social Science & Medicine, Elsevier, vol. 196(C), pages 233-239.
    6. Sweet, Rachel & Kasali, Noé, 2024. "Public health intervention amidst conflict: Violence, politics, and knowledge frames in the 2018-20 Ebola epidemic in Democratic Republic of the Congo," Social Science & Medicine, Elsevier, vol. 350(C).
    7. James, Myfanwy & Kasereka, Joseph Grace & Kasiwa, Benjamin & Kavunga-Membo, Hugo & Kambale, Kasonia & Grais, Rebecca & Muyembe-Tamfum, Jean-Jacques & Bausch, Daniel G. & Watson-Jones, Deborah & Lees, , 2023. "Protection, health seeking, or a laissez-passer: Participants’ decision-making in an EVD vaccine trial in the eastern Democratic Republic of the Congo," Social Science & Medicine, Elsevier, vol. 323(C).
    8. Claire J Standley & Ellie Graeden & Justin Kerr & Erin M Sorrell & Rebecca Katz, 2018. "Decision support for evidence-based integration of disease control: A proof of concept for malaria and schistosomiasis," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 12(4), pages 1-23, April.
    9. Rebecca Horn, 2013. "Psychosocial Distress and Well-Being among Acholi Women in Northern Uganda," World Bank Publications - Reports 17860, The World Bank Group.
    10. Beekam Kebede Olkeba & Pieter Boets & Seid Tiku Mereta & Belayhun Mandefro & Gemechu Debesa & Mahmud Ahmednur & Argaw Ambelu & Wolyu Korma & Peter L. M. Goethals, 2021. "Malacological and Parasitological Surveys on Ethiopian Rift Valley Lakes: Implications for Control and Elimination of Snail-Borne Diseases," IJERPH, MDPI, vol. 19(1), pages 1-15, December.
    11. Slagboom, M. Nienke & Crone, Mathilde R. & Reis, Ria, 2022. "Exploring syndemic vulnerability across generations: A case study of a former fishing village in the Netherlands," Social Science & Medicine, Elsevier, vol. 295(C).
    12. Bardosh, Kevin & Inthavong, Phouth & Xayaheuang, Sivilai & Okello, Anna L., 2014. "Controlling parasites, understanding practices: The biosocial complexity of a One Health intervention for neglected zoonotic helminths in northern Lao PDR," Social Science & Medicine, Elsevier, vol. 120(C), pages 215-223.
    13. Isaac Koomson & Moses Okumu & David Ansong, 2022. "Introducing the Disease Outbreak Resilience Index (DORI) Using the Demographic and Health Surveys Data from sub-Saharan Africa," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 162(3), pages 1149-1175, August.
    14. Otake, Yuko, 2019. "Suffering of silenced people in northern Rwanda," Social Science & Medicine, Elsevier, vol. 222(C), pages 171-179.
    15. Manca, Terra, 2025. "“Vaccines protect both you and your newborn:” A discourse analysis of risk and uncertainty in information about vaccination in pregnancy," Social Science & Medicine, Elsevier, vol. 364(C).
    16. Richard B. Yapi & Clarisse A. Houngbedji & Daniel K.G. N’Guessan & Arlette O. Dindé & Aimé R. Sanhoun & Ariane Amin & Kossia D.T. Gboko & Kathrin Heitz-Tokpa & Gilbert Fokou & Bassirou Bonfoh, 2021. "Knowledge, Attitudes, and Practices (KAP) Regarding the COVID-19 Outbreak in Côte d’Ivoire: Understanding the Non-Compliance of Populations with Non-Pharmaceutical Interventions," IJERPH, MDPI, vol. 18(9), pages 1-21, April.
    17. Blume, Stuart S., 2005. "Lock in, the state and vaccine development: Lessons from the history of the polio vaccines," Research Policy, Elsevier, vol. 34(2), pages 159-173, March.
    18. Inchi, Liron & Shimoni, Baruch & Madjar, Batia & Bord, Shiran, 2025. "Encounters between fields: Integrating military forces into the health field's epidemiological effort during COVID-19 in Israel," Social Science & Medicine, Elsevier, vol. 379(C).
    19. Kim Ozano & Laura Dean & Mami Yoshimura & Eleanor MacPherson & Natalia Linou & Mariam Otmani del Barrio & Christine M Halleux & Olumide Ogundahunsi & Sally Theobald, 2020. "A call to action for universal health coverage: Why we need to address gender inequities in the neglected tropical diseases community," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 14(3), pages 1-7, March.
    20. Streefland, Pieter H., 2001. "Public doubts about vaccination safety and resistance against vaccination," Health Policy, Elsevier, vol. 55(3), pages 159-172, March.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:382:y:2025:i:c:s0277953625006045. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.