The Ethicality of Mandatory COVID-19 Vaccinations in Uganda: A Qualitative Study

Abstract Background COVID-19 spread globally and caused greater than 3.9 million deaths worldwide. Approximately 2.8 billion doses of COVID-19 vaccines were administered worldwide. Some studies have suggested that vaccination is the most effective strategy for mitigating COVID-19. However, due to vaccine hesitancy, many people end up shunning vaccinations. The parliamentary committee on health in Uganda proposed making coronavirus vaccinations mandatory and as a result, the Public Health Act was amended in 2022 making vaccinations of immunizable diseases mandatory. There has not been a scientific study to explore the views of healthcare workers, bioethicists, and the general public on the ethicality of mandatory COVID-19 vaccinations in Uganda. Methods This was a cross-section sectional study that employed in-depth interviews and focus group discussions. The study was conducted in Mulago National Referral Hospital, Makerere University, College of Health Sciences, Wandegeya, and Mulago areas. Fifteen participants were purposively selected based on their expertise for in-depth interviews and four groups of twenty-four members for focus group discussions. Data were transcribed verbatim and analyzed. The coding was both deductive and inductive. NVivo software 12 was used to support data analysis and illustrative quotes were extracted. Results The participants shared their perspective on the ethicality surrounding mandatory COVID-19 vaccinations. Opinions were divided: 21 participants supported the mandates, 5 expressed reservations, and 13 opposed them. Supporters argued that requiring vaccination helped reduce infection rates and that the overall benefits outweighed any potential risks. Those with reservations felt that, while mandates were necessary in principle, there were significant practical concerns, controversies, and shortcomings in their implementation. Opponents contended that such mandates infringed upon their personal autonomy. Conclusion This inquiry into the ethicality of mandatory COVID-19 vaccinations raised mixed views among the stakeholders, and implementors of vaccination programs should have put this in mind. Clinical Trial number: Not Applicable