About 63% of participants self-reported their willingness to accept the COVID-19 vaccine. This prevalence is slightly lower than the prevalence (72.7%) that was reported by Muhindo et al. 2022, conducted in Kampala Uganda among People living with HIV/AIDS (PLHIV) [
35]. This could be attributed to the positive belief that COVID-19 vaccines are safe and beneficial to PLHIV. A phone survey conducted in Uganda reported that 91% were willing to accept COVID-19 vaccination [
36]. The higher acceptance rate reported in this study that is relative to our study could be explained by the method of data collection that is to say, using phones to collect the data. Participants who owned mobile phones could have easily accessed information about COVID-19 vaccines and hence influencing their willingness to take a vaccine compared to those who did not own phones hence affecting the outcome of interest. Conversely, this study’s prevalence was higher than the prevalence of 37.3% reported by Kanyike et al., 2021 conducted in Uganda among medical students [
25]. The low prevalence in this study could be attributed to the low willingness to utilize healthcare services amongst students [
37]. Additionally, low proportions of willingness to accept the COVID-19 vaccine were reported in South Africa (57%) [
38] and Ethiopia (54.6%) [
22]. The possible explanation for the low willingness to accept COVID-19 vaccination in Ethiopia could be attributed to the differences in methodologies, our study utilized a prospective community-based approach while the Ethiopian study was a hospital-based survey. Low willingness to accept vaccination were reported in Nigeria and Ethiopia (54.6%, and 33.7%), respectively [
22,
39]. The Nigerian study was conducted among the tertiary institutions compared to our study that was conducted among the general population. Therefore, this could have affected the outcome of interest (willingness to receive COVID-19 vaccine). Another study conducted in Gondor city of Ethiopia among college students reported that, only 32% of the participants were willing to receive COVID-19 vaccine [
18]. Furthermore, a study conducted in South Western Ethiopia reported that, only 29% of the participants were willing to receive COVID-19 vaccine [
40]. The relatively high willingness to accept COVID-19 vaccine in our study could be attributed to the vigorous campaigns by the government of Uganda to promote COVID-19 vaccination [
41]. However, several studies have reported higher proportions of willingness to accept COVID-19 vaccine compared to our study findings for instance Ghana (70%) [
42], Nigeria (85.29%) [
43], and Canada (84%) [
21]. The relatively lower prevalence of willingness to accept COVID-19 vaccine, observed in our study relative to the above studies. This could be attributed to the differences in methodologies and the socio-demographic characteristics of population studied. The overall rate of respondent’s willingness to receive COVID-19 vaccines (63%) from our findings was consistent with a systematic review. This revealed that the rate of participants’ willingness to receive the COVID-19 vaccine ranged from 27.7–91.3% [
44]. We examined some of the reasons for not taking COVID-19 vaccine among persons aged 13–80 years. Majority of the participants reported concerns about side effects resulting from the COVID-19 vaccines. This finding is in line with studies conducted in Uganda and Spain [
26,
45]. Besides that, our findings also revealed that vaccines were not liked and that these vaccines could instead infect them with COVID-19 virus. We found consistent findings from rural Uganda [
46] and Malaysia [
47]. Furthermore, our findings indicated that some people were not willing to accept COVID-19 vaccine because they had not contracted COVID-19 infection in the past six months. Therefore, they thought they were ineligible for COVD-19 vaccine uptake. This finding agrees with an online survey conducted among US adults [
28]. The USA study used similar methodologies which could explain the consistency of results.
Persons aged 13–19 years (aPR = 0.79; 95% CI: 0.74, 0.84) or 20–29 years (aPR = 0.93; 95% CI: 0.88, 0.98) were less likely to accept the vaccine compared to persons aged 40–49 years. This finding is consistent with findings from studies conducted in Africa that reported that young participants were less likely to accept COVID-19 vaccine compared to older participants [
40,
48‐
50]. The possible explanation could be that, young people perceived themselves to be safer and not at risk of COVID-19 infections as compared to the ageing population [
49,
50]. We found that, persons with post-primary level of education (aPR = 1.05; 95% CI: 1.02, 1.09) were more likely to accept COVID-19 vaccine compared to those with primary level of education. This is consistent with findings from other studies conducted in other settings [
18,
40,
51,
52]. The possible explanation could be that, high level of education is positively correlated with knowledge. Therefore, persons with high level of education are more likely to be knowledgeable and aware of COVID-19 preventive strategies such as vaccination compared to those with non-formal education. Our study reported that, students or government staff were more likely to accept COVID-19 vaccine (aPR = 1.13; 95% CI: 1.04, 1.23) compared to those doing construction and mechanic work as their main occupation. This finding is consistent with studies conducted elsewhere [
1,
40]. The possible explanation could be attributed to ease with accessibility to information amongst government workers or students as opposed to construction/mechanic workers. Although variables such as marital status, sex and comorbidity were not associated with willingness to receive COVID-19 vaccine. These variables have been previously associated with willingness to receive COVID-19 vaccine [
34,
53]. The possible explanation could be due to differences in the study methodology and socio-demographic characteristics of population studied.