Determinants of COVID-19 Vaccine Uptake among Female Foreign Domestic Workers in Hong Kong: A Cross-Sectional Quantitative Survey

Globally, minority groups and non-citizens may not be sufficiently included in the COVID-19 vaccine coverage. This study seeks to understand determinants of vaccine uptake among female foreign domestic workers (FDWs) in Hong Kong. We conducted a cross-sectional study of female FDWs (n = 581) from June to August 2021. Respondents completed an online survey obtaining sociodemographic, employment, and health status information. Based upon the socio-ecological model, we obtained individual, interpersonal, and socio-structural factors that may be associated with COVID-19 vaccine uptake. Multivariable logistic regression analysis was used to examine factors associated with having received at least one dose of a COVID-19 vaccine. At the individual level, agreeing that taking COVID-19 vaccines can contribute to COVID-19 control in Hong Kong (OR 6.11, 95% CI 2.27-16.43) was associated with increased vaccine uptake, while being worried of severe side-effects from vaccination (OR 0.29, 95% CI 0.16-0.55) was associated with decreased uptake. At the interpersonal level, those being encouraged by their employer (OR 2.05, 95% CI 1.06-3.95) and family members (OR 2.27, 95% CI 1.17-4.38) were more likely to be vaccinated, while at the socio-structural level, believing vaccination would violate religious beliefs (OR 0.19, 95% CI 0.06-0.65) was associated with decreased uptake. The government can formulate a multi-level approach according to our findings to target the remaining unvaccinated FDW population.