Josphat Martin Muchangi ¹ Rogers Moraro ^1* Jarim Omogi ² Abrar Alasmari ³ Sheillah Simiyu ⁴ Ana Bolio ³ Lennah Kanyangi ¹ Rehema Mwema ¹ Rose Bukania ⁵ Sarah Kosgei ¹

• ¹ Amref Health Africa, Nairobi, Kenya
• ² Amref International University, Nairobi, Nairobi, Kenya
• ³ Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, England, United Kingdom
• ⁴ African Population and Health Research Center (APHRC), Nairobi, Kenya
• ⁵ State Department for Social Protection and Senior Citizen Affairs, Ministry of Labour and Social Protection, Government of Kenya, Nairobi, Kenya

Access and uptake of COVID-19 vaccine by persons with disabilities remains largely unknown in lowand middle-income countries, despite the unique barriers they face, their special vulnerabilities and and trust in health workers and behaviour change techniques that inspire confidence in vaccines to improve vaccine uptake.The COVID-19 pandemic exacerbated inequalities embedded in global health systems, disproportionately impacting vulnerable populations, particularly persons with disabilities (PWDs).Throughout the pandemic, PWDs faced heightened risks of infection, severe health outcomes, and profound socioeconomic consequences due to barriers such as limited access to information, communication difficulties, and reduced availability of essential healthcare services (Jesus et al., 2020; Croft & Fraser, 2022). Globally, vaccine inequity prolonged the crisis, amplifying the disparity and further marginalising those at high risk (Asundi et al., 2021). Despite their status as a high-priority group, many governments were slow to implement inclusive COVID-19 response plans that addressed the unique needs of PWDs (Santos Saldanha et al., 2021). Research showed that while innovative care approaches and inclusive policies helped mitigate these impacts, disparities in vaccine uptake persisted due to complex social, behavioural, and structural factors (Croft & Fraser, 2022; Larson et al., 2014).For instance, in Latin America, socioeconomic challenges and low education levels hindered vaccine acceptance (Guzmán-Holst et al., 2019), while globally, misinformation and weak public health strategies fueled vaccine hesitancy (Shakeel et al., 2022). Multi-faceted interventions, such as social mobilisation and targeted communication training for healthcare workers, demonstrated potential but required adaptation to specific community needs (Jarrett et al., 2015). Kenya was no exception to these challenges. The country experienced significant impacts from the COVID-19 pandemicis one of the countries significantly affected by the global pandemic of coronavirus disease 2019, with reported high transmission rates that led tos resulting in over 0.34