KAMPALA, Uganda—A clutch of bus passengers were reluctant to show their Covid-19 vaccination cards at a routine checkpoint on Uganda’s main highway on a recent Monday morning. Health inspectors showed little patience: They called the police.

While countries in some parts of the world have offered all manner of incentives or threats to convince people to get inoculated, from vaccine passports to lottery tickets, some African nations are taking a more aggressive stance by involving law enforcement.

For...

KAMPALA, Uganda—A clutch of bus passengers were reluctant to show their Covid-19 vaccination cards at a routine checkpoint on Uganda’s main highway on a recent Monday morning. Health inspectors showed little patience: They called the police.

While countries in some parts of the world have offered all manner of incentives or threats to convince people to get inoculated, from vaccine passports to lottery tickets, some African nations are taking a more aggressive stance by involving law enforcement.

For the bus passengers, that meant being removed by the police if they couldn’t produce evidence that they had received the vaccine. They were then taken to a white tent at the side of the road where they were injected with the AstraZeneca vaccine before being allowed to proceed.

“We are doing this to protect people against the pandemic. It is in everyone’s best interests,” said Marutsya Tumwine, a police commander in Kasese district, who witnessed the scene.

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In most countries, there isn’t a legal basis for the strategy. Uganda, for example, hasn’t yet made Covid-19 vaccinations mandatory. But because rumors and conspiracy theories about the vaccines—chiefly that they cause infertility—have slowed uptake, countries such as Uganda and Rwanda have been prompted to vaccinate by force, if necessary.

“We are doing all this to protect lives,” said Dr. Alfred Driwale, head of the immunization program at Uganda’s health ministry. “We are faced with an unprecedented health crisis.”

Across the continent, some 80% of the 1.4 billion population has yet to receive a single shot of a Covid-19 vaccine, according to the World Health Organization. Initially this was because of slow supplies, and this continues to be the case in many areas.

So far, nearly 700 million doses have been shipped to Africa, the WHO says, but less than half of those have been administered across the continent’s 54 countries.

Testing for Covid-19 outside the soccer stadium in Yaounde, Cameroon, before one of the Africa Cup of Nations games.

Photo: THAIER AL-SUDANI/REUTERS

In some instances, vaccines have been destroyed after expiring, the rollout is slow because some areas are hard to access and residents are resistant to the vaccine. In the Democratic Republic of Congo’s capital, Kinshasa, troops roam the streets to enforce nighttime curfews to stem the spread of the virus and at least 11 provinces in the vast nations lack any kind of vaccination center. From Burundi to Togo, many poorer countries have yet to fully reopen their borders, and hospitals are running out of supplies to treat those infected.

Even as the shots have become more widely available in some areas, there has been a deluge of misinformation on social media—specifically the unfounded fear that vaccination will cause sterility. This, combined with fringe religious teachings and a lack of faith in government, has hindered the rollout. It has also raised questions about the numbers of Africans who, like many in the U.S., will choose to stay unvaccinated.

“We know that increasing supply by itself is not enough to turn vaccines into vaccinations,” U.S. Secretary of State Antony Blinken told a global meeting on Covid-19 this month. “We’ve got to address the information gaps that lead to low confidence in vaccines. In some cases, bad actors are spreading misinformation and disinformation.”

In Cameroon, where only 2.5% of the population is vaccinated, thousands of soccer fans who refused to be inoculated jumped fences to force their way into stadiums during the Africa Cup of Nations tournament in January, the Ministry of Sports said. Government officials have blamed the stampede outside a soccer stadium that killed eight people on fans who were trying to dodge Covid-19 checks.

Hence the extreme measures, officials say. In Uganda, armed police have been sweeping up unvaccinated people from buses and at checkpoints for months to inoculate them, according to residents and police officers. It appears to be working. In early November, only 14% of Ugandan adults had received their first dose. That had increased to over 60% by the end of January.

Zimbabwe reopened schools in February after a delay following a rise in Covid-19 infections.

Photo: Tsvangirayi Mukwazhi/Associated Press

New legislation making its way through the country’s parliament also now proposes a six-month jail term for anyone refusing to be vaccinated.

Some health officials, such as Dr. Phionah Atuhebwe, new vaccines introduction officer at WHO Africa, have cautioned about the way vaccine mandates are being enforced.

“We request countries to engage communities and increase public confidence and trust in these vaccines before mandates are used,” Dr. Atuhebwe said at WHO’s weekly briefing. “Mandates should be a last resort to getting people vaccinated.”

Such concerns, however, aren’t stopping countries such as Rwanda from taking tough steps. Local leaders are searching for vaccine evaders, house by house across the length of the mountainous nation, as they try to increase the number of people who have had at least two doses. At over 60%, Rwanda’s vaccination rate is among the highest in Africa.

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Last month, authorities in the Democratic Republic of Congo forcefully repatriated hundreds of Rwandans who had illegally entered the country to flee forced vaccinations. Hundreds of other Rwandans have also fled to neighboring Burundi to escape the injections, due to religious beliefs, Rwanda’s health ministry said.

Other nations, including Ghana and Zimbabwe, have announced vaccine mandates for some groups of public employees as they try to open their economies after lengthy lockdowns. According to the World Bank, every month of delay in lifting Covid-19 containment measures is estimated to cost Africa $13.8 billion from trade disruptions and lost jobs.

Amid the tough measures, Uganda’s long-serving leader, Yoweri Museveni, reopened bars and nightclubs that had remained closed since early 2020. Schools have also reopened, ending one of the world’s longest school closures due to the pandemic.

In African countries, there have been only a few antivaccination protests like those in the U.S. and parts of Europe. In some nations, such as Rwanda, citizens are aware that criticizing government policy “almost guarantees some form of reprisal,” according to Human Rights Watch.

Instead, those who are wary of the vaccine go underground, such as the people who tried to slip out from Rwanda to neighboring Congo. Others consider leaving the cities for more remote areas where they believe there will be less pressure to get vaccinated.

“I don’t want to be given this vaccine by force because my pastor told me it could be dangerous,” said Martha Nansamba, who works as a waitress at a restaurant in Kampala. She is planning to relocate to her village in the countryside to avoid being vaccinated. “I don’t have any children yet and I hear that it makes people sterile,” she said.

Write to Nicholas Bariyo at nicholas.bariyo@wsj.com