The delay or refusal of vaccination, which defines vaccine hesitancy, is a major challenge to successful control of COVID-19 epidemic. The huge number of publications addressing COVID-19 vaccine hesitancy necessitates periodic review to provide a concise summary of COVID-19 vaccine acceptance rates worldwide. In the current narrative review, data on COVID-19 vaccine acceptance rates were retrieved from surveys in 114 countries/territories. In East and Southern Africa (n = 9), the highest COVID-19 vaccine acceptance rate was reported in Ethiopia (92%), while the lowest rate was reported in Zimbabwe (50%). In West/Central Africa (n = 13), the highest rate was reported in Niger (93%), while the lowest rate was reported in Cameroon (15%). In Asia and the Pacific (n = 16), the highest rates were reported in Nepal and Vietnam (97%), while the lowest rate was reported in Hong Kong (42%). In Eastern Europe/Central Asia (n = 7), the highest rates were reported in Montenegro (69%) and Kazakhstan (64%), while the lowest rate was reported in Russia (30%). In Latin America and the Caribbean (n = 20), the highest rate was reported in Mexico (88%), while the lowest rate was reported in Haiti (43%). In the Middle East/North Africa (MENA, n = 22), the highest rate was reported in Tunisia (92%), while the lowest rate was reported in Iraq (13%). In Western/Central Europe and North America (n = 27), the highest rates were reported in Canada (91%) and Norway (89%), while the lowest rates were reported in Cyprus and Portugal (35%). COVID-19 vaccine acceptance rates ≥60% were seen in 72/114 countries/territories, compared to 42 countries/territories with rates between 13% and 59%. The phenomenon of COVID-19 vaccine hesitancy appeared more pronounced in the MENA, Europe and Central Asia, and Western/Central Africa. More studies are recommended in Africa, Eastern Europe and Central Asia to address intentions of the general public to get COVID-19 vaccination. 

A Global Map of COVID-19 Vaccine Acceptance Rates per Country: An Updated Concise Narrative Review

COVID-19 vaccines have met varying levels of acceptance and hesitancy in different parts of the world, which has implications for eliminating the COVID-19 pandemic. The aim of this systematic review is to examine how and why the rates of COVID-19 vaccine acceptance and hesitancy differ across countries and continents. PubMed, Web of Science, IEEE Xplore and Science Direct were searched between 1 January 2020 and 31 July 2021 using keywords such as “COVID-19 vaccine acceptance”. 81 peer-reviewed publications were found to be eligible for review. The analysis shows that there are global variations in vaccine acceptance among different populations. The vaccine-acceptance rates were the highest amongst adults in Ecuador (97%), Malaysia (94.3%) and Indonesia (93.3%) and the lowest amongst adults in Lebanon (21.0%). The general healthcare workers (HCWs) in China (86.20%) and nurses in Italy (91.50%) had the highest acceptance rates, whereas HCWs in the Democratic Republic of Congo had the lowest acceptance (27.70%). A nonparametric one-way ANOVA showed that the differences in vaccine-acceptance rates were statistically significant (H (49) = 75.302, p = 0.009*) between the analyzed countries. However, the reasons behind vaccine hesitancy and acceptance were similar across the board. Low vaccine acceptance was associated with low levels of education and awareness, and inefficient government efforts and initiatives. Furthermore, poor influenza-vaccination history, as well as conspiracy theories relating to infertility and misinformation about the COVID-19 vaccine on social media also resulted in vaccine hesitancy. Strategies to address these concerns may increase global COVID-19 vaccine acceptance and accelerate our efforts to eliminate this pandemic.

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Global COVID-19 Vaccine Acceptance: A Systematic Review of Associated Social and Behavioral Factors

Determinants of COVID-19 Vaccine Acceptance among the Adult Population of Bangladesh Using the Health Belief Model and the Theory of Planned Behavior Model

Introduction Vaccination is an essential intervention to curb the coronavirus disease 2019 (COVID-19) pandemic. This review aimed to estimate the pooled proportion of COVID-19 vaccine acceptance worldwide. Methods A systematic search of the MEDLINE (PubMed) database using “COVID-19,” “vaccine” and “acceptance” to obtain original research articles published between 2020 and July 2021. Only studies with full text and that were published in English were included. The Joanna Briggs Institute meta-analysis was used to assess the data quality. The meta-analysis was performed using generic inverse variance with a random-effects model using the Review Manager software. Results A total of 172 studies across 50 countries worldwide were included. Subgroup analyses were performed with regard to vaccine acceptance, regions, population, gender, vaccine effectiveness, and survey time. The pooled proportion of COVID-19 vaccine acceptance was 61% (95% CI: 59, 64). It was higher in Southeast Asia, among healthcare workers, in males, for vaccines with 95% effectiveness, and during the first survey. Conclusion COVID-19 vaccine acceptance needs to be increased to achieve herd immunity to protect the population from the disease. It is crucial to enhance public awareness of COVID-19 vaccination and improve access to vaccines. Systematic Review Registration PROSPERO 2021, identifier CRD42021268645.

Systematic Review and Meta-Analysis of COVID-19 Vaccination Acceptance

Background Considering medical and economic burden of the coronavirus disease 2019 (COVID-19), a high COVID-19 vaccination coverage among health care workers (HCWs) is an urgent need. Objective To estimate the intention of HCWs to accept COVID-19 vaccination and to find out related factors. Design We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines for this study. Data sources We searched PubMed, Medline, Scopus, Web of Science, ProQuest, CINAHL and medRxiv from January 1, 2020 to December 02, 2020. Methods The heterogeneity between results was very high and thus we applied a random effect model to estimate pooled effects. We performed subgroup and meta-regression analysis to identify possible resources of heterogeneity. Results Eleven studies, including 8847 HCWs met the inclusion criteria. The overall proportion of HCWs that intent to accept COVID-19 vaccination was 55.9% (95% CI: 43.6-67.9%) with a wide range among studies from 27.7% to 81.5%. Intention of HCWs to accept COVID-19 vaccination was higher in studies with moderate quality and in studies that were conducted in Europe. The following factors were associated with increased HCWs’ willingness to get vaccinated against COVID-19: male gender, older age, physician profession, fewer work experience, comorbidity among HCWs, seasonal influenza vaccination, stronger vaccine confidence, positive attitude towards a COVID-19 vaccine, fear about COVID-19, individual perceived risk about COVID-19, and contact with suspected or confirmed COVID-19 patients. Conclusions HCWs represent a high-risk group for SARS-CoV-2 infection. The reluctance or refusal of HCWs to vaccinate against COVID-19 could diminish the trust of individuals and trigger a ripple effect in the general public. Since vaccination is a complex behavior, understanding the way that HCWs take the decision to accept or not COVID-19 vaccination will give us the opportunity to develop the appropriate interventions to increase COVID-19 vaccination uptake. Knowledge of the factors that affect intention of HWCs to accept COVID-19 vaccination is limited and there is an urgent need for further and more valid studies.

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Intention of health care workers to accept COVID-19 vaccination and related factors: a systematic review and meta-analysis

Psychological Determinants of COVID-19 Vaccine Acceptance among Healthcare Workers in Kuwait: A Cross-Sectional Study Using the 5C and Vaccine Conspiracy Beliefs Scales

Mariam Al-Sanafi

Papers

Psychological Determinants of COVID-19 Vaccine Acceptance among Healthcare Workers in Kuwait: A Cross-Sectional Study Using the 5C and Vaccine Conspiracy Beliefs Scales