Quantitative Synthesis of Factors Associated with COVID-19 Vaccine Acceptance and Vaccine Hesitancy in 185 Countries
Author:
Dinga Jerome Nyhalah12ORCID, Kabakama Severin3, Njimoh Dieudonne Lemuh4, Chia Julius Ebua5, Morhason-Bello Imran6, Lumu Ivan7ORCID
Affiliation:
1. Michael Gahnyam Gbeugvat Foundation, Buea P.O. Box 63, Cameroon 2. Biotechnology Unit, University of Buea, Buea P.O. Box 63, Cameroon 3. Humanitarian and Public Health Consultant, Mwanza P.O. Box 511, Tanzania 4. Department of Biochemistry and Molecular Biology, University of Buea, Buea P.O. Box 63, Cameroon 5. World Health Organization-Regional Office for Africa, Brazaville P.O. Box 06, Congo 6. College of Medicine, University of Ibadan, Ibadan 200284, Nigeria 7. Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala P.O. Box 7072, Uganda
Abstract
Mass vaccination against COVID-19 is the best method to ensure herd immunity in order to curb the effect of the pandemic on the global economy. It is therefore important to assess the determinants of COVID-19 vaccine acceptance and hesitancy on a global scale. Factors were recorded from cross-sectional studies analyzed with t-Test, ANOVA, correlation, and meta-regression analyses and synthesized to identify global trends in order to inform policy. We registered the protocol (ID: CRD42022350418) and used standard Cochrane methods and PRISMA guidelines to collect and synthesize cross-sectional articles published between January 2020 and August 2023. A total of 67 articles with 576 studies from 185 countries involving 3081,766 participants were included in this synthesis. Global COVID-19 vaccine acceptance was 65.27% (95% CI; 62.72–67.84%), while global vaccine hesitancy stood at 32.1% (95% CI; 29.05–35.17%). One-Way ANOVA showed that there was no significant difference in the percentage Gross Domestic Product spent on vaccine procurement across the World Bank income levels (p < 0.187). There was a significant difference of vaccine acceptance (p < 0.001) and vaccine hesitancy (p < 0.005) across the different World Bank Income levels. World Bank income level had a strong influence on COVID-19 vaccine acceptance (p < 0.0004) and hesitancy (p < 0.003) but percentage Gross Domestic Product spent on vaccine procurement did not. There was no correlation between percentage Gross Domestic Product spent on vaccine procurement and COVID-19 vaccine acceptance (r = −0.11, p < 0.164) or vaccine hesitancy (r = −0.09, p < 0.234). Meta-regression analysis showed that living in an urban setting (OR = 4.83, 95% CI; 0.67–212.8), rural setting (OR = 2.53, 95% CI; 0.29–119.33), older (OR = 1.98, 95% CI; 0.99–4.07), higher education (OR = 1.76, 95% CI; 0.85–3.81), and being a low income earner (OR = 2.85, 95% CI; 0.45–30.63) increased the odds of high COVID-19 vaccine acceptance. Factors that increased the odds of high COVID-19 vaccine hesitancy were no influenza vaccine (OR = 33.06, 95% CI; 5.03–1395.01), mistrust for vaccines (OR = 3.91, 95% CI; 1.92–8.24), complacency (OR = 2.86, 95% CI; 1.02–8.83), pregnancy (OR = 2.3, 95% CI; 0.12–141.76), taking traditional herbs (OR = 2.15, 95% CI; 0.52–10.42), being female (OR = 1.53, 95% CI; 0.78–3.01), and safety concerns (OR = 1.29, 95% CI; 0.67–2.51). We proposed a number of recommendations to increase vaccine acceptance and ensure global herd immunity against COVID-19.
Subject
Pharmacology (medical),Infectious Diseases,Drug Discovery,Pharmacology,Immunology
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