COVID‐19 vaccination intention in the first year of the pandemic: A systematic review

Abstract

Aims and objectives:To synthesise evidence regarding vaccination intention, identify factors contributing to vaccine hesitancy among healthcare professionals and the general populations globally. Background:As COVID-19 vaccine becomes available worldwide, attention is being directed to community vaccine uptake, to achieve population-wide immunity. A number of factors have been reported to influence vaccine intention. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search of COVID-19 vaccination intention related literature published on or before 31 December 2020 from seven databases was undertaken.Results: Thirty articles were included in this systematic review. Overall COVID-19 vaccination intention during the first year of the pandemic ranged from 27.7% to 93.3%. Findings highlighted that socio-demographic differences, perceptions of risk and susceptibility to COVID-19 and vaccine attributes influenced vaccination intention. Healthcare professionals particularly, nurses have higher vaccine hesitancy reportedly due to concerns regarding vaccine safety and efficacy and mistrust of health authorities. Negative information about COVID-19 vaccines in the social media and low confidence in the health system were associated with lower acceptability among the community. Interestingly, cumulative increase in COVID-19 caseloads of countries over time was not associated with vaccination intention. Conclusions:The significant variability in vaccine intention rates worldwide would hamper efforts to achieve immunity against COVID-19. Nurses' concerns about vaccine safety and efficacy need to be addressed to increase vaccine acceptance and maximise their influence on vaccination decision in the community. As misinformation through social media negatively impacts vaccination uptake, authoritative and reliable information on vaccine attributes, disease risks and vaccination benefits are needed.

To Get Vaccinated, or Not to Get Vaccinated, That Is the Question: Illness Representations about COVID-19 and Perceptions about COVID-19 Vaccination as Predictors of COVID-19 Vaccination Willingness among Young Adults in The Netherlands

“…These results replicate earlier findings indicating that the two treatment perception dimensions are independently related to the uptake of and adherence to pharmaceuticals [47,57,62,63]. These findings also correspond with systematic reviews on determinants of COVID-19 vaccination hesitancy [19,64,65] and the uptake of seasonal and pandemic influenza vaccination [66,67] that highlighted, in addition to a number of contextual factors, lower risk perceptions and worry about the disease as well as concerns about the effectiveness and safety of the vaccine as important barriers of vaccination intention and uptake.…”

“…According to previous literature [24,25], evidence-based change techniques that could be used to target these cognitions may be utilizing persuasive communication, modelling of the targeted behavior, introducing new arguments in favor of the behavior change, or stimulating anticipated regret. Additionally, the present results along with earlier findings [19,[64][65][66][67] indicate that strengthening concerns about COVID-19 might also promote the willingness to receive the vaccine. However, Vollmann and colleagues [42] pointed out that as the illness representation dimensions perceived control and concerns are naturally negatively associated, it is fairly impossible to simultaneously threaten people and make them believe in an effective solution for a health problem in one intervention.…”

“…Based on the findings of the present study and former research [19,[64][65][66][67], the focus of these public campaigns should lie on increasing the perception that a COVID-19 infection can be prevented by vaccination and on fostering the perceived personal need of the vaccination for staying healthy, while concerns about side effects and long-term consequences of the vaccination should be decreased. According to previous literature [24,25], evidence-based change techniques that could be used to target these cognitions may be utilizing persuasive communication, modelling of the targeted behavior, introducing new arguments in favor of the behavior change, or stimulating anticipated regret.…”

“…For example, reviews on vaccination hesitancy also identified self-efficacy, behavioral control, and social influences such as normative pressure as important psychological factors affecting the decision for or against vaccination [66,67,81]. Furthermore, contextual influences (e.g., access to health services, policies, communication and media environment) and vaccine-specific issues (e.g., costs, mode of administration, vaccination schedule) that have previously been identified as potential determinants in the context of vaccination [19,64,66,67,81] were not considered in the present study. Future studies would profit from investigating the actual COVID-19 vaccination uptake in a sample with a more heterogeneous educational background while considering multiple determinants of preventive behaviors and specifically vaccination uptake.…”

Drivers of COVID-19 Vaccine Uptake amongst Healthcare Workers (HCWs) in Nigeria

“…A systematic review, comprising studies of vaccination intention in high-income countries (HICs), conducted in 2020, found similar patterns: Older HCWs were more willing to be vaccinated, physicians were more willing to be vaccinated than nurses, more educated HCWs were more willing to be vaccinated, and HCWs who had encountered or were taking care of COVID-19 patients were more willing to be vaccinated. The review concluded that addressing misinformation, especially among nurses, should be a high priority [5]. A systematic review of HCWs' attitudes towards COVID-19 vaccination, which included seven studies from the US and two from China, found relatively low rates of vaccine acceptance [6].…”