COVID-19 Vaccine Hesitancy Worldwide: A Concise Systematic Review of Vaccine Acceptance Rates

Abstract

Utility of vaccine campaigns to control coronavirus 2019 disease (COVID-19) is not merely dependent on vaccine efficacy and safety. Vaccine acceptance among the general public and healthcare workers appears to have a decisive role in the successful control of the pandemic. The aim of this review was to provide an up-to-date assessment of COVID-19 vaccination acceptance rates worldwide. A systematic search of the peer-reviewed English survey literature indexed in PubMed was done on December 25, 2020. Results from 31 peer-reviewed published studies met the inclusion criteria and formed the basis for the final COVID-19 vaccine acceptance estimates. Survey studies on COVID-19 vaccine acceptance rates were found from 33 different countries. Among adults representing the general public, the highest COVID-19 vaccine acceptance rates were found in Ecuador (97.0%), Malaysia (94.3%), Indonesia (93.3%) and China (91.3%). However, the lowest COVID-19 vaccine acceptance rates were found in Kuwait (23.6%), Jordan (28.4%), Italy (53.7), Russia (54.9%), Poland (56.3%), US (56.9%), and France (58.9%). Only eight surveys among healthcare workers (doctors and nurses) were found, with vaccine acceptance rates ranging from 27.7% in the Democratic Republic of the Congo to 78.1% in Israel. In the majority of survey studies among the general public stratified per country (29/47, 62%), the acceptance of COVID-19 vaccination showed a level of ≥ 70%. Low rates of COVID-19 vaccine acceptance were reported in the Middle East, Russia, Africa and several European countries. This could represent a major problem in the global efforts to control the current COVID-19 pandemic. More studies are recommended to address the scope of COVID-19 vaccine hesitancy. Such studies are particularly needed in the Middle East and North Africa, Sub-Saharan Africa, Eastern Europe, Central Asia, Middle and South America. Addressing the scope of COVID-19 vaccine hesitancy in various countries is recommended as an initial step for building trust in COVID-19 vaccination efforts.

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“…However, about onefourth of the study participants were unwilling or uncertain to accept a vaccine for coronavirus. Our prevalence of vaccine acceptance was similar to a population-based study conducted in France, Denmark, Australia, Mexico, India, and Ireland [6,15,17,20,21]. Though few other studies conducted in the UK (63.5%-67%), Kuwait (23.6%), Saudia Arabia (64.7%), Russia (54.9%), and Italy (53.7%) showed a lower prevalence of vaccine acceptance compared to our study [18,[28][29][30][31][32].…”

“…However, data on vaccine acceptance from Low-and-middle Income Countries (LMIC), mainly from Central and South Asia, is substantially limited [20,21]. This indicates a need for specific research in these regions to explore the factors that determine the acceptance, hesitancy, and refusal of vaccines, as evidence from developed countries will not be applicable here due to the significant differences in social, cultural, and economic contexts.…”

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“…The results portray somewhat less skepticism towards vaccination in the Norwegian population compared to other countries across Europe. Vaccine hesitancy rates in European countries in the first half of 2020 (i.e., February until the end of May) ranged from 17% to 38%, and in the second half of 2020 (i.e., June until December) ranged from 25% to 46% (Lazarus et al, 2021;Sallam, 2021). A plausible explanation for the lower prevalence of vaccination hesitancy in Norway includes the high level of trust in health and governmental officials in the Norwegian population and the Nordic countries in general VACCINE HESITANCY DURING THE COVID-19 PANDEMIC 12 (Edlund, 1999;Stein et al, 2019).…”

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“…It is also important to mention that, to guarantee a successful and effective vaccination program, governments and social media should encourage citizens to be willing to work together to solve the public health problem [53,54], as well as providing information to relieve their uncertainties. In several countries, survey studies have noted varying vaccine acceptance rates, so hesitancy needs to be addressed at the beginning of vaccination programs [55]. The countries with the highest rates of acceptance are Vietnam (98%), India (91%), China (91%), Denmark (87%), and South Korea (87%), whereas Serbia (38%), Croatia (41%), France (44%), Lebanon (44%), and Paraguay (51%) are those with the lowest acceptance rates [56].…”