Vaccination against COVID-19: A systematic review and meta-analysis of acceptability and its predictors

Abstract

We aimed to estimate the coronavirus disease 2019 (COVID-19) vaccine acceptance rate and identify predictors associated with acceptance. To this end, we searched PubMed, Web of Science, Cochrane Library, and Embase databases until November 4, 2020. Meta-analyses were performed to estimate the rate with 95% confidence intervals (CI). Predictors were identified to be associated with vaccination intention based on the health belief model framework. Thirty-eight articles, with 81,173 individuals, were included. The pooled COVID-19 vaccine acceptance rate was 73.31% (95%CI: 70.52, 76.01). Studies using representative samples reported a rate of 73.16%. The pooled acceptance rate among the general population (81.65%) was higher than that among healthcare workers (65.65%). Gender, educational level, influenza vaccination history, and trust in the government were strong predictors of COVID-19 vaccination willingness. People who received an influenza vaccination in the last year were more likely to accept COVID-19 vaccination (odds ratio: 3.165; 95%CI: 1.842, 5.464). Protecting oneself or others was the main reason for willingness, and concerns about side effects and safety were the main reasons for unwillingness. National- and individual-level interventions can be implemented to improve COVID-19 vaccine acceptance before large-scale vaccine rollout. Greater efforts could be put into addressing negative predictors associated with willingness.

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.…”

Changes in Attitudes and Beliefs Concerning Vaccination and Influenza Vaccines between the First and Second COVID-19 Pandemic Waves: A Longitudinal Study

“…Analogously, among Italian undergraduates, previous IV was associated with greater acceptance of COVID-19 vaccination (aOR 3.81; 95% CI: 1.18-12.27) [35]. Finally, a meta-analysis of four studies showed that previous IV was a strong predictor (OR 3.17; 95% CI: 1.84-5.46) of COVID-19 vaccine acceptance [36]. It is therefore likely that effective vaccination counseling on one infection may have indirect positive effects on the other.…”

Cross-sectional assessment of predictors for COVID-19 vaccine uptake: an online survey in Greece

“…COVID-19 vaccine acceptance shows a great variability across countries or regions which may affect the efforts to contain the pandemic (Aw et al, 2021). According to meta-analyses (Snehota et al, 2021; Q Wang et al, 2021), the average COVID-19 vaccine acceptance rate in the general population is about 73% which is lower than the percentage estimated to be sufficient for reaching herd immunity threshold with a COVID-19 vaccine that is at least 80% effective (Bartsch et al, 2020). Moreover, the longer the COVID-19 pandemic lasts, the smaller rate of the general population wants to get vaccinated (Snehota et al, 2021).…”