review · Tropical Medicine and Infectious Disease
A systematic review and meta-analysis evaluated global acceptance and uptake of COVID-19 vaccine booster doses across 48 high-quality studies comprising 198,831 individuals. The overall pooled booster dose acceptance rate was 81 percent, with 79 percent expressing an intention to receive the booster, whereas actual recorded uptake was 31 percent. Among healthcare workers, booster acceptance was 66 percent. Regional acceptance varied substantially, led by the Western Pacific at 89 percent and Europe at 86 percent, followed by the Americas at 77 percent, the Eastern Mediterranean at 59 percent, and Southeast Asia at 52 percent. Prior COVID-19 infection was associated with lower intention to receive a booster but higher actual uptake. The presence of chronic disease and trust in vaccine effectiveness were significant predictors of booster acceptance, highlighting the need for intensive awareness campaigns.
Tracking willingness to receive booster vaccines is crucial for managing the COVID-19 pandemic and reaching broad population immunity. The significant gap between high intention and low actual uptake reveals that positive public attitude alone does not guarantee vaccination. Identifying key predictors, such as trust in vaccine effectiveness and chronic illness, allows health authorities to design better-targeted communication strategies.
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The World Health Organization (WHO) recommended coronavirus disease 2019 (COVID-19) booster dose vaccination after completing the primary vaccination series for individuals ≥18 years and most-at-risk populations. This study aimed to estimate the pooled proportion of COVID-19 vaccine booster dose uptake and intention to get the booster dose among general populations and healthcare workers (HCWs). We searched PsycINFO, Scopus, EBSCO, MEDLINE Central/PubMed, ProQuest, SciELO, SAGE, Web of Science, Google Scholar, and ScienceDirect according to PRISMA guidelines. From a total of 1079 screened records, 50 studies were extracted. Meta-analysis was conducted using 48 high-quality studies according to the Newcastle-Ottawa Scale quality assessment tool. Using the 48 included studies, the pooled proportion of COVID-19 vaccine booster dose acceptance among 198,831 subjects was 81% (95% confidence interval (CI): 75-85%, <i>I</i><sup>2</sup> = 100%). The actual uptake of the booster dose in eight studies involving 12,995 subjects was 31% (95% CI: 19-46%, <i>I</i><sup>2</sup> = 100%), while the intention to have the booster dose of the vaccine was 79% (95% CI: 72-85%, <i>I</i><sup>2</sup> = 100%). The acceptance of the booster dose of COVID-19 vaccines among HCWs was 66% (95% CI: 58-74%), <i>I</i><sup>2</sup> = 99%). Meta-regression revealed that previous COVID-19 infection was associated with a lower intention to have the booster dose. Conversely, previous COVID-19 infection was associated with a significantly higher level of booster dose actual uptake. The pooled booster dose acceptance in the WHO region of the Americas, which did not include any actual vaccination, was 77% (95% CI: 66-85%, <i>I</i><sup>2</sup> = 100%). The pooled acceptance of the booster dose in the Western Pacific was 89% (95% CI: 84-92%, <i>I</i><sup>2</sup> = 100), followed by the European region: 86% (95% CI: 81-90%, <i>I<sup>2</sup></i> = 99%), the Eastern Mediterranean region: 59% (95% CI: 46-71%, <i>I</i><sup>2</sup> = 99%), and the Southeast Asian region: 52% (95% CI: 43-61%, <i>I</i><sup>2</sup> = 95). Having chronic disease and trust in the vaccine effectiveness were the significant predictors of booster dose COVID-19 vaccine acceptance. The global acceptance rate of COVID-19 booster vaccine is high, but the rates vary by region. To achieve herd immunity for the disease, a high level of vaccination acceptance is required. Intensive vaccination campaigns and programs are still needed around the world to raise public awareness regarding the importance of accepting COVID-19 vaccines needed for proper control of the pandemic.
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DOI: 10.3390/tropicalmed7100298
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