Global acceptance and rejection of COVID-19 vaccines: A systematic review and meta-analysis

Abstract

A challengeable obstacle to the introduction of new vaccine that affects the transmission of certain infections is vaccine hesitancy, despite the availability of vaccines. To assess the theoretical tendencies and public attitudes concerning the COVID-19 vaccinations. PsycINFO, Science Direct, Embase, Scopus, EBSCO, MEDLINEcentral/PubMed, ProQuest, SciELO, SAGE, Web of Science, and Google Scholar were searched. All papers detailing rejection and acceptance of the COVID-19 vaccine were included with no language restriction. Abstracts, proposals, conferences, editorials, author responses, reviews, case reports & series, books, and studies with data not accurately extracted or overlapping data were excluded. A meta-analysis was conducted using the random effect model of the pooled proportion of vaccine acceptance and rejection using the meta-package of R software. Egger’s regression test was performed to assess publication bias, and the quality of included studies was assessed using the Newcastle-Ottawa Scale. Out of 12246 identified records, 36 articles were included in the quantitative analysis. The pooled proportion of COVID-19 vaccine rejection was 16% (95%CI:13-20, I2=100%), while that of COVID-19 vaccine acceptance was 65% (95% CI:60-70, I2=100%. Case-fatality ratio and geographical distribution represented the main determinants of vaccine acceptance. Vaccine acceptance increased by 27.17% (95% CI:3.46-50.88) for each 1% increase in case fatality (p<0.02). The acceptance increased in Africa by 1.86 (p=0.04) while the vaccine rejection decreased in Australia by 3.93(p<0.0001). This meta-analysis demonstrated poor acceptance of COVID-19 vaccines, and the ratio of cases to fatalities had a profound effect on public perception of the vaccines. These findings should be used to inform relevant interventions for future pandemic responses.PROSPERO registration-number:CRD42021232805