Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2021 Apr 8;39(15):2024-2034.
doi: 10.1016/j.vaccine.2021.02.005. Epub 2021 Feb 6.

International estimates of intended uptake and refusal of COVID-19 vaccines: A rapid systematic review and meta-analysis of large nationally representative samples

Eric Robinson  1 , Andrew Jones  2 , India Lesser  2 , Michael Daly  3
Affiliations
Meta-Analysis

International estimates of intended uptake and refusal of COVID-19 vaccines: A rapid systematic review and meta-analysis of large nationally representative samples

Eric Robinson et al. Vaccine. .

Abstract

Background: Widespread uptake of COVID-19 vaccines will be essential to controlling the COVID-19 pandemic. Vaccines have been developed in unprecedented time and quantifying levels of hesitancy towards vaccination among the general population is of importance.

Methods: Systematic review and meta-analysis of studies using large nationally representative samples (n ≥ 1000) to examine the percentage of the population intending to vaccinate, unsure, or intending to refuse a COVID-19 vaccine when available. Generic inverse meta-analysis and meta-regression were used to pool estimates and examine time trends. PubMed, Scopus and pre-printer servers were searched from January-November 2020. Registered on PROSPERO (CRD42020223132).

Findings: Twenty-eight nationally representative samples (n = 58,656) from 13 countries indicate that as the pandemic has progressed, the percentage of people intending to vaccinate decreased and the percentage of people intending to refuse vaccination increased. Pooled data from surveys conducted during June-October suggest that 60% (95% CI: 49% to 69%) intend to vaccinate and 20% (95% CI: 13% to 29%) intend to refuse vaccination, although intentions vary substantially between samples and countries (I2 > 90%). Being female, younger, of lower income or education level and belonging to an ethnic minority group were consistently associated with being less likely to intend to vaccinate. Findings were consistent across higher vs. lower quality studies.

Interpretation: Intentions to be vaccinated when a COVID-19 vaccine becomes available have been declining across countries and there is an urgent need to address social inequalities in vaccine hesitancy and promote widespread uptake of vaccines as they become available.

Funding: N/A.

Keywords: Acceptance; Attitudes; COVID-19; Coronavirus; Intentions; Vaccine.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Study selection flowchart.
Fig. 2
Fig. 2
Raw proportions of intentions to vaccinate across the 28 samples.
Fig. 3
Fig. 3
Raw proportions of individuals reporting intending not to vaccinate across 16 samples.
Fig. 4
Fig. 4
Raw proportions of individuals reporting unsure of vaccination across 28 studies.
Fig. 5
Fig. 5
Proportion of populations intending to vaccinate by country and time.
See this image and copyright information in PMC

Comment in

References

    1. WHO. WHO COVID-19 Weekly Operational Update. 2020. Accessed 30/11/20 from: https://www.who.int/docs/default-source/coronaviruse/situation-reports/2....
    1. Maringe C., Spicer J., Morris M., et al. The impact of the COVID-19 pandemic on cancer deaths due to delays in diagnosis in England, UK: a national, population-based, modelling study. Lancet Oncol. 2020;21(8):1023–1034. - PMC - PubMed
    1. WHO, 2020. Accessed 30/11/20: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/covid-19....
    1. Bartsch S.M., O'Shea K.J., Ferguson M.C., et al. Vaccine efficacy needed for a COVID-19 coronavirus vaccine to prevent or stop an epidemic as the sole intervention. Am J Prev Med. 2020;59(4):493–503. - PMC - PubMed
    1. Iboi E.A., Ngonghala C.N., Gumel A.B. Will an imperfect vaccine curtail the COVID-19 pandemic in the U.S.? Infectious Disease Modelling. 2020;5:510–524. - PMC - PubMed

Publication types

Substances