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. 2021 Oct:40:101113.
doi: 10.1016/j.eclinm.2021.101113. Epub 2021 Sep 2.

Attitudes, acceptance and hesitancy among the general population worldwide to receive the COVID-19 vaccines and their contributing factors: A systematic review

Fidelia Cascini  1 , Ana Pantovic  2 , Yazan Al-Ajlouni  3 , Giovanna Failla  4 , Walter Ricciardi  1
Affiliations

Attitudes, acceptance and hesitancy among the general population worldwide to receive the COVID-19 vaccines and their contributing factors: A systematic review

Fidelia Cascini et al. EClinicalMedicine. 2021 Oct.

Abstract

Background: High rates of vaccination worldwide are required to establish a herd immunity and stop the current COVID-19 pandemic evolution. Vaccine hesitancy is a major barrier in achieving herd immunity across different populations. This study sought to conduct a systematic review of the current literature regarding attitudes and hesitancy to receiving COVID-19 vaccination worldwide.

Methods: A systematic literature search of PubMed and Web of Science was performed on July 5th, 2021, using developed keywords. Inclusion criteria required the study to (1) be conducted in English; (2) investigate attitudes, hesitancy, and/or barriers to COVID-19 vaccine acceptability among a given population; (3) utilize validated measurement techniques; (4) have the full text paper available and be peer-reviewed prior to final publication.

Findings: Following PRISMA guidelines, 209 studies were included. The Newcastle Ottawa (NOS) scale for cross-sectional studies was used to assess the quality of the studies.Overall, vaccine acceptance rates ranged considerably between countries and between different time points, with Arabian countries showing the highest hesitancy rates compared with other parts of the world.

Interpretation: A variety of different factors contributed to increased hesitancy, including having negative perception of vaccine efficacy, safety, convenience, and price. Some of the consistent socio-demographic groups that were identified to be associated with increased hesitancy included: women, younger participants, and people who were less educated, had lower income, had no insurance, living in a rural area, and self-identified as a racial/ethnic minority.

Keywords: Attitudes; Barriers; COVID-19; Hesitancy; Respiratory diseases; Vaccination.

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Conflict of interest statement

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
Preferred reporting items for systematic reviews and meta-analyses (PRISMA) study selection flow diagram. *indicates numbers from both searches; former number refers to the initial systematic review conducted in February, the latter number refers to the update systematic review conducted in July.
Fig 2
Fig. 2
Map reflecting vaccine acceptance rates worldwide.
See this image and copyright information in PMC

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Further reading

    1. Abdelhafiz A.S., Mohammed Z., Ibrahim M.E., Ziady H.H., Alorabi M., Ayyad M. Knowledge, perceptions, and attitude of Egyptians towards the novel Coronavirus disease (COVID-19) J Community Health. 2020;45(5):881–890. - PMC - PubMed
    1. Elhadi M., Alsoufi A., Alhadi A., Hmeida A., Alshareea E., Dokali M. Knowledge, attitude, and acceptance of healthcare workers and the public regarding the COVID-19 vaccine: a cross-sectional study. BMC Public Health. 2021;21(1):955. doi: 10.1186/s12889-021-10987-3. PMID: 34016073. - DOI - PMC - PubMed
    1. Habib M.A., Dayyab F.M., Iliyasu G., Habib A.G. Knowledge, attitude and practice survey of COVID-19 pandemic in Northern Nigeria. PLoS One. 2021;16(1) - PMC - PubMed
    1. Adebisi Y.A., Alaran A.J., Bolarinwa O.A., Akande-Sholabi W., Lucero-Prisno D.E. When it is available, will we take it? Social media users’ perception of hypothetical COVID-19 vaccine in Nigeria. Pan Afr Med J. 2021;38:230. doi: 10.11604/pamj.2021.38.230.27325. PMID: 34046135. - DOI - PMC - PubMed
    1. Ilesanmi O., Afolabi A., Uchendu O. The prospective COVID-19 vaccine: willingness to pay and perception of community members in Ibadan, Nigeria. PeerJ. 2021;9:e11153. - PMC - PubMed