COVID-19 vaccine acceptance and its associated factors in Ethiopia: A systematic review and meta-analysis

Abstract

Background: COVID-19 vaccination is considered as an effective intervention for controlling the burden of the pandemic. However, vaccine hesitation is increasing and hindering efforts targeting to reduce the burden of the COVID-19 disease. Hence, determining COVID-19 vaccine acceptance and identifying determinants that would hinder people to vaccinate against COVID-19 is crucial to effectively improve COVID-19 vaccine uptake. In Ethiopia, the pooled proportion of COVID-19 vaccine acceptance and its determinants is not well known. Thus, the aim of this study is to estimate the pooled proportion of COVID-19 vaccine acceptance and its determinants in Ethiopia.

Methods: A systematic search of articles was conducted from PubMed, Scopus, Web of Science, MEDLINE, CINAHL, Science Direct and Cochrane Library. Data were extracted using a data extraction tool which was adapted from the Joanna Briggs Institute. The quality of each included primary studies was evaluated using the Newcastle-Ottawa scale tool. Data analysis was performed using STATA 14. Heterogeneity in studies was assessed using Cochrane Q and I² test. Publication bias was assessed using visual inspection of funnel plots and Egger's test. A random effects model was applied to determine the pooled estimates if heterogeneity was exhibited; otherwise, a fixed-effects model was used.

Results: A total of 14 studies involving 6373 participants were included for the final analysis. The pooled proportion of COVID-19 vaccine acceptance in Ethiopia was 56.02% (95% CI: 47.84, 64.20). The likelihood of COVID-19 vaccine acceptance was higher among participants who had history of chronic disease (AOR = 1.33, 95% CI: 1.09, 2.97), good knowledge (AOR = 2.13, 95% CI: 1.59, 4.97), positive attitude (AOR = 2.23, 95% CI: 1.21, 4.66), good COVID-19 preventive practice (AOR = 1.97, 95% CI: 1.82, 2.12), and high perceived seriousness of COVID-19 (AOR = 3.21, 95% CI: 2.32, 5.98).

Conclusion: More than half participants were willing to accept COVID-19 vaccine. Thus, awareness creation battles about the efficacy and safety of the COVID-19 vaccine should be provided to the community. Besides, policy-makers, health planners and other stakeholders should encourage COVID-19 vaccine uptake behaviors by providing trusted information.Systematic review and meta-analysis registration: PROSPERO CRD42021264708.

Keywords: AOR, Adjusted odd ratio; Acceptance; CI, Confidence intervals; COVID-19; COVID-19, Coronavirus disease 2019; Ethiopia; PRISMA, Preferred Reporting Items for Systematic review and Meta-analysis; Risk factors; SMP, self-medication practice; Vaccine; WHO, World Health Organization.

Fig. 1

Flow chart of study selection for systematic review and meta-analysis of COVID-19 vaccine acceptance in Ethiopia, 2021.

Fig. 2

Funnel plot assessed for publication bias in the studies conducted on of COVID-19 vaccine acceptance in Ethiopia, 2021.

Fig. 3

Forest plot of the pooled proportion of COVID-19 vaccine acceptance in Ethiopia, 2021.

Fig. 4

Sub-group analysis (by region) of the pooled proportion of COVID-19 vaccine acceptance in Ethiopia, 2021.

Fig. 5

Sub-group analysis (by study population) of the pooled proportion of COVID-19 vaccine acceptance in Ethiopia, 2021.

Fig. 6

Sub-group analysis (by data collection method) of the pooled proportion of COVID-19 vaccine acceptance in Ethiopia, 2021.