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Review
. 2022 Mar 11;10(3):427.
doi: 10.3390/vaccines10030427.

COVID-19 Vaccine Acceptance among Low- and Lower-Middle-Income Countries: A Rapid Systematic Review and Meta-Analysis

Muhammad Mainuddin Patwary  1   2 , Md Ashraful Alam  3   4 , Mondira Bardhan  1   2 , Asma Safia Disha  1   2 , Md Zahidul Haque  1   2 , Sharif Mutasim Billah  1   2 , Md Pervez Kabir  1   2 , Matthew H E M Browning  5 , Md Mizanur Rahman  6 , Ali Davod Parsa  7 , Russell Kabir  7
Affiliations
Review

COVID-19 Vaccine Acceptance among Low- and Lower-Middle-Income Countries: A Rapid Systematic Review and Meta-Analysis

Muhammad Mainuddin Patwary et al. Vaccines (Basel). .

Abstract

Widespread vaccination against COVID-19 is critical for controlling the pandemic. Despite the development of safe and efficacious vaccinations, low-and lower-middle income countries (LMICs) continue to encounter barriers to care owing to inequitable access and vaccine apprehension. This study aimed to summarize the available data on COVID-19 vaccine acceptance rates and factors associated with acceptance in LMICs. A comprehensive search was performed in PubMed, Scopus, and Web of Science from inception through August 2021. Quality assessments of the included studies were carried out using the eight-item Joanna Briggs Institute Critical Appraisal tool for cross-sectional studies. We performed a meta-analysis to estimate pooled acceptance rates with 95% confidence intervals (CI). A total of 36 studies met the inclusion criteria and were included in the review. A total of 83,867 respondents from 33 countries were studied. Most of the studies were conducted in India (n = 9), Egypt (n = 6), Bangladesh (n = 4), or Nigeria (n = 4). The pooled-effect size of the COVID-19 vaccine acceptance rate was 58.5% (95% CI: 46.9, 69.7, I2 = 100%, 33 studies) and the pooled vaccine hesitancy rate was 38.2% (95% CI: 27.2-49.7, I2 = 100%, 32 studies). In country-specific sub-group analyses, India showed the highest rates of vaccine acceptancy (76.7%, 95% CI: 65.8-84.9%, I2= 98%), while Egypt showed the lowest rates of vaccine acceptancy (42.6%, 95% CI: 16.6-73.5%, I2= 98%). Being male and perceiving risk of COVID-19 infection were predictors for willingness to accept the vaccine. Increasing vaccine acceptance rates in the global south should be prioritized to advance global vaccination coverage.

Keywords: COVID-19; SARS-CoV-2; low- and lower-middle income countries; meta-analysis; vaccine; vaccine acceptance; vaccine hesitancy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram of the study selection process.
Figure 2
Figure 2
Forest plot of vaccine acceptance rates across LMICs.
Figure 3
Figure 3
Forest plot of vaccine hesitancy rates across LMICs.
Figure 4
Figure 4
Forest plot of country-specific vaccine acceptance rates within LMICs.
Figure 5
Figure 5
Forest plot of country-specific vaccine hesitancy rates within LMICs.
Figure 6
Figure 6
Meta-analysis of COVID-19 vaccination acceptance factors across LMICs.
See this image and copyright information in PMC

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