Community and Provider Acceptability of the COVID-19 Vaccine: A Systematic Review and Meta-analysis

Background: The novel coronavirus disease (COVID-19) vaccines may help control the current pandemic but would require immunization levels that would achieve herd immunity. This study aimed to quantify current COVID-19 vaccine acceptance rates, as well as characterize the determinants, enablers and barriers to vaccine acceptability across the globe by synthesizing published evidence. Methods: A systematic review and meta-analysis of studies was performed on studies assessing the acceptability of a COVID-19 vaccine published between November 1st, 2019, and November 30th, 2020. PubMed, Embase and Cochrane central were searched for eligible studies. Data extracted from retained studies was analyzed using STATA statistical software. A quantitative and narrative synthesis was produced. Results: A total of 35 eligible articles (38 studies) involving a total of 70,997 participants across 7 regions and 35 countries were included. All studies were cross-sectional survey designs. The pooled vaccine acceptance rate across 32 studies was 71% (95% CI: 66 – 76%, p2= 99.4%, range: 29-97%). The pooled vaccine acceptance rate of parents for their children across 4 studies was 52% (95% CI: 37-67%, p2= 99.1%). Vaccine uptake was significantly higher among males (N=13 studies), older age groups (N=7), and healthcare providers (N=2). Enablers of vaccine uptake included perceived individual susceptibility to COVID-19 infection (N=11), prior influenza vaccination (N=7) and high vaccine effectiveness (N=6). The most common barriers to vaccine uptake were general negative attitudes towards vaccines/vaccine hesitancy (N=8), concerns over vaccine safety and efficacy (N=6), vaccine side effects (N=5), and misinformation or conspiracy beliefs around the experimental COVID-19 vaccines (N=2). Conclusions: There is a good acceptance of COVID-19 vaccines globally despite wide variations across countries. Public health campaigns may benefit from capitalising on identified enablers and dispelling important barriers with regards to vaccine safety