Mapping the prevalence of COVID-19 vaccine acceptance at the Global and Regional Level. A systematic review and meta-Analysis

Despite the availability of effective and safe vaccines, the acceptance of COVID-19 vaccination is suboptimal. In this meta-analysis we quantified the prevalence estimates of COVID-19 vaccine acceptance with a specific focus on worldwide geographical differences. We searched PubMed, Scopus, Web of Science and PsycInfo up to April 2021 (PROSPERO ID: CRD42021235328). Generalized random-effects linear models with a logit link were used to calculate the pooled estimated rate of vaccine acceptance at both the global and regional level. A meta-regression analysis was performed to assess the association between COVID-19 vaccine acceptance and various characteristics of the studies. Overall, 71 articles yielding 128 prevalence estimates were included. The pooled prevalence of COVID-19 vaccination acceptance rate was 66% (95% CI: 61-71%). This varied by geographic area, ranging from 36% (95% CI: 18-60%) in Africa to 83% (95% CI: 82-84%) in Oceania, and there was high variability between countries (15.4% Cameroon-100% Bhutan). Meta-regression analysis showed that studies that investigated COVID-19 vaccination intentions using multiple choice/scoring gave a vaccine acceptance prevalence lower than studies with only two possible answers (yes/no) (ß: -1.02 95% CI: -1.41 to -0.63). Despite some variation in the estimates, the results showed that one in three people may refuse/delay COVID-19 vaccination.