Global spatio-temporal distribution of coronavirus disease 2019 vaccine hesitancy between 2020 and 2022: A meta-analysis

IF 4.5 3区医学 Q2 IMMUNOLOGY Vaccine Pub Date : 2025-04-19 Epub Date: 2025-03-03 DOI:10.1016/j.vaccine.2025.126933

Tianshuo Zhao , Qingsong Xu , Xianming Cai , Mingting Wang , Le Ao , Tingting Wei , Han Yang , Sihui Zhang , Xiyu Zhang , Shifeng Jin , Xinyu Wang , Xin Feng , Jiayi Zhao , Yifei Wu , Jieru Yang , Fuqiang Cui

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Abstract

Objective: Vaccine hesitancy is a major barrier to high coronavirus disease 2019 (COVID-19) vaccine coverage. To synthesize global research on COVID-19 vaccine hesitancy, a meta-analysis was conducted to provide scientific evidence for understanding its spatial and temporal variations and influencing factors.

Methods: We searched the PubMed, Web of Science, and Embase databases for studies published in English between January 2020 and December 2023 and included cross-sectional and cohort studies with study populations that included the general adult population aged ≥18 years and provided quantitative data on COVID-19 vaccine acceptance or hesitancy. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis elements and guidance for abstracting and assessing data quality and validity. Two groups of investigators independently extracted the study characteristics, including the outcome variable (the vaccine hesitancy rate). Our meta-analysis used a random-effects model. The outcome of interest was COVID-19 vaccine hesitancy. The included studies were divided into two categories based on their definitions of COVID-19 vaccine hesitancy. Definition 1 combined vaccination behavior and willingness, and Definition 2 was based solely on willingness to vaccinate.

Results: 855 studies were included in the final analytical dataset; 121 met Definition 1, and 734 met Definition 2. There were 277,285,178 participants in the included studies. In studies meeting Definition 1, hesitancy rates increased annually: 18.8 % in 2020, 29.1 % in 2021, and 30.8 % in 2022. However, in studies that met Definition 2, the hesitancy rates remained at 35 %. African studies reported the highest hesitancy rates globally (42.0 %), whereas European studies reported the lowest (16.5 %). Furthermore, there was a temporal association between mortality trends and COVID-19 hesitancy because the monthly cumulative death peaks coincided with lower hesitancy peaks.

Conclusion: COVID-19 vaccine hesitancy increased across the continent during 2020–2022 and might be influenced by misinformation, policy changes, and public fatigue. Demographic factors like age, gender, and education also play a key role in vaccine hesitancy. The link between vaccine hesitancy and pandemic severity highlights the need for timely and effective public health responses.

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2020 - 2022年冠状病毒病2019疫苗犹豫的全球时空分布：一项荟萃分析

目的：疫苗犹豫是2019冠状病毒病（COVID-19）疫苗高覆盖率的主要障碍。为综合全球COVID-19疫苗犹豫研究，通过荟萃分析，为了解其时空变化及其影响因素提供科学依据。方法：我们检索了PubMed、Web of Science和Embase数据库，检索了2020年1月至2023年12月期间发表的英文研究，纳入了横断面和队列研究，研究人群包括年龄≥18岁的一般成年人，并提供了关于COVID-19疫苗接受或犹豫的定量数据。我们将首选报告项目用于系统评价和元分析元素，并指导抽象和评估数据质量和有效性。两组研究者独立提取研究特征，包括结果变量（疫苗犹豫率）。我们的荟萃分析使用了随机效应模型。关注的结果是COVID-19疫苗犹豫。纳入的研究根据其对COVID-19疫苗犹豫的定义分为两类。定义1结合了接种行为和接种意愿，定义2仅基于接种意愿。结果：855项研究被纳入最终的分析数据集；121人符合定义1,734人符合定义2。纳入的研究共有277,285,178名参与者。在符合定义1的研究中，犹豫率逐年上升：2020年为18.8%，2021年为29.1%，2022年为30.8%。然而，在符合定义2的研究中，犹豫率保持在35%。非洲研究报告了全球最高的犹豫率（42.0%），而欧洲研究报告的犹豫率最低（16.5%）。此外，死亡率趋势与COVID-19犹豫之间存在时间相关性，因为每月累积死亡高峰与较低的犹豫高峰相吻合。结论：2020-2022年期间，整个非洲大陆对COVID-19疫苗的犹豫有所增加，这可能受到错误信息、政策变化和公众疲劳的影响。年龄、性别和教育等人口因素也在疫苗犹豫中发挥关键作用。疫苗犹豫与大流行严重程度之间的联系凸显了及时有效的公共卫生反应的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

期刊介绍： Vaccine is unique in publishing the highest quality science across all disciplines relevant to the field of vaccinology - all original article submissions across basic and clinical research, vaccine manufacturing, history, public policy, behavioral science and ethics, social sciences, safety, and many other related areas are welcomed. The submission categories as given in the Guide for Authors indicate where we receive the most papers. Papers outside these major areas are also welcome and authors are encouraged to contact us with specific questions.