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Perceived COVID-19 vaccine effectiveness, acceptance, and drivers of vaccination decision-making among the general adult population: A global survey of 20 countries

Marzo RR 1 , Ahmad A 2 , Islam MS 3 , Essar MY 4 , Heidler P 5 , King I 6 Show all authors , Thiyagarajan A 7 , Jermsittiparsert K 8 , Songwathana K 9 , Younus DA 10 , El-Abasiri RA 11 , Bicer BK 12 , Pham NT 13 , Respati T 14 , Fitriyana S 15 , Faller EM 16 , Baldonado AM 17 , Billah MA 18 , Aung Y 19 , Hassan SM 20 , Asad MM 21 , El-Fass KA 22 , Bhattacharya S 23 , Shrestha S 24 , Hamza NAE 25 , Friedmann P 26 , Head M 27 , Lin Y 28 , Yi S 29

Affiliations 

  • 1 Department of Community Medicine, International Medical School, Management and Science University, Shah Alam, Selangor Darul Ehsan, Malaysia
  • 2 Department of Community Medicine, Manipal Tata Medical College, Jamshedpur, Manipal Academy of Higher Education, Manipal, India
  • 3 Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
  • 4 Kabul University of Medical Sciences, Kabul, Afghanistan
  • 5 Department of Health Sciences, St. Pölten University of Applied Sciences, St. Pölten, Austria
  • 6 University of the Sunshine Coast, School of Health and Behavioural Sciences, Maroochydore, Australia
  • 7 Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
  • 8 College of Innovative Business and Accountancy, Dhurakij Pundit University, Bangkok, Thailand
  • 9 Faculty of Economics and Investment, Bangkok University, Bangkok, Thailand
  • 10 General Directorate for Scientific Research Center, Salahaddin University-Erbil, Erbil, Iraq
  • 11 Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
  • 12 Faculty of Medicine, Department of Medical Education and Informatics, Gazi University, Ankara, Turkey
  • 13 School of Business, International University, Ho Chi Minh City, Vietnam
  • 14 Department of Public Health, Faculty of Medicine and Faculty of Graduate Studies, Universitas Islam Bandung, Bandung, Indonesia
  • 15 Faculty of Medicine, Universitas Islam Bandung, Bandung, Indonesia
  • 16 Department of Pharmacy, Faculty of Pharmacy, San Pedro College, Davao City, Philippines
  • 17 College of Nursing, Saint Alexius College, City of Koronadal, Philippines
  • 18 Faculty of Business, Economics and Social Development, Universiti Malaysia Terengganu, Kuala Terengganu, Malaysia
  • 19 Medical Statistics Division, Department of Medical Research, Pyin Oo Lwin, Myanmar
  • 20 Faculty of Life Sciences, Ahmadu Bello University, Zaria, Nigeria
  • 21 Education Department, Sukkur IBA University, Sukkur, Pakistan
  • 22 Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al Hassa, Saudi Arabia
  • 23 Department of Community Medicine, Himalayan Institute of Medical Sciences, Dehradun, India
  • 24 School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
  • 25 Medical Agency for Research and Statistics, Giza, Egypt
  • 26 Lumpkin College of Business and Technology, Eastern Illinois University, Charleston, Illinois, United States of America
  • 27 Clinical Informatics Research Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
  • 28 Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
  • 29 Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
PLoS Negl Trop Dis, 2022 01;16(1):e0010103.
PMID: 35089917 DOI: 10.1371/journal.pntd.0010103

Abstract

BACKGROUND: Mass vaccination campaigns have significantly reduced the COVID-19 burden. However, vaccine hesitancy has posed significant global concerns. The purpose of this study was to determine the characteristics that influence perceptions of COVID-19 vaccine efficacy, acceptability, hesitancy and decision making to take vaccine among general adult populations in a variety of socioeconomic and cultural contexts.

METHODS: Using a snowball sampling approach, we conducted an online cross-sectional study in 20 countries across four continents from February to May 2021.

RESULTS: A total of 10,477 participants were included in the analyses with a mean age of 36±14.3 years. The findings revealed the prevalence of perceptions towards COVID-19 vaccine's effectiveness (78.8%), acceptance (81.8%), hesitancy (47.2%), and drivers of vaccination decision-making (convenience [73.3%], health providers' advice [81.8%], and costs [57.0%]). The county-wise distribution included effectiveness (67.8-95.9%; 67.8% in Egypt to 95.9% in Malaysia), acceptance (64.7-96.0%; 64.7% in Australia to 96.0% in Malaysia), hesitancy (31.5-86.0%; 31.5% in Egypt to 86.0% in Vietnam), convenience (49.7-95.7%; 49.7% in Austria to 95.7% in Malaysia), advice (66.1-97.3%; 66.1% in Austria to 97.3% in Malaysia), and costs (16.0-91.3%; 16.0% in Vietnam to 91.3% in Malaysia). In multivariable regression analysis, several socio-demographic characteristics were identified as associated factors of outcome variables including, i) vaccine effectiveness: younger age, male, urban residence, higher education, and higher income; ii) acceptance: younger age, male, urban residence, higher education, married, and higher income; and iii) hesitancy: male, higher education, employed, unmarried, and lower income. Likewise, the factors associated with vaccination decision-making including i) convenience: younger age, urban residence, higher education, married, and lower income; ii) advice: younger age, urban residence, higher education, unemployed/student, married, and medium income; and iii) costs: younger age, higher education, unemployed/student, and lower income.

CONCLUSIONS: Most participants believed that vaccination would effectively control and prevent COVID-19, and they would take vaccinations upon availability. Determinant factors found in this study are critical and should be considered as essential elements in developing COVID-19 vaccination campaigns to boost vaccination uptake in the populations.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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