COVID-19 vaccination intention and vaccine characteristics influencing vaccination acceptance: a global survey of 17 countries

Wong LP 1 , Alias H 2 , Danaee M 2 , Ahmed J 2 , Lachyan A 2 , Cai CZ 3 Show all authors , Lin Y 4 , Hu Z 5 , Tan SY 6 , Lu Y 7 , Cai G 7 , Nguyen DK 8 , Seheli FN 9 , Alhammadi F 10 , Madhale MD 11 , Atapattu M 12 , Quazi-Bodhanya T 13 , Mohajer S 14 , Zimet GD 15 , Zhao Q 16

Affiliations 

  • 1 Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, 350122, Fujian, China. wonglp@ummc.edu.my
  • 2 Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
  • 3 Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, 350122, Fujian, China
  • 4 Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, 350122, Fujian, China. yulanlin@fjmu.edu.cn
  • 5 Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, 350122, Fujian, China. huzhijian@fjmu.edu.cn
  • 6 Leadership Institute for Global Health Transformation, Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive, Singapore, 117549, Singapore
  • 7 Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8523, Japan
  • 8 Department of Academic Affairs and Testing, Dong Nai Technology University, Dong Nai, Vietnam
  • 9 Institute of Epidemiology, Disease Control & Research (IEDCR), Mohakhali, Dhaka, 1212, Bangladesh
  • 10 Ministry of Health and Prevention (MOHAP), Sharjah, United Arab Emirates
  • 11 Vijaya College of Nursing, Belgaum, Ayodhya Nagar, Belgaum, Karnataka, 590001, India
  • 12 Department of Nursing, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka
  • 13 Leadership Dialogue, 16 Elland Road, Manor Gardens, Durban, 4001, South Africa
  • 14 Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
  • 15 Department of Pediatrics, School of Medicine, Indiana University, 410 W, 10th St., HS 1001, Indianapolis, IN, 46202, USA
  • 16 State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University, Xiamen, Fujian, China
Infect Dis Poverty, 2021 Oct 07;10(1):122.
PMID: 34620243 DOI: 10.1186/s40249-021-00900-w

Abstract

BACKGROUND: The availability of various types of COVID-19 vaccines and diverse characteristics of the vaccines present a dilemma in vaccination choices, which may result in individuals refusing a particular COVID-19 vaccine offered, hence presenting a threat to immunisation coverage and reaching herd immunity. The study aimed to assess global COVID-19 vaccination intention, vaccine characteristics influencing vaccination acceptance and desirable vaccine characteristics influencing the choice of vaccines.

METHODS: An anonymous cross-sectional survey was conducted between 4 January and 5 March 2021 in 17 countries worldwide. Proportions and the corresponding 95% confidence intervals (CI) of COVID-19 vaccine acceptance and vaccine characteristics influencing vaccination acceptance were generated and compared across countries and regions. Multivariable logistic regression analysis was used to determine the factors associated with COVID-19 vaccine hesitancy.

RESULTS: Of the 19,714 responses received, 90.4% (95% CI 81.8-95.3) reported likely or extremely likely to receive COVID-19 vaccine. A high proportion of likely or extremely likely to receive the COVID-19 vaccine was reported in Australia (96.4%), China (95.3%) and Norway (95.3%), while a high proportion reported being unlikely or extremely unlikely to receive the vaccine in Japan (34.6%), the U.S. (29.4%) and Iran (27.9%). Males, those with a lower educational level and those of older age expressed a higher level of COVID-19 vaccine hesitancy. Less than two-thirds (59.7%; 95% CI 58.4-61.0) reported only being willing to accept a vaccine with an effectiveness of more than 90%, and 74.5% (95% CI 73.4-75.5) said they would accept a COVID-19 vaccine with minor adverse reactions. A total of 21.0% (95% CI 20.0-22.0) reported not accepting an mRNA vaccine and 51.8% (95% CI 50.3-53.1) reported that they would only accept a COVID-19 vaccine from a specific country-of-origin. Countries from the Southeast Asia region reported the highest proportion of not accepting mRNA technology. The highest proportion from Europe and the Americas would only accept a vaccine produced by certain countries. The foremost important vaccine characteristic influencing vaccine choice is adverse reactions (40.6%; 95% CI 39.3-41.9) of a vaccine and effectiveness threshold (35.1%; 95% CI 33.9-36.4).

CONCLUSIONS: The inter-regional and individual country disparities in COVID-19 vaccine hesitancy highlight the importance of designing an efficient plan for the delivery of interventions dynamically tailored to the local population.

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

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