Systematic Review and Meta-analysis on COVID-19 Vaccine Hesitancy

Abdulmoneim, S. A.; Aboelsaad, I. A. F.; Hanaa Hafez, D. M.; Almaghraby, A.; el-ganainy, s. o.; Alnagar, A.; Shaaban, R.; Elhadi, Y. A. M.; Deghidy, E. A.; Nour El-Deen, A. E.-S.; Salem, K. M.; Hamdy, N. A.; kabeel, S. G.; Elsherbeny, E. A. F.; Tahoun, M. M.; Ghazy, R. M.; Elfeshawy, N. I.; Elrewany, E.; khalil, A.

Background: The presented meta-analysis was developed in response to the publication of several studies addressing COVID-19 vaccines hesitancy. We aimed to identify the proportion of vaccine acceptance and rejection, and factors affecting vaccine hesitancy worldwide especially with the fast emergency approval of vaccines. Methods: Online database search was performed, and relevant studies were included with no language restriction. A meta-analysis was conducted using R software to obtain the random effect model of the pooled prevalence of vaccine acceptance and rejection. Egger regression test was performed to assess publication bias. Quality assessment was assessed using Newcastle-Ottawa Scale quality assessment tool. Results: Thirty-nine out of 12246 articles met the predefined inclusion criteria. All studies were cross-sectional designs. The pooled proportion of COVID-19 vaccine hesitancy was 17% (95% CI: 14-20) while the pooled proportion of COVID-19 vaccine acceptance was 75% (95% CI: 71-79). The vaccine hesitancy and the vaccine acceptance showed high heterogeneity (I 2 =100%). Case fatality ratio and the number of reported cases had significant effect on the vaccine acceptance as the pooled proportion of vaccine acceptance increased by 39.95% (95% CI: 20.1-59.8) for each 1% increase in case fatality (P<0.0001) and decreased by 0.1% (95% CI: -0.2-0.01) for each 1000 reported case of COVID-19, P= 0.0183). Conclusion: Transparency in reporting the number of newly diagnosed COVID-19 cases and deaths is mandatory as these factors are the main determinants of COVID-19 vaccine acceptance.