Worldwide vaccination willingness for COVID-19: A systematic review and meta-analysis

Countries across the globe are currently experiencing a third or fourth wave of SARS-CoV-2 infections; therefore, the need for effective vaccination campaigns is higher than ever. However, effectiveness of these campaigns in disease reduction is highly dependent on vaccination uptake and coverage in susceptible populations. Therefore, this systematic review and meta-analysis estimated the vaccination intention and identified determinants of willingness and hesitancy. This study updates the existing body of literature on vaccination willingness, and was conducted according to the PRISMA guidelines. PubMed was searched for publications, selecting only studies published between 20 October 2020 and 1 March 2021, in English, with participants aged >16 years of age. The search identified 411 articles, of which 63 surveys were included that accounted for more than 30 countries worldwide. The global COVID-19 vaccination willingness was estimated at 66.01% [95% CI: 60.76–70.89% I² = 99.4% [99.3%; 99.4%]; τ² = 0.83]. The vaccination willingness varied within as well as between countries. Age, gender, education, attitudes and perceptions about vaccines were most frequently observed to be significantly associated with vaccine acceptance or refusal.