Ayyalasomayajula Shruti, Dhawan Aditi, Karattuthodi Mohammed Salim, Thorakkattil Shabeer Ali, Abdulsalim Suhaj, Elnaem Mohamed Hassan, Sridhar Sathvik, Unnikrishnan Mazhuvancherry Kesavan
Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Madhav Nagar 576104, India.
Pharmacy Services Department, Johns Hopkins Aramco Healthcare, Dhahran 34465, Saudi Arabia.
Vaccines (Basel). 2023 Mar 9;11(3):623. doi: 10.3390/vaccines11030623.
While considerable evidence supports the safety and efficacy of COVID-19 vaccines, a sizable population expresses vaccine hesitancy. As per the World Health Organization, vaccine hesitancy is one of the top 10 hazards to global health. Vaccine hesitancy varies across countries, with India reporting the least vaccine hesitancy. Vaccine hesitancy was higher toward COVID-19 booster doses than previous shots. Therefore, identifying factors determining COVID-19 vaccine booster hesitance (VBH) is the of a successful vaccination campaign.
This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) 2020 standards. A total of 982 articles were pooled from Scopus, PubMed and Embase, while 42 articles that addressed the factors of COVID-19 VBH were finally included for further analysis.
We identified factors responsible for VBH and divided them into three major groups: sociodemographic, financial, and psychological. Hence, 17 articles stated age to be a major factor for vaccine hesitancy, with most reports suggesting a negative correlation between age and fear of poor vaccination outcomes. Nine studies found females expressing greater vaccine hesitancy than males. Trust deficit in science (n = 14), concerns about safety and efficacy (n = 12), lower levels of fear regarding infection (n = 11), and worry about side effects (n = 8) were also reasons for vaccine hesitancy. Blacks, Democrats, and pregnant women showed high vaccine hesitancy. Few studies have stated income, obesity, social media, and the population living with vulnerable members as factors influencing vaccine hesitancy. A study in India showed that 44.1% of vaccine hesitancy towards booster doses could be attributed dominantly to low income, rural origin, previously unvaccinated status, or living with vulnerable individuals. However, two other Indian studies reported a lack of availability of vaccination slots, a lack of trust in the government, and concerns regarding safety as factors for vaccine hesitancy toward booster doses.
Many studies have confirmed the multifactorial nature of VBH, which necessitates multifaceted, individually tailored interventions that address all potentially modifiable factors. This systematic review chiefly recommends strategizing the campaign for booster doses by identifying and evaluating the reasons for vaccine hesitancy, followed by appropriate communication (at both individual and community levels) about the benefits of booster doses and the risk of losing immunity without them.
虽然有大量证据支持新冠疫苗的安全性和有效性,但仍有相当一部分人对疫苗持犹豫态度。根据世界卫生组织的说法,疫苗犹豫是全球健康面临的十大危害之一。不同国家的疫苗犹豫情况各不相同,印度报告的疫苗犹豫情况最少。人们对新冠疫苗加强针的犹豫程度高于之前的接种。因此,确定决定新冠疫苗加强针犹豫(VBH)的因素是成功开展疫苗接种运动的关键。
本系统评价遵循系统评价和Meta分析的首选报告项目(PRISMA)2020标准。从Scopus、PubMed和Embase中总共汇总了982篇文章,最终纳入42篇涉及新冠疫苗加强针犹豫因素的文章进行进一步分析。
我们确定了导致疫苗加强针犹豫的因素,并将其分为三大类:社会人口学因素、经济因素和心理因素。因此,17篇文章指出年龄是疫苗犹豫的主要因素,大多数报告表明年龄与对不良接种结果的恐惧之间呈负相关。9项研究发现女性比男性表现出更高的疫苗犹豫程度。对科学的信任缺失(n = 14)、对安全性和有效性的担忧(n = 12)、对感染的恐惧程度较低(n = 11)以及对副作用的担忧(n = 8)也是疫苗犹豫的原因。黑人、民主党人和孕妇表现出较高的疫苗犹豫程度。很少有研究指出收入、肥胖、社交媒体以及与弱势群体共同生活的人群是影响疫苗犹豫的因素。印度的一项研究表明,44.1%的对加强针的疫苗犹豫主要可归因于低收入、农村出身、之前未接种疫苗的状态或与弱势群体共同生活。然而,印度的另外两项研究报告称,缺乏接种时段、对政府缺乏信任以及对安全性的担忧是对加强针疫苗犹豫的因素。
许多研究证实了疫苗加强针犹豫的多因素性质,这就需要采取多方面、针对个人量身定制的干预措施,解决所有可能可改变的因素。本系统评价主要建议通过识别和评估疫苗犹豫的原因来制定加强针接种运动策略,随后就加强针的益处以及不接种加强针会失去免疫力的风险进行适当的沟通(在个人和社区层面)。