COVID-19 vaccination intention and vaccine characteristics influencing vaccination acceptance: a global survey of 17 countries
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.
Abstract
<jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>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.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>An anonymous cross<jats:italic>-</jats:italic>sectional survey was conducted between 4 January and 5 March 2021 in 17 countries worldwide. Proportions and the corresponding 95% confidence intervals (<jats:italic>CI</jats:italic>) 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.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Of the 19,714 responses received, 90.4% (95% <jats:italic>CI</jats:italic> 81.8–95.3) reported likely or extremely likely to receive COVID-19 vaccine. A high proportion of <jats:italic>likely</jats:italic> or <jats:italic>extremely likely</jats:italic> 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 <jats:italic>unlikely</jats:italic> or <jats:italic>extremely unlikely</jats:italic> 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% <jats:italic>CI</jats:italic> 58.4–61.0) reported only being willing to accept a vaccine with an effectiveness of more than 90%, and 74.5% (95% <jats:italic>CI</jats:italic> 73.4–75.5) said they would accept a COVID-19 vaccine with minor adverse reactions. A total of 21.0% (95% <jats:italic>CI</jats:italic> 20.0–22.0) reported not accepting an mRNA vaccine and 51.8% (95% <jats:italic>CI</jats:italic> 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% <jats:italic>CI</jats:italic> 39.3–41.9) of a vaccine and effectiveness threshold (35.1%; 95% <jats:italic>CI</jats:italic> 33.9–36.4).</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>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.</jats:p> </jats:sec><jats:sec> <jats:title>Graphic Abstract</jats:title> </jats:sec>