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

  1. Iman Ahmed Fathalla Aboelsaad
  2. Dina Mohamed Hafez
  3. Abdallah Almaghraby
  4. Shaimaa Abdulaziz Abdulmoneim
  5. Samar Ossama El-ganainy
  6. Noha Alaa Hamdy
  7. Ehsan Akram Deghidy
  8. Ahmed El-Sayed Nour El-Deen
  9. Ehab Mohamed Adel Elrewany
  10. Alaa Hamdy Taha Khalil
  11. Karem Mohamed Salem
  12. Samar Galal kabeel
  13. Yasir Ahmed Mohammed Elhadi
  14. Ramy Shaaban
  15. Amr Alnagar
  16. Eman Ahmad Fadel Elsherbeny
  17. Nagwa Ibrahim Elfeshawy
  18. Mohamed Moustafa Tahoun
  19. Ramy Mohamed Ghazy

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Abstract

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’s 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.

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  1. ScreenIT

    SciScore for 10.1101/2021.05.15.21257261: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Cell Line AuthenticationAuthentication: Publication bias: Publication biases were assessed by visual inspection of the funnel plot and statistically by Begg’s modified funnel plot and Egger’s regression test (13).

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    databases; PsycINFO, ScienceDirect, Embase, Scopus, EBSCO, MEDLINE central/PubMed
    PsycINFO
    suggested: (PsycINFO, RRID:SCR_014799)
    Embase
    suggested: (EMBASE, RRID:SCR_001650)
    MEDLINE
    suggested: (MEDLINE, RRID:SCR_002185)
    , ProQuest, SciELO, SAGE, Web of science, and Google scholar.
    ProQuest
    suggested: (ProQuest, RRID:SCR_006093)
    SAGE
    suggested: (SAGE, RRID:SCR_009302)
    Google scholar
    suggested: (Google Scholar, RRID:SCR_008878)
    All articles were imported into EndNote X7.0.1 to detect and remove the duplicates with two methods: title, author, year, and then manually using title, author, and journal.
    EndNote
    suggested: (EndNote, RRID:SCR_014001)
    Further manual search for eligible citations was done through careful examination of the references of included studies as well as studies citing the selected articles using PubMed and google scholar.
    PubMed
    suggested: (PubMed, RRID:SCR_004846)
    At Annex 2 https://drive.google.com/file/d/12tiK2yW9RGmVnxOTphDKOAuAFyMVub_K/view?usp=sharing Investigations of heterogeneity: Cochrane Q test and (I2) test was used to assess and measure heterogeneity between studies, considering I2 ≥ 75% represents substantial heterogeneity and strength of evidence for heterogeneity is the P-value ≤ 0.05 from the Q test; according to Cochrane Handbook for Systematic Reviews of Interventions (13).
    Cochrane Q
    suggested: None

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a protocol registration statement.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2021.05.15.21257261v1 on medRxiv