Barriers and facilitators of vaccine hesitancy for COVID-19, influenza, and pertussis during pregnancy and in mothers of infants under two years: An umbrella review

Nichol, Bethany; McCready, Jemma; Steen, Mary; Unsworth, John; Simonetti, Valentina; Tomietto, Marco

doi:10.1371/journal.pone.0282525

Cited by 12 publications

(6 citation statements)

References 96 publications

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“…The predictors of COVID-19 vaccine hesitancy in the study by Kigongo et al were perceived low risk of COVID-19 infection, vaccine side effects, and negative beliefs towards vaccine [ 157 ], whereas in this synthesis, no influenza vaccine, mistrust of vaccine, complacency, pregnancy, being female, and safety concerns were predictor of VH. However, factors similar to the ones identified in this synthesis were also identified in other studies [ 163 , 164 , 165 , 166 ]. These discrepancies may be because factors change with time, place, and culture as well as being psychologically- and context-specific [ 167 ].…”

Section: Discussionsupporting

confidence: 86%

Quantitative Synthesis of Factors Associated with COVID-19 Vaccine Acceptance and Vaccine Hesitancy in 185 Countries

Dinga,

Kabakama,

Njimoh

et al. 2023

Vaccines

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Mass vaccination against COVID-19 is the best method to ensure herd immunity in order to curb the effect of the pandemic on the global economy. It is therefore important to assess the determinants of COVID-19 vaccine acceptance and hesitancy on a global scale. Factors were recorded from cross-sectional studies analyzed with t-Test, ANOVA, correlation, and meta-regression analyses and synthesized to identify global trends in order to inform policy. We registered the protocol (ID: CRD42022350418) and used standard Cochrane methods and PRISMA guidelines to collect and synthesize cross-sectional articles published between January 2020 and August 2023. A total of 67 articles with 576 studies from 185 countries involving 3081,766 participants were included in this synthesis. Global COVID-19 vaccine acceptance was 65.27% (95% CI; 62.72–67.84%), while global vaccine hesitancy stood at 32.1% (95% CI; 29.05–35.17%). One-Way ANOVA showed that there was no significant difference in the percentage Gross Domestic Product spent on vaccine procurement across the World Bank income levels (p < 0.187). There was a significant difference of vaccine acceptance (p < 0.001) and vaccine hesitancy (p < 0.005) across the different World Bank Income levels. World Bank income level had a strong influence on COVID-19 vaccine acceptance (p < 0.0004) and hesitancy (p < 0.003) but percentage Gross Domestic Product spent on vaccine procurement did not. There was no correlation between percentage Gross Domestic Product spent on vaccine procurement and COVID-19 vaccine acceptance (r = −0.11, p < 0.164) or vaccine hesitancy (r = −0.09, p < 0.234). Meta-regression analysis showed that living in an urban setting (OR = 4.83, 95% CI; 0.67–212.8), rural setting (OR = 2.53, 95% CI; 0.29–119.33), older (OR = 1.98, 95% CI; 0.99–4.07), higher education (OR = 1.76, 95% CI; 0.85–3.81), and being a low income earner (OR = 2.85, 95% CI; 0.45–30.63) increased the odds of high COVID-19 vaccine acceptance. Factors that increased the odds of high COVID-19 vaccine hesitancy were no influenza vaccine (OR = 33.06, 95% CI; 5.03–1395.01), mistrust for vaccines (OR = 3.91, 95% CI; 1.92–8.24), complacency (OR = 2.86, 95% CI; 1.02–8.83), pregnancy (OR = 2.3, 95% CI; 0.12–141.76), taking traditional herbs (OR = 2.15, 95% CI; 0.52–10.42), being female (OR = 1.53, 95% CI; 0.78–3.01), and safety concerns (OR = 1.29, 95% CI; 0.67–2.51). We proposed a number of recommendations to increase vaccine acceptance and ensure global herd immunity against COVID-19.

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Section: Discussionsupporting

confidence: 86%

Quantitative Synthesis of Factors Associated with COVID-19 Vaccine Acceptance and Vaccine Hesitancy in 185 Countries

Dinga,

Kabakama,

Njimoh

et al. 2023

Vaccines

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“…These findings were also found among teachers in Poland, 12 Greece 14 and America, 15 and were similar to results from the study of HCWs, 46 elders, 47 and other group of people. 48 , 49 A belief in the efficacy and safety of vaccines was a sign of vaccine confidence. 50 Increasing vaccine confidence could increase acceptance of vaccines.…”

Section: Discussionmentioning

confidence: 99%

Acceptance of influenza vaccination and associated factors among teachers in China: A cross-sectional study based on health belief model

Gu,

Liu,

Chen

et al. 2023

Human Vaccines & Immunotherapeutics

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Teachers played an important role on the transmission of influenza in schools and communities. The study aims to investigate the influenza vaccination coverage and the factors determining flu vaccination acceptance among teachers in Hangzhou, China. A total of 1039 junior high school teachers in Hangzhou were recruited. The self-made questionnaire was used to investigate the influenza vaccine coverage among teachers and the influencing factors of influenza vaccination acceptance. Univariate analysis using the chi-square test and multivariable analysis using binary logistic regression were conducted to determine the relative predictors. The Influenza vaccine coverage among teachers was 5.9% (62/1039). 52.9% of teachers had the intention to receive influenza vaccine, 25.3% (247/977)/21.8% (213/977) of participants was hesitant/did not have the intention to get influenza vaccine. The top three sources for teachers to gain knowledge about influenza were website (72%), TV/radio (66.1%) and social media (58%). Whether get influenza vaccination before, knowledge about influenza and influenza vaccine, the beliefs for the likelihood of catching flu, the severity of getting flu, the effectiveness of influenza vaccine, the possibility of side effects after vaccination, and the troublesome of vaccination, doctors’ recommendation, as well as the situation of vaccination among other teachers were the associated factors of influenza vaccination acceptance. The influenza vaccination coverage was low but the intentions were relatively high among junior high school teachers. Future research should focus on the relationship between vaccination acceptance and behavior to increase influenza vaccination rates.

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“…Studies on factors influencing vaccination decision-making during pregnancy suggest that healthcare professional (HCP) recommendations and beliefs about vaccine safety and efficacy are key drivers of vaccination uptake [53][54][55]. However, the impact of HCP recommendations could be diminished by factors such as belief in vaccine-induced harm, particularly for novel vaccines like COVID-19 [54,56,57].…”

Section: Plos Onementioning

confidence: 99%

“…Recent qualitative research has identified belief in conspiracy theories and misinformation as obstacles to vaccine uptake among pregnant women [56]. Previous systematic reviews have mainly included quantitative methodologies [53] and may have focused less on the complexity, context, nuance and meaning of vaccinations in pregnancy. Our study aims to fill this knowledge gap.…”

Section: Plos Onementioning

confidence: 99%

Facilitators and barriers to vaccination uptake in pregnancy: A qualitative systematic review

Razai,

Mansour,

Ravindran

et al. 2024

PLoS ONE

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Introduction Vaccination during pregnancy protects both the mother and the foetus from vaccine-preventable diseases. However, uptake of the recommended vaccines (influenza, pertussis, COVID-19) by pregnant women remains low in Europe and the USA. Understanding the reasons for this is crucial to inform strategies to increase vaccination rates in pregnant women. This qualitative systematic review aimed to identify the barriers and facilitators to vaccination against influenza, pertussis/whooping cough and COVID-19 during pregnancy and identify possible strategies to increase vaccination rates. Methods We conducted a comprehensive search of electronic databases, including Medline, PsycINFO, CINAHL, Web of Science, WHO database, Embase and grey literature to identify qualitative studies that explored barriers and facilitators to vaccine uptake among pregnant women (PROSPERO CRD42023399488). The search was limited to studies published between 2012 and 2022 conducted in high-income countries with established vaccination programmes during pregnancy. Studies were thematically analysed and underwent quality assessment using the Joanna Briggs Institute validated critical appraisal tool for qualitative research. Results Out of 2681 articles screened, 28 studies (n = 1573 participants) were eligible for inclusion. Five overarching themes emerged relating to personal, provider and systemic factors. Barriers to vaccine uptake included concerns about vaccine safety and efficacy, lack of knowledge about vaccines’ benefits and necessity, fear of adverse effects on the foetus or mother and low perception of disease severity. Facilitators included recommendations from trusted healthcare providers, easy access to vaccination, clear communication on the benefits and safety of vaccination, and positive social influences from family and friends. Strategies for increasing vaccination uptake included strong and proactive vaccine recommendations by trusted healthcare professionals, provision of vaccines during routine antenatal care, and clear and consistent communication about vaccines addressing pregnant women’s concerns. Conclusion This review highlights the need for interventions that address the identified barriers to vaccine uptake among pregnant women. Recommendation from a healthcare provider can play a significant role in promoting vaccine uptake, as can clear risk/benefit communication and convenient access to vaccination. Addressing concerns about vaccine safety and providing accurate information about vaccines is also important.

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Barriers and facilitators of vaccine hesitancy for COVID-19, influenza, and pertussis during pregnancy and in mothers of infants under two years: An umbrella review

Cited by 12 publications

References 96 publications

Quantitative Synthesis of Factors Associated with COVID-19 Vaccine Acceptance and Vaccine Hesitancy in 185 Countries

Quantitative Synthesis of Factors Associated with COVID-19 Vaccine Acceptance and Vaccine Hesitancy in 185 Countries

Acceptance of influenza vaccination and associated factors among teachers in China: A cross-sectional study based on health belief model

Facilitators and barriers to vaccination uptake in pregnancy: A qualitative systematic review

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