COVID-19 vaccine hesitancy: A Systematic review of cognitive determinants

Abstract

Background: Although mass vaccination is considered one of the most effective public health strategies during the pandemic, in the COVID-19 era, many people considered vaccines unnecessary and, or doubted the effectiveness of the COVID-19 vaccine. This review aimed to tabulate cognitive causes of COVID-19 vaccination hesitancy, which may help public health policymakers overcome the barriers to mass vaccinations in future pandemics. Methods: For this systematic review, studies pertaining to COVID-19 vaccine hesitancy published up to June 2022 were retrieved from six online databases (Cochrane Library, Google Scholar Medline through PubMed, Scopus, and Web of Science). Inclusion criteria were the studies conducted on people who had a delay in accepting or refusing COVID-19 vaccines, reported the impact of cognitive determinants on vaccine hesitancy, and were written in English in the timeframe of 2020–2022. Results: This systematic review initially reviewed 1171 records. From these 91 articles met the inclusion criteria. The vaccination hesitation rate was 29.72% on average. This systematic review identified several cognitive determinants influencing vaccination hesitancy. Lack of confidence and complacency were the most frequent factors that predicted vaccine hesitancy. Conclusion: The identified prevailing cognitive determinants for COVID-19 vaccine hesitancy indicated that using initiative and effective communication strategies would be a determinant factor in building people’s trust in vaccines during the pandemic and mass vaccinations.

Influences on COVID-19 Vaccine Adherence among Pregnant Women: The Role of Internet Access and Pre-Vaccination Emotions

“…In light of these findings, it becomes evident that targeted strategies to increase awareness and discernment regarding online vaccine information are indispensable. The study [12] corroborates our observation on the significant influence of exposure to fake news on vaccine hesitancy and the importance of multifaceted strategies to mitigate this effect. This includes not only improving digital literacy among the targeted audience but also implementing communication campaigns that specifically address their concerns, clarify doubts, and proactively debunk myths.…”

“It’s not that I don’t trust vaccines, I just don’t think I need them”: Perspectives on COVID-19 vaccination

“…Our results also revealed that the decline in the protection conferred by COVID-19 vaccines against new variants and over time had a negative influence on participants’ confidence in these vaccines, potentially leading to a decrease in willingness to receive a booster dose. Perceived efficacy of the vaccine remains one of the most significant reasons for people to get vaccinated, either for primary COVID-19 vaccine series or booster dose(s) [ 19 , 23 , 24 ]. Participants’ perceived risk of COVID-19 also decreased during the pandemic, particularly if they had already received vaccine doses or contracted the virus.…”

“…Other studies have shown that prior COVID-19 infection could negatively influence COVID-19 vaccine willingness [ 19 , 25 ]. Low-risk perception of the threat of COVID-19 and low perceived efficacy of the vaccines are known determinants of COVID-19 vaccine hesitancy [ 24 ], including for the receipt of booster doses [ 19 , 23 , 26 ]. These factors are also associated with low COVID-19 vaccine acceptance among parents in this study, as well as in others [ 11 , 27 – 29 ].…”

The role of vaccine literacy and health literacy in the health prevention decision-making process

“… 8 Furthermore, differently from screening procedures that involve mostly undergoing minimally invasive tests, vaccinations include the injection of a substance into the body of healthy people, an action that may require strong vaccine confidence. 9 In addition, there are other motivations underlying adherence to these two interventions that are likely to be different: while for screening the benefits to undergo a diagnostic test are clearly individual, vaccinations may be perceived to contribute more to increase population health than to protect individuals. 10 Another important difference to take into account regards the target population.…”