Abstract
BackgroundThe 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.MethodsAn anonymous cross-sectional survey was conducted between 4 January and 5 March 2021 in 17 countries worldwide. Proportions and the corresponding 95% confidence intervals (CI) 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.ResultsOf the 19,714 responses received, 90.4% (95% CI 81.8–95.3) reported likely or extremely likely to receive COVID-19 vaccine. A high proportion of likely or extremely likely 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 unlikely or extremely unlikely 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% CI 58.4–61.0) reported only being willing to accept a vaccine with an effectiveness of more than 90%, and 74.5% (95% CI 73.4–75.5) said they would accept a COVID-19 vaccine with minor adverse reactions. A total of 21.0% (95% CI 20.0–22.0) reported not accepting an mRNA vaccine and 51.8% (95% CI 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% CI 39.3–41.9) of a vaccine and effectiveness threshold (35.1%; 95% CI 33.9–36.4).ConclusionsThe 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.Graphic
Highlights
The availability of various types of COVID-19 vaccines and diverse characteristics of the vaccines pre‐ sent a dilemma in vaccination choices, which may result in individuals refusing a particular COVID-19 vaccine offered, presenting a threat to immunisation coverage and reaching herd immunity
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
A high proportion of likely or extremely likely 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 unlikely or extremely unlikely to receive the COVID-19 vaccine in Japan (34.6%), the U.S (29.4%) and Iran (27.9%)
Summary
The availability of various types of COVID-19 vaccines and diverse characteristics of the vaccines pre‐ sent a dilemma in vaccination choices, which may result in individuals refusing a particular COVID-19 vaccine offered, presenting a threat to immunisation coverage and reaching herd immunity. Coronavirus disease 2019 (COVID-19), firstly reported in December 2019 [1], was declared a global pandemic by the World Health Organisation (WHO) on March 11, 2020 [2]. The novel coronavirus proliferated across the globe and has since become the greatest public health crisis the world has faced in over a century [3]. One year into the pandemic, as of early March 2021, there have been over 100 million global cases and over 2 million deaths reported [4]. Mass COVID-19 vaccination rollout is a public health top priority to mitigate the pandemic. The pandemic has motivated a global race in vaccine development initiatives which started as soon as the genetic sequence of SARS-CoV-2 was revealed. Of significant importance to pandemic control, seven vaccines have been approved for full use and six for early or limited use across various countries as of 3 April 2021
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