The refusal of COVID-19 vaccination and its associated factors: a meta-analysis

Abstract

Background To date, more than 10% of the global population is unvaccinated against the coronavirus disease 2019 (COVID-19), and the reasons why this population is not vaccinated are not well identified. Objectives We investigated the prevalence of COVID-19 vaccine refusal and to assess the factors associated with COVID-19 vaccine refusal. Methods A meta-analysis was conducted from August to November 2022 (PROSPERO: CRD42022384562). We searched for articles investigating the refusal of COVID-19 vaccination and its potential associated factors in PubMed, Scopus, and the Web of Sciences. The quality of the articles was assessed using the Newcastle–Ottawa scale, and data were collected using a pilot form. The cumulative prevalence of the refusal to vaccinate against COVID-19 was identified through a single-arm meta-analysis. Factors associated with COVID-19 vaccine refusals were determined using the Mantel-Haenszel method. Results A total of 24 articles were included in the analysis. Our findings showed that the global prevalence of COVID-19 vaccine refusal was 12%, with the highest prevalence observed in the general population and the lowest prevalence in the healthcare worker subgroup. Furthermore, individuals with a high socioeconomic status, history of previous vaccination, and a medical background had a lower rate of COVID-19 vaccination refusal. Subsequently, the following factors were associated with an increased risk of COVID-19 vaccine refusal: being female, educational attainment lower than an undergraduate degree, and living in a rural area. Conclusion Our study identified the prevalence of and factors associated with COVID-19 vaccine refusal. This study may serve as an initial reference to achieve global coverage of COVID-19 vaccination by influencing the population of COVID-19 vaccine refusal.