Predictors of COVID-19 vaccination hesitancy in China: a meta-analysis

OBJECTIVES: This study aimed to examine predictors and moderators of COVID-19 vaccine hesitancy in Chinese cultural contexts. STUDY DESIGN: A meta-analysis and meta-regression analyses were conducted to examine the associations between predictors and vaccine hesitancy as well as moderators that may impact these associations. METHODS: We searched relevant articles from January 1, 2020, to May 12, 2022, in the databases of Web of Science, PubMed, ProQuest, ProQuest Dissertations & Theses Global and CNKI. Weighted average effect sizes (e.g., odds ratio) and 95% confidence intervals were computed in Comprehensive Meta-Analysis 3.0 using random-effects models. Heterogeneity tests were conducted prior to moderation analyses. RESULTS: Results from 161 studies in 73 published articles (N = 705,957) were meta-analyzed. Perceived risk of COVID-19 infection, health status, medical workers' recommendation, recommendations from family and friends, and vaccine coverage among relatives and friends were significantly associated with COVID-19 vaccine hesitancy in Chinese cultural contexts. Participant age, operationalization of vaccine hesitancy, and the time of each study exerted significant moderation effects. CONCLUSIONS: Both individual and relational factors influence vaccine hesitancy in Chinese cultural contexts Future vaccine promotion initiatives should focus on risk perceptions as well as influence from medical professionals, family and friends.