The acceptance of COVID-19 vaccine at early stage of development and approval: A global systematic review and meta-analysis

BACKGROUND: Vaccination seems to be the most effective way to prevent and control the spread of COVID-19, a disease that has adversely impacted the lives of over 7 billion people across the globe. Vaccine hesitancy represents an important threat to combat infectious diseases worldwide. This study aims to inspect the COVID-19 vaccine acceptance rate worldwide and the regional variation of the acceptance rates among the general population and healthcare workers across different territories of the world. In addition, it compares the vaccine acceptance rates between the pre- and post-vaccine approval periods. METHOD: A comprehensive systematic review was conducted using PRISMA statements. After quality evaluation, the data from eligible studies were analyzed using the random effect model. Q-test and [Formula: see text] statistics were used to search for heterogeneity. The publication bias was assessed by using Egger’s test and funnel plot. RESULTS: The combined COVID-19 vaccine acceptance rate among the general population and healthcare workers (n = 1,581,562) was estimated at 62.79% (95% CI: 58.98–66.60). The acceptance rate substantially decreased from 66.29% (95% CI: 61.24–71.35) to 56.69% (95% CI: 48.68–64.71) among the general population from the pre-to post-vaccine approval periods but remained almost constant at 58.25% (95% CI: 46.52–69.97) among healthcare workers. The acceptance rates also varied in different regions of the world. The highest acceptance rate was found in the South-East Asia region at 70.18% (95% CI: 58.12–82.25) and the lowest was found in African Region at 39.51% (95% CI: 23.42–55.59). CONCLUSION: Low COVID-19 vaccine acceptance rate might be a massive barrier to controlling the pandemic. More research is needed to address the responsible factors influencing the low global rate of COVID-19 vaccine acceptance. Integrated global efforts are required to remove the barriers.