COVID-19 vaccine acceptance, attitude and perception among slum and underserved communities: A systematic review and meta-analysis

Joseph KAWUKI, Siyu CHEN, Yuan Josephine FANG, Xue LIANG, Paul Shing-fong CHAN, Zixin WANG

Research output: Contribution to journalArticlespeer-review

5 Citations (Scopus)

Abstract

This systematic review summarises the literature on Coronavirus Disease 2019 (COVID-19) vaccination, including acceptance, uptake, hesitancy, attitude and perceptions among slum and underserved communities. Relevant studies were searched from PubMed, Scopus, Web of Science and Google Scholar, following a pre-registered protocol in PROSPERO (CRD42022355101) and PRISMA guidelines. We extracted data, used random-effects models to combine the vaccine acceptance, hesitancy and uptake rates categorically, and performed meta-regression by R software (version 4.2.1). Twenty-four studies with 30,323 participants met the inclusion criteria. The overall prevalence was 58% (95% CI: 49–67%) for vaccine acceptance, 23% (95% CI: 13–39%) for uptake and 29% (95% CI: 18–43%) for hesitancy. Acceptance and uptake were positively associated with various sociodemographic factors, including older age, higher education level, male gender, ethnicity/race (e.g., Whites vs African Americans), more knowledge and a higher level of awareness of vaccines, but some studies reported inconsistent results. Safety and efficacy concerns, low-risk perception, long distance to vaccination centres and unfavourable vaccination schedules were prominent reasons for hesitancy. Moreover, varying levels of attitudes and perceptions regarding COVID-19 vaccination were reported with existing misconceptions and negative beliefs, and these were strong predictors of vaccination. Infodemic management and continuous vaccine education are needed to address existing misconceptions and negative beliefs, and this should target young, less-educated women and ethnic minorities. Considering mobile vaccination units to vaccinate people at home or workplaces would be a useful strategy in addressing access barriers and increasing vaccine uptake. Copyright © 2023 by the authors.

Original languageEnglish
Article number886
JournalVaccines
Volume11
Issue number5
DOIs
Publication statusPublished - Apr 2023

Citation

Kawuki, J., Chen, S., Fang, Y., Liang, X., Chan, P. S.-F., & Wang, Z. (2023). COVID-19 vaccine acceptance, attitude and perception among slum and underserved communities: A systematic review and meta-analysis. Vaccines, 11(5), Article 886. https://doi.org/10.3390/vaccines11050886

Keywords

  • Slum
  • Underserved communities
  • Vaccine acceptance
  • Vaccine hesitancy
  • COVID-19
  • Attitude and perception
  • Vaccine uptake

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