Determinants of COVID-19 and non-COVID-19 vaccine confidence in low- and middle-income countries: A systematic review of qualitative evidence and thematic synthesis

IF 4.5 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2024-11-27 DOI:10.1016/j.vaccine.2024.126546

Alice Blukacz , Alexandra Obach , Paola Vásquez , Carla Campaña , Catalina Huerta , Yanara Bernal , Báltica Cabieses

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引用次数: 0

Abstract

Background

The COVID-19 pandemic has shown the immediate risk for global and public health posed by vaccination inequities worldwide. The regions most affected are low- and middle-income countries (LMICs). In addition to systemic challenges, vaccine hesitancy driven by low vaccine confidence has been identified as a threat to vaccine uptake. The aim of this systematic review of qualitative literature is to explore the determinants of COVID-19 and non-COVID-19 vaccine confidence in LMICs.

Methods

A systematic review was conducted following the PRISMA and ENTREQ guidelines. The electronic databases Cinahl, Embase, Pubmed, Scopus and Web of Science were searched for qualitative studies focusing on the topic of interest in LMICs published between 2013 and 2023. The quality of the studies was assessed using the Joanna Briggs Institute's Checklist for Qualitative Research. A thematic synthesis was conducted. The study was registered on the Open Science Framework platform.

Findings

66 studies were included in the review. Three main determinants of vaccine confidence were identified: (1) General perceptions of the safety and efficacy of vaccines; (2) Information and experience; (3) Trust in healthcare providers, institutions, and systems. General perceptions of vaccine safety and efficacy were similar between COVID-19 and non-COVID-19 vaccines, and doubts regarding vaccine safety were neither new nor exclusive to the COVID-19 vaccine, indicating a persisting challenge. Furthermore, low vaccine confidence was partly determined by broader dynamics of mistrust towards Western countries and institutions, which was reflected for both vaccine groups. While conspiracy theories have been persisting determinants of low confidence, low COVID-19 vaccine confidence was partly determined by what was perceived as a lack of specific information.

Conclusion

Persistent challenges to vaccine confidence were identified, rooted in colonial legacies and global health inequities, as well as limited intercultural approaches to building trust with regards to vaccines.

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中低收入国家对 COVID-19 和非 COVID-19 疫苗信心的决定因素：定性证据的系统回顾和专题综合

背景COVID-19 大流行表明，全球范围内疫苗接种的不平等给全球和公众健康带来了直接风险。受影响最严重的地区是中低收入国家 (LMIC)。除系统性挑战外，疫苗信心不足导致的疫苗犹豫也被认为是对疫苗接种的威胁。本定性文献的系统综述旨在探讨 LMICs 中 COVID-19 和非 COVID-19 疫苗信心的决定因素。在 Cinahl、Embase、Pubmed、Scopus 和 Web of Science 等电子数据库中检索了 2013 年至 2023 年间发表的有关 LMICs 相关主题的定性研究。研究质量采用乔安娜-布里格斯研究所的定性研究核对表进行评估。进行了专题综合。研究结果66项研究被纳入综述。确定了疫苗信心的三个主要决定因素：(1) 对疫苗安全性和有效性的一般看法；(2) 信息和经验；(3) 对医疗保健提供者、机构和系统的信任。COVID-19和非COVID-19疫苗对疫苗安全性和有效性的总体看法相似，对疫苗安全性的怀疑既不是新问题，也不是COVID-19疫苗独有的问题，这表明疫苗安全问题一直存在。此外，对疫苗信心不足的部分原因是对西方国家和机构的不信任，这在两组疫苗中都有所体现。虽然阴谋论一直是导致低信任度的决定性因素，但 COVID-19 疫苗的低信任度在一定程度上是由人们认为缺乏具体信息所决定的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

期刊介绍： Vaccine is unique in publishing the highest quality science across all disciplines relevant to the field of vaccinology - all original article submissions across basic and clinical research, vaccine manufacturing, history, public policy, behavioral science and ethics, social sciences, safety, and many other related areas are welcomed. The submission categories as given in the Guide for Authors indicate where we receive the most papers. Papers outside these major areas are also welcome and authors are encouraged to contact us with specific questions.