K.ABDUL JAABAR1, S.Y.LUN1, S.GAO1, Y.G.TANG1, C.C.YU1, Y.H.LOW2, P.P.GEORGE3
Geriatric Education and Research Institute1, Khoo Teck Puat Hospital2, National Healthcare Group HQ3
Vaccination is a key component in the overall control of any pandemic; low vaccination acceptance among the public could dampen the success of any COVID-19 vaccination programs. This review uses the social ecological framework to understand the barriers and facilitators to COVID-19 vaccination acceptance.
This review is guided by the five-stage methodological framework by Arksey and O’Malley. Five major electronic databases – Medline, Embase, Pubmed, CINAHL and PsycInfo – were searched. This review focused only on COVID-19 vaccine acceptance and hesitancy in adults and excluded studies with samples consisting of those ≤16 years old and/or specialized populations (e.g. healthcare workers).
A total of 1066 records were systematically screened using title and abstract by three reviewers. Following the second stage of full-text screening, 129 studies were included in the synthesis. The factors affecting COVID-19 vaccine acceptance or hesitancy identified in the studies were mapped to the respective categories in the ecological model, namely intrapersonal, interpersonal, institutional factors, community, as well as public policies.
Based on our findings, the majority of the factors were categorized under intrapersonal, which might require further exploration to be addressed at the policy level. Possible policy examples to encourage vaccination among those hesitant include: (a) convincing them that their specific concerns are unfounded via education, (b) providing them with reassurances that they would be taken care of if they were to experience negative side effects, or (c) understand the characteristics of those who are hesitant and develop customized strategies to encourage them to vaccinate.