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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
Journal article   Open access   Peer reviewed

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

Alice Blukacz, Alexandra Obach, Paola Vásquez, Carla Campaña, Catalina Huerta, Yanara Bernal and Báltica Cabieses
Vaccine, Vol.44, 126546
2024
DOI: https://doi.org/10.1016/j.vaccine.2024.126546
PMID: 39608248
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Published737.19 kBDownloadView
CC BY V4.0,  Open Access

Abstract

Confidence Global Health Low- and middle-income countries Qualitative research Vaccine
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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UN Sustainable Development Goals (SDGs)

This output has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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