Table 3.
Individual/group determinants of increased vaccine hesitancy in high-income countries or regions.
| Factor | Number of Supporting Studies | References | Number of Studies Which Found no Significance | References | Number of Disagreeing Studies | References |
|---|---|---|---|---|---|---|
| Experience with past vaccination | ||||||
| History of influenza vaccination | 0 | 1 | [103] | 28 | [15,19,20,22,25,33,35,36,37,41,46,47,49,50,58,61,65,66,68,73,74,75,78,79,86,89,90,95,104] | |
| Having children with up-to-date vaccinations | 0 | 0 | 1 | [25] | ||
| Beliefs, attitudes about health and prevention | ||||||
| Lesser fear for health or worry about COVID-19 | 16 | [32,33,35,37,38,40,49,53,54,59,61,67,68,79,81,90] | 2 | [80,103] | 2 | [28,37] |
| Perception of lower risk of contracting COVID-19 | 15 | [28,43,44,49,52,54,59,61,63,81,94,96,98,104,105] | 4 | [51,55,74,92] | 1 | [69] |
| Belief that COVID-19 is not severe | 12 | [22,36,41,49,52,58,63,64,81,92,98,105] | 1 | [43] | 1 | [69] |
| Greater conspiracy beliefs | 8 | [30,32,50,54,98,106,107,108] | 1 | [80] | 0 | |
| Belief in greater efficacy of complementary alternative medicine or one’s natural immune system | 5 | [20,29,62,73,102] | 0 | 0 | ||
| Belief that COVID-19 is not a disease | 4 | [20,58,85,109] | 0 | 0 | ||
| Belief that threat of COVID-19 is exaggerated | 2 | [85,109] | 0 | 0 | ||
| Lesser compliance with COVID-19 prevention behaviors | 2 | [22,51] | 0 | 0 | ||
| Knowledge and awareness | ||||||
| Lower knowledge about COVID-19 | 4 | [38,79,85,98] | 3 | [22,37,52] | 0 | |
| Lower knowledge about vaccination | 1 | [33] | 2 | [22,37] | 0 | |
| Health-system and providers—trust and personal experience | ||||||
| Lesser trust in healthcare system | 11 | [22,30,32,50,62,68,73,92,106,107,108] | 2 | [80,81] | 0 | |
| Lesser trust in science or in scientist | 9 | [30,33,35,40,54,55,58,73,91] | 0 | 0 | ||
| Immunization as a social norm vs. not needed/harmful | ||||||
| Belief that vaccination is non-beneficial and/or unimportant | 12 | [20,31,37,43,54,68,78,90,91,92,102,105] | 0 | 0 | ||
| Belief that vaccination is a hoax/harmful | 1 | (32, 92) | 1 | [20] | 0 | |
| Humanistic traits | ||||||
| Lesser sense of collective responsibility e.g., protect loved ones, neighbors | 10 | [30,35,37,49,54,89,90,94,101,109] | 2 | [55,103] | 0 | |
| Lower self-efficacy | 4 | [31,43,54,105] | 0 | 0 | ||
| Other factors | ||||||
| No concomitant chronic diseases or not taking regular medications | 11 | [20,30,33,36,57,62,74,78,82,89,98] | 8 | [25,33,46,61,75,84,90,92] | 2 | [64,69] |
| Peers or family with previous COVID-19 infection | 0 | 4 | [22,30,46,103] | 3 | [33,67,89] | |
| Greater desire to return to normalcy | 0 | 0 | 2 | [35,37] | ||
| Previously tested for COVID-19 antibodies or do not mind testing for COVID-19 antibodies | 0 | 0 | 3 | [40,54,65] |