Next Article in Journal
Inactivated Whole Virus Particle Influenza Vaccine Induces Anti-Neuraminidase Antibodies That May Contribute to Cross-Protection against Heterologous Virus Infection
Next Article in Special Issue
COVID-19 Vaccine Intention and Knowledge, Literacy, and Health Beliefs among Japanese University Students
Previous Article in Journal
Leishmania tarentolae as an Antigen Delivery Platform: Dendritic Cell Maturation after Infection with a Clone Engineered to Express the SARS-CoV-2 Spike Protein
Previous Article in Special Issue
Barriers and Facilitators to Receiving the COVID-19 Vaccination and Development of Theoretically-Informed Implementation Strategies for the Public: Qualitative Study in Hong Kong
 
 
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Review

COVID-19 Vaccine Acceptance Rate and Its Factors among Healthcare Students: A Systematic Review with Meta-Analysis

1
Environment and Sustainability Research Initiative, Khulna 9208, Bangladesh
2
Environmental Science Discipline, Life Science School, Khulna University, Khulna 9208, Bangladesh
3
Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
4
Tokyo Foundation for Policy Research, Tokyo 106-6234, Japan
5
Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, SC 29634, USA
*
Author to whom correspondence should be addressed.
Vaccines 2022, 10(5), 806; https://doi.org/10.3390/vaccines10050806
Submission received: 9 April 2022 / Revised: 5 May 2022 / Accepted: 16 May 2022 / Published: 19 May 2022
(This article belongs to the Special Issue Vaccination Intention against the COVID-19 Pandemic)

Abstract

:
Healthcare students are clinicians-in-training likely to come into contact with COVID-19 as much as other frontline healthcare professionals. It is therefore necessary to prioritize vaccinations for this group. We conducted a global systematic assessment of COVID-19 vaccine acceptance rates and related factors among healthcare students using the PubMed, Scopus, and Web of Science databases and keyword searches in March of 2022. We found 1779 articles with relevant information and 31 articles that matched our inclusion criteria. We performed a random-effects meta-analysis and quality assessment using the eight-item Joanna Briggs Institute Critical Appraisal test for cross-sectional studies. A total of 30,272 individuals from 16 countries were studied. Most of the studies were carried out in the U.S. (n = 6), China (n = 5), Poland (n = 5), India (n = 2), Italy (n = 2), and Israel (n = 2). The prevalence of the COVID-19 vaccine acceptance rate was 68.8% (95% confidence interval [CI]: 60.8–76.3, I2 = 100%), and the prevalence of the vaccine hesitancy rate was 25.8% (95% CI: 18.5–33.8, I2 = 99%). In country-specific analyses, Romania showed the highest acceptance rate (88.0%, 95% CI: 44.5–100%), while Iraq showed the lowest acceptance rate (66.2%, 95% CI: 35.5–90.8%). In time-trend analyses, we found that acceptance rates among healthcare students decreased over time. Students concerned about potentially serious side effects of the vaccine were less willing to accept the vaccine. National and international interventions should be adopted to reduce COVID-19 vaccination hesitancy rates among these important frontline workers.

1. Introduction

The ongoing COVID-19 pandemic has turned into a global challenge due to its dramatically contagious nature. The virus has led to more than 4.6 million deaths globally between February of 2020 and August of 2021 [1]. Vaccinations are one of the most cost-effective and long-lasting measures in helping to control such a public health disaster [2]. Vaccination rates directly impact herd immunity. Studies reported that when a population’s acquired immunity reaches 67%, the prevalence of COVID-19 infections will continue to decline [3]. Multiple biological and chemotherapeutic measures (i.e., plasma therapy, hydroxychloroquine, remdesivir, and tocilizumab) have been used to treat COVID-19 patients, but their curative effects have generally not been recommended or proven for patient treatment [4]. Many countries have encountered ongoing surges in COVID-19 cases due to relaxed precautionary measures like lockdowns, social distancing, hand washing, and personal hygiene practices [5]. Vaccinations remain the most important tool in combatting the pandemic.
Scientific authorities have undertaken over 300 vaccine invention projects, among which approximately 40 are in the clinical trial stage and a few are available to the general population [6]. Vaccine development was accelerated when two of these vaccines were granted Emergency Use Authorization (EUA) in December of 2020—a process that generally takes several years or more [7]. As of July of 2021, about three billion doses of COVID-19 vaccines have been administered worldwide. More than 11.48 billion doses of vaccines have been approved in at least one country. Clinical trials have shown that some of these have significant promise for real-world use, while others are customized to the unique needs of certain groups (i.e., older adults). Vaccination effectiveness generally varies between 50% and 77%. There is evidence that many vaccines may help minimize the likelihood of severe illness and asymptomatic disease, thus limiting the spread of SARS-CoV-2 [8,9].
Any vaccination program’s success depends upon people’s willingness to be vaccinated, the demand for vaccines, and positive attitudes toward vaccines [10,11]. Therefore, vaccine hesitancy limits the success of a vaccination program’s success; such hesitancy is defined by the indecision, reluctance, or refusal of vaccination [12,13]. The World Health Organization (WHO) has stated that vaccine hesitancy is a serious threat to public health [14]. For example, the 2018 measles outbreak in New York City revealed that vaccine hesitancy resulted in continuous transmission [15]. Vaccine hesitancy has been linked to numerous factors, such as distrust in the government, fear of side effects, and religious convictions [16].
During the COVID-19 pandemic, there has been much discussion about vaccines, especially among healthcare workers (HCWs) and students [17,18]. Healthcare students (HCSs) in medical, dental, nursing, and related programs are future clinical caregivers and important populations who need to be vaccinated against COVID-19. Several governments have chosen to incorporate medical students as volunteers who assist with coronavirus treatment while finishing their residency training [19]. HCSs are likely come into contact with COVID-19-infected patients during training sessions and clinical practice [20,21]. To avoid further infection and increase vaccine acceptance rates, medical students must be taught about the benefits of vaccines as part of their training. Furthermore, their families and friends look to them as competent and trustworthy resources of information, which means their opinions and views have an influence on the general public’s vaccine acceptance levels [22].
Numerous studies have investigated vaccine acceptance or hesitancy rates among HCSs. Some of these studies showed surprisingly high rates of vaccine hesitancy [17]. For example, one study in the U.S. found that nearly one-quarter of medical students were reluctant to be vaccinated, even after an approved COVID-19 vaccine was available [18]. Another study among nursing students in Greece, Albania, Cyprus, Spain, Italy, the Czech Republic, and Kosovo found that less than one-half were willing to be vaccinated [23]. In contrast, nearly 90% of medical students in India [24] and nursing students in China [2] were willing to get vaccinated.
We conducted a rapid systematic review with meta-analysis on HCSs’ perception of being vaccinated in response to this growing body of literature on vaccination acceptance and hesitancy among HCSs and the seemingly disparate results. Comparable systematic reviews and meta-analyses have been conducted among general populations [10,25,26] and healthcare workers [27,28], but not HCSs. Our aim was to assess the acceptance and hesitancy of COVID-19 vaccination rates among HCSs globally and identify the factors predicting vaccine acceptance. We expected the findings to help understand the challenges associated with vaccine hesitancy among HCSs, as well as inform strategies for overcoming these challenges.

2. Materials and Methods

We followed the Cochrane Rapid Review guidelines to conduct a rapid systematic review with a streamlined but robust approach. The criteria were searches in English and peer-reviewed studies. Similar approaches have been used to provide time-sensitive information that informs decision-making surrounding COVID-19 immunization programs [29].

2.1. Search Strategy

We systematically searched three databases (PubMed, Web of Science, and Scopus) using the PRISMA checklist (http://www.prisma-statement.org/) on 5 March 2022. We utilized the following Medical Subject Heading (MeSH) terms as well as text words (tw) for COVID-19: “COVID-19”, “SARS-CoV-2”, “coronavirus”, “novel coronavirus”, “nCoV”, “2019-ncov”, “SARS-2”, and “severe acute respiratory syndrome coronavirus 2”. For vaccines, we used: “vaccines”, “vaccination”, “COVID-19 vaccines”, “vaccina”, “vaccine uptake”, and “SARS-CoV-2 vaccine”. For acceptance/hesitancy, we used: “vaccine hesitancy”, “vaccine hesitance”, “vaccine acceptance”, “vaccine confidence”, “vaccine safety”, “vaccination attitudes”, “vaccine rejection”, and “vaccine willingness”. We did not specify the population terms to avoid excluding potentially important and relevant articles. Additional articles were identified using the references and citation lists of articles and reviews found in the keyword searches via forward and backward citation tracking in Google Scholar.

2.2. Study Selection

All records were imported to ‘Rayyan’ (https://www.rayyan.ai/; accessed on 5 March 2022). This is a tool for intelligent systematic reviews. Duplicates were removed using this software. Irrelevant records were excluded through title and abstract screening. Next, the full texts of the remaining articles were screened (Figure 1). Discrepancies were resolved by discussion among the three reviewers (MMP, MB, and MZH) and, if required, consultation with other co-authors for reaching a consensus.
We had six inclusion criteria for the articles. These included: (1) survey studies among HCSs; (2) descriptive and observational studies among HCSs with cross-sectional, experimental, or longitudinal designs; (3) studies focused on evaluating COVID-19 vaccine acceptance and/or hesitancy; (4) studies published in English with no restriction to country; (5) studies published since January of 2020; and (6) peer-reviewed scientific journal articles.
Six exclusion criteria were included. These were: (1) articles not aiming to evaluate COVID-19 vaccine acceptance or hesitancy; (2) study populations other than HCSs; (3) publication types other than peer-reviewed journal articles, such as literature reviews, systematic reviews, unpublished data, books, conference papers, editorials, commentaries, letters to the editor, and case reports; (4) studies with non-human subjects; (5) studies without available full-texts; and (6) studies other than in English.

2.3. Data Extraction

Data extraction was performed independently by three co-authors. The extracted data included: author-name; publication year; study country; study design; survey method and period; target population; sampling method; sample size; measurement scale of vaccine acceptance; statistical analysis; acceptance rate; hesitancy rate; factors associated with vaccine acceptance, hesitance, or refusal; and summary of results. These data are summarized in Table 1. After independent data extraction, any differences were resolved by consensus among the same three co-authors.

2.4. Assessment of Study Quality

Regarding quality assessment and evaluating the risk of bias, we adopted the Joanna Briggs Institute critical appraisal tools for analytical cross-sectional studies (Table S1) [30]. This allowed us to determine whether certain articles should be included or excluded, or if additional information was required. We used a checklist with eight questions on the study’s methods and applicable data analysis for this purpose. The total score for each study was assessed by aggregating the individual scores and categorizing them into a high- or low-quality group following previous studies [31,32].

2.5. Data Analysis

Acceptance and hesitancy rates were pooled using random-effects models. The Higgin’s and Thompsons’s I2 statistics determined the heterogeneity [33,34]. Funnel plots and the Egger’s tests identified potential publication bias. We considered the survey year and country for subgroup analysis and conducted meta-regression analyses for four predictors: sex, residence, history of prior vaccinations, and concern about serious side effects. All analyses were performed using the ‘meta’ statistical packages in R software (version 4.2.1).

3. Results

3.1. Search Results

A total of 2781 articles were identified in preliminary searches across three databases including PubMed, Web of Science, and Scopus. Of these, 1002 articles were duplicates. After assessing their eligibility based on the title and abstract, 39 articles were eligible for full-text screening. Ultimately, 31 articles were included in the analyses (Figure 1).

3.2. Characteristics of Included Studies

The characteristics of the included articles are summarized in Table 1. Most used a cross-sectional design and collected data via telephone or online surveys. The majority also relied heavily on snowball sampling (i.e., via social media or email) and convenience sampling for recruitment. Studies were mostly conducted between March of 2020 and March of 2021.
The total number of healthcare students included in the studies was 30,272. Sample sizes ranged from 104 in Israel [35] to 6639 in one study across 22 countries [36]. Approximately 19,425 students (64% of total sample) were female. Most of the studies were conducted in the U.S. (n = 6), China (n = 5), Poland (n = 2), India (n = 2), Italy (n = 2), and Israel (n = 2). The largest share of HCSs were medical students, followed by nursing and dental students.
Table 1. Characteristics of included studies.
Table 1. Characteristics of included studies.
SLAuthorStudy CountryType of Healthcare
Students
Study DesignSurvey MethodSurvey PeriodSampling MethodSample Size, NGender, Female (%)Vaccine
Acceptance Rate (%)
1Al Janabi et al. [37]USAOsteopathic medicalCross-sectionalOnlineOctober 2020NR19757.945
2Bălan et al. [38]RomaniaGeneral Medicine, Dentistry, Pharmacy and Nursing and MidwiferyCross-sectionalOnline12 January until 3 March 2021NR158174.588
3Belingheri et al. [39]ItalyNursingCross-sectionalOnline21–27 December 2020NR42282.980.9
4Bolatov et al. [40]KazakhstanMedicalCross-sectionalOnlineMarch 2021NR88876.522.4
5De Sousa Chaves et al. [41]BrazilMedicalCross-sectionalOnline18 December 2020 to 8 January 2021Snowball sampling25058.584
6Gao et al. [42]ChinaMedicalCross-sectionalOnlineFebruary–March 2021Convenience sampling61263.2NR
7Gotlib et al. [43]PolandNursing undergraduate studentsCross-sectionalOnlineMarch–April 2021NR79390.838
8Grochowska et al. [44]PolandMedicalCross-sectionalOnline/Off line4 September–5 November 2020NR419n = 33170.7
9Jain et al. [45]IndiaMedicalCross-sectionalOnline2 February–7 March 2021Respondent-driven sampling strategy106848.689.4
10Jiang et al. [2]ChinaNursingCross-sectionalOnlineFebruary–April 2021Convenience148884.271256
11Kanyike et al. [4]UgandaMedicalCross-sectionalOnline15–21 March 2021Convenience60037.2224
12Katz et al. [35]IsraelMedicalCross-sectionalOnlineDecember 2020NR10461.591.35
13Kelekar et al. [17]USAMedicalCross-sectionalOnlineNovember–December 2019NR167NR126
Dental248135
14L. Jain et al. [46]IndiaHealthcare studentCross-sectionalOnlineNovember 2020–January 2021Snowball sampling65561.9863.82
15Li et al. [47]ChinaMedicalCross-sectionalOnline15 March–30 March 2021NR219681.71291
16Lindner-Pawłowicz et al. [48]PolandMedicalCross-sectionalOnline8–31 December 2020NR350NR76.9
17Lucia et al. [18]USAMedicalCross-sectionalOnlineNRNR16757126
18Lo Moro et al. [49]ItalyMedicalCross-sectionalOnline20 November 2020–2 February 2021NR83863.593.3
19Mahdi [50]IraqMedicalCross-sectionalOnline2021NR81060.233.83
20Manning et al. [21]USANursingCross-sectionalOnline10 August–14 September 2020NR102987.7466
21Mascarenhas et al. [20]USADentalCross-sectionalOnline2020NR24858136
22Mayan et al. [51]USAMedicalCross-sectionalOnline9 February–15 March 2021NR189964.393.31
23Mose et al. [52]EthiopiaMedical and health scienceCross-sectionalNR1–30 March 2021Simple random sampling42041.758.8
24Petravic et al. [53]SloveniaMedical & Healthcare studentsCross-sectionalOnlineDecember 2020NR62479.49Medical: 82, Healthcare: 51
25Riad et al. [36]22 countriesDentalCross-sectionalOnline6–28 February 2021NR663970.563.6
26Rosental and Shmueli [54]IsraelMedical and nursingCross-sectionalOnline27 August–28 September 2020NR62866.6Medical: 282Nursing: 234
27Saied et al. [6]EgyptMedicalCross-sectionalOnline8–15 January 2021Convenience sampling2133NR34.9
28Szmyd et al. [55]PolandMedicalCross-sectionalOnline22–25 December 2020NR68764.77632
29Talarek et al. [56]PolandMedicalCross-sectionalOnlineMarch and April 2020NR41168.494.6
30Zhang et al. [57]ChinaHealthcare studentsCross-sectionalOnline16–20 August 2021NR63179.7177.81
31Zhou et al. [58]ChinaNursingCross-sectionalOnline4–20 January 2021NR107082.151.9
Notes: NR, Not Reported.

3.3. Prevalence of Vaccine Acceptance and Hesitancy

The estimated total COVID-19 vaccination acceptance rate among HCSs was 68.8% (95% CI: 60.8–76.3% I2 = 100%) (Figure 2). Talarek et al. [56] observed the highest acceptance rate (95.6%, 95% CI: 92.0–96.6%) in a study in Poland. The study in Kazakhstan by Bolatov et al. [40] reported the lowest vaccination acceptance rate of 22.4% (95% CI: 19.7–25.3%).
The total estimated COVID-19 vaccination hesitancy rates among HCSs was 25.8% (95%CI: 18.5–33.8% I2 = 99%) (Figure 3). Mahdi [50] reported the highest hesitancy rates in Iraq (66.2%, 95%CI: 62.8–69.4%), and the lowest rate of hesitancy was found in Poland (3.9%, 95% CI: 2.6–5.7%) by Szmyd et al. [55].

3.4. Sub-Group Analysis

Figure 4 and Figure 5 present country-specific COVID-19 vaccine acceptance rates among HCSs. The pooled prevalence of the highest acceptance rate was observed in Romania (88.0%, 95% CI: 44.5–100%), followed by Italy (87.8%, 95% CI: 58.3–100%, I2 = 98%), Israel (87.0%, 95% CI: 58.7–100%, I2 = 84%), Brazil (84.0%, 95% CI: 38.4–100%), and India (78.0%, 95% CI: 45.3–98.0%, I2 = 99%).
Country sub-group analyses are presented in Figure 6. Iraq showed the highest rates of vaccine hesitancy (66.2%, 95% CI: 35.5–90.8%), followed by Egypt (45.5%, 95% CI: 17.5–75.5%), Ethiopia (41.2%, 95% CI: 14.0–71.8%), China (37.1%, 95% CI: 23.0–52.6%, I2 = 99%), and the U.S. (33.4%, 95% CI: 17.4–51.4%, I2 = 92%).

3.5. Time Trends

COVID-19 vaccine acceptance rates decreased with time (Figure 7). During 2020, the pooled acceptance rate was 75.0% (95% CI: 63.5–85.0%, I2 = 99%). The acceptance rate in 2021 was only 62.8% (95% CI: 51.3–73.6%).

3.6. Predictors of Vaccine Acceptance

Figure 8 presents the potential predictors associated with COVID-19 vaccine acceptance among HCSs. Sex, place of residence, previous history of vaccination, and concern about the vaccination side effects were considered. Only one factor—concern about potentially serious side effects of vaccines (n = 3 studies, OR = 0.2, 95% CI: 0.1–0.4)—was significantly associated with lower acceptance rates.

3.7. Risk of Bias

All 31 studies were assessed to be of the highest possible quality based on the JBI technique (Table S1). Studies that used ineffective recruitment methods like convenience and snowball sampling via social media were not removed, but their results may not have been representative of the population.
We observed no risk of publication bias. The Egger’s tests among studies of vaccine acceptance (p-value = 0.64) and vaccine hesitancy (p-value = 0.97) were not significant (Figures S1 and S2).

4. Discussion

4.1. Summary of the Main Findings

Vaccines have been revolutionary in their the potential to end the COVID-19 pandemic [38]. However, vaccine hesitancy remains high and an important obstacle in many vaccination programs [59,60]. Vaccine skepticism is on the rise among healthcare workers due in part to the rapid development of these vaccines [61]. Healthcare students can act as role models in their communities to increase trust about the safety of vaccinations [38]. Furthermore, healthcare students are frontline workers likely to be exposed to COVID-19 during training and clinical practice. It is necessary to prioritize vaccinations for this group. To our knowledge, no systematic review or meta-analysis had been conducted on vaccination acceptance and hesitancy rates among healthcare students.
The current study systematically reviewed and analyzed the data from 30,272 healthcare students across the world. Our pooled estimations showed that approximately two-thirds of healthcare students were willing to accept a COVID-19 vaccine. Meanwhile, approximately one-quarter were hesitant about accepting a COVID-19 vaccine. Such rates are similar to those observed in general populations [10] and healthcare workers [62]. One potential explanation for these findings is that healthcare students may be exposed to large amounts of health-related information, which may make them more aware of the vaccine’s serious side effects and thus influence their decision to be vaccinated [18].
Country-wise, pooled results found that healthcare students from comparatively high-income countries like Romania, Poland, Italy, and the U.S. were more likely to accept a COVID-19 vaccine than students in other countries. One possible explanation is that vaccines were more prevalent in higher-income countries, making it easier for students to receive vaccinations. A recent study reported that, among 25 countries, 10 high-income countries received a median of 51.7% more vaccine doses than their low-income counterparts (31–14.9%) despite high rates of authorization [63]. Furthermore, most of these studies were conducted during the early stages of the pandemic, when countries were experiencing increasing rates of COVID-19-related mortality. Fear of becoming infected could have influenced vaccine acceptance levels.
Low vaccine acceptance and high vaccine hesitancy were observed in Middle Eastern and African countries (e.g., Kazakhstan, Egypt, and Iraq). Middle Eastern results may be attributed to high belief rates in conspiracy theories and high dependence on social media platforms to obtain vaccine-related information [64]. Lower COVID-19 mortality rates might have influenced vaccine acceptance rates in African countries [65]. In addition, people in Africa have a history of vaccination skepticism, which may have contributed to low acceptance rates [66]. Traditionally, many African groups have shown poor health-seeking behaviors because of spiritual considerations that limit vaccination uptake [67].
Our study found that vaccine acceptance among healthcare students decreased over time. Earlier studies have also found that vaccine acceptance varies over time [68]. For example, a global systematic review on vaccine acceptancy rates reported a decline from 79% in March–May to 60% in June–October of 2020 [10]. This finding could be explained by the fact that students during the early stages of the pandemic were more fearful of being infected, which motivated them to receive a vaccine. Similar findings were observed among Egyptian medical students [6]. Additionally, Wong et al. [69] reported that individuals who were more fearful of COVID-19 demonstrated greater willingness to receive a vaccine due to the perceived benefit of immunization reducing the risk of infection. With time, healthcare students were exposed to more professional information, which likely influenced their decisions. Recent research shows that the observed decreases in vaccination intentions may be caused by COVID-19-related misinformation, as well as public worries about vaccine safety [70,71].
Finally, we found that concerns about serious side effects of COVID-19 predicted vaccine acceptance. A similar finding was observed in Egypt, where 74% of medical students reported that side effects were major barriers of vaccine acceptance [6]. Another study conducted among Egyptian healthcare professionals (HCWs) found that 57% of HCWs were unwilling to accept a vaccine due to their belief that vaccines were unsafe [72]. Such findings could be explained by students being doubtful of vaccine efficacy due to its rapid development. However, it is worth mentioning that different countries and regions often use different types of vaccines, and potential side effects vary, which may also influence vaccine hesitancy from study to study.

4.2. Implications

COVID-19 vaccinations should be prioritized for frontline workers since they are critical to COVID-19 responses and are at high risk of infection. Given the low degree of intention to vaccinate against COVID-19 among healthcare students, it is necessary to boost vaccine acceptability rates in this population. The majority of countries agree that frontline workers should be immunized against COVID-19 [27]. Our systematic review could be an initial step, as it estimated country-wise vaccine acceptancy and hesitancy coverage among healthcare students. This information could help decision-makers determine where and how to prioritize vaccine distribution. It is critical to focus on establishing confidence in COVID-19 vaccinations among this population. Governments of each country could mandate vaccination policies for not only healthcare workers but also healthcare students.

4.3. Strengths and Limitations

This study has a number of strengths. It is the first comprehensive meta-analysis study on vaccination acceptability among healthcare students that we are aware of. All of the publications considered in this review were judged as high-quality observational studies. Our evaluation considered the most recent study findings when calculating the final vaccination acceptance rate.
Our review also has limitations. First, our search was confined to three databases (Scopus, PubMed, and Web of Science). Other databases, such as Embase, PsycINFO, CINAHL, PMC, or NCBI were not searched. Secondly, we excluded preprints and unpublished grey literature. Given the spike in COVID-19 papers throughout our research period, we may have reached a different outcome if preprints or unpublished grey literature were included. Third, the data collection period for the included studies was from 2020 to early 2022, which may have influenced the findings due to the fact that public sentiments regarding vaccination change over time. Fourth, most of the reviewed research was cross-sectional and performed through online surveys. Conclusions from online research are prone to clarity and self-selection bias [73]. Finally, we were unable to investigate some potential determinants of vaccine acceptance owing to data constraints.

5. Conclusions

Healthcare students were moderately willing to accept a COVID-19 vaccine as of March of 2022. Romania and Kazakhstan showed the highest and lowest vaccine acceptance rates, respectively. Vaccination acceptance rates among healthcare students decreased from 2020 to 2021. Healthcare students who expressed concerns about the potential side effects of the vaccine were less likely to accept a vaccine.
Governments should prioritize vaccine distribution to frontline healthcare workers, including students, as soon as safe vaccines are available. These efforts should be coupled with comprehensive educational programs that reinforce the safety of vaccines to healthcare students. Previous studies indicate that vaccine-exposed medical students have positive attitudes toward vaccines. If more healthcare students are vaccinated, they can relate their positive experiences to their patients and increase vaccine uptake in the general public.

Supplementary Materials

The following supporting information can be downloaded at: https://www.mdpi.com/article/10.3390/vaccines10050806/s1, Figure S1: Funnel plot of vaccine acceptance among healthcare students. Figure S2: Funnel plot of vaccine hesitancy among healthcare students.; Table S1: Quality assessment of included studies.

Author Contributions

Conceptualization: M.M.P., M.B., M.A.A., M.Z.H., and R.S.; methodology: M.M.P., M.A.A., and M.B.; software: M.M.P. and M.A.A.; validation: M.M.P., M.B., M.Z.H., and M.A.A.; formal analysis: M.M.P. and M.A.A.; investigation: M.M.P.; data curation: M.M.P., M.B., and M.Z.H.; writing—original draft preparation: M.M.P. and M.B.; writing—review and editing: M.M.P., M.B., M.A.A., M.Z.H., R.S., and M.H.E.M.B.; visualization: M.M.P. and M.A.A.; supervision: M.M.P. and M.A.A.; project administration: M.M.P. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Not applicable.

Data Availability Statement

Data generated in this study is available by contacting the first author, Muhammad Mainuddin Patwary, if requested reasonably.

Conflicts of Interest

The authors declare no conflict of interest.

References

  1. Worldometer COVID Live Update: 223,669,445 Cases and 4,613,672 Deaths from the Coronavirus. Available online: https://www.worldometers.info/coronavirus/ (accessed on 5 September 2021).
  2. Jiang, N.; Wei, B.; Lin, H.; Wang, Y.; Chai, S.; Liu, W. Nursing students’ attitudes, knowledge and willingness of to receive the coronavirus disease vaccine: A cross-sectional study. Nurse Educ. Pract. 2021, 55, 103148. [Google Scholar] [CrossRef] [PubMed]
  3. Fontanet, A.; Cauchemez, S. COVID-19 herd immunity: Where are we? Nat. Rev. Immunol. 2020, 20, 583–584. [Google Scholar] [CrossRef] [PubMed]
  4. Kanyike, A.M.; Olum, R.; Kajjimu, J.; Ojilong, D.; Akech, G.M.; Nassozi, D.R.; Agira, D.; Wamala, N.K.; Asiimwe, A.; Matovu, D.; et al. Acceptance of the coronavirus disease-2019 vaccine among medical students in Uganda. Trop. Med. Health 2021, 49, 37. [Google Scholar] [CrossRef] [PubMed]
  5. Looi, M.-K. COVID-19: Is a second wave hitting Europe? BMJ 2020, 371, 4113. [Google Scholar] [CrossRef]
  6. Saied, S.M.; Saied, E.M.; Kabbash, I.A.; Abdo, S.A.E.-F. Vaccine hesitancy: Beliefs and barriers associated with COVID-19 vaccination among Egyptian medical students. J. Med. Virol. 2021, 93, 4280–4291. [Google Scholar] [CrossRef]
  7. Mullard, A. COVID-19 vaccine development pipeline gears up. Lancet 2020, 395, 1751–1752. [Google Scholar] [CrossRef]
  8. Forni, G.; Mantovani, A.; Forni, G.; Mantovani, A.; Moretta, L.; Rappuoli, R.; Rezza, G.; Bagnasco, A.; Barsacchi, G.; Bussolati, G.; et al. COVID-19 vaccines: Where we stand and challenges ahead. Cell Death Differ. 2021, 28, 626–639. [Google Scholar] [CrossRef]
  9. Wong, M.C.S.; Wong, E.L.Y.; Cheung, A.W.L.; Huang, J.; Lai, C.K.C.; Yeoh, E.K.; Chan, P.K.S. COVID-19 vaccine hesitancy in a city with free choice and sufficient doses. Vaccines 2021, 9, 1250. [Google Scholar] [CrossRef]
  10. Robinson, E.; Jones, A.; Lesser, I.; Daly, M. International estimates of intended uptake and refusal of COVID-19 vaccines: A rapid systematic review and meta-analysis of large nationally representative samples. Vaccine 2021, 39, 2024–2034. [Google Scholar] [CrossRef]
  11. Gates, A.; Gates, M.; Rahman, S.; Guitard, S.; MacGregor, T.; Pillay, J.; Ismail, S.J.; Tunis, M.C.; Young, K.; Hardy, K.; et al. A systematic review of factors that influence the acceptability of vaccines among Canadians. Vaccine 2021, 39, 222–236. [Google Scholar] [CrossRef]
  12. Patwary, M.M.; Bardhan, M.; Disha, A.S.; Hasan, M.; Haque, M.Z.; Sultana, R.; Hossain, M.R.; Browning, M.H.E.M.; Alam, M.A.; Sallam, M. Determinants of COVID-19 Vaccine Acceptance among the Adult Population of Bangladesh Using the Health Belief Model and the Theory of Planned Behavior Model. Vaccines 2021, 9, 1393. [Google Scholar] [CrossRef] [PubMed]
  13. Salomoni, M.G.; di Valerio, Z.; Gabrielli, E.; Montalti, M.; Tedesco, D.; Guaraldi, F.; Gori, D. Hesitant or Not Hesitant? A Systematic Review on Global COVID-19 Vaccine Acceptance in Different Populations. Vaccines 2021, 9, 873. [Google Scholar] [CrossRef]
  14. Nossier, S.A. Vaccine hesitancy: The greatest threat to COVID-19 vaccination programs. J. Egypt. Public Health Assoc. 2021, 96, 1–3. [Google Scholar] [CrossRef] [PubMed]
  15. Yang, W. Transmission dynamics of and insights from the 2018-2019 measles outbreak in New York City: A modeling study. Sci. Adv. 2020, 6, 4037–4064. [Google Scholar] [CrossRef]
  16. Wang, Q.; Yang, L.; Jin, H.; Lin, L. Vaccination against COVID-19: A systematic review and meta-analysis of acceptability and its predictors. Prev. Med. 2021, 150, 106694. [Google Scholar] [CrossRef] [PubMed]
  17. Kelekar, A.K.; Lucia, V.C.; Afonso, N.M.; Mascarenhas, A.K. COVID-19 vaccine acceptance and hesitancy among dental and medical students. J. Am. Dent. Assoc. 2021, 152, 596–603. [Google Scholar] [CrossRef]
  18. Lucia, V.C.; Kelekar, A.; Afonso, N.M. COVID-19 vaccine hesitancy among medical students. J. Public Health 2020, 1–5, 445–449. [Google Scholar] [CrossRef]
  19. Bazan, D.; Nowicki, M.; Rzymski, P. Medical students as the volunteer workforce during the COVID-19 pandemic: Polish experience. Int. J. Disaster Risk Reduct. 2021, 55, 102109. [Google Scholar] [CrossRef] [PubMed]
  20. Mascarenhas, A.K.; Lucia, V.C.; Kelekar, A.; Afonso, N.M. Dental students’ attitudes and hesitancy toward COVID-19 vaccine. J. Dent. Educ. 2021, 85, 1504–1510. [Google Scholar] [CrossRef]
  21. Manning, M.L.; Gerolamo, A.M.; Marino, M.A.; Hanson-Zalot, M.E.; Pogorzelska-Maziarz, M. COVID-19 vaccination readiness among nurse faculty and student nurses. Nurs. Outlook 2021, 69, 565–573. [Google Scholar] [CrossRef] [PubMed]
  22. Herzog, R.; Álvarez-Pasquin, M.J.; Díaz, C.; Del Barrio, J.L.; Estrada, J.M.; Gil, Á. Are healthcare workers intentions to vaccinate related to their knowledge, beliefs and attitudes? A systematic review. BMC Public Health 2013, 13, 1–17. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  23. Park, K.; Cartmill, R.; Johnson-Gordon, B.; Landes, M.; Malik, K.; Sinnott, J.; Wallace, K.; Wallin, R. Preparing for a School-Located COVID-19 Vaccination Clinic. NASN Sch. Nurse 2021, 36, 156–163. [Google Scholar] [CrossRef] [PubMed]
  24. Jain, J.; Saurabh, S.; Goel, A.D.; Gupta, M.K.; Bhardwaj, P.; Raghav, P.R. COVID-19 vaccine hesitancy among undergraduate medical students. medRxiv 2021, 12. [Google Scholar] [CrossRef]
  25. Sallam, M. COVID-19 vaccine hesitancy worldwide: A concise systematic review of vaccine acceptance rates. Vaccines 2021, 9, 160. [Google Scholar] [CrossRef]
  26. Wake, A.D. The Willingness to Receive COVID-19 Vaccine and Its Associated Factors: “Vaccination Refusal Could Prolong the War of This Pandemic”—A Systematic Review. Risk Manag. Healthc. Policy 2021, 14, 2609. [Google Scholar] [CrossRef] [PubMed]
  27. Luo, C.; Yang, Y.; Liu, Y.; Zheng, D.; Shao, L.; Jin, J.; He, Q. Intention to COVID-19 vaccination and associated factors among health care workers: A systematic review and meta-analysis of cross-sectional studies. Am. J. Infect. Control 2021, 49, 1295–1304. [Google Scholar] [CrossRef]
  28. Li, M.; Luo, Y.; Watson, R.; Zheng, Y.; Ren, J.; Tang, J.; Chen, Y. Healthcare workers’ (HCWs) attitudes and related factors towards COVID-19 vaccination: A rapid systematic review. Postgrad. Med. J. 2021, 1–7. [Google Scholar] [CrossRef] [PubMed]
  29. Garritty, C.; Gartlehner, G.; Nussbaumer-Streit, B.; King, V.J.; Hamel, C.; Kamel, C.; Affengruber, L.; Stevens, A. Cochrane Rapid Reviews Methods Group offers evidence-informed guidance to conduct rapid reviews. J. Clin. Epidemiol. 2021, 130, 13–22. [Google Scholar] [CrossRef]
  30. Joanna Briggs Institute. Checklist for Analytical cross Sectional Studies, Critical Appraisal Tools. 2017. Available online: https://jbi.global/critical-appraisal-tools (accessed on 18 May 2022).
  31. Al-Amer, R.; Maneze, D.; Everett, B.; Montayre, J.; Villarosa, A.R.; Dwekat, E.; Salamonson, Y. COVID-19 vaccination intention in the first year of the pandemic: A systematic review. J. Clin. Nurs. 2021, 1–25. [Google Scholar] [CrossRef]
  32. Villarosa, A.R.; Maneze, D.; Ramjan, L.M.; Srinivas, R.; Camilleri, M.; George, A. The effectiveness of guideline implementation strategies in the dental setting: A systematic review. Implement. Sci. 2019, 14, 1–16. [Google Scholar] [CrossRef]
  33. Higgins, J.P.T.; Thompson, S.G. Quantifying heterogeneity in a meta-analysis. Stat. Med. 2002, 21, 1539–1558. [Google Scholar] [CrossRef] [PubMed]
  34. Higgins, J.P.T.; Thompson, S.G.; Deeks, J.J.; Altman, D.G. Measuring inconsistency in meta-analyses. BMJ 2003, 327, 557–560. [Google Scholar] [CrossRef] [Green Version]
  35. Katz, M.; Azrad, M.; Glikman, D.; Peretz, A. COVID-19 Vaccination Compliance and Associated Factors among Medical Students during an Early Phase of Vaccination Rollout—A Survey from Israel. Vaccines 2021, 10, 27. [Google Scholar] [CrossRef] [PubMed]
  36. Riad, A.; Abdulqader, H.; Morgado, M.; Domnori, S.; Koščík, M.; Mendes, J.J.; Klugar, M.; Kateeb, E. Global prevalence and drivers of dental students’ covid-19 vaccine hesitancy. Vaccines 2021, 9, 566. [Google Scholar] [CrossRef] [PubMed]
  37. Al Janabi, T.; Chinsky, R.; Pino, M.A. Perceptions of COVID-19 vaccines among osteopathic medical students (OMS). Int. J. Osteopath. Med. 2021, 42, 23–28. [Google Scholar] [CrossRef] [PubMed]
  38. Bălan, A.; Bejan, I.; Bonciu, S.; Eni, C.E.; Ruță, S. Romanian medical students’ attitude towards and perceived knowledge on covid-19 vaccination. Vaccines 2021, 9, 854. [Google Scholar] [CrossRef] [PubMed]
  39. Belingheri, M.; Ausili, D.; Paladino, M.E.; Luciani, M.; Di Mauro, S.; Riva, M.A. Attitudes towards COVID-19 vaccine and reasons for adherence or not among nursing students. J. Prof. Nurs. 2021, 37, 923–927. [Google Scholar] [CrossRef]
  40. Bolatov, A.K.; Seisembekov, T.Z.; Askarova, A.Z.; Pavalkis, D. Barriers to COVID-19 vaccination among medical students in Kazakhstan: Development, validation, and use of a new COVID-19 Vaccine Hesitancy Scale. Hum. Vaccines Immunother. 2021, 17, 4982–4992. [Google Scholar] [CrossRef]
  41. De Sousa Chaves, Í.E.; Brito, P.R.P.; de Araújo Rodrigues, J.G.B.; Costa, M.S.; Cândido, E.L.; Moreira, M.R.C. Hesitation regarding the covid-19 vaccine among medical students in brazil. Rev. Assoc. Med. Bras. 2021, 67, 1397–1402. [Google Scholar] [CrossRef]
  42. Gao, X.; Li, H.; He, W.; Zeng, W. COVID-19 Vaccine Hesitancy among Medical Students: The Next COVID-19 Challenge in Wuhan, China. Disaster Med. Public Health Prep. 2021, 1–6. [Google Scholar] [CrossRef] [PubMed]
  43. Gotlib, J.; Sobierajski, T.; Jaworski, M.; Wawrzuta, D.; Borowiak, E.; Dobrowolska, B.; Dyk, D.; Gaworska-Krzemińska, A.; Grochans, E.; Kózka, M.; et al. “Vaccinate, Do Not Hesitate!”. Vaccination Readiness against COVID-19 among Polish Nursing Undergraduate Students: A National Cross-Sectional Survey. Vaccines 2021, 9, 1029. [Google Scholar] [CrossRef] [PubMed]
  44. Grochowska, M.; Ratajczak, A.; Zdunek, G.; Adamiec, A.; Waszkiewicz, P.; Feleszko, W. A Comparison of the Level of Acceptance and Hesitancy towards the Influenza Vaccine and the Forthcoming COVID-19 Vaccine in the Medical Community. Vaccines 2021, 9, 475. [Google Scholar] [CrossRef] [PubMed]
  45. Jain, J.; Saurabh, S.; Kumar, P.; Verma, M.K.; Goel, A.D.; Gupta, M.K.; Bhardwaj, P.; Raghav, P.R. COVID-19 vaccine hesitancy among medical students in India. Epidemiol. Infect. 2021, 149, 132. [Google Scholar] [CrossRef] [PubMed]
  46. Jain, L.; Vij, J.; Satapathy, P.; Chakrapani, V.; Patro, B.; Kar, S.S.; Singh, R.; Pala, S.; Sankhe, L.; Modi, B.; et al. Factors Influencing COVID-19 Vaccination Intentions Among College Students: A Cross-Sectional Study in India. Front. Public Health 2021, 9, 1966. [Google Scholar] [CrossRef] [PubMed]
  47. Li, M.; Zheng, Y.; Luo, Y.; Ren, J.; Jiang, L.; Tang, J.; Yu, X.; Luo, D.; Fan, D.; Chen, Y. Hesitancy toward COVID-19 vaccines among medical students in Southwest China: A cross-sectional study. Hum. Vaccin. Immunother. 2021, 17, 4021–4027. [Google Scholar] [PubMed]
  48. Lindner-Pawłowicz, K.; Mydlikowska-śmigórska, A.; Łampika, K.; Sobieszczańska, M. COVID-19 Vaccination Acceptance among Healthcare Workers and General Population at the Very Beginning of the National Vaccination Program in Poland: A Cross-Sectional, Exploratory Study. Vaccines 2021, 10, 66. [Google Scholar] [CrossRef] [PubMed]
  49. Lo Moro, G.; Cugudda, E.; Bert, F.; Raco, I.; Siliquini, R. Vaccine Hesitancy and Fear of COVID-19 Among Italian Medical Students: A Cross-Sectional Study. J. Community Health 2022, 1–9. [Google Scholar] [CrossRef]
  50. Mahdi, B.M. COVID-19 vaccine hesitancy and acceptance among medical students: An online cross-sectional study in Iraq. Open Access Maced. J. Med. Sci. 2021, 9, 955–958. [Google Scholar] [CrossRef]
  51. Mayan, D.; Nguyen, K.; Keisler, B. National attitudes of medical students towards mandating the COVID-19 vaccine and its association with knowledge of the vaccine. PLoS ONE 2021, 16, e0260898. [Google Scholar] [CrossRef]
  52. Mose, A.; Haile, K.; Timerga, A. COVID-19 vaccine hesitancy among medical and health science students attending Wolkite University in Ethiopia. PLoS ONE 2022, 17, e0263081. [Google Scholar] [CrossRef]
  53. Petravić, L.; Arh, R.; Gabrovec, T.; Jazbec, L.; Rupčić, N.; Starešinič, N.; Zorman, L.; Pretnar, A.; Srakar, A.; Zwitter, M.; et al. Factors affecting attitudes towards covid-19 vaccination: An online survey in slovenia. Vaccines 2021, 9, 247. [Google Scholar] [CrossRef] [PubMed]
  54. Rosental, H.; Shmueli, L. Integrating Health Behavior Theories to Predict COVID-19 Vaccine Acceptance: Differences between Medical Students and Nursing Students. Vaccines 2021, 9, 783. [Google Scholar] [CrossRef] [PubMed]
  55. Szmyd, B.; Bartoszek, A.; Karuga, F.F.; Staniecka, K.; Błaszczyk, M.; Radek, M. Medical students and sars-cov-2 vaccination: Attitude and behaviors. Vaccines 2021, 9, 128. [Google Scholar] [CrossRef]
  56. Talarek, E.; Warzecha, J.; Banasiuk, M.; Banaszkiewicz, A. Influenza Vaccination Coverage and Intention to Receive Hypothetical Ebola and COVID-19 Vaccines among Medical Students. Vaccines 2021, 9, 709. [Google Scholar] [CrossRef] [PubMed]
  57. Zhang, J.; Dean, J.; Yin, Y.; Wang, D.; Sun, Y.; Zhao, Z.; Wang, J. Determinants of COVID-19 Vaccine Acceptance and Hesitancy: A Health Care Student-Based Online Survey in Northwest China. Front. Public Health 2022, 9, 2146. [Google Scholar] [CrossRef] [PubMed]
  58. Zhou, Y.; Wang, Y.; Li, Z. Intention to get vaccinated against COVID-19 among nursing students: A cross-sectional survey. Nurse Educ. Today 2021, 107, 105152. [Google Scholar] [CrossRef] [PubMed]
  59. Patwary, M.M.; Alam, M.A.; Bardhan, M.; Disha, A.S.; Haque, M.Z.; Billah, S.M.; Kabir, M.P.; Browning, M.H.E.M.; Rahman, M.M.; Parsa, A.D.; et al. COVID-19 Vaccine Acceptance among Low- and Lower-Middle-Income Countries: A Rapid Systematic Review and Meta-Analysis. Vaccines 2022, 10, 427. [Google Scholar] [CrossRef]
  60. Ahmed, M.A.M.; Colebunders, R.; Gele, A.A.; Farah, A.A.; Osman, S.; Guled, I.A.; Abdullahi, A.A.M.; Hussein, A.M.; Ali, A.M.; Siewe Fodjo, J.N. COVID-19 Vaccine Acceptability and Adherence to Preventive Measures in Somalia: Results of an Online Survey. Vaccines 2021, 9, 543. [Google Scholar] [CrossRef]
  61. Nguyen, K.H.; Srivastav, A.; Razzaghi, H.; Williams, W.; Lindley, M.C.; Jorgensen, C.; Abad, N.; Singleton, J.A. COVID-19 Vaccination Intent, Perceptions, and Reasons for Not Vaccinating Among Groups Prioritized for Early Vaccination—United States, September and December 2020. MMWR. Morb. Mortal. Wkly. Rep. 2021, 70, 217–222. [Google Scholar] [CrossRef]
  62. Galanis, P.; Vraka, I.; Fragkou, D.; Bilali, A.; Kaitelidou, D. Intention of healthcare workers to accept COVID-19 vaccination and related factors: A systematic review and meta-analysis. Asian Pac. J. Trop. Med. 2021, 14, 543. [Google Scholar] [CrossRef]
  63. Ramachandran, R.; Ross, J.S.; Miller, J.E. Access to COVID-19 Vaccines in High-, Middle-, and Low-Income Countries Hosting Clinical Trials. JAMA Netw. Open 2021, 4, 2134233. [Google Scholar] [CrossRef] [PubMed]
  64. Sallam, M.; Dababseh, D.; Eid, H.; Al-Mahzoum, K.; Al-Haidar, A.; Taim, D.; Yaseen, A.; Ababneh, N.A.; Bakri, F.G.; Mahafzah, A. High Rates of COVID-19 Vaccine Hesitancy and Its Association with Conspiracy Beliefs: A Study in Jordan and Kuwait among Other Arab Countries. Vaccines 2021, 9, 42. [Google Scholar] [CrossRef]
  65. Bono, S.A.; Faria de Moura Villela, E.; Siau, C.S.; Chen, W.S.; Pengpid, S.; Hasan, M.T.; Sessou, P.; Ditekemena, J.D.; Amodan, B.O.; Hosseinipour, M.C.; et al. Factors Affecting COVID-19 Vaccine Acceptance: An International Survey among Low- and Middle-Income Countries. Vaccines 2021, 9, 515. [Google Scholar] [CrossRef] [PubMed]
  66. Kabamba Nzaji, M.; Kabamba Ngombe, L.; Ngoie Mwamba, G.; Banza Ndala, D.B.; Mbidi Miema, J.; Luhata Lungoyo, C.; Lora Mwimba, B.; Cikomola Mwana Bene, A.; Mukamba Musenga, E. Acceptability of Vaccination Against COVID-19 Among Healthcare Workers in the Democratic Republic of the Congo. Pragmatic Obs. Res. 2020, 11, 103–109. [Google Scholar] [CrossRef]
  67. Dzinamarira, T.; Nachipo, B.; Phiri, B.; Musuka, G. COVID-19 vaccine roll-out in south africa and zimbabwe: Urgent need to address community preparedness, fears and hesitancy. Vaccines 2021, 9, 250. [Google Scholar] [CrossRef] [PubMed]
  68. Nehal, K.R.; Steendam, L.M.; Ponce, M.C.; van der Hoeven, M.; Smit, G.S.A. Worldwide vaccination willingness for covid-19: A systematic review and meta-analysis. Vaccines 2021, 9, 1071. [Google Scholar] [CrossRef] [PubMed]
  69. Wong, L.P.; Alias, H.; Wong, P.-F.; Lee, H.Y.; AbuBakar, S. The use of the health belief model to assess predictors of intent to receive the COVID-19 vaccine and willingness to pay. Hum. Vaccin. Immunother. 2020, 16, 2204–2214. [Google Scholar] [CrossRef]
  70. Paul, E.; Steptoe, A.; Fancourt, D. Anti-Vaccine Attitudes and Risk Factors for Not Agreeing to Vaccination Against COVID-19 Amongst 32,361 UK Adults: Implications for Public Health Communications. SSRN Electron. J. 2020, 1, 100012. [Google Scholar] [CrossRef]
  71. Roozenbeek, J.; Schneider, C.R.; Dryhurst, S.; Kerr, J.; Freeman, A.L.J.; Recchia, G.; Van Der Bles, A.M.; Van Der Linden, S. Susceptibility to misinformation about COVID-19 around the world: Susceptibility to COVID misinformation. R. Soc. Open Sci. 2020, 7, 201199. [Google Scholar] [CrossRef]
  72. Hussein, A.A.M.; Galal, I.; Makhlouf, N.A.; Makhlouf, H.A.; Abd-Elaal, H.K.; Kholief, K.M.; Saad, M.M.; Abdellah, D.A. A national survey of potential acceptance of COVID-19 vaccines in healthcare workers in Egypt. medRxiv 2021. [Google Scholar] [CrossRef]
  73. Wright, K.B. Researching internet-based populations: Advantages and disadvantages of online survey research, online questionnaire authoring software packages, and web survey services. J. Comput. Commun. 2005, 10, JCMC1034. [Google Scholar] [CrossRef]
Figure 1. PRISMA flow diagram of the study selection process.
Figure 1. PRISMA flow diagram of the study selection process.
Vaccines 10 00806 g001
Figure 2. COVID-19 vaccine acceptance rates among healthcare students by study.
Figure 2. COVID-19 vaccine acceptance rates among healthcare students by study.
Vaccines 10 00806 g002
Figure 3. COVID-19 vaccine hesitancy rates among healthcare students by study.
Figure 3. COVID-19 vaccine hesitancy rates among healthcare students by study.
Vaccines 10 00806 g003
Figure 4. Map of COVID-19 vaccine acceptance rates among healthcare students by country.
Figure 4. Map of COVID-19 vaccine acceptance rates among healthcare students by country.
Vaccines 10 00806 g004
Figure 5. COVID-19 vaccine acceptance rates among healthcare students by country.
Figure 5. COVID-19 vaccine acceptance rates among healthcare students by country.
Vaccines 10 00806 g005
Figure 6. COVID-19 vaccine hesitancy rates among healthcare students by country.
Figure 6. COVID-19 vaccine hesitancy rates among healthcare students by country.
Vaccines 10 00806 g006
Figure 7. COVID-19 vaccine acceptance rates among healthcare students by year.
Figure 7. COVID-19 vaccine acceptance rates among healthcare students by year.
Vaccines 10 00806 g007
Figure 8. Predictors of COVID-19 vaccination acceptance among healthcare students.
Figure 8. Predictors of COVID-19 vaccination acceptance among healthcare students.
Vaccines 10 00806 g008
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Share and Cite

MDPI and ACS Style

Patwary, M.M.; Bardhan, M.; Haque, M.Z.; Sultana, R.; Alam, M.A.; Browning, M.H.E.M. COVID-19 Vaccine Acceptance Rate and Its Factors among Healthcare Students: A Systematic Review with Meta-Analysis. Vaccines 2022, 10, 806. https://doi.org/10.3390/vaccines10050806

AMA Style

Patwary MM, Bardhan M, Haque MZ, Sultana R, Alam MA, Browning MHEM. COVID-19 Vaccine Acceptance Rate and Its Factors among Healthcare Students: A Systematic Review with Meta-Analysis. Vaccines. 2022; 10(5):806. https://doi.org/10.3390/vaccines10050806

Chicago/Turabian Style

Patwary, Muhammad Mainuddin, Mondira Bardhan, Md. Zahidul Haque, Rabeya Sultana, Md Ashraful Alam, and Matthew H. E. M. Browning. 2022. "COVID-19 Vaccine Acceptance Rate and Its Factors among Healthcare Students: A Systematic Review with Meta-Analysis" Vaccines 10, no. 5: 806. https://doi.org/10.3390/vaccines10050806

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Back to TopTop