BACKGROUND: During WHO’s 13th meeting of the Interna-tional Health Regulations in October 2022, the Emergency Committee regarding the COVID-19 pandemic highlighted the continued need for tailored risk communications and contextualized policies given the dangers posed by pervasive disinformation on vaccination and vaccine hesitancy. Effec-tive vaccination strategies require in-depth understanding of the drivers of COVID-19 vaccine hesitancy and patient prefer-ence within the dynamics of the COVID-19 landscape.
OBJECTIVE: To conduct a targeted literature review (TLR) to identify the key drivers of vaccine hesitancy, preference or choice affecting patient willingness for COVID-19 vaccines and boosters globally. These results have informed an ongo-ing population COVID-19 vaccine preference study to elicit patient-reported quantitative trade-offs.
METHODS: A TLR was conducted in Ovid MEDLINE, consistent with PRISMA 2020 guidance, to identify studies on patient preferences for COVID-19 vaccines and boosters. Qualita-tive and quantitative preference studies published between January 2020 to September 2022 were included. Studies not focused on COVID-19 vaccine preference, choice or hesitancy, and non-English studies were excluded.
RESULTS: Screening of 262 abstracts identified 35 qualitative and quantitative studies (USA, Europe, Israel, China, Australia and multinational) that met the eligibility criteria. The full text review extracted a total of 30 attributes contributing towards preference and vaccine hesitancy. Attributes related to effica-cy, safety, duration of protection, and number of doses in the primary vaccination series were the most frequently reported as most important drivers. Additional to vaccine attributes, vaccine hesitancy was higher according to patient-level fac-tors of younger age, ethnic minorities, and lower education or income.
CONCLUSIONS: As the pandemic unfolds, it is critical that policy makers and manufacturers understand the evolving drivers of COVID-19 vaccine preference and hesitancy, to sup-port public health objectives for vaccine coverage. Addressing gaps in the current literature, such as on preferences for newly available vaccine technologies and booster frequency, will support the understanding of patient attitudes towards vaccination and choice, which may generate actionable in-sights as the COVID-19 landscape develops. These findings have informed an ongoing multinational population COVID-19 vaccine preference research study to elicit patient-reported quantitative trade-offs that can aid future policy and tailored vaccine recommendations.
