Determinants of COVID-19 vaccine hesitancy across 186 countries: a multifaceted analysis using structural equation modeling.
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Van Truong Le, Van Nguyen Thanh, Trang Vu Thi Thu, Le Thi Thu Thao, Thum Chern Choong, Nguyen Dang, Wong Yen Jun, Jain Nityanand, Binh Minh Nguyen Le Thi, Anh Dao Huynh, Marzouk Sammer, Sabet Cameron, El Idrissi Fatima Ezzahraa, Thuy Le Thi, Huynh Khoa Le Anh, Makram Abdelrahman M, Pham Hiep-Hung, Lesmana Elvira, Simadibrata Daniel Martin, Abbas Ahmed Mohamed, Kudsi Muhammad Anas, Minh Nguyen Anh, Ngoc Nguyen Thanh, Binh Nguyen Huy, Nam Nguyen Truong, Ali Ibrahim Abdelrhim, Gurav Jaiprakash Suresh, Tri Nguyen Hoang Minh, Tin Pham Trung, Makki Abdulmajid, Albakkar Momen, Naji Mustafa Hamed, Jouini Jaafer Ammar, Anand Aditya, Al-Moughales Amal Abdulaziz Abdulwali Raweh, Tuyen Pham Ba, Kashyap Abhishek, Mohamed Malaz Hamed Nasr, Alhosni Hisham, MohamedAhmed Barah Badreldin Ali, Ramanarayanan Subramaniam, Menna Clara, Ramzi Ahmed, Arnaout Moumen, James Jesline Merly, Van Pham Manh, Mokhtar Fathia Mokhtar Babiker, Mani Ebenezer, Kumari Usha, Fathima S Shabana, Rampengan Derren David Christian Homenta, Pham Thi Cam Hung, Elhadidy Ali Mohamed Abdelgawwad Mansour, Okeh Debra Ukamaka, Soetomo Cindy Thiovany, Latti Pooja, Babu Priya, Ghanam Abdelatte Khaled, Osman Mohammed Osman Ahmed, Putrinata Ni Putu Menganti Harum, George Gis, Alhumrani Zahraa Adnan Khalaf, Kwaah Patrick Amanning, Saad Mohab Alsaid, Ibrahim Abdulelah Ibrahim Dawod, Mohamed Mahmoud Ahmed Said, Dinh Xuyen Thi, Salim Jonathan, Bouey Jennifer, Huy Nguyen Tien, TMGH Online Research Club Global Team
Аннотация
METHODS: In 2023, a multinational cross-sectional study was conducted using a 69-question survey presented in 33 languages to evaluate the relationships among demographics, knowledge, attitudes, experiences, psychological stress, and CVH. The Structural Equation Model (SEM) was used to explore the interrelations of CVH and potential factors.
FINDINGS: The study, conducted across over 186 countries, obtained 102,407 valid responses, with an average age of 27.3 years, 57.9 % female, and high response rates in Asia and Africa. Participants regularly or consistently acquired knowledge about COVID-19 vaccines through social networks (56.9 %), colleagues/friends (43.8 %), and media (40.0 %). Participants' concerns hindering COVID-19 vaccination included the perceived mildness of COVID-19 (44.8 %), insufficient vaccine research (41.9 %), misinformation on social media (39.9 %), and disagreement with COVID-19 vaccination (33.1 %). The SEM results (RMSEA = 0.032/CFI = 0.955/TLI = 0.950) indicated that gender, education level, and family member's COVID-19 severity explained 48.5 % of the variance. Conversely, those with higher education and hesitancy related to vaccine reactions (HRVR) expressed increased concerns about COVID-19 vaccine information (CVI). Antisociality and egocentricity were associated with increased concern about HRVR (aOR: 1.08 and 1.12, 95 %CI: 1.06-1.09 and 1.10-1.14, respectively, p < 0.001), while callousness and egocentricity reduced concern about CVI (aOR: 0.76 and 0.97, 95 %CI: 0.75-0.77 and 0.96-0.98, respectively, p < 0.001).
INTERPRETATION: Our research revealed that a third of participants disagreed with vaccination. Education level, gender, severity of family members' COVID-19 infection, and psychological stress significantly impact CVH.