The Perfect Enemy | A survey of COVID-19 vaccine acceptance across 23 countries in 2022 - Nature.com
July 8, 2025

A survey of COVID-19 vaccine acceptance across 23 countries in 2022 – Nature.com

A survey of COVID-19 vaccine acceptance across 23 countries in 2022  Nature.comView Full Coverage on Google News

A survey of COVID-19 vaccine acceptance across 23 countries in 2022 – Nature.com
A survey of COVID-19 vaccine acceptance across 23 countries in 2022 – Nature.com
  • Watson, O. J. et al. Global impact of the first year of COVID-19 vaccination: a mathematical modelling study. Lancet Infect. Dis. 22, 1293–1302 (2022).

    Article  CAS  Google Scholar 

  • Meslé, M. M. I. et al. Estimated number of deaths directly averted in people 60 years and older as a result of COVID-19 vaccination in the WHO European Region, December 2020 to November 2021. Euro Surveill. 26, 2101021 (2021).

    Article  Google Scholar 

  • Larson, H. J., Gakidou, E. & Murray, C. J. L. The vaccine-hesitant moment. N. Engl. J. Med. 386, 58–65 (2022).

    Article  Google Scholar 

  • World Health Organization. Ten threats to global health in 2019. https://www.who.int/news-room/spotlight/ten-threats-to-global-health-in-2019 (2019).

  • Lazarus, J. V. et al. A global survey of potential acceptance of a COVID-19 vaccine. Nat. Med. 27, 225–228 (2020).

    Article  Google Scholar 

  • Lazarus, J. V. et al. Revisiting COVID-19 vaccine hesitancy around the world using data from 23 countries in 2021. Nat. Commun. 13, 3801 (2022).

    Article  CAS  Google Scholar 

  • Shakeel, C. S., Mujeeb, A. A., Mirza, M. S., Chaudhry, B. & Khan, S. J. Global COVID-19 vaccine acceptance: a systematic review of associated social and behavioral factors. Vaccines (Basel) 10, 110 (2022).

    Article  CAS  Google Scholar 

  • Wang, Y., McKee, M., Torbica, A. & Stuckler, D. Systematic literature review on the spread of health-related misinformation on social media. Soc. Sci. Med. 240, 112552 (2019).

    Article  Google Scholar 

  • Pierri, F. et al. Online misinformation is linked to early COVID-19 vaccination hesitancy and refusal. Sci. Rep. 12, 5966 (2022).

    Article  CAS  Google Scholar 

  • Our World in Data. Coronavirus (COVID-19) vaccinations. https://ourworldindata.org/covid-vaccinations

  • Hassan, M. A. K. & Aliyu, S. Delayed access to COVID-19 vaccines: a perspective on low-income countries in Africa. Int. J. Health Serv. 52, 323 (2022).

    Article  Google Scholar 

  • Singh, J. A. et al. WHO guidance on COVID-19 vaccine trial designs in the context of authorized COVID-19 vaccines and expanding global access: ethical considerations. Vaccine 40, 2140–2149 (2022).

    Article  CAS  Google Scholar 

  • Levin, E. G. et al. Waning immune humoral response to BNT162b2 Covid-19 vaccine over 6 months. N. Engl. J. Med. 385, e84 (2021).

    Article  CAS  Google Scholar 

  • Chenchula, S., Karunakaran, P., Sharma, S. & Chavan, M. Current evidence on efficacy of COVID-19 booster dose vaccination against the Omicron variant: a systematic review. J. Med. Virol. 94, 2969–2976 (2022).

    Article  CAS  Google Scholar 

  • MacDonald, N. E. & SAGE Working Group on Vaccine Hesitancy. Vaccine hesitancy: definition, scope and determinants. Vaccine 33, 4161–4164 (2015).

    Article  Google Scholar 

  • Schmid, P., Rauber, D., Betsch, C., Lidolt, G. & Denker, M. L. Barriers of influenza vaccination intention and behavior—a systematic review of influenza vaccine hesitancy, 2005–2016. PLoS ONE 12, e0170550 (2017).

    Article  Google Scholar 

  • Nguyen, K. H. et al. Who has not been vaccinated, fully vaccinated, or boosted for COVID-19. Am. J. Infect. Control 50, 1185–1189 (2022).

    Article  CAS  Google Scholar 

  • Zhang, Y., Banga Ndzouboukou, J. L., Gan, M., Lin, X. & Fan, X. Immune evasive effects of SARS-CoV-2 variants to COVID-19 emergency used vaccines. Front. Immunol. 12, 4842 (2021).

    Google Scholar 

  • Wang, C. Y. et al. A multitope SARS-CoV-2 vaccine provides long-lasting B cell and T cell immunity against Delta and Omicron variants. J. Clin. Invest. 132, e157707 (2022).

    Article  CAS  Google Scholar 

  • Petherick, A. et al. A worldwide assessment of changes in adherence to COVID-19 protective behaviours and hypothesized pandemic fatigue. Nat. Hum. Behav. 5, 1145–1160 (2021).

    Article  Google Scholar 

  • Levin-Zamir, D. Communication, health literacy and a systems approach for mitigating the COVID-19 pandemic: the case for massive vaccine roll-out in Israel. J. Health Commun. 25, 816–818 (2020).

    Article  Google Scholar 

  • Choukou, M. A. et al. COVID-19 infodemic and digital health literacy in vulnerable populations: a scoping review. Digit. Health 8, 20552076221076927 (2022).

  • Schwarzinger, M., Watson, V., Arwidson, P., Alla, F. & Luchini, S. COVID-19 vaccine hesitancy in a representative working-age population in France: a survey experiment based on vaccine characteristics. Lancet Public Health 6, e210–e221 (2021).

    Article  Google Scholar 

  • National Institutes of Health. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. https://www.covid19treatmentguidelines.nih.gov/ (National Institutes of Health, 2022).

  • Ciotti, M., Ciccozzi, M., Pieri, M. & Bernardini, S. The COVID-19 pandemic: viral variants and vaccine efficacy. Crit. Rev. Clin. Lab. Sci. 59, 66–75 (2022).

    Article  CAS  Google Scholar 

  • The World Bank. Population, total—Brazil, Canada, China, Ecuador, France, Germany, Ghana, India, Italy, Kenya, Mexico, Nigeria, Peru, Poland, Russian Federation, South Africa, Korea, Rep., Singapore, Spain, Sweden, Turkiye, United Kingdom, United States. https://data.worldbank.org/indicator/SP.POP.TOTL?locations=BR-CA-CN-EC-FR-DE-GH-IN-IT-KE-MX-NG-PE-PL-RU-ZA-KR-SG-ES-SE-TR-GB-US (2022).

  • Lounis, M., Bencherit, D., Rais, M. A. & Riad, A. COVID-19 vaccine booster hesitancy (VBH) and its drivers in Algeria: national cross-sectional survey-based study. Vaccines (Basel) 10, 621 (2022).

    Article  CAS  Google Scholar 

  • Machida, M. et al. Individual-level social capital and COVID-19 vaccine hesitancy in Japan: a cross-sectional study. Hum. Vaccin. Immunother. 18, 2086773 (2022).

  • Batra, K., Sharma, M., Dai, C. L. & Khubchandani, J. COVID-19 booster vaccination hesitancy in the United States: a multi-theory-model (MTM)-based national assessment. Vaccines (Basel) 10, 758 (2022).

    Article  CAS  Google Scholar 

  • Wong, L. P. et al. Intention to receive a COVID-19 vaccine booster dose and associated factors in Malaysia. Hum. Vaccin. Immunother. 2078634 (2022).

  • Yadete, T. et al. Assessing acceptability of COVID-19 vaccine booster dose among adult Americans: a cross-sectional study. Vaccines (Basel) 9, 1424 (2021).

    Article  CAS  Google Scholar 

  • Wang, R. et al. The association between social media use and hesitancy toward COVID-19 vaccine booster shots in China: a web-based cross-sectional survey. Hum. Vaccin. Immunother. 18, 2065167 (2022).

    Article  Google Scholar 

  • Al-Qerem, W., Al Bawab, A. Q., Hammad, A., Ling, J. & Alasmari, F. Willingness of the Jordanian population to receive a COVID-19 booster dose: a cross-sectional study. Vaccines (Basel) 10, 410 (2022).

    Article  CAS  Google Scholar 

  • Trent, M., Seale, H., Chughtai, A. A., Salmon, D. & MacIntyre, C. R. Trust in government, intention to vaccinate and COVID-19 vaccine hesitancy: a comparative survey of five large cities in the United States, United Kingdom, and Australia. Vaccine 40, 2498–2505 (2022).

    Article  CAS  Google Scholar 

  • Caserotti, M. et al. Associations of COVID-19 risk perception with vaccine hesitancy over time for Italian residents. Soc. Sci. Med. 272, 113688 (2021).

    Article  Google Scholar 

  • Huang, Z., Su, Y., Zhang, T. & Xia, N. A review of the safety and efficacy of current COVID-19 vaccines. Front. Med. 16, 39 (2022).

    Article  Google Scholar 

  • Rzymski, P., Poniedziałek, B. & Fal, A. Willingness to receive the booster COVID-19 vaccine dose in Poland. Vaccines (Basel) 9, 1286 (2021).

    Article  CAS  Google Scholar 

  • Chen, F., He, Y. & Shi, Y. Parents’ and guardians’ willingness to vaccinate their children against COVID-19: a systematic review and meta-analysis. Vaccines (Basel) 10, 179 (2022).

    Article  Google Scholar 

  • Pan, F. et al. Parents’ decisions to vaccinate children against COVID-19: a scoping review. Vaccines (Basel) 9, 1476 (2021).

    Article  CAS  Google Scholar 

  • UNDP Data Futures Platform. Global Dashboard for Vaccine Equity. https://data.undp.org/vaccine-equity/ (2022).

  • World Health Organization. Pandemic fatigue: reinvigorating the public to prevent COVID-19: policy framework for supporting pandemic prevention and management: revised version November 2020. https://apps.who.int/iris/handle/10665/337574 (2020).

  • US Food and Drug Administration. Why you should not use ivermectin to treat or prevent COVID-19. https://www.fda.gov/consumers/consumer-updates/why-you-should-not-use-ivermectin-treat-or-prevent-covid-19 (2022).

  • Bryant, A. et al. Ivermectin for prevention and treatment of COVID-19 infection: a systematic review, meta-analysis, and trial sequential analysis to inform clinical guidelines. Am. J. Ther. 28, e434–e460 (2021).

    Article  Google Scholar 

  • Mello, M. M. et al. Effectiveness of vaccination mandates in improving uptake of COVID-19 vaccines in the USA. Lancet 400, 535–538 (2022).

    Article  CAS  Google Scholar 

  • Oliu-Barton, M. et al. The effect of COVID certificates on vaccine uptake, health outcomes, and the economy. Nat. Commun. 13, 3942 (2022).

    Article  CAS  Google Scholar 

  • Bardosh, K. et al. The unintended consequences of COVID-19 vaccine policy: why mandates, passports and restrictions may cause more harm than good. BMJ Glob. Health 7, e008684 (2022).

    Article  Google Scholar 

  • Hudson, A. & Montelpare, W. J. Predictors of vaccine hesitancy: implications for COVID-19 public health messaging. Int. J. Environ. Res. Public Health 18, 8054 (2021).

    Article  CAS  Google Scholar 

  • Skafle, I., Nordahl-Hansen, A., Quintana, D. S., Wynn, R. & Gabarron, E. Misinformation about COVID-19 vaccines on social media: rapid review. J. Med. Internet Res. 24, e37367 (2022).

    Article  Google Scholar 

  • Singh, K. et al. Misinformation, believability, and vaccine acceptance over 40 countries: takeaways from the initial phase of the COVID-19 infodemic. PLoS ONE 17, e0263381 (2022).

    Article  CAS  Google Scholar 

  • Loomba, S., de Figueiredo, A., Piatek, S. J., de Graaf, K. & Larson, H. J. Measuring the impact of COVID-19 vaccine misinformation on vaccination intent in the UK and USA. Nat. Hum. Behav. 5, 337–348 (2021).

    Article  Google Scholar 

  • Tan, C. M., Owuamalam, C. K. & Sarma, V. Improving vaccination intent among skeptics through confidence in governments’ handling of the COVID-19 pandemic. Acta Psychol. (Amst.) 225, 103556 (2022).

    Article  Google Scholar 

  • Evans, W. D. & French, J. Demand creation for COVID-19 vaccination: overcoming vaccine hesitancy through social marketing. Vaccines (Basel) 9, 319 (2021).

    Article  CAS  Google Scholar 

  • Su, Z. et al. Young adults’ preferences for influenza vaccination campaign messages: implications for COVID-19 vaccine intervention design and development. Brain Behav. Immun. Health 14, 100261 (2021).

    Article  CAS  Google Scholar 

  • Abrams, E. M., Singer, A. G., Greenhawt, M., Stukus, D. & Shaker, M. Ten tips for improving your clinical practice during the COVID-19 pandemic. Curr. Opin. Pediatr. 33, 260 (2021).

    Article  CAS  Google Scholar 

  • Argote, P. et al. The shot, the message, and the messenger: COVID-19 vaccine acceptance in Latin America. NPJ Vaccines 6, 118 (2021).

    Article  CAS  Google Scholar 

  • Lin, C. et al. Healthcare providers’ vaccine perceptions, hesitancy, and recommendation to patients: a systematic review. Vaccines (Basel) 9, 713 (2021).

    Article  Google Scholar 

  • Ronzani, P., Panizza, F., Martini, C., Savadori, L. & Motterlini, M. Countering vaccine hesitancy through medical expert endorsement. Vaccine 40, 4635–4643 (2022).

    Article  CAS  Google Scholar 

  • Jarrett, C. et al. Strategies for addressing vaccine hesitancy—a systematic review. Vaccine 33, 4180–4190 (2015).

    Article  Google Scholar 

  • Bokemper, S. E., Huber, G. A., James, E. K., Gerber, A. S. & Omer, S. B. Testing persuasive messaging to encourage COVID-19 risk reduction. PLoS ONE 17, e0264782 (2022).

    Article  CAS  Google Scholar 

  • Fullerton, M. M. et al. Challenges and recommendations for COVID-19 public health messaging: a Canada-wide qualitative study using virtual focus groups. BMJ Open 12, e054635 (2022).

    Article  Google Scholar 

  • Calleja, N. et al. A public health research agenda for managing infodemics: methods and results of the first WHO Infodemiology Conference. JMIR Infodemiology 1, e30979 (2021).

    Article  Google Scholar 

  • World Health Organization. Understanding the behavioural and social drivers of vaccine uptake. Weekly Epidemiological Record 97, 209–224 (2022).

    Google Scholar 

  • United States Census Bureau. American Community Survey 5-Year Data (2009–2020). https://www.census.gov/data/developers/data-sets/acs-5year.html (2022).

  • Organisation for Economic Co-operation and Development. Population data. https://stats.oecd.org/Index.aspx?DataSetCode=EDU_DEM (2022).

  • UNESCO Institute for Statistics. Demographic and Socio-economic Data. http://data.uis.unesco.org/

  • Office for National Statistics, United Kingdom of Great Britain and Northern Ireland. Population estimates. https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates

  • Statistics Sweden. Population statistics. https://www.scb.se/en/finding-statistics/statistics-by-subject-area/population/population-composition/population-statistics/

  • World Bank. World Bank Data: population, total. https://data.worldbank.org/indicator/SP.POP.TOTL

  • US Central Intelligence Agency. The World Factbook. https://www.cia.gov/the-world-factbook/about/archives/ (2021).

  • Lazarus, J. V et al. Keeping governments accountable: the COVID-19 Assessment Scorecard (COVID-SCORE). Nat. Med. 26, 1005–1008 (2020).

  • Lazarus, J. V., Romero, D. & Kopka, C. A multinational Delphi consensus to end the COVID-19 public health threat. Nature 611, 332–345 (2022).

    Article  CAS  Google Scholar 

  • Goldenberg, M. J. Vaccine Hesitancy: Public Trust, Expertise, and the War on Science (University of Pittsburgh Press, 2021).

  • Dubé, E. et al. Vaccine hesitancy: an overview. Hum. Vaccin. Immunother. 9, 1763–1773 (2013).

    Article  Google Scholar 

  • Peretti-Watel, P., Larson, H. J., Ward, J. K., Schulz, W. S. & Verger, P. Vaccine hesitancy: clarifying a theoretical framework for an ambiguous notion. PLoS Curr. 7, ecurrents.outbreaks.6844c80ff9f5b273f34c91f71b7fc289 (2015).