COVID-19 Vaccine Acceptance Level in Ethiopia: A Systematic Review and Meta-Analysis

Background. The coronavirus disease 2019 pandemic has had a devastating impact on the everyday lives of the world's population and to this end, the development of curative vaccines was upheld as a welcome panacea. Despite the undeniable negative impact of the disease on human beings, lower than expected proportions of people have taken up the vaccines, particularly in the developing non-Western world. Ethiopia represents an interesting case example, of a nation where COVID-19 vaccine acceptance levels have not been well investigated and a need exists to assess the overall level of vaccine acceptance. Methods. A systematic multidatabase search for relevant articles was carried out across Google Scholar, Web of Science, Science Direct, Hinari, EMBASE, Boolean operator, and PubMed. Two reviewers independently selected, reviewed, screened, and extracted data by using a Microsoft Excel spreadsheet. The Joanna Briggs Institute prevalence critical appraisal tools and the modified NewcastleOttawa Scale (NOS) were used to assess the quality of evidence. All studies conducted in Ethiopia, reporting vaccine acceptance rates were incorporated. The extracted data were imported into the comprehensive meta-analysis version 3.0 for further analysis. Heterogeneity was confirmed using Higgins's method, and publication bias was checked by using Beggs and Eggers tests. A random-effects meta-analysis model with a 95% confidence interval was computed to estimate the pooled prevalence. Furthermore, subgroup analysis based on the study area and sample size was done. Results and Conclusion. After reviewing 67 sources, 18 articles fulfilled the inclusion criteria and were included in the meta-analysis. The pooled prevalence of COVID-19 vaccine acceptance in Ethiopia was 57.8% (95% CI: 47.2%-67.8%). The level of COVID-19 vaccine acceptance in Ethiopia was at a lower rate than necessary to achieve herd immunity. The highest level of vaccine acceptance rate was reported via online or telephone surveys followed by the southern region of Ethiopia. The lowest vaccine acceptance patterns were reported in Addis Ababa.