SYSTEMATIC REVIEW article
Front. Public Health
Sec. Infectious Diseases: Epidemiology and Prevention
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1622247
This article is part of the Research TopicSARS-CoV-2: Virology, Epidemiology, Diagnosis, Pathogenesis and Control, Volume IIView all 11 articles
Prevalence of COVID-19 vaccine hesitancy in Brazil: a systematic review and metaanalysis
Provisionally accepted
Daniele Melo Sardinha1,2*
Marcos Jessé Abrahão Silva2
Sebastião Kauã de Sousa Bispo1Alex Patrick Oliveira da Silva1Ilma Pastana Ferreira3Karla Valéria Batista Lima2Luana Nepomuceno Gondim Costa Lima2- 1Evandro Chagas Institute, Ananindeua, Brazil
- 2Postgraduate Program in Epidemiology and Health Surveillance (PPGEVS), Evandro Chagas Institute (IEC), Ananindeua, Brazil
- 3Postgraduate Program in Nursing, Pará State University (PPGENF/UEPA). Belém, Pará, Brazil., Belém, Brazil
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Vaccines have always been the best strategies for public health when we face epidemics and pandemics due to infectious diseases. Vaccine hesitancy is a public health problem in controlling the transmission chain, it means refusing the vaccine for some reason, such as gender, beliefs and lack of confidence in the vaccine. The COVID-19 pandemic was controlled by vaccines, but ideal vaccination coverage needs to be maintained to maintain the reduction in hospitalizations and deaths from COVID-19. In Brazil, coverage did not reach targets and is a concern in the context of COVID-19. Objective: To investigate the prevalence of COVID-19 vaccine hesitancy in Brazil. Methodology: Systematic review with metaanalysis, carried out in databases PubMed, Medline, Lilacs and Science Direct. Results: In the search, 238 articles were analyzed, 8 were eligible for analysis. The prevalence of vaccine hesitancy was 13.3% or 0.133 (95% CI= 0.082 -0.208) in Brazil. In the subgroup analysis, by pandemic wave, the first pandemic wave presented a prevalence of 13.6% or 0.136 (95% CI= 0.081 -0.220), and the second pandemic wave 11.4% or 0.114 (95% CI= 0.029 -0.358). Due to heterogeneity, meta-regression showed a significant association with vaccine hesitancy in parents of children and adolescents (Q= 95.55; df= 2; p=<0.0001), indicating that vaccine hesitancy in this population is much greater when compared to the general population and the elderly. Fake news, lack of knowledge, beliefs, income, and female, young male sex without comorbidities, married with older children, elderly, asymptomatic are the main factors.In the first meta-analysis in Brazil, vaccine hesitancy was more prevalent in parents of children and adolescents, and vaccine hesitancy reduced in the second pandemic wave. Public policies must be developed aimed at factors that interfere with acceptance of the COVID-19 vaccine.
Keywords: vaccine hesitation, Prevalence, Public Health, COVID-19, Brazil
Received: 02 May 2025; Accepted: 14 Jul 2025.
Copyright: © 2025 Sardinha, Silva, Bispo, Silva, Ferreira, Lima and Lima. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Daniele Melo Sardinha, Evandro Chagas Institute, Ananindeua, Brazil
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