JMIR Publications

ABSTRACT

Background:

Vaccination can be viewed as comprising the most important defensive barriers to protect vulnerable groups from infection. However, vaccine hesitancy for COVID-19 is widespread worldwide.

Objective:

We aimed to systematically review studies eliciting the Coronavirus Disease 2019 (COVID-19) vaccine preference using discrete choice experiments (DCEs).

Methods:

A literature search was conducted in PubMed, Embase, Web of Science, Scopus, and CINAHL Plus platforms in April 2023. Search terms included "discrete choice experiments", "covid-19", and "vaccines" and related synonyms. Descriptive statistics were used to summarize the study characteristics. Subgroup analyses were performed by factors such as high-income countries (HICs) and low- and middle-income countries (LMICs), and study period (before, during and after the pandemic wave). Quality appraisal was performed using the five-item PREFS (Purpose, Respondents, Explanation, Findings and Significance) checklist.

Results:

A total of 623 records were yielded and 47 studies with 53 data points were finally included. Attributes were grouped into four categories: outcome, process, cost, and others. The vaccine effectiveness (40%, 21/53) and safety (13%, 7/53) were the most frequently reported and important attributes. Subgroup analyses showed that vaccine effectiveness was the most important attribute through the preference varied among subgroups. A higher proportion of LMICs (17%, 4/24) prioritized safety than that in HICs (10%, 3/29). As the pandemic progressed, duration of protection (8%, 2/24) during the pandemic wave and COVID-19 mortality risk (20%, 5/25) after the pandemic wave, emerged as one of the most important attributes.

Conclusions:

Our review revealed the critical role of vaccine effectiveness and safety in COVID-19 vaccine preference. However, it should be noticed that preference heterogeneity was observed across subpopulations and may change over time.