Assessment of Intention, Acceptance and Hesitancy of COVID-19 Vaccination in Nigeria: A Systematic Review and Meta-Analysis

Background: The COVID-19 pandemic took a toll on nations and ravaged the economies of many countries, and Nigeria was not left out. An urgent need was to stem this tide by rolling out effective vaccines. This study aimed to assess COVID-19 vaccine intention, acceptance and hesitancy.Methods: A systematic review and meta-analysis of 42 studies published in Nigeria on COVID-19 vaccine intention, acceptance and hesitancy was conducted in ten databases and Grey literature between 1st January 2020 and 15th March 2022 (PROSPERO CRD42021291092).Findings: We found that the pooled vaccine intention rate was 48.0% (95% CI 40.2 – 55.8) with a heterogeneity index of 98.8% (p < 0.01). The pooled vaccine acceptance rate was 47.7% (95% CI 26.3 – 69.1) with a heterogeneity index of 98.3% (p < 0.01). Gender, young age, occupation, tribe, and religion were found to be associated with the acceptance of the COVID-19 vaccine. The pooled vaccine hesitancy rate was 44.2% (95% CI 35.6 – 52.9) with a heterogeneity index of 98.5% (p < 0.01). Safety concerns, unreliability of clinical trials, doubt about the efficacy and effectiveness of the vaccine, disbelief in COVID-19 and mistrust in government and manufacturing companies were associated with COVID-19 vaccine hesitancy.Interpretation: This review showed a low pooled COVID-19 vaccine acceptance and a high pooled vaccine intention and hesitancy in Nigeria while highlighting factors associated with vaccine acceptance and hesitancy. This study will direct future public health efforts in this regard.Funding: No financial support was received for this study.Declaration of Interest: We declare no competing interests.