Background: vaccine hesitancy is defined as a delay in the acceptance or refusal of vaccination, even though immunisation is a determinant in reducing the mortality and morbidity associated with Coronavirus Disease 2019 (COVID-19).
Aim: to identify and analyse the predictors of COVID-19 vaccine acceptance and/or hesitancy.
Methods: a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria.
Keywords: vaccine and (COVID or SARS) and (acceptance or acceptability or willingness or hesitancy or refusal) and (multivariate or regression) and (questionnaire or survey) and national. Databases/resources: PubMed, DOAJ, SciELO and b-on. Timeframe: March 2020-2022.
Inclusion criteria: general population, questionnaire-based, calculation of a multivariate regression model and national studies.
Quality assessment: application of the National Heart, Lung, and Blood institute (NHLBI) tool.
Results: a total of 37 studies were selected, whose overall rate was fair. The most predominant predictors of vaccine hesitancy were a lower perceived risk of getting infected, a lower level of institutional trust, not being vaccinated against influenza, lower levels of perceived severity of COVID-19, or stronger beliefs that the vaccination would cause side effects or be unsafe.
Discussion and conclusion: the identified predictors can be used to design tailored health policies and/or public health interventions, or to evaluate subjects' vaccine hesitancy.
Keywords: COVID-19 vaccines; PRISMA; multivariate regression models; national studies; predictors of vaccine hesitancy; questionnaire-based studies; systematic reviews; vaccine acceptance; vaccine hesitancy.