Abstract
BACKGROUND: COVID-19 vaccination is crucial for mitigating the pandemic's impact. However, vaccine hesitancy and access challenges have hindered global vaccination efforts. This meta-analysis aimed to estimate the pooled COVID-19 vaccine uptake proportion and identify associated determinants in Cameroon. METHODS: This review, conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, identified articles through searches of electronic databases, including PubMed, ScienceDirect, and Google Scholar, as well as through gray literature. The search encompassed published and unpublished studies from 2021 to 2024 reporting on COVID-19 vaccine uptake and/or acceptance in Cameroon. Extracted data were compiled in a Microsoft Excel spreadsheet and analyzed using R statistical software (version 4.4.2). A random-effects model was employed when heterogeneity exceeded 50%. Publication bias was assessed using funnel plots, Egger's and Begg's tests. Meta-regression was used to explore the influence of study characteristics. RESULTS: Twenty-two studies, encompassing 24,130 participants, were included. The pooled vaccine uptake proportion was 37.14% (95% CI: 29.24-45.05) with substantial heterogeneity (I(2) = 98.2%, p < 0.001). Subgroup analyses revealed lower uptake among the general population (23.18%; 95% CI: 10.11-36.25) and in community settings (16.0%; 95% CI: 0.97-31.04) compared with healthcare workers (42.12%; 95% CI: 34.14-50.09). Younger age (OR = 0.53; 95% CI: 0.42-0.67) was inversely associated with vaccine uptake, while being in a partnership (OR = 1.59; 95% CI: 1.11-2.27) was positively associated. Higher levels of education (OR = 1.75; 95% CI: 1.56-1.97), urban residence (OR = 1.66; 95% CI: 1.21-2.29) were positively associated with vaccine acceptance. CONCLUSION: This meta-analysis revealed a suboptimal pooled COVID-19 vaccine uptake required to ensure a herd immunity. The results of this meta-analysis underline the crucial need to step up efforts to improve vaccination coverage, particularly among the most vulnerable populations. Identifying and addressing the factors underlying this low coverage is imperative if public health objectives are to be met. Public health interventions should be tailored to address the specific concerns and needs of different age groups and marital statuses.