PONE-D-24-09721Determinants of COVID-19 Vaccine Acceptance and Hesitance among Adolescents and Youths aged 10-35 years in Sub-Saharan African Countries: A Systematic Review and Meta-analysisPLOS ONE

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PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: No

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: In the limitations section, could the fact that all the included studies were cross-sectional also be a limitation?

Please, correct the term hesitance to hesitancy throughout the manuscript.

I look forward to seeing the published version of this manuscript

Reviewer #2: Address the following information in the discussion and introduction section:

Impact of misinformation and disinformation about COVID-19 vaccines on public perception and acceptance

Healthcare providers, government agencies, and pharmaceutical companies role in vaccine acceptance.

Long-Term Impact for sustained acceptance

Reviewer #3: Thank you for giving me an opportunity to review this article about “Determinants of COVID-19 Vaccine Acceptance and Hesitance among Adolescents and Youths aged 10-35 years in Sub-Saharan African Countries: A Systematic Review and Meta-analysis.”

Introduction

It is not so critical as to why this study among adolescents and youth is essential? Is it a COVID-19 high risk group? Why should we worry about them? This could be fixed in the last paragraph

Looks like citations 17 to 20 in the second last paragraph have been manually inserted. Please rectify this.

In the statement, “As of February 2024, the percentage of COVID-19 vaccination in Africa was at 51.85…” is that a percentage?

Methodology

Though the inclusion criteria look fine, the authors just define some of the exclusion criteria as the opposite of inclusion which seems not right. I would advise the authors to use the PECO framework by Morgan RL (2018) to define eligibility.

Proof read the information sources section and remove any repetitions made.

The search strategy is not clear. Is what is being presented the full string that was used? And in which database was this used? Normally, a search is built in PubMed and modified for other databases. Additionally, it would be very useful to present the full search strategy indicating the strings as search in each of the databases together with the number of records and any filters added.

An important step of study selection is mixed-up; this makes following the article hard. I would advise the authors to be systematic following the five steps of systematic reviews clearly. Question, Search, Screening, Extraction, quality assessment, Data management. This flow would make readability easy.

Did you use Endnote, Rayyan of Covidence for screening? please be specific with this. Like I have noted above, please rearrange the write up for logical flow.

In the data analysis section, did you consider heterogeneity at 12 of 50%, or 75%. Please harmonize this.

Results

In the characteristics of included studies, it would be logical to state the reasons to why some studies were excluded after being subjected to full-text screening. this should also include how many studies were excluded for which reason.

It is also not clear the basis on which you performed the subgroup analysis. Please make this clear.

In Figure 1, please state the reasons for exclusion, not just reason 1 and reason 2

For verification purposes, please present a table for study characteristics indicating all the 23 studies, well cited with a column for quality of included studies.

Give keen attention to your P-values most especially in the subgroup analysis by region. First of all, it is a best practice to write P values with three digits after the decimal point (e.g. P=0.056), secondly, any p value that is displayed as 0.000 is written as p<0.001. finally, some of your p values have a greater than sign instead of less than sign, please rectify this.

In the determinants of vaccination acceptance section, I am still confused by the statement, “The odds of receiving Health Officers' information were 4.36 times more likely to influence acceptance of the COVID-19 vaccine than those who said no to the information from the health workers (AOR=4.36, 95%, CI, 2.28-8.32, I2=97.74, p < 0.001).” where the odds more likely? Or those who reported to have received the information were more likely? Please revise how you make these statement. The easiest way would have been, receiving information from the Health officer increased the odds of acceptance of the vaccine by more than 4-folds, or Receiving information from the health officer had a more than 4-folds increased odds of accepting the vaccine.

On your Tables, put a footnote to describe what AOR and CI mean.

Discussion

The first paragraph of your discussion seems to be more fitting into the introduction section.

The findings relating to the main outcome seem not well discussed. No adequate comparisons, no implications, I think you need to improve on this.

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Reviewer #1: Yes: Dr Sahabi Kabir Kabir Sulaiman

Reviewer #2: No

Reviewer #3: No

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Submitted filename: Review comments.docx

Determinants of COVID-19 Vaccine Acceptance and Hesitancy among Adolescents and Youths aged 10-35 years in Sub-Saharan African Countries: A Systematic Review and Meta-analysis

PONE-D-24-09721R1

Dear Dr. Mwiinde,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Dr Richard Makurumidze (MBChB, MPH, PhD)

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #3: (No Response)

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #3: (No Response)

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #3: (No Response)

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #3: (No Response)

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #3: (No Response)

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Thanks once again for improving the quality of your work. I have no further comments to add on this work.

Reviewer #3: (No Response)

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: Yes: Sahabi Kabir Sulaiman

Reviewer #3: No

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