The country-of-origin effect on vaccination: a systematic literature review and research agenda

The COVID-19 pandemic raised awareness and concerns regarding the country-of-origin of vaccines. During this period, we witnessed the emergence of a country-of-origin effect in vaccination perceptions. The country-of-origin effect is a well-documented marketing phenomenon where the origin country of a product influences consumer decisions, brand associations, and evaluations. To investigate this phenomenon, a systematic literature review was conducted using Scopus database, employing a diverse array of search terms. The review identified 52 articles that examined the country-of-origin effect on vaccination. These studies fall under different subject fields, such as Medicine and Social Science, and were published across 39 different journals, confirming the interdisciplinary nature of the topic. Moreover, the studies covered 48 countries, with some being multicultural. The results reveal the presence of a national bias, a preference for Western vaccines, distrust towards Chinese and Russian vaccines, and the impact of demographic factors, such as gender, age, and income. The national bias was observed across at least 17 countries, such as USA, China, UK, Germany, Turkey and Iran. It persists even in countries without early COVID-19 vaccine development (e.g., Brazil, Ghana, Japan, South Korea, Spain and Taiwan). The preference for Western vaccines and distrust towards Chinese and Russian vaccines was observed across diverse regions including Europe (e.g., France), Latin American (e.g., Brazil), Eastern Europe (e.g., Hungary), the Middle East (e.g., Turkey, Israel), and Asia (e.g., Japan). The authors discuss potential underlying reasons, implications for policy makers and health management, and propose a comprehensive agenda for future research, including the role of politics, media, endorsements, and other vaccines and medications.