COVID-19 Vaccine Hesitancy, and Logistical Challenges in a Caribbean island: A Systematic Review

Background: COVID-19 vaccine hesitancy presents a significant challenge to public health efforts, particularly in small island developing states like Trinidad and Tobago. Objective: This review aimed to systematically assess the prevalence of COVID-19 vaccine hesitancy, explore associated factors, and identify logistical challenges in the vaccine rollout in Trinidad and Tobago. Methods: A systematic search was conducted across multiple databases including PubMed, Scopus, and Google Scholar for studies published between 2020 and 2025. Eligibility criteria included observational and survey-based studies reporting on vaccine attitudes or implementation issues within Trinidad and Tobago. The methodological quality was assessed using standard tools. Data were synthesised narratively and meta-analytically. Results: A total of 13 studies were included. The pooled prevalence of vaccine hesitancy was estimated at 37.3% (95% CI: 25.1–49.5%). Key factors influencing hesitancy included concerns about vaccine safety, misinformation, and lack of trust in public health messaging. Logistical barriers involved cold chain limitations, rural access issues, and inconsistent public outreach. Conclusion: Vaccine hesitancy remains moderately high in Trinidad and Tobago, with both attitudinal and logistical factors at play. Targeted public health strategies, enhanced communication, and equitable distribution systems are needed to improve vaccine uptake.