Pandemic fatigue and associated factors: a meta-analysis using the COM-B model

Background Pandemic fatigue during the prolonged COVID-19 crisis undermines sustained engagement with protective measures and public health messaging. Existing studies provide heterogeneous prevalence estimates and disparate lists of correlates but lack a unified, theory-driven synthesis. Methods Searches were conducted in six databases up until March 2026. This study synthesized the prevalence of pandemic fatigue and factors associated with it during COVID-19 using the COM-B model and TDF theory. Results Twenty-three cross-sectional studies ( n = 49,285) were included. The pooled prevalence of pandemic fatigue was 51% (95%CI: 0.38, 0.65), with substantial heterogeneity. Health literacy (Capability) was inversely associated with fatigue ( β = −0.257, 95%CI: −0.404, −0.110). Opportunity-related stressors—including bereavement due to COVID-19 ( β = 0.281, 95%CI: 0.124, 0.437), daily troubles ( β = 0.296, 95%CI:0.211, 0.380), and working student status ( β = 0.232, 95%CI: 0.122, 0.341)—were positively associated with pandemic fatigue. Motivation-related factors showed mixed associations, whereas negative emotional states were associated with higher odds of pandemic fatigue. Conclusion Pandemic fatigue is common and was associated with diverse capability-, opportunity-, and motivation-related factors. A COM-B-informed interpretation suggests multi-level strategies that combine skills building, supportive environments, and psychosocial support.