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Dynamic Trends and Underlying Factors of COVID-19 Vaccine Booster Hesitancy in Adults: Cross-Sectional Observational Study.
JMIR Public Health Surveill. 2023 08 01; 9:e44822.JP

Abstract

BACKGROUND

COVID-19 vaccine hesitancy reduces vaccination rates, which is detrimental to building herd immunity and halting the spread of COVID-19 and its variations. Most researches have simply identified the reasons affecting COVID-19 vaccination reluctance without delving into its dynamics, which makes forecasting future trends difficult.

OBJECTIVE

This study aimed to examine the current COVID-19 vaccine booster hesitancy rate in Chinese adults as well as the dynamics of vaccine hesitancy and its influencing factors. The results of this study will have practical implications for policy responses in mainland China, and effective COVID-19 booster vaccination in specific populations.

METHODS

The web-based survey was completed by creating questionnaires and using a stratified random sampling method to collect information from adults (≥18 years old) among 2556 households in 4 geographical regions of China. We collected sociodemographic information, health status, awareness of COVID-19 and its vaccine, self-perceptions, trust in medical staff and vaccine developers, and so on. The odds ratios and 95% CI for the statistical associations were estimated using logistic regression models.

RESULTS

Overall, 6659 participants (females: n=3540, 53.2%; males: n=3119, 46.8%) responded. In total, 533 (8%; 95% CI 7.4%-8.7%) participants presented a clear hesitancy in receiving the COVID-19 booster vaccination, while 736 (11.1%; 95% CI 10.3%-11.8%) expressed hesitancy in regular booster vaccination. A higher prevalence of vaccine hesitancy in both booster vaccination and regular booster vaccination was observed among participants with a history of allergies, experiencing chronic disease, lower levels of public health prevention measures or susceptibility or benefits or self-efficiency, higher levels of severity or barriers, and lower trust in both medical staff and vaccine developers (P<.05). The females and participants with higher education levels, higher levels of barriers, lower levels of susceptibility, and lower trust in vaccine developers preferred to have attitudinal changes from acceptance to hesitancy, while people with higher education levels, lower self-report health conditions, experiencing chronic disease, history of allergies, and lower trust in medical staff and developers were all positively associated with constant COVID-19 booster hesitancy.

CONCLUSIONS

The prevalence of COVID-19 vaccine booster hesitancy is not high in mainland China. However, there is a slight increment in hesitancy on regular booster vaccination. Conducting targeted information guidance for people with higher education levels and chronic diseases, as well as improving accessibility to booster vaccination and increasing trust in medical staff and vaccine producers may be highly effective in reducing vaccine hesitancy.

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Authors+Show Affiliations

Wu J
Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China. Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China.
Ma M
Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China. Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China.
Li Q
Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China. Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China.
Guo X
Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China. Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China.
Tarimo CS
Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China. Department of Science and Laboratory Technology, Dar es Salaam Institute of Technology, Dar es Salaam, United Republic of Tanzania.
Jia S
Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China. Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China.
Zhou X
Department of Public Utilities Management, College of Health Management, Mudanjiang Medical University, Hei Longjiang, China.
Wang M
Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, China.
Gu J
School of Medicine, Southern University of Science and Technology, Shenzhen, China.
Miao Y
Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China. Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China.
Ye B
Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China. Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China.

MeSH

FemaleMaleHumansAdultAdolescentCOVID-19 VaccinesCOVID-19VaccinationHypersensitivity

Pub Type(s)

Observational Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

37526963

Citation

Wu, Jian, et al. "Dynamic Trends and Underlying Factors of COVID-19 Vaccine Booster Hesitancy in Adults: Cross-Sectional Observational Study." JMIR Public Health and Surveillance, vol. 9, 2023, pp. e44822.
Wu J, Ma M, Li Q, et al. Dynamic Trends and Underlying Factors of COVID-19 Vaccine Booster Hesitancy in Adults: Cross-Sectional Observational Study. JMIR Public Health Surveill. 2023;9:e44822.
Wu, J., Ma, M., Li, Q., Guo, X., Tarimo, C. S., Jia, S., Zhou, X., Wang, M., Gu, J., Miao, Y., & Ye, B. (2023). Dynamic Trends and Underlying Factors of COVID-19 Vaccine Booster Hesitancy in Adults: Cross-Sectional Observational Study. JMIR Public Health and Surveillance, 9, e44822. https://doi.org/10.2196/44822
Wu J, et al. Dynamic Trends and Underlying Factors of COVID-19 Vaccine Booster Hesitancy in Adults: Cross-Sectional Observational Study. JMIR Public Health Surveill. 2023 08 1;9:e44822. PubMed PMID: 37526963.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dynamic Trends and Underlying Factors of COVID-19 Vaccine Booster Hesitancy in Adults: Cross-Sectional Observational Study. AU - Wu,Jian, AU - Ma,Mingze, AU - Li,Quanman, AU - Guo,Xinghong, AU - Tarimo,Clifford Silver, AU - Jia,Shiyu, AU - Zhou,Xue, AU - Wang,Meiyun, AU - Gu,Jianqin, AU - Miao,Yudong, AU - Ye,Beizhu, Y1 - 2023/08/01/ PY - 2022/12/05/received PY - 2023/06/16/accepted PY - 2023/02/18/revised PY - 2023/8/2/medline PY - 2023/8/1/pubmed PY - 2023/8/1/entrez KW - COVID-19 booster vaccination KW - COVID-19 vaccine KW - China KW - influencing factors KW - vaccine hesitancy SP - e44822 EP - e44822 JF - JMIR public health and surveillance JO - JMIR Public Health Surveill VL - 9 N2 - BACKGROUND: COVID-19 vaccine hesitancy reduces vaccination rates, which is detrimental to building herd immunity and halting the spread of COVID-19 and its variations. Most researches have simply identified the reasons affecting COVID-19 vaccination reluctance without delving into its dynamics, which makes forecasting future trends difficult. OBJECTIVE: This study aimed to examine the current COVID-19 vaccine booster hesitancy rate in Chinese adults as well as the dynamics of vaccine hesitancy and its influencing factors. The results of this study will have practical implications for policy responses in mainland China, and effective COVID-19 booster vaccination in specific populations. METHODS: The web-based survey was completed by creating questionnaires and using a stratified random sampling method to collect information from adults (≥18 years old) among 2556 households in 4 geographical regions of China. We collected sociodemographic information, health status, awareness of COVID-19 and its vaccine, self-perceptions, trust in medical staff and vaccine developers, and so on. The odds ratios and 95% CI for the statistical associations were estimated using logistic regression models. RESULTS: Overall, 6659 participants (females: n=3540, 53.2%; males: n=3119, 46.8%) responded. In total, 533 (8%; 95% CI 7.4%-8.7%) participants presented a clear hesitancy in receiving the COVID-19 booster vaccination, while 736 (11.1%; 95% CI 10.3%-11.8%) expressed hesitancy in regular booster vaccination. A higher prevalence of vaccine hesitancy in both booster vaccination and regular booster vaccination was observed among participants with a history of allergies, experiencing chronic disease, lower levels of public health prevention measures or susceptibility or benefits or self-efficiency, higher levels of severity or barriers, and lower trust in both medical staff and vaccine developers (P<.05). The females and participants with higher education levels, higher levels of barriers, lower levels of susceptibility, and lower trust in vaccine developers preferred to have attitudinal changes from acceptance to hesitancy, while people with higher education levels, lower self-report health conditions, experiencing chronic disease, history of allergies, and lower trust in medical staff and developers were all positively associated with constant COVID-19 booster hesitancy. CONCLUSIONS: The prevalence of COVID-19 vaccine booster hesitancy is not high in mainland China. However, there is a slight increment in hesitancy on regular booster vaccination. Conducting targeted information guidance for people with higher education levels and chronic diseases, as well as improving accessibility to booster vaccination and increasing trust in medical staff and vaccine producers may be highly effective in reducing vaccine hesitancy. SN - 2369-2960 UR - https://www.unboundmedicine.com/medline/citation/37526963/Dynamic_Trends_and_Underlying_Factors_of_COVID_19_Vaccine_Booster_Hesitancy_in_Adults:_Cross_Sectional_Observational_Study_ DB - PRIME DP - Unbound Medicine ER -