JMIR Publications

ABSTRACT

Background:

COVID-19 vaccine hesitancy affects vaccination rates, which is not conducive to consolidating herd immunity to stop the spread of COVID-19 and its variants. Most studies have only highlighted the factors influencing COVID-19 vaccine hesitancy, but have not explored its dynamics in depth, which is not conducive to making judgments about future changes in trends.

Objective:

To examine the current COVID-19 vaccine hesitancy rate in booster vaccination of Chinese adults and analyze the dynamics of vaccine hesitancy and its influencing factors.

Methods:

We designed questionnaires and used a stratified random sampling method to access information through our online platform from 2,556 households in four geographical regions of China. The odds ratios (OR) and 95% confidence intervals (CI) for the statistical associations were estimated using logistic regression models.

Results:

Overall, 6,659 participants (53.2% females and 46.8% males) responded. Overall, 533 (8.0%, 95% CI, 7.4%-8.7%) participants endorsed clear vaccine hesitancy response in booster vaccination. Furthermore, 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 higher educational levels, lower self-report health conditions, suffered from chronic disease, history of allergies, and former drinkers. Similar results were found among participants with lower levels of physical activity, lower levels of public health prevention measures/benefits/self-efficiency, higher levels of severity/barriers, and lower trust in medical staff and developers. The females and participants with higher education levels, higher levels of barriers, and lower trust in developers preferred to have attitudinal changes from acceptance to hesitancy (ATH). While, higher education levels, suffering from 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 education 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, will be highly effective in reducing vaccine hesitancy.