Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Dec 5, 2022
Date Accepted: Jun 16, 2023
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Dynamic trends and underlying factors of COVID-19 vaccine booster hesitancy in adults: based on a multi-center observational study
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.
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