Assessing Acceptability of COVID-19 Vaccine Booster Dose among Adult Americans: A Cross-Sectional Study

Abstract

Given the emergence of breakthrough infections, new variants, and concerns of waning immunity from the primary COVID-19 vaccines, booster shots emerged as a viable option to shore-up protection against COVID-19. Following the recent authorization of vaccine boosters among vulnerable Americans, this study aims to assess COVID-19 vaccine booster hesitancy and its associated factors in a nationally representative sample. A web-based 48-item psychometric valid survey was used to measure vaccine literacy, vaccine confidence, trust, and general attitudes towards vaccines. Data were analyzed through Chi-square (with a post hoc contingency table analysis) and independent-sample t-/Welch tests. Among 2138 participants, nearly 62% intended to take booster doses and the remaining were COVID-19 vaccine booster hesitant. The vaccine-booster-hesitant group was more likely to be unvaccinated (62.6% vs. 12.9%) and did not intend to have their children vaccinated (86.1% vs. 27.5%) compared to their non-hesitant counterparts. A significantly higher proportion of booster dose hesitant individuals had very little to no trust in the COVID-19 vaccine information given by public health/government agencies (55% vs. 12%) compared to non-hesitant ones. The mean scores of vaccine confidence index and vaccine literacy were lower among the hesitant group compared to the non-hesitant group. Compared to the non-hesitant group, vaccine hesitant participants were single or never married (41.8% vs. 28.7%), less educated, and living in a southern region of the nation (40.9% vs. 33.3%). These findings underscore the need of developing effective communication strategies emphasizing vaccine science in ways that are accessible to individuals with lower levels of education and vaccine literacy to increase vaccination uptake.

Willingness to Take the Booster Vaccine in a Nationally Representative Sample of Danes

“…The finding that younger individuals are more hesitant to receive the booster dose is consistent with previous literature from various countries [ 21 , 22 , 23 , 24 , 25 ], as well as studies of age patterns in primary vaccination against COVID [ 26 , 27 , 28 , 29 , 30 , 31 ]. Only a few studies do not replicate this age pattern when estimating the willingness to receive a booster dose [ 32 , 33 ].…”

“…However, other studies provide more mixed evidence. Some studies show that willingness to receive a booster vaccine is higher among men [ 23 , 24 ], whereas others report that willingness is higher among women [ 22 ].…”

Intention to Receive the COVID-19 Vaccine Booster Dose in a University Community in Italy

“…A notable finding was that the hesitancy towards the booster dose was low among the responders since 24.7% of the sample were classified as hesitant with a total VHS score ≥25. Other surveys have found varying proportions of participants willing to receive the booster dose with values of 55.3% among HCWs in Saudi Arabia [13], 61.8% in adult Americans [14], 71% among adults in Poland [10], 71.3% among HCWs in Czechia [15], 83.6% a hypothetical yearly booster vaccine among healthcare workers in the United States [12], 84.5% among medical students in Japan [11], and 91.1% in the general population in China [16]. In the present study interviewees highlighted that the most common reasons in vaccine-related decision-making were because they would protect themselves and their relatives.…”

“…Hesitancy and willingness in relation to the COVID-19 vaccination have been investigated in different groups worldwide with a number of individuals who would either be unwilling to receive it or refuse it altogether despite the severity of the disease [8,9]. However, little is known yet about the intention to receive the booster dose [10][11][12][13][14][15][16]. In this current scenario, this is a challenging issue.…”

COVID-19 Vaccine Booster Hesitancy among Healthcare Workers: A Retrospective Observational Study in Singapore

“…Because of this, we had to estimate the longest booster eligibility duration to be 61 days (between 10 October 2021, where booster was open to all HCW regardless of age, and 10 December 2021, the end date of our study), where in actual fact this duration could have been longer due to earlier booster eligibility due to HCW age. There were other demographic factors highlighted in multiple questionnaire-based vaccine hesitancy studies that were not accounted for in our Cox regression model, such as education level, marital status, race, socioeconomic status, and even information sources individuals trust [ 29 , 30 , 31 , 32 ]. Mixed studies could be performed to discover the main reasons for vaccination (such as to protect their family and friends) [ 33 ] and placed in an all-encompassing multivariate model to examine how these different factors interplay in influencing booster hesitancy.…”