Health Beliefs and Socioeconomic Determinants of COVID-19 Booster Vaccine Acceptance: An Indonesian Cross-Sectional Study

Abstract

Introduction: The threat of new SARS-CoV-2 variants indicates the need to implement COVID-19 vaccine booster programs. The aim of this study was to identify the level of booster acceptance and its determinants. Methods: A cross-sectional online survey was conducted in Jakarta and Bali, Indonesia. Booster acceptance was divided into three categories: non-acceptor, planned acceptor, and actual acceptor. The primary independent variables were health beliefs, media influence, and trust in authoritative sources. Other covariates included demographics, socioeconomic status, and COVID-19 history. A primary analysis was conducted through multinomial logistic regression. The effects of the hypothetical situations on booster acceptance were tested using the Wilcoxon signed-rank test. Results: The final analysis included 2674 respondents with a booster acceptance rate of 56.3% (41.2% planned acceptors, 15.1% actual acceptors). Health beliefs, social media influence, and trust in authoritative information sources were identified as determinants for planned and actual booster acceptance. Socioeconomic status indicators were also identified as determinants for actual booster acceptance. Booster acceptance was increased in hypothetical scenarios involving booster requirements for work, travel, and accessing public places. Conclusions: Booster acceptance was found to be lower than the predicted primary vaccine acceptance prior to its launch. The acceleration of booster coverage requires strategies that leverage health beliefs and focus on people with a lower socioeconomic status.

First COVID-19 Booster Dose in the General Population: A Systematic Review and Meta-Analysis of Willingness and Its Predictors

“…Our review identified that people with a higher educational level were more likely to accept a booster dose. This finding is confirmed by the literature since an increased educational level is associated with an increased primary COVID-19 vaccine acceptance rate [ 36 , 50 , 51 ]. Well-educated individuals have a higher risk perception of COVID-19 infection, while less-educated people are vaccine-hesitant because they do not think they will be affected by COVID-19 [ 66 ].…”

“…In particular, older individuals were more likely to accept a booster. Evidence supports this finding since increased age is associated with increased COVID-19 vaccination intentions and uptake [ 36 , 41 , 50 ]. The elderly may have a greater sense of responsibility and accountability for themselves and their societies relative to younger individuals.…”

“…Details of the studies included in this systematic review are presented in Table 1 . We found 14 studies including 104,047 fully vaccinated individuals [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ]. Nine studies were conducted in Asia (four in China; two in Jordan; one in Vietnam; one in Japan; one in Indonesia), three studies in Europe (one in the United Kingdom; one in Denmark; one in Poland), one study in the USA and one study in Africa (Algeria).…”

“…Details of the studies included in this systematic review are presented in Table 1. We found 14 studies including 104,047 fully vaccinated individuals [26][27][28][29][30][31][32][33][34][35][36][37][38][39]. Nine studies were conducted in Asia (four in China; two in Jordan; one in Vietnam; one in Japan; one in Indonesia…”

COVID-19 Vaccine Booster Dose Acceptance: Systematic Review and Meta-Analysis

“…Subgroup analysis according to the actual vaccination or intention to be vaccinated did not explain this heterogeneity ( Supplementary Figure S1 ). Since six studies represented the COVID-19 vaccine booster dose acceptance as actual vaccination or intention to be vaccinated [ 51 , 54 , 55 , 61 , 66 , 73 ], it was a necessary to identify the pooled proportion for the actual booster dose vaccination and intention to receive the booster dose separately.…”