Drivers of and Barriers to COVID-19 Vaccine Booster Dose Acceptance in Indonesia

Abstract

Obtaining a booster dose of coronavirus disease 2019 (COVID-19) vaccine is required to maintain the protective level of neutralizing antibodies and therefore herd immunity in the community, and the success of booster dose programs depends on public acceptance. The aim of this study was to determine the acceptance of a booster dose of COVID-19 vaccine and its drivers and barriers in Indonesia. A cross-sectional survey was conducted in the provinces of Indonesia between 1 and 15 August 2022. Individuals who completed the primary series of the COVID-19 vaccine were asked about their acceptance of a booster dose. Those who refused the booster dose were questioned about their reasons. A logistic regression was used to determine the determinants associated with rejection of a booster dose of COVID-19 vaccine. A total of 2935 respondents were included in the final analysis. With no information on the efficacy and safety of the COVID-19 vaccine, 95% of respondents agreed to receive a booster dose if it were provided for free by the government. This acceptance was reduced to only 50.3% if the vaccine had a 75% efficacy with a 20% chance of side effects. The adjusted logistic regression analysis indicated that there were eight factors associated with the rejection of the booster dose: age, marital status, religion, occupation, type of the first two vaccines received, knowledge regarding the importance of the booster dose, belief that natural immunity is sufficient to prevent COVID-19 and disbelief in the effectiveness of the booster dose. In conclusion, the hesitancy toward booster doses in Indonesia is influenced by some intrinsic factors such as lack of knowledge on the benefits of the booster dose, worries regarding the unexpected side effects and concerns about the halal status of the provided vaccines and extrinsic determinants such as the effectiveness and safety of the vaccine. These findings suggest the need for more campaigns and promotions regarding the booster dose benefits to increase its acceptance.

Willingness to Pay (WTP) for COVID-19 Vaccine Booster Dose and Its Determinants in Indonesia

“…In this study, WTP for the booster dose of COVID-19 vaccines in Indonesia tended to be relatively low at 66.2% (1942/2935), yet it is not definite that if this booster dose vaccine is provided free of charge, the public will refuse it, as evidenced by our previous study on the acceptance of booster COVID-19 vaccination in Indonesia [ 31 ]. Variability in WTP for the primary COVID-19 vaccination has been reported in different studies globally [ 17 , 48 , 49 , 50 , 51 , 52 , 53 ]; however, our study can be considered among the first studies to assess WTP for the booster dose of the vaccine.…”

“…The major finding of the current study was the demonstration of much lower intention to receive the booster doses of COVID-19 vaccination if payment is needed. A recent study among the general public in Indonesia showed that the willingness to receive the booster doses of COVID-19 vaccines, if provided free of charge, was 95% [ 31 ]. The current study with the same target population showed that the need to pay for the vaccine was linked with a discernable decline of willingness to get the booster doses.…”

Knowledge, acceptance, motivators and barriers of booster dose of COVID-19 vaccination among dental patients: A cross-sectional study

“…[ 60 ] Around 71.7% of current study participants believe that a booster dose is required for additional protection against COVID-19, whereas 81.4% of participants in a study from Indonesia believe that booster dose increases immunity, this percentage is quite higher than our study participants. [ 61 ] It is suggesting that knowledge perception and acceptance of the COVID-19 vaccine differs among different populations all over the world. It depends upon their sociodemographic and cultural factors as well.…”

COVID-19 Vaccination Booster Uptake Is Related to End of Pandemic Perception: Population-Based Survey in Four Provinces in Indonesia

“…However, the booster dose coverage was only 24.8%. This lower coverage was despite two studies in Indonesia that found the acceptance of booster dosage was high at 56.3% and 93.9% (Harapan et al, 2022; Wirawan et al, 2022). Understanding the factors contributing to booster shot hesitancy is essential to help policymakers optimize vaccination strategies for COVID-19 control.…”

“…However, the booster dose coverage was only 24.8%. This lower coverage was despite two studies in Indonesia that found the acceptance of booster dosage was high at 56.3% and 93.9% (Harapan et al, 2022;Wirawan et al, 2022).…”