Public Perceptions and Acceptance of COVID-19 Booster Vaccination in China: A Cross-Sectional Study

Abstract

Coronavirus disease 2019 (COVID-19) booster vaccination has been proposed in response to the new challenges of highly contagious variants, yet few studies have examined public acceptance of boosters. This study examined public acceptance of COVID-19 booster vaccination and its influencing factors by using the data from a self-administered online cross-sectional survey conducted in June 2021 in China. Multiple logistic analysis was used to examine the influencing factors of booster acceptance based on the health belief model (HBM). Among 1145 respondents, 84.80% reported to accept COVID-19 booster vaccination. Having COVID-19 vaccination history, perceiving high benefits and low barriers to booster vaccination, being younger (18–30 vs. 41–50), having a lower education level, being employed, and belonging to priority groups for vaccination were associated with increased odds of booster acceptance. The primary reason for refusing booster vaccination was concern about vaccine safety. The vast majority (92.8%) of respondents reported an annual willingness to pay between 0 and 300 CNY (0–46.29 USD) if the booster was not free. Our findings suggest that the acceptance rate of booster vaccination is relatively high in China, and the HBM-based analysis reveals that more efforts are needed to increase perceived benefits and reduce perceived barriers of vaccination to design effective and proper vaccination extension strategies when boosters become widely recommended.

COVID-19 Booster Vaccination Hesitancy in the United States: A Multi-Theory-Model (MTM)-Based National Assessment

“…This construct can be influenced by both policies and the availability of boosters. This finding mirrors the results from the plethora of studies on vaccine hesitancy conducted before the rollout of COVID-19 vaccines and during the rollout of the primary series of vaccines [ 22 , 25 , 26 , 39 , 40 , 41 ]. This indicates a need for sustained and ongoing culturally relevant communication regarding the benefits of these vaccines and their usefulness along with efforts to reduce barriers and perceived disadvantages of these vaccines and their booster doses.…”

“…This indicates a need for sustained and ongoing culturally relevant communication regarding the benefits of these vaccines and their usefulness along with efforts to reduce barriers and perceived disadvantages of these vaccines and their booster doses. Regarding booster doses, vaccine and pandemic fatigue, side effects from prior doses, breakthrough infections, and lower perceived risk of the disease with declining cases of infections could lead to questioning by the public about the utility and need of the boosters, their effectiveness, and whether boosters are a viable solution for pandemic control [ 41 , 42 , 43 ].…”

Prevalence and Drivers of COVID-19 Vaccine Booster Hesitancy Among German University Students and Employees

“…Similarly, Yadete et al ( 35 ) found that about 62% of a representative sample of the American adult population accepted COVID-19 VB in July 2021 ( 35 ). On the other hand, 84.8% of the Chinese adults were willing to receive COVID-19 VB in June 2021, and 88.9% of the American medical students were in favor of receiving COVID-19 VB in Spring 2021 ( 36 , 37 ).…”

The Effectiveness of Interventions for Increasing COVID-19 Vaccine Uptake: A Systematic Review

“…This review included studies measuring either general COVID-19 vaccination intention or behaviour or behaviour relating to receiving the first dose but was conducted before the subsequent booster vaccination roll out. While there is no a priori reason to expect that interventions reported herein would be widely ineffective if applied to the context of booster vaccination (indeed, some of the interventions identified above echo barriers and facilitators identified in the pre-COVID-19 vaccination literature [ 71 , 72 ] and the preliminary global insights on booster vaccinations [ 73 , 74 ]), further review work is recommended to bolster the evidence base for effective vaccination interventions. This is particularly pertinent given the novelty of COVID-19 booster vaccinations.…”