Acceptance of the COVID-19 vaccine booster dose and associated factors among the elderly in China based on the health belief model (HBM): A national cross-sectional study

BackgroundThe reluctance of individuals to obtain solid vaccine-induced immunity represents a fundamental challenge to containing the spread of SARS-CoV-2, including its highly mutated variants. We aimed to assess vaccination acceptance and associated factors for the COVID-19 vaccine booster dose am...

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Main Authors: Chenyuan Qin, Wenxin Yan, Min Du, Qiao Liu, Liyuan Tao, Min Liu, Jue Liu
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-12-01
Series:Frontiers in Public Health
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2022.986916/full
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author Chenyuan Qin
Wenxin Yan
Min Du
Qiao Liu
Liyuan Tao
Min Liu
Jue Liu
Jue Liu
Jue Liu
author_facet Chenyuan Qin
Wenxin Yan
Min Du
Qiao Liu
Liyuan Tao
Min Liu
Jue Liu
Jue Liu
Jue Liu
author_sort Chenyuan Qin
collection DOAJ
description BackgroundThe reluctance of individuals to obtain solid vaccine-induced immunity represents a fundamental challenge to containing the spread of SARS-CoV-2, including its highly mutated variants. We aimed to assess vaccination acceptance and associated factors for the COVID-19 vaccine booster dose among elderly people (≥60 years old) in China, providing a theoretical and practical reference for universal vaccination policy.MethodsA national anonymous survey was conducted in mainland China from May 25 to June 8, 2022, using a stratified random sampling method. Individuals 60 years of age and above were the target population. A chi-squared test and Cochran-Armitage test for trend were used to compare and examine vaccine acceptance rates by characteristics. Via a backward stepwise method, multivariable logistic regression models were established to assess factors associated with booster dose acceptance. Two-sided P < 0.05 was considered statistically significant.ResultsOf 3,321 eligible participants, 82.8% (95% CI: 81.5–84.1%) were willing to receive COVID-19 vaccine booster shots. Concerns about contraindications (38.3%), vaccine safety (32.0%), and limited movement (28.0%) were the main reasons for vaccine hesitancy. Nearly one-third still believed that the booster dose was unnecessary after receiving the initial vaccination. Older adults with a low level of perceived barriers (aOR = 1.86, 95% CI, 1.03–3.38), a high level of perceived benefit (aOR = 2.31, 95% CI, 1.38–3.87), and higher cues to action (moderate, aOR = 2.22, 95% CI, 1.39–3.56; high, aOR = 5.46, 95% CI: 3.44–8.67) were more likely to accept the booster dose. Other major factors affecting the booster dose acceptance rate were occupation, time spent on social media, vaccination history, and a high knowledge score for COVID-19 and vaccines. In addition, for those over 70 years of age, rising awareness of susceptibility could be a better gateway for improving their willingness to get vaccinated.ConclusionsA total of 82.8% of recruited older adults were willing to receive the booster dose. Acceptance behaviors were closely related to occupation, time spent on social media, vaccination history, knowledge factors, perception of barriers, and benefit, as well as action cues. Targeted public health measures are a priority for improving the vaccination coverage of valid immunity among the elderly population, not only to prevent infection and poor prognosis caused by emerging variants but also to reduce the huge disease and economic burden caused by the long-term sequelae after SARS-CoV-2 infection.
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spelling doaj.art-ba557f590ee94adba6d3ad1c273612b02022-12-22T04:23:12ZengFrontiers Media S.A.Frontiers in Public Health2296-25652022-12-011010.3389/fpubh.2022.986916986916Acceptance of the COVID-19 vaccine booster dose and associated factors among the elderly in China based on the health belief model (HBM): A national cross-sectional studyChenyuan Qin0Wenxin Yan1Min Du2Qiao Liu3Liyuan Tao4Min Liu5Jue Liu6Jue Liu7Jue Liu8Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, ChinaDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, ChinaDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, ChinaDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, ChinaResearch Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, ChinaDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, ChinaDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, ChinaInstitute for Global Health and Development, Peking University, Beijing, ChinaNational Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, ChinaBackgroundThe reluctance of individuals to obtain solid vaccine-induced immunity represents a fundamental challenge to containing the spread of SARS-CoV-2, including its highly mutated variants. We aimed to assess vaccination acceptance and associated factors for the COVID-19 vaccine booster dose among elderly people (≥60 years old) in China, providing a theoretical and practical reference for universal vaccination policy.MethodsA national anonymous survey was conducted in mainland China from May 25 to June 8, 2022, using a stratified random sampling method. Individuals 60 years of age and above were the target population. A chi-squared test and Cochran-Armitage test for trend were used to compare and examine vaccine acceptance rates by characteristics. Via a backward stepwise method, multivariable logistic regression models were established to assess factors associated with booster dose acceptance. Two-sided P < 0.05 was considered statistically significant.ResultsOf 3,321 eligible participants, 82.8% (95% CI: 81.5–84.1%) were willing to receive COVID-19 vaccine booster shots. Concerns about contraindications (38.3%), vaccine safety (32.0%), and limited movement (28.0%) were the main reasons for vaccine hesitancy. Nearly one-third still believed that the booster dose was unnecessary after receiving the initial vaccination. Older adults with a low level of perceived barriers (aOR = 1.86, 95% CI, 1.03–3.38), a high level of perceived benefit (aOR = 2.31, 95% CI, 1.38–3.87), and higher cues to action (moderate, aOR = 2.22, 95% CI, 1.39–3.56; high, aOR = 5.46, 95% CI: 3.44–8.67) were more likely to accept the booster dose. Other major factors affecting the booster dose acceptance rate were occupation, time spent on social media, vaccination history, and a high knowledge score for COVID-19 and vaccines. In addition, for those over 70 years of age, rising awareness of susceptibility could be a better gateway for improving their willingness to get vaccinated.ConclusionsA total of 82.8% of recruited older adults were willing to receive the booster dose. Acceptance behaviors were closely related to occupation, time spent on social media, vaccination history, knowledge factors, perception of barriers, and benefit, as well as action cues. Targeted public health measures are a priority for improving the vaccination coverage of valid immunity among the elderly population, not only to prevent infection and poor prognosis caused by emerging variants but also to reduce the huge disease and economic burden caused by the long-term sequelae after SARS-CoV-2 infection.https://www.frontiersin.org/articles/10.3389/fpubh.2022.986916/fullCOVID-19vaccinationbooster dosehesitancyold people
spellingShingle Chenyuan Qin
Wenxin Yan
Min Du
Qiao Liu
Liyuan Tao
Min Liu
Jue Liu
Jue Liu
Jue Liu
Acceptance of the COVID-19 vaccine booster dose and associated factors among the elderly in China based on the health belief model (HBM): A national cross-sectional study
Frontiers in Public Health
COVID-19
vaccination
booster dose
hesitancy
old people
title Acceptance of the COVID-19 vaccine booster dose and associated factors among the elderly in China based on the health belief model (HBM): A national cross-sectional study
title_full Acceptance of the COVID-19 vaccine booster dose and associated factors among the elderly in China based on the health belief model (HBM): A national cross-sectional study
title_fullStr Acceptance of the COVID-19 vaccine booster dose and associated factors among the elderly in China based on the health belief model (HBM): A national cross-sectional study
title_full_unstemmed Acceptance of the COVID-19 vaccine booster dose and associated factors among the elderly in China based on the health belief model (HBM): A national cross-sectional study
title_short Acceptance of the COVID-19 vaccine booster dose and associated factors among the elderly in China based on the health belief model (HBM): A national cross-sectional study
title_sort acceptance of the covid 19 vaccine booster dose and associated factors among the elderly in china based on the health belief model hbm a national cross sectional study
topic COVID-19
vaccination
booster dose
hesitancy
old people
url https://www.frontiersin.org/articles/10.3389/fpubh.2022.986916/full
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