Researchers investigated why more than 80% of eligible Americans have not taken their severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) vaccine booster dose. They conducted an online survey of 2,298 respondents to evaluate the reasons underlying the low observed response.
Their results elucidate that, despite consistent research and clinical reports depicting positive, anti-coronavirus disease of 2019 (COVID-19) outcomes for individuals receiving the booster, misinformation regarding prior SARS-CoV-2 infection and vaccination, and concerns pertaining to vaccine side effects and the presence and degree of protection conferred by the booster stalled booster reception in the United States (US). These results highlight the need for additional media outreach elucidating the benefits of COVID-19 vaccines as the best intervention against the disease, especially severe infections by SARS-CoV-2.
Study
This study enrolled Americans participating in the Arizona COVID-19 Cohort (CoVHORT). This study group is longitudinal in methodology and is aimed at investigating the long-term and acute effects of SAR-CoV-2 infection on Arizonans. CoVHORT participants included both individuals who had suffered from prior COVID-19 infections and those who had not. This study comprised a subset of 4827 participants selected to best represent the American populace. Participants were recruited via online survey participation requests between February 13 and March 29, 2023.
Data collection involved recording demographic- and COVID-19-associated details, especially pre-existing health conditions, severity and symptoms of SARS-CoV-2 infection, COVID-19 test results, and health behaviors. The REDCap was used for survey design and administration. As and when required, additional COVID-19-specific research questionnaires were emailed to the relevant survey respondents. Surveys are administered at study enrollment and every subsequent three months, with data collection still ongoing.
Three themes were identified a priori, which classified responses into three associated groups – 1. Bivalent vaccine knowledge, 2. Unclear about the risks/benefits of vaccination/boosters, 3. Logistic concerns. Finally, statistical analyses focused on individuals who had received at least the initial vaccination dose, excluding respondents who had never consumed a vaccine against COVID-19. Multivariable logistic regression (MLR) analysis was used to identify trends between themes and demographic information (age, gender, education, race/ethnicity, and income). MLR models were adjusted for all the listed demographic characteristics.
Results
Of the 4,827 individuals contacted, 2,298 (47.6%) completed all survey rounds, 2,196 of whom had received at least one vaccination dose and were hence included in statistical analyses. Participants who completed the survey were on average, older (mean = 52.8) than those who did not (mean = 47.6), with all other demographic characteristics remaining statistically equal. This study represented a deviation from previous American vaccination reports, with 1,637 (74.5%) respondents receiving the second bivalent vaccination booster dose compared to less than 20% of the general US populace.
Results revealed that individuals who received the booster vaccine were slightly younger (mean = 50.5) than those who did not (mean = 52.8). Women (73.3%) and respondents of Hispanic ethnicity (12.6%) were less likely to take the booster dose than the overall study cohort (70.0% and 9.7%, respectively). Education and income were found to significantly impact vaccine booster reception, with individuals at lower tiers of both quintiles of both characteristics less likely to receive the booster.
Of the 559 respondents who did not receive the booster, 39.5% claimed that prior COVID-19 infection and the perceived resistance conferred by the infection was the reason for their aversion to the booster.
Conclusion
In the present study, researchers investigated the underlying reason for most (>80%) of Americans refusing booster vaccines against COVID-19 using a cohort of 2196 individuals from Arizona as representatives. The analysis revealed that misinformation about infection-conferred resistance (39.5%), and concerns about side effects (31.5%) of the vaccine were the most cited reasons for vaccine booster aversion. Concerns regarding booster safety (23.4%) and efficacy concerns (anti-COVID-19 effects [23.1%] and severe disease/death resistance [12.2%]) were the next most cited underpinnings for low vaccine acceptance.
Knowledge about the disease and vaccination effects were the least cited yet significant results of the survey. However, education and income were found to play important roles in anti-COVID-19 vaccination as a whole and not just bivalent booster dose acceptance.
Based on these results, efforts to reach out to the media and disseminate information would likely have the greatest impact on future vaccination drives, both for COVID-19 and disease outbreaks.
Source:
https://www.news-medical.net/news/20231005/Why-are-most-Americans-skipping-the-COVID-19-booster.aspx