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COVID-19: Original Article
Predictors of COVID-19 booster vaccine hesitancy among fully vaccinated adults in Korea: a nationwide cross-sectional survey
Yunha Noh, Ju Hwan Kim, Dongwon Yoon, Young June Choe, Seung-Ah Choe, Jaehun Jung, Sang-Won Lee, Ju-Young Shin
Epidemiol Health. 2022;44:e2022061.   Published online July 22, 2022
  • 2,744 View
  • 266 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
This study explored predictors of coronavirus disease 2019 (COVID-19) booster hesitancy among fully vaccinated young adults and parental COVID-19 vaccine hesitancy for their children.
This cross-sectional study administered an online survey from December 2 to December 20, 2021. We enrolled participants aged 18-49 years, for whom ≥2 weeks had passed after their initial COVID-19 vaccination. We estimated odds ratios (ORs) with 95% confidence intervals (CIs) using multivariate logistic regression to evaluate factors associated with booster/vaccine hesitancy.
Among the 2,993 participants, 48.8% showed hesitancy (wait and see: 40.2%; definitely not: 8.7%). Booster hesitancy was more common among women (OR, 1.25; 95% CI, 1.05 to 1.50), younger people (OR, 1.44; 95% CI, 1.17 to 1.77), those with a lower education level (OR, 2.05; 95% CI, 1.10 to 3.82), those who received the mRNA-1273 vaccine type (OR, 2.01; 95% CI, 1.65 to 2.45), and those who experienced serious adverse events following previous COVID-19 vaccination (OR, 2.03; 95% CI, 1.47 to 2.80). The main reasons for booster hesitancy were concerns about safety (54.1%) and doubts about efficacy (29.8%). Among the 1,020 respondents with children aged <18 years, 65.8% were hesitant to vaccinate their children against COVID-19; hesitancy was associated with younger parental age, education level, the type of vaccine the parent received, and a history of COVID-19 infection.
Concerns about the efficacy and safety of COVID-19 vaccines were the major barrier to booster acceptance. The initial COVID-19 vaccine type (mRNA-1273), young age, gender (women), a low education level, and adverse events after the first COVID-19 vaccine were key predictors of booster hesitancy.
Korean summary
본 연구는 국내 19-49세 성인을 대상으로, 코로나19 3차접종 의향과 그들의 18세 미만 자녀에 대한 코로나19 기초접종 의향을 조사하고, 코로나19 백신접종 기피와 관련된 요인을 파악하고자 하였다. 2021년 12월 2일부터 20일까지 온라인 설문조사를 통하여 자료를 수집하였으며, 연구대상자는 코로나19 기초접종을 완료한 후 2주 경과한 19-49세 성인으로, 전국 대표성을 확보하기 위해 성별, 연령, 지역별로 층화하여 모집하였다. 코로나19 3차접종 기피율은 약 48.8%로 나타났으며, 접종 기피 관련 영향요인으로는 젊은 연령층, 여성, 낮은 교육수준, 기초접종 백신 종류, 기초접종 후 중증 이상반응 경험이 포함되었으며, 18세 미만 자녀에 대한 코로나19 기초접종 기피율은 65.8%로, 관련 영향요인으로는 젊은 부모 연령, 교육수준, 부모의 기초접종 백신 종류, 코로나19 감염 과거력이 포함되었다.
Key Message
Concerns about the safety and efficacy of COVID-19 vaccines were the major barrier to booster acceptance; the initial COVID-19 vaccine type (mRNA-1273), younger age, gender (women), a low education level, and adverse events after the first COVID-19 vaccine were key predictors of booster hesitancy.
COVID-19: Original Article
Clinical outcomes of COVID-19 following the use of angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers among patients with hypertension in Korea: a nationwide study
Ju Hwan Kim, Yeon-Hee Baek, Hyesung Lee, Young June Choe, Hyun Joon Shin, Ju-Young Shin
Epidemiol Health. 2021;43:e2021004.   Published online December 29, 2020
  • 25,343 View
  • 426 Download
  • 8 Citations
AbstractAbstract AbstractSummary PDF
Recent evidence has shown no harm associated with the use of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin-receptor blockers (ARBs) in patients with coronavirus disease 2019 (COVID-19). We sought to further clarify the possible association between ACEI/ARB use and the risk of poor clinical outcomes of COVID-19.
From the completely enumerated COVID-19 cohort in Korea, we identified 1,290 patients with hypertension, of whom 682 had and 603 did not have records of ACEI/ARB use during the 30-day period before their COVID-19 diagnosis. Our primary endpoint comprised clinical outcomes, including all-cause mortality, use of mechanical ventilation, intensive care unit admission, and sepsis. We used inverse probability of treatment weighting (IPTW) to mitigate selection bias, and a Poisson regression model to estimate the relative risks (RRs) and 95% confidence intervals (CIs) for comparing outcomes between ACEI/ARB users and non-users.
Compared to non-use, ACEI/ARB use was associated with lower clinical outcomes (IPTW-adjusted RR, 0.60; 95% CI, 0.42 to 0.85; p=0.005). For individual outcomes, ACEI/ARB use was not associated with all-cause mortality (IPTW-adjusted RR, 0.62; 95% CI, 0.35 to 1.09; p=0.097) or respiratory events (IPTW-adjusted RR, 0.99; 95% CI, 0.84 to 1.17; p=0.904). Subgroup analysis showed a trend toward a protective role of ACEIs and ARBs against overall outcomes in men (IPTW-adjusted RR, 0.84; 95% CI, 0.69 to 1.03; pinteraction=0.008) and patients with pre-existing respiratory disease (IPTW-adjusted RR, 0.74; 95% CI, 0.60 to 0.92; pinteraction=0.002).
We present clinical evidence to support continuing ACE/ARB use in COVID-19 patients with hypertension based on the completely enumerated Korean cohort.
Korean summary
– 코로나-19 검사를 받은 69,793명 중에 코로나-19 양성이며 고혈압이 있는 1,290명을 연구대상자로 선정했으며, 이중 코로나-19 진단일로부터 30일이내에 ACEI 또는 ARB를 사용한 환자는 682명이었음. – ACEI 또는 ARB 사용은 비사용 대비 사망 또는 폐 관련 질환의 위험과의 관련성이 없었음. – 하위그룹 분석에서 남성 또는 기저 폐질환 보유 환자에서 ACEI 또는 ARB 사용이 코로나-19 예후 악화를 예방하는 트렌드를 보였음.
Key Message
– Among 69,793 individuals screened for COVID-19, we identified 1,290 patients with hypertension who tested positive, of whom 682 had records of using ACEIs or ARBs in the 30 days before their COVID-19 diagnosis. – ACEI/ARB use (compared with non-use) was not associated with all-cause mortality or respiratory events. – A subgroup analysis showed a trend toward a protective role of ACEIs and ARBs against the overall composite endpoint of poor outcomes in men and those with pre-existing respiratory disease.


Citations to this article as recorded by  
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Epidemiol Health : Epidemiology and Health