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Epidemiol Health > Accepted Articles
Epidemiology and Health 2022;e2022061.
DOI: https://doi.org/10.4178/epih.e2022061    [Accepted] Published online Jul 22, 2022.
Predictors of COVID-19 booster vaccine hesitancy among fully vaccinated adults in South Korea: a nationwide cross-sectional survey
Yunha Noh1  , Ju Hwan Kim1  , Dongwon Yoon1  , Young June Choe2  , Seung-Ah Choe3  , Jaehun Jung4  , Sang-Won Lee1  , Ju-Young Shin1 
1Sungkyunkwan University, Suwon, Gyeong gi-do, Korea
2Korea University Anam Hospital, Seoul, Korea
3Korea University College of Medicine, Seoul, Korea
4Gachon University College of Medicine, Incheon, Korea
Correspondence  Sang-Won Lee ,Email: shin.jy@skku.edu
Ju-Young Shin ,Email: shin.jy@skku.edu
Received: Mar 30, 2022  Accepted after revision: Jul 22, 2022
To explore predictors of COVID-19 booster hesitancy among fully vaccinated young adults and parental factors on COVID-19 vaccine hesitancy for their children.
A cross-sectional study was conducted via an online survey from December 2 to 20, 2021. We enrolled participants aged 18-49 years and elapsed ≥2 weeks after completing a primary series of COVID-19 vaccination. We estimated odds ratios (ORs) with 95% confidence intervals (CIs) using multivariate logistic regressions to evaluate factors associated with booster/vaccine hesitancy.
Among 2,993 participants, 48.8% indicated hesitancy (wait and see: 40.2%; definitely not: 8.7%). The booster hesitancy was more in females (OR 1.25, 95% CI 1.05-1.50), younger age group (1.44 [1.17-1.77] at 18-29 years vs. 40-49 years), lower education level (2.05 [1.10-3.82] in no high school vs. graduate degree), mRNA-1273 (2.01, 1.65-2.45 vs. BNT162b2), and those with serious adverse events following previous COVID-19 vaccination (2.03, 1.47-2.80). The main reasons for booster hesitancy were concerns about its safety (54.1%), followed by doubt about the efficacy (29.8%). Among 1,020 respondents who had children aged <18 years, 65.8% indicated COVID-19 vaccine hesitancy for their children; the hesitancy for children was higher at the younger age, and lower at lower education level, ChAdOx1 (vs. BNT162b2), and those with history of COVID-19 infection.
Concerns on the efficacy and safety of COVID-19 vaccines were the major barrier to booster hesitancy. The initial COVID-19 vaccine type, younger age, women, lower education level, and adverse events following COVID-19 vaccine were the key predictors of booster hesitancy.
Keywords: Coronavirus; Vaccine hesitancy; Booster immunization; Public health


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