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Preplanned Studies: Willingness of the General Public to Receive A COVID-19 Vaccine Booster — China, April–May 2021

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  • Summary

    What is already known about this topic?

    A coronavirus disease 2019 (COVID-19) vaccine booster is planned for administration to eligible individuals. Understanding the factors that influence attitudes towards the booster shot will help to identify groups that will most readily accept a booster dose.

    What is added by this report?

    Of the individuals polled, 75.2% reported they would receive a booster shot. Sociodemographic characteristics influencing booster vaccine acceptance included age, gender, occupation, and education. Moreover, those who had been vaccinated against influenza, who believed herd immunity would be effective against severe acute respiratory syndrome coronavirus 2, and who reported reduced anxiety after vaccination were more likely to accept a booster dose.

    What are the implications for public health practice?

    A booster shot of the COVID-19 vaccine could be widely accepted. Communicating about the effectiveness of the COVID-19 vaccine and the impact of infection on people’s health could help increase public willingness to get a booster dose.

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  • Funding: Supported by the National Natural Science Foundation of China (Project Number: 81701067, 82101264) and National Major Science and Technology Projects (Project No.2018ZX10732401-003)
  • [1] World Health Organization. SAGE October 2021 meeting highlights. https://www.who.int/news/item/10-10-2021-sage-october-2021-meeting-highlights. [2021-10-27].https://www.who.int/news/item/10-10-2021-sage-october-2021-meeting-highlights
    [2] Centers for Disease Control and Prevention. COVID-19 vaccine booster shot. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/booster-shot.html. [2021-10-27].https://www.cdc.gov/coronavirus/2019-ncov/vaccines/booster-shot.html
    [3] National Health Commission of the People’s Republic of China. Transcript of press conference of the joint prevention and control mechanism of the state council on March 28, 2021. http://www.nhc.gov.cn/xcs/s3574/202103/b8e12b9385b44813af117faad928b7d3.shtml. [2021-10-27]. (In Chinese). http://www.nhc.gov.cn/xcs/s3574/202103/b8e12b9385b44813af117faad928b7d3.shtml
    [4] Nehal KR, Steendam LM, Campos Ponce M, van der Hoeven M, Smit GSA. worldwide vaccination willingness for COVID-19: a systematic review and meta-analysis. Vaccines 2021;9(10):1071. http://dx.doi.org/10.3390/vaccines9101071CrossRef
    [5] de Albuquerque Veloso Machado M, Roberts B, Wong BLH, van Kessel R, Mossialos E. The relationship between the COVID-19 pandemic and vaccine hesitancy: a scoping review of literature until August 2021. Front Public Health 2021;9:747787. http://dx.doi.org/10.3389/fpubh.2021.747787CrossRef
    [6] National Bureau of Statistics of China. Tabulation on the 2010 population census of the People’s Republic of China. http://www.stats.gov.cn/tjsj/pcsj/rkpc/6rp/indexch.htm. [2021-10-27]. (In Chinese). http://www.stats.gov.cn/tjsj/pcsj/rkpc/6rp/indexch.htm
    [7] Centers for Disease Control and Prevention. Building confidence in COVID-19 vaccines. https://www.cdc.gov/vaccines/covid-19/vaccinate-with-confidence.html. [2021-10-27].https://www.cdc.gov/vaccines/covid-19/vaccinate-with-confidence.html
    [8] Wang Q, Yang LQ, Jin H, Lin L. Vaccination against COVID-19: a systematic review and meta-analysis of acceptability and its predictors. Prev Med 2021;150:106694. http://dx.doi.org/10.1016/j.ypmed.2021.106694CrossRef
    [9] Han SS, Cai J, Yang J, Zhang JJ, Wu QH, Zheng W, et al. Time-varying optimization of COVID-19 vaccine prioritization in the context of limited vaccination capacity. Nat Commun 2021;12(1):4673. http://dx.doi.org/10.1038/s41467-021-24872-5CrossRef
  • TABLE 1.  Characteristics of the study population.

    CharacteristicsWeChat sample (n=1,644)Tencent sample (n=403)
    Age group, years
    18–24184 (11.3)14 (3.5)
    25–34614 (37.6)18 (4.5)
    35–44451 (27.6)43 (10.7)
    45–54254 (15.5)245 (60.8)
    55–6491 (5.6)68 (16.9)
    ≥6541 (2.5)15 (3.7)
    Gender
    Male613 (37.3)164 (40.7)
    Female1,031 (62.7)239 (59.3)
    Non-healthcare staff
    Yes973 (59.2)398 (98.8)
    No671 (40.8)5 (1.2)
    Education
    Junior high school and below105 (6.4)135 (33.5)
    Senior high school78 (4.7)216 (53.6)
    Associate or bachelor809 (49.2)49 (12.2)
    Master and above652 (39.7)3 (0.7)
    Income (CNY per month)
    0–2,000201 (12.2)106 (26.3)
    2,000–5,000300 (18.3)221 (54.8)
    5,000–10,000459 (27.9)66 (16.4)
    10,000 and above684 (41.6)10 (2.5)
    Area type
    Rural1,498 (91.6)285 (70.9)
    Urban138 (8.4)117 (29.1)
    Flu vaccination history
    Yes680 (41.4)189 (46.9)
    No/unsure964 (58.6)214 (53.1)
    Whether herd immunity works
    Yes1,423 (86.6)382 (94.8)
    No/unsure221 (13.4)21 (5.2)
    Whether vaccination
    help reduce anxiety
    Yes1,098 (66.8)268 (66.5)
    No546 (33.2)135 (33.5)
    Note: All data are described in term of “Number (%) of participants”.

    Abbreviation: CNY=China Yuan.
    Download: CSV

    TABLE 2.  The process of calculating age- and gender- standardized acceptance rate of a COVID-19 vaccine booster.

    Age (year)GenderObserved acceptance rates (%)Population according to census 2016Expected number
    18–24Female71.083,878,76259,553,921
    Male77.085,832,49666,091,022
    25–34Female69.097,793,19567,477,305
    Male76.4100,358,86076,674,169
    35–44Female73.1118,780,14186,828,283
    Male80.5123,999,78299,819,825
    45–54Female78.390,208,07270,632,920
    Male86.294,139,65281,148,380
    55–64Female67.769,062,39246,755,239
    Male81.870,917,36458,010,404
    ≥65Female60.649,507,02930,001,260
    Male82.648,430,78340,003,827
    Total75.21,032,908,528782,996,554
    Note: The age- and gender- standardized acceptance rate of a COVID-19 vaccine booster equals 75.8%.
    Abbreviation: COVID-19=coronavirus disease 2019.
    Download: CSV

    TABLE 3.  Influencing factors on COVID-19 vaccine booster preference.

    CharacteristicsCOVID-19 vaccine
    booster preference
    Univariate analysisMultivariate analysis
    No (percentage %)Yes (percentage %)Crude OR
    (95% CI)
    PAdjusted OR
    (95% CI)
    P
    Age group, years
    18–2453 (26.8)145 (73.2)1.19 (0.62, 2.29)0.5961.99 (0.97, 4.10)0.062
    25–34178 (28.2)454 (71.8)1.11 (0.61, 2.02)0.7272.06 (1.09, 3.91)0.026
    35–44119 (24.1)375 (75.9)1.37 (0.75, 2.52)0.3042.24 (1.18, 4.28)0.014
    45–5494 (18.8)405 (81.2)1.88 (1.02, 3.46)0.0442.07 (1.09, 3.94)0.026
    55–6442 (26.4)117 (73.6)1.21 (0.62, 2.37)0.5701.14 (0.56, 2.30)0.719
    ≥6517 (30.4)39 (69.6)Ref.Ref.
    Gender<0.0010.016
    Male154 (19.8)623 (80.2)1.56 (1.26, 1.93)1.33 (1.05, 1.67)
    Female353 (27.8)917 (72.2)Ref.Ref.
    Non-healthcare staff<0.0010.002
    Yes284 (20.7)1,087 (79.3)1.88 (1.53, 2.32)1.50 (1.17, 1.92)
    No223 (33.0)453 (67.0)Ref.Ref.
    Education
    Junior high school and below35 (14.6)205 (85.4)2.65 (1.79, 3.93)<0.0012.64 (1.50, 4.62)0.001
    Senior high school49 (16.7)245 (83.3)2.26 (1.60, 3.20)<0.0012.12 (1.34, 3.35)0.001
    Associate or bachelor219 (25.5)639 (74.5)1.32 (1.05, 1.65)0.0161.26 (0.98,1.63)0.070
    Master and above204 (31.1)451 (68.9)Ref.Ref.
    Income (CNY per month)
    0–2,00071 (23.1)236 (76.9)1.22 (0.89, 1.67)0.2200.64 (0.40, 1.01)0.054
    2,000–5,000114 (21.9)407 (78.1)1.31 (1.00, 1.71)0.0490.83 (0.59, 1.16)0.269
    5,000–10,000136 (25.9)389 (74.1)1.05 (0.81, 1.36)0.7250.86 (0.65, 1.15)0.309
    10,000 and above186 (26.8)508 (73.2)Ref.Ref.
    Residence0.0020.553
    Rural43 (16.9)212 (83.1)1.72 (1.22, 2.43)1.14 (0.74, 1.76)
    Urban461 (25.9)1,322 (74.1)Ref.Ref.
    Flu vaccination history0.0280.039
    Yes194 (22.3)675 (77.7)1.26 (1.03, 1.55)1.26 (1.01, 1.57)
    No/unsure313 (26.6)865 (73.4)Ref.Ref.
    Whether herd immunity works<0.001<0.001
    Yes380 (21.1)1,425 (78.9)4.14 (3.14, 5.46)3.58 (2.69, 4.77)
    No/unsure127 (52.5)115 (47.5)Ref.Ref.
    Whether vaccination help reduce anxiety0.0080.035
    Yes314 (23.0)1,052 (77.0)1.33 (1.08, 1.63)1.27 (1.02, 1.59)
    No193 (28.3)488 (71.7)Ref.Ref.
    Abbreviations: COVID-19=coronavirus disease 2019; OR=odds ratio; CI=confidence interval; CNY=China Yuan; Ref.=reference.
    Download: CSV

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Willingness of the General Public to Receive A COVID-19 Vaccine Booster — China, April–May 2021

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Summary

What is already known about this topic?

A coronavirus disease 2019 (COVID-19) vaccine booster is planned for administration to eligible individuals. Understanding the factors that influence attitudes towards the booster shot will help to identify groups that will most readily accept a booster dose.

What is added by this report?

Of the individuals polled, 75.2% reported they would receive a booster shot. Sociodemographic characteristics influencing booster vaccine acceptance included age, gender, occupation, and education. Moreover, those who had been vaccinated against influenza, who believed herd immunity would be effective against severe acute respiratory syndrome coronavirus 2, and who reported reduced anxiety after vaccination were more likely to accept a booster dose.

What are the implications for public health practice?

A booster shot of the COVID-19 vaccine could be widely accepted. Communicating about the effectiveness of the COVID-19 vaccine and the impact of infection on people’s health could help increase public willingness to get a booster dose.

  • 1. Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
  • 2. Department of Infectious Diseases, Peking University Third Hospital, Beijing, China
  • Corresponding authors:

    Xiaoguang Li, lixiaoguangpuh3@bjmu.edu.cn

    Nan Li, linan917@163.com

  • Funding: Supported by the National Natural Science Foundation of China (Project Number: 81701067, 82101264) and National Major Science and Technology Projects (Project No.2018ZX10732401-003)
  • Online Date: January 28 2022
    doi: 10.46234/ccdcw2022.013
  • On October 11, 2021, the strategic advisory group of experts (SAGE) of the World Health Organization (WHO) recommended that an additional dose of coronavirus disease 2019 (COVID-19) vaccine should be offered to moderately and severely immunocompromised people and to those aged 60 and over who were previously immunized with Sinovac or Sinopharm inactivated vaccines (1). The National Health Commission of the People’s Republic of China (NHC) and the United States Centers for Disease Control Advisory Committee on Immunization Practices (ACIP) are planning a COVID-19 vaccine booster so that vaccinated people can maintain protection over the coming months (2-3). Numerous studies have shown that vaccination willingness is influenced by a variety of factors and that it changes over time (4-5). It is necessary to understand the public’s willingness to receive a COVID-19 vaccine booster. Identifying factors that influence booster vaccine acceptance will aid in determining who is most likely to accept a booster dose.

    Online questionnaires were completed by 2,047 vaccinated Chinese adults in April and May 2021. Respondents’ sociodemographic characteristics, attitudes towards vaccination, and attitudes towards a COVID-19 vaccine booster were collected. All data were analyzed using R statistical software (version 4.0.3, R Core Team, Vienna, Austria). Logistic regression models were built to identify factors associated with respondents’ acceptance of a COVID-19 vaccine booster. The odds ratio (OR) and its corresponding 95% confidence interval (CI) were calculated.

    Of the respondents, 75.2% reported they planned to receive a booster shot. Respondents who expressed significantly higher acceptance of a booster dose tended to be aged 25–54 years old, male, non-healthcare workers, and less educated. Moreover, those who had been vaccinated against influenza (OR=1.26, 95% CI: 1.01–1.57), who believed herd immunity would be effective against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (OR=3.58, 95% CI: 2.69–4.77), or who reported reduced anxiety after vaccination (OR=1.27, 95% CI: 1.02–1.59) were more likely to report planning to receive a booster dose.

    Based on these results, it seems that a booster shot of the COVID-19 vaccine could be widely accepted in China. Communicating to the public the effectiveness of COVID-19 vaccines and the impact of COVID-19 infection on one’s health could increase individuals’ willingness to receive a booster dose.

    In April and May 2021, an online questionnaire was disseminated via WeChat, a Chinese multipurpose social media app. Using WeChat moments, which spread questionnaires by snowballing, 1,656 respondents were recruited. To reduce the risk of bias due to starting with a single sample source, 403 additional respondents were recruited via the Tencent questionnaire sample database. This database contains over 1 million people with verified personal information, and we used the recruitment service to recruit subjects aged ≥18. Incomplete questionnaires were excluded. The final sample consisted of 2,047 respondents. Respondents’ sociodemographic characteristics, flu vaccination history, attitudes towards herd immunity, anxiety levels after initial vaccination, acceptance of a booster shot, and antibody tests were collected. The study was approved by Peking University Third Hospital Medical Science Research Ethics Committee (No. 2021-184-01).

    The age- and gender-standardized acceptance rate of a COVID-19 vaccine booster was calculated using the 2010 population census of China as the reference (6). Logistic regression models were built to identify factors influencing COVID-19 vaccine booster acceptance (event: receiving COVID-19 vaccine booster when available). All data were analyzed using R statistical software. A P-value <0.05 was considered statistically significant.

    Of the 2,047 vaccinated respondents (Table 1), 1,540 (75.2%) reported that they planned to receive a COVID-19 vaccine booster shot when it was available. The age- and gender-standardized acceptance rate was 75.8% (Table 2). In addition, 1,257 (81.6% of those who planned to receive the booster shot) reported that they would receive antibody tests, which could help to determine the effectiveness of the booster dose.

    CharacteristicsWeChat sample (n=1,644)Tencent sample (n=403)
    Age group, years
    18–24184 (11.3)14 (3.5)
    25–34614 (37.6)18 (4.5)
    35–44451 (27.6)43 (10.7)
    45–54254 (15.5)245 (60.8)
    55–6491 (5.6)68 (16.9)
    ≥6541 (2.5)15 (3.7)
    Gender
    Male613 (37.3)164 (40.7)
    Female1,031 (62.7)239 (59.3)
    Non-healthcare staff
    Yes973 (59.2)398 (98.8)
    No671 (40.8)5 (1.2)
    Education
    Junior high school and below105 (6.4)135 (33.5)
    Senior high school78 (4.7)216 (53.6)
    Associate or bachelor809 (49.2)49 (12.2)
    Master and above652 (39.7)3 (0.7)
    Income (CNY per month)
    0–2,000201 (12.2)106 (26.3)
    2,000–5,000300 (18.3)221 (54.8)
    5,000–10,000459 (27.9)66 (16.4)
    10,000 and above684 (41.6)10 (2.5)
    Area type
    Rural1,498 (91.6)285 (70.9)
    Urban138 (8.4)117 (29.1)
    Flu vaccination history
    Yes680 (41.4)189 (46.9)
    No/unsure964 (58.6)214 (53.1)
    Whether herd immunity works
    Yes1,423 (86.6)382 (94.8)
    No/unsure221 (13.4)21 (5.2)
    Whether vaccination
    help reduce anxiety
    Yes1,098 (66.8)268 (66.5)
    No546 (33.2)135 (33.5)
    Note: All data are described in term of “Number (%) of participants”.

    Abbreviation: CNY=China Yuan.

    Table 1.  Characteristics of the study population.

    Age (year)GenderObserved acceptance rates (%)Population according to census 2016Expected number
    18–24Female71.083,878,76259,553,921
    Male77.085,832,49666,091,022
    25–34Female69.097,793,19567,477,305
    Male76.4100,358,86076,674,169
    35–44Female73.1118,780,14186,828,283
    Male80.5123,999,78299,819,825
    45–54Female78.390,208,07270,632,920
    Male86.294,139,65281,148,380
    55–64Female67.769,062,39246,755,239
    Male81.870,917,36458,010,404
    ≥65Female60.649,507,02930,001,260
    Male82.648,430,78340,003,827
    Total75.21,032,908,528782,996,554
    Note: The age- and gender- standardized acceptance rate of a COVID-19 vaccine booster equals 75.8%.
    Abbreviation: COVID-19=coronavirus disease 2019.

    Table 2.  The process of calculating age- and gender- standardized acceptance rate of a COVID-19 vaccine booster.

    COVID-19 vaccine booster acceptance rate was highest among adults aged 45–54 years (81.2%) and lowest among adults aged ≥65 years (69.6%). Male respondents were more likely than female respondents to accept a COVID-19 vaccine booster (80.2% vs. 72.2%), and those who were not healthcare workers were more likely to accept a booster dose than healthcare workers (79.3% vs. 67.0%). Respondents who held a bachelor’s degree or below were more likely to accept a booster dose (68.9%, 74.5%, 83.3%, vs. 85.4%). Vaccine booster acceptance was slightly higher among respondents who earned <5,000 CNY per month (77.7% vs. 73.6%). Respondents who lived in rural areas were more likely to accept a booster dose (83.1% vs. 74.1%). Moreover, those who had been vaccinated against influenza (77.7% vs. 73.4% who had not been), who believed herd immunity would be effective against SARS-CoV-2 (78.9% vs. 47.5% who did not believe this), and who reported reduced anxiety after vaccination (77.0% vs. 71.7% who did not report this) were more likely to accept a booster dose.

    The multiple logistic regression model identified the people most likely to get the booster dose as soon as it was available (Table 3). Those who expressed significantly higher acceptance of a booster dose included respondents who were: 25–34 years old (OR=2.06, 95% CI: 1.09–3.91); 35–44 years old (OR=2.24, 95% CI: 1.18–4.28); 45–54 years old (OR=2.07, 95% CI: 1.09–3.94); male (OR=1.33, 95% CI: 1.05–1.67); and non-healthcare workers (OR=1.50, 95% CI: 1.17–1.92). Booster shot acceptance was also higher among those who had: a junior high school level of education or below (OR=2.64, 95% CI: 1.50–4.62); a high school level of education (OR=2.12, 95% CI: 1.34–3.35); and who had been vaccinated against influenza (OR=1.26, 95% CI: 1.01–1.57). Finally, those who believed herd immunity would be effective against SARS-CoV-2 or who reported reduced anxiety after vaccination were more likely to accept a booster dose (OR=3.58, 95% CI: 2.69–4.77 and OR=1.27, 95% CI: 1.02–1.59, respectively).

    CharacteristicsCOVID-19 vaccine
    booster preference
    Univariate analysisMultivariate analysis
    No (percentage %)Yes (percentage %)Crude OR
    (95% CI)
    PAdjusted OR
    (95% CI)
    P
    Age group, years
    18–2453 (26.8)145 (73.2)1.19 (0.62, 2.29)0.5961.99 (0.97, 4.10)0.062
    25–34178 (28.2)454 (71.8)1.11 (0.61, 2.02)0.7272.06 (1.09, 3.91)0.026
    35–44119 (24.1)375 (75.9)1.37 (0.75, 2.52)0.3042.24 (1.18, 4.28)0.014
    45–5494 (18.8)405 (81.2)1.88 (1.02, 3.46)0.0442.07 (1.09, 3.94)0.026
    55–6442 (26.4)117 (73.6)1.21 (0.62, 2.37)0.5701.14 (0.56, 2.30)0.719
    ≥6517 (30.4)39 (69.6)Ref.Ref.
    Gender<0.0010.016
    Male154 (19.8)623 (80.2)1.56 (1.26, 1.93)1.33 (1.05, 1.67)
    Female353 (27.8)917 (72.2)Ref.Ref.
    Non-healthcare staff<0.0010.002
    Yes284 (20.7)1,087 (79.3)1.88 (1.53, 2.32)1.50 (1.17, 1.92)
    No223 (33.0)453 (67.0)Ref.Ref.
    Education
    Junior high school and below35 (14.6)205 (85.4)2.65 (1.79, 3.93)<0.0012.64 (1.50, 4.62)0.001
    Senior high school49 (16.7)245 (83.3)2.26 (1.60, 3.20)<0.0012.12 (1.34, 3.35)0.001
    Associate or bachelor219 (25.5)639 (74.5)1.32 (1.05, 1.65)0.0161.26 (0.98,1.63)0.070
    Master and above204 (31.1)451 (68.9)Ref.Ref.
    Income (CNY per month)
    0–2,00071 (23.1)236 (76.9)1.22 (0.89, 1.67)0.2200.64 (0.40, 1.01)0.054
    2,000–5,000114 (21.9)407 (78.1)1.31 (1.00, 1.71)0.0490.83 (0.59, 1.16)0.269
    5,000–10,000136 (25.9)389 (74.1)1.05 (0.81, 1.36)0.7250.86 (0.65, 1.15)0.309
    10,000 and above186 (26.8)508 (73.2)Ref.Ref.
    Residence0.0020.553
    Rural43 (16.9)212 (83.1)1.72 (1.22, 2.43)1.14 (0.74, 1.76)
    Urban461 (25.9)1,322 (74.1)Ref.Ref.
    Flu vaccination history0.0280.039
    Yes194 (22.3)675 (77.7)1.26 (1.03, 1.55)1.26 (1.01, 1.57)
    No/unsure313 (26.6)865 (73.4)Ref.Ref.
    Whether herd immunity works<0.001<0.001
    Yes380 (21.1)1,425 (78.9)4.14 (3.14, 5.46)3.58 (2.69, 4.77)
    No/unsure127 (52.5)115 (47.5)Ref.Ref.
    Whether vaccination help reduce anxiety0.0080.035
    Yes314 (23.0)1,052 (77.0)1.33 (1.08, 1.63)1.27 (1.02, 1.59)
    No193 (28.3)488 (71.7)Ref.Ref.
    Abbreviations: COVID-19=coronavirus disease 2019; OR=odds ratio; CI=confidence interval; CNY=China Yuan; Ref.=reference.

    Table 3.  Influencing factors on COVID-19 vaccine booster preference.

    • This survey demonstrated that most of the vaccinated respondents (75.2%) would accept a COVID-19 vaccine booster shot when it became available. Although data on the efficacy and safety of the booster shot are still lacking, booster shots have a higher level of acceptance now than earlier doses of the vaccines did (4). Multiple studies have shown that vaccine acceptance changes over time, and the proportion of people who accept a vaccine may rise as the pandemic continues to fluctuate and the safety of vaccines is properly reported (4-5). Sociodemographic characteristics were important factors affecting the acceptability of the COVID-19 vaccine booster. Respondents who were aged 25–54 years old, male, non-healthcare workers, and less educated expressed significantly higher acceptance of the booster dose. According to WHO recommendations, people aged 60 or older who received inactivated vaccines should receive booster shots. The relatively low acceptance among people over 60 is therefore of great concern.

      Moreover, those who had been vaccinated against influenza (OR=1.26, 95% CI: 1.01–1.57), who believed herd immunity would be effective against SARS-COV-2 (OR=3.58, 95% CI: 2.69–4.77) or who reported reduced anxiety after vaccination (OR=1.27, 95% CI: 1.02–1.59) were more likely to accept a booster dose. These results suggest that strong confidence in the vaccines would lead to more people getting vaccinated, which is consistent with previous studies (7-8). Therefore, efforts focused on clearly communicating to the public the effectiveness and safety of the COVID-19 booster vaccination and the risk of getting sick and dying from COVID-19 could help increase public willingness to get vaccinated.

      This is the first study to address public acceptance of a booster shot of COVID-19 vaccines, and we find that they are likely to be widely accepted. This survey identifies priority groups to target for COVID-19 vaccine booster shots, which is of crucial importance in public health policy implementation (9).

      This study was subject to some limitations. First is that convenience sampling was used, which may affect the representativeness of the individuals sampled compared to the population as a whole. The epidemic was relatively stable when the survey was conducted and therefore not causing a great amount of panic among members of the public, which suggests that this sample provided some insight to public willingness to get a booster dose. Second, acceptance of a COVID-19 vaccine booster could also be influenced by information spread in the media and on social networks, including the local number of daily confirmed cases, the capacity of healthcare services, and relevant policies in different areas. However, we are unable to consider these issues in this study due to unavailability of the data. Further investigation is therefore needed in the future.

    • No conflicts of interest declared.

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