Understanding low COVID-19 booster uptake among US adults

Area of Science:

• Public Health
• Epidemiology
• Vaccinology

Background:

• COVID-19 vaccines reduce severe disease, but bivalent booster uptake is low (<20%) in the US.
• Understanding barriers to booster uptake is critical for public health initiatives.

Purpose of the Study:

• To identify and analyze the reasons individuals have not received the bivalent COVID-19 booster.
• To assess demographic associations with specific reasons for non-receipt of the bivalent booster.

Main Methods:

• Survey administered to 2196 adult participants in the Arizona CoVHORT cohort.
• Data collected on bivalent booster receipt and reasons for non-receipt.
• Descriptive statistics and multivariable logistic regression analyzed participant characteristics and reasons for non-vaccination.

Main Results:

• Prior SARS-CoV-2 infection (39.5%) was the most common reason for not getting boosted.
• Concerns about vaccine side effects (31.5%), perceived lack of additional protection (28.6%), and safety concerns (23.4%) were also significant barriers.
• Older adults were less concerned about knowledge or logistical issues, while Hispanic individuals reported more logistical concerns. Those with some college education were more likely to cite unclear risks and benefits.

Conclusions:

• Low bivalent booster uptake presents a public health challenge in the US.
• Targeted interventions addressing specific concerns (e.g., safety, effectiveness, logistics, clarity of information) are needed to improve vaccination rates.
• Developing and implementing effective strategies to increase booster uptake is essential for ongoing pandemic management.