Uptake and hesitancy of the second booster dose of COVID-19 vaccine among the general population in China after the surge period of the COVID-19 pandemic: a large-scale national study.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968562 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2458 (Electronic) Linking ISSN: 14712458 NLM ISO Abbreviation: BMC Public Health Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

COVID-19 Vaccines*/administration & dosage ; COVID-19*/prevention & control ; COVID-19*/epidemiology ; Vaccination Hesitancy*/statistics & numerical data ; Vaccination Hesitancy*/psychology ; Immunization, Secondary*/statistics & numerical data ; Immunization, Secondary*/psychology; Humans ; China/epidemiology ; Female ; Male ; Cross-Sectional Studies ; Adult ; Middle Aged ; Young Adult ; Adolescent ; Aged ; Pandemics/prevention & control ; SARS-CoV-2

Background: Although the second booster dose of COVID-19 vaccines is available, vaccine hesitancy among the public may have peaked due to the surge in infections caused by the Omicron variant. To improve coverage of the second booster dose, it is crucial to investigate the prevalence of vaccine hesitancy among the general population during this period and explore the reasons for this phenomenon.
Methods: A cross-sectional survey was conducted between January 5 to February 9, 2023. Variables including sociodemographics, mental health, COVID-19 infection status, COVID-19 vaccination status, and vaccine hesitancy were collected. Univariate and multivariate logistic regression analysis were performed to identify factors associated with the hesitancy of the second booster dose of COVID-19 vaccine among the general population.
Results: Among the 10,623 participants, the uptake rate of the second booster dose was 4.3%. Among those who did not receive the second booster dose, 43.6% expressed vaccine hesitancy. The highest hesitancy rate was observed among participants who had not completed primary immunization (71.4%), followed by those with chronic diseases (48.6%) and those aged 60 and above (33.2%). The COVID-19 vaccine hesitancy was higher among females, participants with high incomes, those with a history of COVID-19 infection, those with depressive symptoms and post-traumatic stress disorder, and those with adverse events after COVID-19 vaccination. Conversely, lower hesitancy was observed among students, participants aged 60 and above, those from southern China, and those with higher level of perceived social support.
Conclusions: COVID-19 vaccine hesitancy remains prevalent among the general population in China after the surge period of the pandemic. Crucial steps, such as raising public awareness of the benefits and potential side effects of regular COVID-19 vaccination, ensuring timely monitoring and disclosure of pandemic information, and implementing targeted measures to improve social support and mental health, should be taken. These efforts will be instrumental in reducing vaccine hesitancy, advancing vaccination campaigns, and effectively preparing for the potential future outbreaks.
Competing Interests: Declarations. Ethics approval and consent to participate: The study was conducted in accordance with the Declaration of Helsinki and was approved by the Ethics Committee of Peking Union Medical College (Approval number: CAMS&PUMC-IEC-2022–83). Informed consent was obtained from all participants. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.
(© 2025. The Author(s).)

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2020-I2M-2-015 Chinese Academy of Medical Sciences

Keywords: COVID-19; General population; Second booster dose; Vaccine hesitancy

0 (COVID-19 Vaccines)

Date Created: 20250207 Date Completed: 20250208 Latest Revision: 20250210

20250210

PMC11803999

10.1186/s12889-025-21691-x

39920639