Determinants of COVID-19 vaccine booster hesitancy among outpatients completing the primary scheme in Turkey

Abstract

Objective: To examine the change in COVID-19 booster vaccine hesitancy according to descriptive characteristics, characteristics related to COVID-19, health literacy (HL) skills related to booster dose.

Methods: The inclusion criterion was the completion of the primary scheme as two doses of COVID-19 vaccine. The study was conducted in January 2022 by applying face-to-face interview technique. Questions regarding HL were used to question the ability of individuals to access, understand, interpret and use information regarding the COVID-19 booster dose in their decisions.

Results: A total of 1 210 people were included in this study with an mean age of (41.3±16.6) years, and 51.4% were women. In multivariate analysis, hesitation increased in the “moderately concerned” (aOR 2.65, 95% CI 1.09-6.45), “slightly concerned” (aOR 3.1, 95% CI 1.26-7.19), “not concerned at all” (aOR 5.69, 95% CI 2.27-14.28) groups compared to the group “extremely concerned” about COVID-19 transmission. Those with Sinovac-CoronaVac as their most recent vaccine had increased hesitation compared to those with Pfizer-BioNTech (aOR 3.68, 95% CI 2.05-6.61). The effect of HL skills including “accessing”, “understanding”, and “appraising” information on hesitation was not statistically significant (P>0.05). HL skill of “applying” was assessed with ability of information to help decision making. Whether the information is helpful for decision-making, the risk of hesitancy increased for those who stated that it “sometimes helps” (aOR 2.55; 95% CI 1.31-4.99) and “never helps” (aOR 11.62; 95% CI 3.03-44.58) compared to those who stated that it “always helps”.

Conclusions: The increased propability of hesitation in those less concerned about COVID-19 transmission shows the importance of appropriately guiding individuals’ concern levels with a health communication strategy based on risk communication. The fact that the only HL skill with a significant effect in the multivariate model was “applying”, shows the critical role of this skill in influencing behavioral changes.

Keywords

COVID-19 / Vaccine hesitancy / Booster hesitancy / Health literacy / Risk communication

Conflict of interest statement

We declare that we have no conflict of interest.

Funding

There is no funding support fort his study.

Ethical approval

The Gazi University Ethics Committee approved the study with Research Code No: 2022-270.

Authors’ contributions

Conceptualization; Hakan Tüzün, Mehmet A. Özçelik; Literature searches and data extraction: Hakan Tüzün, Cansu Özbaş, Mehmet A. Özçelik; Analysis: Hakan Tüzün, Mehmet A. Özçelik; Writing and Review: Hakan Tüzün, Mehmet A. Özçelik, Cansu Özbaş; Editing: Hakan Tüzün, Mustafa N. İlhan; Supervision: Hakan Tüzün, Cansu Özbaş, Mustafa N. İlhan. All authors reviewed the manuscript and confirmed the approval of the submitted manuscript.

Publisher’s note

The Publisher of the Journal remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Editde by Lei Y, Zhang Q, Pan Y

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