The Perfect Enemy | US adults cite misbeliefs about eligibility, immunity for not getting COVID booster
February 8, 2023

US adults cite misbeliefs about eligibility, immunity for not getting COVID booster

The most-cited reasons for not getting new COVID-19 boosters were lack of awareness about eligibility and overestimations of their own existing immunity.

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An online survey of 1,200 previously vaccinated US adults reveals that the most-cited reasons for not getting a bivalent (two-strain) COVID-19 booster dose were lack of awareness about eligibility and overestimations of their own existing immunity.

A team led by Duke University researchers conducted the opt-in survey, published today in Morbidity and Mortality Weekly Report, from Nov 1 to 5, 2022, with an unannounced follow-up survey from Dec 6 to 10.

All respondents had received at least two doses of COVID-19 vaccine, 34.4% had received the bivalent booster, 65.4% were White, 51.9% were women, and the proportions of participants in all age-groups were roughly equal.

The researchers noted that the Centers for Disease Control and Prevention (CDC) first recommended a bivalent booster for people 12 years and older on Sep 1, 2022. As of today, however, only 15.3% of Americans have gotten one.

Good intentions, low follow-through

The 396 participants who received a booster said they did so to protect themselves (90.7%) and others (75.0%) and to prevent severe disease (80.6%).

The most common reasons for not receiving a booster were lack of awareness of eligibility (23.2%) or of vaccine availability (19.3%) and overconfidence in their immunity (18.9%). Over half of those overestimating their immunity had never been infected, and nearly 72% hadn’t been infected or received a vaccine dose in the past 6 months.

Health care and public health professionals should use evidence-based strategies … while also working to increase convenient access.

After participants were given information on eligibility and availability, 67.8% of those who hadn’t gotten a booster said that they would pursue one; a survey 1 month later showed that 28.6% of these participants had done so.

Of those who said they would receive a booster but hadn’t done so, 82.6% said they still planned to. The most often-cited reasons for not having gotten one were that they were too busy (35.6%), forgot (22.7%), or were worried about side effects (22.7%).

“To help increase bivalent booster dose coverage, health care and public health professionals should use evidence-based strategies to convey information about booster vaccination recommendations and waning immunity, while also working to increase convenient access,” the authors wrote.