Acceptance of COVID-19 booster vaccination based on the protection motivation theory: A cross-sectional study in China

The promotion of the booster shots against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is an open issue to be discussed. Little is known about the public intention and the influencing factors regarding the booster vaccine. A cross-sectional survey in Chinese adults was conducted using an online questionnaire, which designed on the basis of protection motivation theory (PMT) scale and vaccine hesitancy scale (VHS). Hierarchical multiple regression was used to compare the fitness of the PMT scale and VHS for predicting booster vaccination intention. Multivariable logistic regression was used to analyze the factors associated with the acceptance. Six thousand three hundred twenty-one (76.8%) of participants were willing to take the booster shot. However, the rest of the participants (23.2%) were still hesitant to take the booster vaccine. The PMT scale was more powerful than the VHS in explaining the vaccination intention. Participants with high perceived severity (adjusted odds ratio [aOR] = 0.69) and response cost (aOR = 0.47) were less willing to take the booster shots, but participants with high perceived susceptibility (aOR = 1.19), response efficacy (aOR = 2.13), and self-efficacy (aOR = 3.33) were more willing to take the booster shots. In summary, interventions based on PMT can provide guidance to ensure the acceptance of the booster vaccine.

Automated summary

This study investigated the acceptance intention and influencing factors of booster shots in Chinese adults. The results showed that 76.8% of participants were willing to take the booster shot, while 23.2% were still hesitant. The protection motivation theory (PMT) was more effective in explaining vaccination intention compared to the vaccine hesitancy scale (VHS). Factors such as perceived severity, response cost, susceptibility, efficacy, and self-efficacy had an impact on the willingness to take the booster shots.