Factors associated with COVID-19 booster vaccine hesitancy: a nationwide, cross-sectional survey in Japan

Objectives: COVID-19 vaccine hesitancy/fatigue is increasing as the pandemic enters the endemic phase. The present study aimed to explore current perceptions about COVID-19 booster vaccination among the Japanese public. Study design: This was a cross-sectional study. Methods: This cross-sectional study used data from the Japan COVID-19 and Society Internet Survey conducted in September 2021 and September 2022. The public's perceptions of COVID-19 vaccination and factors associated with COVID-19 booster vaccine hesitancy were analyzed. Results: In total, 56,735 respondents were included. In the Japan COVID-19 and Society Internet Survey 2021, 75.1% of the participants (21,126/28,118) had completed the primary vaccination series. In the 2022 survey, 74.1% of the respondents (21,216/28,617) completed the primary series of vaccination with booster doses. The proportion of fear toward COVID-19 and obtaining information about COVID-19 has decreased from 2021 to 2022. Factors independently associated with booster vaccine hesitancy were young age (range: 18-29 years; adjusted odds ratio [aOR]: 6.56), history of COVID-19 (aOR: 1.82), distrust of the Japanese government's COVID-19 prevention measures (aOR: 1.55), lack of confidence in COVID-19 vaccine efficacy (aOR: 1.30), lack of confidence in COVID-19 vaccine safety (aOR: 1.62), low reliance on the COVID-19 vaccine (aOR: 1.92), and belief in COVID-19 conspiracy theories (aOR: 1.77). Conclusions: Providing clear and trustworthy information is critically important, especially targeted and tailored messages for the young generation, to promoting COVID-19 booster vaccination. Policymakers should therefore develop consistent and transparent communication strategies and the ability to respond promptly and flexibly to mitigate the negative impact of COVID-19 on the public while preparing for the next pandemic. (c) 2023 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Automated summary

This study explored the current perceptions about COVID-19 booster vaccination among the Japanese public. The results showed that factors such as young age, history of COVID-19, distrust of the government's prevention measures, lack of confidence in vaccine efficacy and safety, low reliance on the vaccine, and belief in conspiracy theories were associated with booster vaccine hesitancy. Clear and trustworthy information, especially targeted and tailored messages for the young generation, are important for promoting COVID-19 booster vaccination.