Association Between Community Distress and COVID-19 Booster Dose Hesitancy in the US

The COVID-19 pandemic has resulted in significant global morbidity and mortality. While primary vaccination efforts successfully reduced severe outcomes, the evolution of the SARS-CoV-2 virus has necessitated booster vaccinations to maintain immunity. Despite their efficacy, hesitancy toward booster doses threatens vaccine uptake. A study published in Vaccines analyzed the association between community distressed and COVID-19 booster dose hesitancy in the US.

The cross-sectional study analyzed data from a nationwide survey conducted from July 14 to July 19, 2021, using a psychometrically validated 48-item questionnaire. Participants were categorized into quintiles of community distress based on their zip codes using the Distressed Communities Index (DCI), which assesses socioeconomic indicators such as poverty rates, educational attainment, and employment levels. It included 2138 US adults aged 18 years and older and evaluated for attitudes toward vaccinations, vaccine literacy, and trust in vaccine safety, efficacy, and the health care system.

Among the 2138 participants, 61.8% intended to receive a booster dose, while 38% did not. A significantly larger proportion of residents in distressed communities reported hesitancy (42.9%) compared with those in prosperous communities (33.8%; P = .05). Participants from distressed communities also exhibited significantly lower trust in vaccine information (26.6% vs 37.6%; P < .001) and lower COVID Vaccine Confidence Index (VCI) scores (1.70 ± 1.01 vs 2.22 ± 1.13; P < .001).

The study highlights the significant influence of community distress on COVID-19 booster hesitancy. Findings support the development of tailored, community-level interventions to address booster hesitancy, such as educational initiatives, pop-up vaccination sites in distressed areas, and partnerships with community leaders to build trust. Addressing disparities promotes equitable vaccine uptake and enhances pandemic resilience.

“There is a significant association between community distress level and vaccine literacy, vaccine confidence, and trust in vaccine information. These components impact the vaccine hesitancy level of communities and are areas to be addressed in designing interventions to ameliorate vaccine inequity,” the researchers concluded.

Reference

Krasner H, Harmon N, Martin J, Olaco CA, Netski Dm, Batra K. Community level correlates of COVID-19 booster vaccine hesitancy in the United States: a cross-sectional analysis. Vaccines. 2024;12(2):167. doi:10.3390/vaccines12020167