Barriers to initial COVID-19 booster among US adults who completed a primary vaccine series in the CHASING COVID cohort, September 2021–October 2022

• Rane, Madhura S ^[1] ; Shen, Yanhan ^[1] ; Robertson, Mc Kaylee ^[1] ; Penrose, Kate ^[1] ; Srivastava, Avantika ^[1] ; Puzniak, Laura ^[2] ; Allen, Kristen E ^[2] ; Porter, Thomas M ^[2] ; Kulkarni, Sarah ^[1] ; You, William ^[1] ; Berry, Amanda ^[1] ; Parcesepe, Angela M ^[1] ; Grov, Christian ^[1] ; Zimba, Rebecca ^[1] ; Nash, Denis ^[1]
  1. [1] City University of New York

     City University of New York

     Estados Unidos

     
  2. [2] Pfizer Inc. , New York, NY ,
• Localización: American journal of epidemiology, ISSN-e 1476-6256, ISSN 0002-9262, Vol. 194, Nº. 5, 2025, págs. 1341-1351
• Idioma: inglés
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• Resumen

  • Abstract It is crucial to understand factors associated with COVID-19 booster uptake in the United States given the updated COVID-19 vaccine recommendations. Using data from a national prospective cohort (n = 4616) between September 2021 and October 2022, we examined socioeconomic, demographic, and behavioral factors of initial booster uptake among participants fully vaccinated with the primary COVID-19 vaccines series. Cox proportional hazards models were used to estimate the associations of each factor with time to initial booster uptake. Most participants (86.5%) reported receiving their initial booster. After adjusting for age, race/ethnicity, education, region, and employment, participants with greater risk for severe COVID-19 had similar booster uptake compared with those with lower risk (adjusted hazard ratio [aHR], 1.04; 95% CI, 0.95-1.14). Participants with greater barriers to healthcare (aHR, 0.89; 95% CI, 0.84-0.96), food insecurity (aHR, 0.82; 95% CI, 0.75-0.89), and housing instability (aHR, 0.81; 95% CI, 0.73-0.90) were less likely to report receiving initial booster compared with those without those barriers. Factors motivating the decision to vaccinate changed from safety-related concerns for the primary series to perceived need for the booster. It is key to address economic and health access barriers to achieve equitable COVID-19 vaccine uptake and continued protection against COVID-19.