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Variations in Uptake of COVID-19 Booster Doses in Fully Vaccinated Adults in the United States

September 12, 2022

COVID-19 vaccines are an important preventative measure against the spread of infections and reduce the risk of severe illness and premature death. Between December 2020 and February 2021, the U.S. Food and Drug Administration issued an Emergency Use Authorization for three vaccines with high efficacy, namely, Ad26.COV2.S (Johnson & Johnson–Janssen), mRNA-1273 (Moderna), and BNT162b2 (Pfizer-BioNTech). Since then, both the Moderna and Pfizer-BioNTech vaccines have been fully approved for use. To boost immunity and provide increased protection against emerging strains, booster doses are recommended for individuals who have completed the initial vaccine schedule.

Many factors might affect an individual’s decision to receive a booster dose. Understanding how underlying geographic, occupational, and sociodemographic factors influence the receipt of booster doses among the fully vaccinated can help inform any future efforts to increase coverage and protection of the population.

In a paper recently published in JAMA Network Open, Executive Director Dr. Ted Long, the Senior author on the paper, along with other colleagues from NYC Test and Trace Corps, investigated how the uptake of COVID-19 booster doses among fully vaccinated US adults varied by geographic location, occupation, and sociodemographic characteristics during December 1, 2021 to January 10, 2022.

Read more about the study here: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2795410

Key points:

  • Study data were obtained from the Household Pulse Survey (HPS) which is an ongoing, biweekly, national and state-specific, COVID-19–related, cross-sectional survey of US adults aged 18 years or older.
  • In the New York Metropolitan area, 46.0% of all fully vaccinated adults had received a booster dose.
  • There were wide variations in booster coverage even among workers in the same industry. For example, within health care facilities nationwide, booster coverage was higher among those working in hospitals compared with those working in a pharmacy, even with similar rates of initial COVID-19 vaccine completion.
  • Barriers to the receipt of booster doses may be different from those against the initial doses. While hesitancy in receiving an initial dose has been shown in previous studies to be associated with fear of unknown side effects, perceived low susceptibility to COVID-19, or not having a severe illness in the instance of a breakthrough infection, may be reasons that may explain a lower uptake of booster doses. In the current study for example, COVID-19 survivors were 30% less likely to receive a booster dose among those fully vaccinated.
  • These findings underscore the need for intensified efforts to increase booster vaccine receipt among subgroups with low coverage.