Vaccine Refusal Research Articles

COVID-19 vaccines and mental health

ABSTRACT In this study, we aimed to examine the impacts of COVID-19 vaccines on mental health and relationships between psychological factors and vaccine acceptance in Turkey during the early pandemic period. The study included 1042 adults (70.9% females) with a mean age of 29.55 (SD = 10.29). The results showed that vaccinated participants had lower levels of COVID-19-induced anxiety and depression, and higher levels of life satisfaction compared to those without the vaccine. Furthermore, we found that COVID-19-induced anxiety and protective behaviours towards COVID-19 significantly increased the probability of vaccine acceptance, while depression significantly decreased it. Accordingly, governments should consider the mental health consequences of vaccination, as well as vaccine acceptance and refusal. More attention should be paid to psychological factors associated with attitudes towards the COVID-19 vaccine.

P692 An IBD nurse-led educational programme on safety and efficacy of adjuvated recombinant zoster vaccine can improve vaccine uptake in IBD patients on immunosuppressive treatment

Abstract Background Herpes Zoster (HZ) represents one of the most frequent opportunistic infections in IBD patients under immunosoppressive treatment and can be prevented by vaccination. Adjuvated recombinant zoster vaccine (RZV) is the first HZ vaccine approved for immunocompromised persons. IBD patients are less likely to receive appropriate vaccinations compared to the general population. IBD nurses operate as the primary point of contact for patients and this unique position provides a suitable opportunity to positively impact patient care and encourage vaccination. We aimed to improve RZV vaccination rates by a nurse-led education intervention within an on-site RZV vaccination programme. Methods IBD patients on immunosuppressive therapies were actively recruited by phone contact, mail and during outpatient clinic or infusion centre attendance. Prior immunization to VZV was collected from medical records. Patients were randomly assigned to receive either standard explanation on the importance of HZ vaccination by the IBD attending physician (group P) or additional education by an IBD nurse (group N). Patients in group N were referred to an IBD nurse for an individual 15 minutes nurse–patient interview. During the interview, disease activity and current treatment, previous immunization to VZV and history of HZ were reviewed; the importance, benefits and safety of HZ vaccination with RZV were discussed with the patient. Patients were then referred to dedicated on-site vaccination clinics where vaccine administration was provided by the IBD nurses running the infusion centre. Reasons for vaccine refusal was also recorded. Results From February to April 2022, 164 (80%) out of 205 eligible patients were enrolled (median age 48.5 years, 54.1% male; 48.7% UC, 51.3% CD); 65 patients (39.6%) were randomized to group P and 99 patients (60.4%) to group N. Six months after randomization, 112 (68.2%) had received at least 1 RZV vaccine dose whereas vaccination was completed in 110 patients (67%). Vaccination rate was significantly higher in the nurse-led education intervention group compared to standard clinical care (group N 75.7% vs group P 56.9%,p<0.05). Most common reasons for vaccine hesitancy were concerns about side effects (40.9%), fear of vaccine aggravating the disease (14.7%), considering themselves not at risk (13.3%) and objection to the administration of vaccine (10.1%). Conclusion Vaccination recommendations should be responsibility of the IBD patient care team and efforts should be made to reduce vaccine hesitancy. We showed that a simple nurse-led educational intervention on vaccine safety and efficacy was able to improve RVZ vaccination rates in IBD patients on immunosuppressive treatment.

P1155 Impact of COVID19 pandemic and vaccination among IBD patients: a multinational cross sectional survey

Abstract Background The aim of current study is to evaluate impact of COVID19 pandemic and vaccination against it on the course and symptoms of IBD. Methods During a six months’ period, all of the IBD cases who attend in outpatient clinics of nine referral centers in 6 countries include and request to fill a questionnaire about their demographic characters and pattern of IBD, any history of involvement with COVID19 and their vaccination history. Results overall 812 cases from 16 countries included (52.4% male) with average age of 36.8 y (range 7 – 76). 68.5% of participants diagnosed as UC and 29.5% as CD. 80% of participants have vaccinated against COVID19 (average 2.3 times, range 1 – 5). Among those who vaccinated (group A) 31.6% experienced side effects and complication without any mortality. The most common complications of vaccination include fever (24%), fatigue (20.1%) and anorexia 8.6%. The most common reasons for vaccination refusal (group B) were fear of vaccine complication (55.5%), no believe in vaccine protection (29.6%) and fear of immunocompromised condition (17.9%). In group A overall 61% of participants involved with COVID 19 (36.2% after vaccination) in comparison with 48.1% in group B (P = 0.0052). Most of the involvements in both groups were not sever and just a minority of patients admitted to hospital (10% in group A and 6.4% in group B). Following COVID involvement, 45.1% of cases suffered with GI symptoms (mostly diarrhea (72.5%) and abdominal pain (64.5%)). In group A, 37.3% of involvements have happened before vaccination. Conclusion Vaccination against COVID19 is safe and effective among IBD patients and following vaccination, most of complications are minor and negligible. In case of COVID involvement, it would not be serious and there is no need to hold the medications. Among IBD patients, the most common reason for vaccination refusal is fear of vaccine side effect.

The mental health symptoms of individuals with sensory disabilities and the reasons that lead to COVID-19 vaccine refusal and hesitancy

The relationship between the reasons for COVID-19 vaccine hesitancy or refusal among people with sensory disabilities and mental health conditions (MHCs) are unclear. Data from the Census Bureau’s Household Pulse Survey were analyzed to examine reasons for COVID-19 vaccination refusal among persons with sensory disabilities. Multivariable logistic and polytomous regression were used to examine the relationships among sensory disability status, MHC, and reasons for vaccine refusal and hesitancy. Individuals with sensory disabilities had higher proportion of anxiety and depression than those without a sensory disability. Individuals with a sensory disability and MHCs were less likely to obtain a vaccine and have a general distrust in the COVID-19 vaccine and the government than those without a disability or a MHC. These findings can assist in tailoring messages and developing programs to increase COVID-19 vaccination trust and uptake among individuals with disabilities and MHCs.

Characterizing predictors of COVID-19 vaccine refusal in an urban southern California jail population

BackgroundCorrectional populations have been disproportionately affected by COVID-19, and many large outbreaks have occurred in jails and prisons. Vaccination is a key strategy to reduce the SARS-CoV-2 transmission in carceral settings. Although implementation can be challenging due to vaccine hesitancy and medical mistrust, correctional settings provide largely equitable healthcare access and present a unique opportunity to identify potential predictors of vaccine hesitancy independent of access issues. MethodsWe retrospectively analyzed electronic health record data for individuals offered COVID-19 vaccination at the Los Angeles County Jail between January 19, 2021, and January 31, 2023, and used multivariable logistic regression to determine predictors of COVID-19 vaccine refusal. ResultsOf the 21,424 individuals offered COVID-19 vaccination, 2,060 (9.6 %) refused. Refusal was associated with male sex ([aOR] = 2.3, 95 % CI (1.9, 2.8)), age 18–34 ([aOR] = 1.2, 95 % CI (1.1, 1.4), referent group: age 45–54), Black race ([aOR] = 1.2, 95 % CI (1.1, 1.4)), reporting ever being houseless ([aOR] = 1.2, 95 % CI (1.1, 1.3)), and having a history of not receiving influenza vaccination while incarcerated ([aOR] = 2.4, 95 % CI (2.0, 2.8)). When analyzing male and female populations separately, male-specific trends reflected those seen in the overall population, whereas the only significant predictor of vaccine refusal in the female population was not receiving influenza vaccination while in custody ([aOR] = 6.5, 95 % CI (2.4, 17.6)). ConclusionIdentifying predictors of vaccine refusal in correctional populations is an essential first step in the development and implementation of targeted interventions to mitigate vaccine hesitancy.

The duty of care and the right to be cared for: is there a duty to treat the unvaccinated?

Vaccine hesitancy or refusal has been one of the major obstacles to herd immunity against Covid-19 in high-income countries and one of the causes for the emergence of variants. The refusal of people who are eligible for vaccination to receive vaccination creates an ethical dilemma between the duty of healthcare professionals (HCPs) to care for patients and their right to be taken care of. This paper argues for an extended social contract between patients and society wherein vaccination against Covid-19 is conceived as essential for the protection of the right of healthcare providers to be taken care of. Thus, a duty of care is only valid when those who can receive vaccination actually receive it. Whenever that is not the case, the continuing functioning of HCPs can only be perceived as supererogatory and not obligatory.

Prevalence of intentions to receive monkeypox vaccine. A systematic review and meta-analysis

BackgroundImmunization, as a preventive strategy against infectious diseases, has consolidated its position as a fundamental pillar in the field of public health. Therefore, the present study aimed to determine the prevalence of the intention to receive the monkeypox (Mpox) vaccine.MethodsA systematic review and meta-analysis of the available evidence was performed using five databases (PubMed, Scopus, Web of Science, Embase, and ScienceDirect) with a search strategy until July 24, 2023. Data analysis was performed in R software version 4.2.3. The quality of the included cross-sectional studies was assessed using the “JBI-MAStARI”. In addition, a subgroup analysis by population and continent was developed.ResultsTwenty-nine cross-sectional articles with a total sample of 52 658 participants were included. The pooled prevalence of intention to vaccinate against Mpox was 61% (95% CI: 53–69%; 52,658 participants; 29 studies; I2 = 100%). In the subgroup analysis, the intention to be vaccinated against Mpox according to continents was 64% (95% CI: 53–74%; 13,883 participants; 17 studies; I2 = 99%) in Asian countries, 43% (95% CI: 39–47%; 1538 participants; 3 studies; I2 = 53%) in African countries, 62% (95% CI: 45–78%; 35,811 participants; 6 studies; I2 = 99%) in European countries, and 63% (95% CI: 32–89%; 1426 participants; 3 studies; I2 = 99%) in American countries. In the subgroup analysis on the intention to be vaccinated against Mpox, according to study subjects, it was 54% (95% CI: 45–62%; 10,296 participants; 11 studies; I2 = 99%) in the general population, 57% (95% CI: 33–79%; 3333 participants; 10 studies; I2 = 99%) in health care workers, and 76% (95% CI: 70–82%; 39,029 participants; 8 studies; I2 = 98%) in the lesbian, gay, bisexual, transgender, and intersex (LGBTI) community. In addition, as a secondary outcome, a prevalence of refusal of Mpox vaccination was found to be 22% (95% CI: 16–30%; 45,577 participants; 21 studies; I2 = 99%).ConclusionThe study highlights the importance of recognizing regional and subgroup disparities in Mpox vaccine willingness and refusal. It emphasizes the importance of employing strategies to achieve widespread vaccination coverage and safeguard public health worldwide.Terms usedJoanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI), Prospective International Registry of Systematic Reviews (PROSPERO), and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).

Meneodlučnost u vezi sa vakcinacijom protiv COVID-19 u Srbiji

Introduction/Aim: Vaccine hesitancy is recognized as important determinant of routine immunization coverage, but also as a factor of inadequate acceptance of the COVID-19 vaccine. The World Health Organization proposed a "3C" model, with confidence, complacency and convenience as the core components of vaccine hesitancy. The purpose of this study was to assess the intention to receive COVID-19 vaccine through the 3C framework in Serbia. Materials and Methods: This cross-sectional study was based on the data collected from 1,435 adult respondents from the general population using an online questionnaire in the period December 2020-January 2021. Convenience, non-probability sampling was applied. Participants were reached through the existing social networks and mailing lists. The main outcome variable was the intention to get vaccinated against COVID-19, with three categories: vaccine refusal, vaccine indecisiveness, and vaccine acceptance. To explore associations of predictor variables (socio-demographics, source credibility, general vaccine attitudes and COVID-19 vaccine hesitancy measured through three scales - Confidence, Convenience and Complacency) with the outcome variable, binary logistic regression models were conducted. Results: Less than one third of respondents (28.6%) were vaccine refusing, 33.7% were vaccine accepting, while 37.7% were undecided. Increased likelihood of being both vaccine undecided and vaccine refusing was significantly associated with lower scores on Confidence and Convenience scales, and a higher score on the Complacency scale. Conclusion: Confidence in health authorities and government, confidence in COVID-19 vaccine safety and efficacy, perception of ease of access to vaccination and complacency (perceived lack of need for vaccination) were the most important factors driving the intention to get vaccinated, confirming relevance of the "3C" model.

Kvalitativna procena pojedinaca u domu zdravlja porodične medicine - izbegavanje/odbijanje COVID-19 vakcinacije

Background. The avoidance or refusal of vaccines is a significant public health problem during the COVID-19 pandemic. This article focuses on vaccine avoidance and refusal among patients at a Family Health Center (FHC). We will attempt to identify and describe the factors that contribute to avoidance and refusal so that new strategies can be developed. Methods. This study was conducted between December 2021 and August 2022. Eight individuals were interviewed with a semi-structured form. The study cite was Turgut Reis FHC Kayseri/Turkey. Thematic analysis was used to analyze the qualitative data. Results. The study identified three main themes and 16 sub-themes based on verbatim notes. The main themes were the level of knowledge regarding COVID-19 and individual and non-individual factors causing COVID-19 vaccine avoidance/refusal. Some of the sub-themes included the reality of the disease, protective measures, concerns about the content and production process of the vaccine, the interaction between chronic disease and COVID-19, and the positive or negative effects of religion and national identity on vaccination. The study demonstrated that concerns about vaccine safety, efficacy, and production, as well as individual preferences, media influence, and mandatory regulations of health care management were the most influential factors in vaccine avoidance/refusal. Conclusions. The sudden onset of COVID-19 resulted in a delayed response from society and health authorities. This delay may be due to distrust of the disease, reluctance to adopt preventive measures, and uncertainty about treatment options. While advanced technology exists, limited public information about the vaccine's effectiveness and production processes could be contributing to this reaction.

The effect of the COVID-19 pandemic on vaccine hesitancy and vaccine refusal in children with food allergies

The effect of the COVID-19 pandemic on vaccine hesitancy and vaccine refusal in children with food allergies

The impact of vaccine hesitancy on psychological impairment among healthcare workers in a Total Worker Health© approach.

Vaccination practice is a well-known individual protective measure for biological risk in healthcare. During the COVID-19 pandemic vaccine hesitancy has grown among healthcare workers (HCWs). The study aims to investigate how vaccine hesitancy influences the psychological burden experienced by healthcare workers. This study aimed to explore attitudes of HCWs in acceptance or refusal of vaccinations related to the risk of psychological impairment (PI) and describe the associated occupational factors, during the seasonal flu/COVID-19 vaccination campaign of 2022-2023. 302 HCWs were enrolled in the study. A questionnaire was self-administered, including two scales on the risk of psychological impairment (Psychological Injury Risk Indicator, PIRI) and vaccine hesitancy (Adult Vaccine Hesitancy Scale, AVHS). PIRI scores revealed that 29.8% of participants were at risk of PI. Differences in sex, age, occupational seniority, professional category, and night shifts were found between HCWs at risk of PI and those not at risk. Females registered a four-fold higher risk than males (85.6% vs. 14.4%, χ2 = 4.450, p < 0.05). Nurses were the highest risk category, followed by physicians and technicians (54.4% vs. 30.0% vs. 12.2%, χ2 = 14.463, p < 0.001). 41.7% of participants received the flu vaccination, and 98.9% received the COVID-19 vaccine. HCWs were prone to being vaccinated to protect patients and family members. Conversely, vaccine refusal was attributed to the perception of flu vaccines as not beneficial and COVID-19 contagion at low risk. The latter was more frequently reported for HCWs at risk of PI (16.7% vs. 4.7%, χ2 = 11.882, p = 0.001). Finally, hesitant HCWs were at higher risk of psychological impairment than others. HCWs expressed vaccine acceptance considering their social role in the community as protectors. However, the underestimation of the risk of severity of COVID-19 was more relevant among HCWs at risk of PI than others. Psychological aspects need to be considered by healthcare providers when fighting vaccine hesitancy.

COVID-19 vaccines, perceptions and trust amongst vaccine refusers: A qualitative thematic analysis study

BackgroundThe outbreak of coronavirus disease 2019 (COVID-19) has resulted in huge morbidity and mortality since its onset in 2019. By June 24, 2023, only 32.2% of people in low-income countries have received at least one dose. This paper explores the perceptions and trust of vaccine refusers based on the thematic analysis. MethodsIn this study, we used a descriptive qualitative research design to explore the perceptions of the persons who did not believe in receiving the COVID-19 vaccine in Iraqi Kurdistan. This approach allowed us to explore the COVID-19 vaccine issue in-depth. Individual interviews were conducted with 14 participants in Kurdistan, Iraq. ResultsResults showed that the participants had a great fear of the serious side effects of COVID-19 vaccines. Some believed that the virus was not natural and had been made by humans for different reasons including making profits from vaccines. Some believed that there was a silver material inside the vaccine that would force people to receive more doses in the future. Few believed that receiving COVID-19 vaccines was crossing the borders of God. Reinfection was a factor in selling more doses of vaccines. The participants were affected by the advice of the community and social media and not receiving the COVID-19 vaccines from healthcare workers, lack of responsibility from the government and companies, and not having trust in vaccines in this region. ConclusionsConspiracy thinking, perceived negative effects, fear, reinfection, side effects of COVID-19 vaccines could be related to perceived vulnerability and seriousness among vaccine refusers.

Refusal and hesitation regarding vaccination against COVID-19 in Douala, Cameroon

vaccination is one of the strategies the World Health Organization recommends to reduce the burden of COVID-19. However, many African countries like Cameroon have low COVID-19 vaccination coverage. The purpose of this study was to investigate the reasons for the refusal of the population of the city of Douala to be vaccinated against COVID-19. we conducted a cross-sectional and analytical study in Douala from February 10 to May 31, 2022. Participants, aged at least 21 years and residing in the city of Douala, were interviewed. Associations between the variables of interest were measured using Chi-square and Fisher tests, with a 95% confidence interval. a total of 1555 people were included in the study. Only 168 (11%) had been vaccinated. The proportion of vaccine refusal was high, with 711 (45.7%) refusing, 640 participants (41.1%) hesitating, and 204 people (13.2%) being in favor of COVID-19 vaccination. The main reasons for refusing anti-COVID-19 vaccination were fear of adverse effects (406; 44.8%), lack of information about vaccines (331; 36.5%), and lack of confidence (302; 33.3%). Factors associated with vaccine refusal were religion (p=0.026) and level of education (p=0.002). this study revealed low COVID-19 vaccination coverage in Douala, with a significant proportion of refusal and hesitation towards vaccination. Communication strategies should take into account the reasons and factors associated with refusal.

Болезнь и смерть в жизни казанских мещан (конец XVIII - первая половина XIX в.)

The article deals with the issues of illness and death in the everyday life of Kazan burghers of the first half of the 19th century. Based on the analysis of a significant number of archival documents, an analysis of the nature of diseases was carried out, climatic, geographical and social causes of diseases and mortality were identified. The social factors of diseases are the low standard of living of the burghers, the peculiarities of the city as a habitat, the weak level of sanitary culture, the lack of qualified medical care. A significant role was played by the commitment of the burghers to the traditional conservative lifestyle, which was based on adherence to established practices and habits, including the refusal to consult doctors. The daily way of life was significantly corrected by epidemic diseases, among which smallpox and cholera were especially significant. The therapeutic and preventive measures taken significantly changed everyday life and required new practices that were perceived differently by people. Restrictive measures violated the usual order of life, a mass phenomenon was the refusal of smallpox vaccination, as well as non-compliance with sanitary measures. The burghers understood the disease as an attribute of the material world, which was expressed in the rational perception and designation of the disease as a state of the body, although some features of the irrational understanding of the disease can still be traced in the language of the burghers. The burghers realized death as an inevitable natural outcome of life, which required the necessary actions to complete earthly affairs.

Perceptions of childhood immunization in São Paulo: quantitative-qualitative cross-sectional study.

Vaccination hesitation spans from historical diseases such as smallpox to the current challenges with the coronavirus disease (COVID-19). In Brazil, vaccination faces obstacles related to trust and convenience. Despite the National Immunization Program, fear of adverse effects as well as misinformation challenge confidence in vaccines, and anti-vaccine movements have gained momentum. This study investigated childhood vaccine refusal, including COVID-19 vaccines, by comparing the reasons for and sociodemographic differences between vaccinated individuals and those who hesitated or refused immunization. A cross-sectional study was conducted in São Paulo, Brazil, using questionnaires administered during pediatric consultations between January and April 2023. This study investigated vaccine hesitancy and the attitudes of parents and caregivers of children (0-12 years) towards vaccines. The questionnaire was administered during routine pediatric consultations at three different locations, each with 50 participants for a total of 150 participants, to avoid selection bias. Marked differences were evident among caregivers in terms of sex, race, income, education, and religion, which influenced their attitudes toward vaccination. There was an increase in the refusal of seasonal vaccinations and a significant distrust of the efficacy of the COVID-19 vaccine (52%), with concerns about its side effects. Although most patients did not stop vaccination, significant delays occurred, especially in the clinical setting (58%). This study emphasizes the importance of childhood health decisions, indicating the need to build trust in vaccines, tailor health policies, and investigate the causes of distrust to promote childhood immunizations.

Nursing as a player in tackling vaccine hesitancy and refusal

Nursing as a player in tackling vaccine hesitancy and refusal

Nursing as a player in tackling vaccine hesitancy and refusal

Nursing as a player in tackling vaccine hesitancy and refusal

Vaccination against COVID-19: the view of Brazilian federal judges.

The aim was to analyze the perception of Brazilian federal judges on the implications of COVID-19 vaccination. A study was carried out with Brazilian federal judges, who received a survey designed with multiple-choice questions on COVID-19 vaccination, covering topics such as its mandatory aspect, the application of coercive measures, hesitation to vaccinate, priority groups, the duties of Brazilian Health Regulatory Agency (Anvisa, acronym in Portuguese), the role of the Judiciary branch, and immunity passports. A total of 254 out of 1,300 federal judges from all states responded to the survey. Most respondents have a Bachelor's degree or a specialization (59.1%) and have been judges for more than 10 years (63.8%). A great majority of the judges (87.7%) agree with vaccine mandates for adults and for children and adolescents (66.1%). Over 75% of judges believe that all levels of government can impose sanctions on those who refuse to get vaccinated. The judges trust vaccination 93% of the time, 56.1% reject anti-vaccination movements, and 75.2% believe that Anvisa duties should be respected. The Judiciary branch actions concerning the COVID-19 pandemic are approved by 62.6% of judges, and 88.2% support immunity passports. There is a direct connection among mandatory vaccination, trust in the vaccine, and the adoption of immunity passports. Most federal judges agree with vaccine mandates for children and adults, support the application of sanctions for vaccination refusal, disapprove of anti-vaccination movements, agree with Anvisa's duties, and support judicial intervention in relation to the COVID-19 pandemic.

Parents' attitudes and refusal towards childhood vaccinations and associated factors

The aim of this study is to determine the demographic characteristics of vaccine refusals in Malatya province, identify reasons for vaccine hesitancy, and guide future intervention efforts. Data for this descriptive study were collected through face-to-face interviews using a socio-demographic form developed by researchers, reasons for non-vaccination, and the short form of the "Turkish Vaccine Hesitancy Scale" and "Parental Attitudes towards Childhood Vaccinations" (PACV) scales. Statistical analysis included chi-square test, Mann-Whitney U test, and Spearman correlation test. Vaccine hesitancy was found in 86.0% of parents who did not vaccinate their children. The most common reasons for non-vaccination were "lack of confidence in vaccine content" (65.1%), "observation of side effects in others after vaccination" (19.8%), and "exposure to negative statements about vaccines on social media". As the educational level of both parents increased, non-vaccination due to a lack of confidence in vaccine content was more common. There was no relationship found between the presence of vaccine hesitancy and socio-demographic characteristics. Parents who do not vaccinate have low confidence in vaccines, and the influence of media, particularly press and social media, is significant in vaccination decision-making. Efforts should be made by both healthcare professionals and policymakers to increase confidence in vaccines and prevent access to misinformation about vaccines, thus minimizing vaccine hesitancy.

Refusal of COVID-19 booster vaccination among people living in remote tourism area, Samosir, Indonesia

Background and purpose: Samosir Island is a tourist area located in the middle of Toba Lake, Sumatra. It was reported that the coverage of COVID-19 booster vaccination had not reached the national target. This study aims to determine factors associated with the refusal of the COVID-19 booster vaccination. Methods: A community-based survey was conducted in the Sitiotio Sub-district of Samosir, from January to March 2023. Four out of eight villages were selected to represent the farthest and closer area. A multistage systematic random sampling was applied to select 156 out of 2073 households (HH). We interviewed 376 respondents to explore sociodemographic, experience of side effects of previous COVID-19 vaccination, comorbidities, family support, information, knowledge and perceptions. Booster vaccination status was determined through p-Care and immunization card. Descriptive, simple and multiple logistic regression were conducted. Results: About 32.4% of respondents refused the COVID-19 booster for fear of vaccine side effects (95.5%), had been vaccinated against COVID-19 (91.8%), and believed that the COVID-19 virus was gone (66.4%). The refusal of boosters was higher for those with low education, experienced side effects, have comorbidities, no family support and insufficient information, had poor knowledge and perception about COVID-19 vaccinations. Lack of trust of COVID-19 vaccine (AOR=2.31, 95%CI: 1.05-5.07), high perceived barriers (AOR=4.75, 95%CI: 1.96-11.49) and low self-efficacy (AOR=4.94, 95%CI: 1.44-16.98), less family support (AOR=6.34, 95%CI: 1.89-21.26) and poor knowledge (AOR=7.74, 95%CI: 1.74-34.02) significantly associated with COVID-19 booster vaccination refusal. Conclusion: Poor knowledge and perception of the COVID-19 vaccine and lack of family support increase refusal of the COVID-19 booster. Continuous evidence-based health promotion and family involvement can be carried out to increase public trust.