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Dr Marie Sartain
/ Categories: APhA News

CDC examines top reasons adults didn’t get bivalent COVID-19 booster

A new CDC report finds that low vaccination uptake for the COVID-19 bivalent vaccine was due to lack of awareness about eligibility status as well as overconfidence in immunity against the virus.

The findings, published January 20, 2023, in CDC’s Morbidity and Mortality Weekly Report, were based on an online opt-in survey of 1,200 previously vaccinated U.S. residents who responded about the most common reasons for not getting the bivalent booster dose. Nearly two thirds (65.4%) of participants were white, and approximately one half (51.9%) were women. Most participants (95.8%) had received more than 2 COVID-19 vaccine doses. Among these participants, 396 (34.4%) had received the bivalent booster dose, and 714 (62.1%) had not.

Approximately equal numbers of adults aged 18–39, 40–59, and 60 years and over were recruited; however the reasons given by these age groups differed. Among adults ages 18–39 years, the most commonly reported reasons for not receiving the bivalent booster dose were being unaware that they were eligible (29.8%), being unaware that updated booster doses were available (23.5%), or believing they still had strong protection against infection (18.4%). The most commonly reported reasons among adults 40–59 years old were being unaware that they were eligible (22.1%) or believing they still had strong protection against severe disease (21.3%) or infection (18.5%). Among adults ages 60 years and older, the most commonly reported reasons were believing they still had strong protection against infection (20.2%), concern about side effects (17.5%), or being unsure whether the bivalent booster dose was effective (16.1%).

Among the 396 participants who had received the bivalent booster dose, the most common reasons cited were to protect oneself (90.7%), prevent severe disease (80.6%), and protect others (75.0%). These top reasons were consistent among age groups.

“All eligible adults should receive a bivalent COVID-19 booster vaccine,” wrote the authors of the report. “To help increase bivalent booster dose coverage, health care and public health professionals should use evidence-based strategies to inform persons about booster vaccine recommendations and waning immunity.”

On October 12, 2022, FDA issued EUAs for bivalent (mRNA encoding the spike protein from the SARS-CoV-2 ancestral strain and BA.4/BA.5 Omicron variants) formulations of Pfizer-BioNTech and Moderna mRNA COVID-19 vaccines for use as a single booster dose 2 or more months after completion of primary series or monovalent booster vaccination for children ages 5–11 years (Pfizer-BioNTech) and 6–17 years (Moderna). FDA amended the EUAs on December 8, 2022, to include children 6 months and older.

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