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Why did most Americans choose not to get a COVID-19 booster?

With an updated COVID-19 vaccine just being released in September, public health officials want to know why most didn't get last year's booster.
Why did most Americans choose not to get a COVID-19 booster?
Posted at 11:46 AM, Oct 05, 2023

In September 2022, an updated COVID-19 booster shot was released, intended to give those previously vaccinated against the virus enhanced immunity. Despite urging from the Centers for Disease Control and Prevention and other leading medical agencies, a minority of Americans got the shot. 

According to the CDC, just 17% of the U.S. population got an updated booster from September 2022 through May 2023. By comparison, 69.5% of the population were considered fully vaccinated with the original vaccine. 

While 79.1% of the adult population got the primary series of COVID-19 shots, just 20.5% of adults went back for a booster. 

This week, researchers from the University of Arizona released findings as to why so many Americans who had gotten at least one dose of the primary series of the vaccine opted not to get a booster. The results indicated there were many reasons why. 

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The No. 1 reason cited was a prior COVID-19 infection (39.5%), which was followed by concerns over side effects (31.5%). About 28.6% said they believed the booster would not provide added protection, while 23.4% said they were concerned about the safety of the shot. About 23.1% said they thought the vaccine would not provide protection against COVID-19 infections. 

Others said they didn't know they were eligible, that the shot was available, or didn't have the time to get the shot. 

"The results of this work provide support for continued efforts to promote SARS-CoV-2 vaccinations and boosters among the United States population," the study's authors said. "Uptake of boosters continues to be well below the coverage needed for optimal protection of all people. The development of vaccines against SARS-CoV-2 occurred at an unprecedented speed, but implementation remains among the biggest current public health challenges as updated boosters continue to be developed and made available to the public."

The CDC recommended the shots for those ages 5 and up who already had received their primary series of shots. The shots released in September 2022 were considered bivalent, which provided antibodies against early strains of the virus and the omicron variant. 

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"The updated COVID-19 boosters are formulated to better protect against the most recently circulating COVID-19 variant," CDC Director Rochelle Walensky said in September 2022. "They can help restore protection that has waned since previous vaccination and were designed to provide broader protection against newer variants. This recommendation followed a comprehensive scientific evaluation and robust scientific discussion. If you are eligible, there is no bad time to get your COVID-19 booster and I strongly encourage you to receive it."

Last year's boosters have since been replaced with an updated shot. Unlike last year's booster shot which required previous vaccination against COVID-19, the updated shots this year are available to everyone, regardless of whether they have been previously vaccinated. 

The updated vaccines are being made by Moderna and Pfizer/BioNTech and are intended to target more recent variants of the virus. 

The updated mRNA vaccines are approved for individuals 12 years of age and older and are authorized under emergency use for individuals 6 months through 11 years of age.

The Food and Drug Administration has said it is confident the safety and effectiveness of the vaccine outweighs the risks.

Officials say the study of last year's vaccine can help increase awareness surrounding this year's vaccine.

“Our results indicate that many people don’t know that a booster provides additional protection even if they have already been infected or that the effectiveness of prior boosters wanes over time due to new variants,” said first author Elizabeth Jacobs. "So it’s important to get another booster as we head into the fall and winter."

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