Who gets COVID-19 booster vaccination? Trust in public health institutions and promotion strategies post-pandemic in the Republic of Korea

Vaccine. 2023 Dec 7;41(50):7560-7572. doi: 10.1016/j.vaccine.2023.11.001. Epub 2023 Nov 15.


Introduction: It is increasingly recognized that regular boosters will be necessary for the continued management of the COVID-19 pandemic. While vaccine hesitancy in the context of the initial COVID-19 vaccinations has been extensively studied, less is known about hesitancy around boosters in the post-pandemic era, where the immediate threat of COVID-19 has diminished.

Methods: Using 5,584 survey responses from people who had received at least one COVID-19 vaccine dose based on a four-round survey between May and November 2022, we examined various factors that affect booster vaccine uptake and the willingness to take an additional shot. Ordinary least squares regressions were conducted to confirm the statistical significance of the findings.

Results: Nearly 99% of vaccinated respondents reported having had two COVID-19 vaccine doses, while 69% of respondents reported having received a booster shot (three or more vaccine doses) and 48% reported being willing to get another shot. Booster uptake was strongly increased along with the degree of trust in the Korean Disease Control Agency (KDCA) and was also significantly associated with older age, gender, political propensity, and household income-level. When examining willingness to get an additional shot, the predictors were similar to booster vaccine uptake. However, the effect of trust in the KDCA became more salient.

Conclusion: The factors associated with booster uptake and willingness to continue to boost are similar to those associated with initial vaccine acceptance in the ROK, namely trust in the public health authority and older age. Despite high initial uptake in the ROK, convincing the public of the continued necessity of routine immunization against COVID-19 may pose challenges in the post-pandemic era.

Keywords: COVID-19; Cross-sectional survey; Trust; Vaccine hesitancy; Vaccine uptake.

MeSH terms

  • COVID-19 Vaccines
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Humans
  • Pandemics / prevention & control
  • Public Health
  • Republic of Korea / epidemiology
  • Trust*
  • Vaccination


  • COVID-19 Vaccines