Why Some People Are Hesitant to Receive COVID-19 Boosters: A Systematic Review

Yam B. Limbu, Bruce A. Huhmann

Research output: Contribution to journalReview articlepeer-review

22 Scopus citations


As the COVID-19 pandemic continues and transitions to an endemic stage, booster vaccines will play an important role in personal and public health. However, convincing people to take boosters continues to be a key obstacle. This study systematically analyzed research that examined the predictors of COVID-19 booster vaccine hesitancy. A search of PubMed, Medline, CINAHL, Web of Science, and Scopus uncovered 42 eligible studies. Globally, the average COVID-19 booster vaccination hesitancy rate was 30.72%. Thirteen key factors influencing booster hesitancy emerged from the literature: demographics (gender, age, education, income, occupation, employment status, ethnicity, and marital status), geographical influences (country, region, and residency), adverse events, perceived benefit/efficacy, perceived susceptibility, perceived severity, prior history of COVID-19 infection, vaccination status, vaccination recommendations, health status, knowledge and information, skepticism/distrust/conspiracy theories, and vaccine type. Vaccine communication campaigns and interventions for COVID boosters should focus on factors influencing booster confidence, complacency, and convenience.

Original languageEnglish
Article number159
JournalTropical Medicine and Infectious Disease
Issue number3
StatePublished - Mar 2023


  • COVID-19
  • booster
  • systematic review
  • vaccine hesitancy


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