Differences in non-positive intention to accept the COVID-19 booster vaccine between three countries in the cross-border region Meuse-Rhine Euroregion: The Netherlands, Belgium, and Germany

Céline J A van Bilsen; Christina Stabourlos; Chrissy P B Moonen; Stephanie Brinkhues; Stefaan Demarest; Daniëlle A T Hanssen; Inge H M van Loo; Paul H M Savelkoul; Dirk Philippsen; Brigitte A M van der Zanden; Nicole H T M Dukers-Muijrers; Christian J P A Hoebe

doi:10.1016/j.jvacx.2023.100306

Differences in non-positive intention to accept the COVID-19 booster vaccine between three countries in the cross-border region Meuse-Rhine Euroregion: The Netherlands, Belgium, and Germany

Vaccine X. 2023 Aug:14:100306. doi: 10.1016/j.jvacx.2023.100306. Epub 2023 Apr 20.

Authors

Céline J A van Bilsen^{1

2}, Christina Stabourlos³, Chrissy P B Moonen^{1

2}, Stephanie Brinkhues⁴, Stefaan Demarest³, Daniëlle A T Hanssen^{5

6}, Inge H M van Loo^{5

6}, Paul H M Savelkoul^{5

6}, Dirk Philippsen⁷, Brigitte A M van der Zanden⁸, Nicole H T M Dukers-Muijrers^{2

9}, Christian J P A Hoebe^{1

2

5}

Affiliations

¹ Department of Social Medicine, Maastricht University, Care and Public Health Research Institute (CAPHRI), Maastricht, the Netherlands.
² Department of Sexual Health, Infectious Diseases, and Environmental Health, Public Health Service South Limburg, Heerlen, the Netherlands.
³ Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.
⁴ Department of Knowledge & Innovation, Public Health Service South Limburg, Heerlen, the Netherlands.
⁵ Department of Medical Microbiology, Infectious Diseases & Infection Prevention, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands.
⁶ Care and Primary Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.
⁷ Gesundheitsberichterstattung, Gesundheitsamt Düren, Düren, Germany.
⁸ Foundation euPrevent, Heerlen, the Netherlands.
⁹ Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.

Abstract

COVID-19 booster vaccination has shown to add to the protection against infection with SARS-CoV2 and subsequent severe disease. This longitudinal cross-border study aimed to identify factors associated with COVID-19 booster vaccine intentions in an initially vaccinated adult population living in the Meuse-Rhine Euroregion (EMR; including the Netherlands, Belgium, and Germany) and differences between countries. Data collection took place in autumn of 2021 and consisted of online questionnaires sent to a random sample of the population based on governmental registries. Data from 3,319 fully and partially vaccinated adults were used to examine determinants of non-positive intention for a booster vaccination (i.e., uncertain or do not want), using multivariable logistic regression analyses weighted by age group, sex, and country. Compared to German residents, Dutch residents (OR = 2.4) and Belgian residents (OR = 1.4) were more likely to be uncertain or not want to receive a booster vaccine in September-October 2021. Factors independently associated with non-positive intention were female sex (OR = 1.6), absence of comorbidities (OR = 1.3), time since last vaccination less than 3 months ago for those fully vaccinated (OR = 1.6), being partially vaccinated (OR = 3.6), a negative experience with communication of COVID-19 measures (OR = 2.2), and regarding measures as ineffective (OR = 1.1). Results indicate that booster vaccine intentions differ between countries in the cross border Meuse-Rhine Euroregion. Non-positive intention for the booster vaccine is prevalent in all three countries of the EMR, but to a different extent, as shown in this study. Cross-border collaboration and sharing information and knowledge about vaccination strategies could play a role in limiting the impact of COVID-19.

Keywords: COVID-19; COVID-19 vaccines; Intention; Logistic models; Pandemics; Surveys and questionnaires.