COVID-19 vaccine acceptance and 5C psychological antecedents amid the omicron surge in South Korea and China

Background

It is crucial to emphasize the necessity of annual COVID-19 vaccination, particularly for vulnerable populations like older and chronically ill individuals.

Objectives

This study aimed to quantify the level of vaccination acceptance and its 5C psychological antecedents in the South Korean and Chinese populations and also to identify the predictors, considering contextual variations that influence vaccine acceptance in both countries.

Methods

A cross-sectional survey study was undertaken in South Korea and China between March 15 and March 30, 2023, coinciding with the emergence of the SARS-CoV-2 Omicron variant in both nations. The study comprised 1000 participants from South Korea and 3000 participants from China. A chi-square analysis, t-tests and multivariable logistic regression analysis were employed to evaluate the factors influencing the acceptance of COVID-19 vaccines.

Results

A higher degree of vaccine acceptance was observed among Chinese participants (48.5 %), in contrast to the 16.8 % among South Koreans. Analyzing the psychological antecedents for vaccination, the Chinese cohort showed high vaccine confidence, whereas South Koreans had increased constraint perceptions. Psychological antecedents, particularly Confidence, play a significant positive role in vaccine acceptance in both South Korea (OR 2.98, CI [2.26–4.01], p < 0.001) and China (OR 2.93, CI [2.58–3.33], p < 0.001), while Constraints in South Korea (OR 0.83, CI [0.69–0.99], p < 0.05) and China (OR 0.86, CI [0.79–0.94], p < 0.001) contribute negatively to vaccine acceptance. Notably, divergent trends in the impact of age and underlying health conditions on vaccine acceptance were observed.

Conclusions

This study reveals a substantial disparity in acceptance, psychological antecedents, and predictors of vaccine acceptance between China and South Korea. This importance of understanding contextual factors influencing public vaccine acceptance is emphasized. There is an urgent need for robust vaccination strategies that boost confidence and alleviate constraints to COVID-19 vaccination, which should be tailored to the unique contextual factors of each country.