The association between social media use and hesitancy toward COVID-19 vaccine booster shots in China: A web-based cross-sectional survey

COVID-19 vaccine booster shots are necessary to provide durable immunity and stronger protection against the emerging SARS-CoV-2 variants. As a major platform for access to information, social media plays an important role in disseminating health information. This study aimed to evaluate hesitancy toward COVID-19 vaccine booster shots in China, assess its association with social media use, and provide information to manage social media. We conducted a cross-sectional study across all 31 provinces in mainland China from November 12, 2021, to November 17, 2021. In total, 3,119 of 3,242 participants completed the questionnaire (response rate = 96.2%). COVID-19 vaccine booster shot hesitancy rate in China was 6.5% (95% CI: 5.6–7.3). Unemployment (adjusted odds ratio [aOR] 2.428, 95% CI: 1.590–3.670), low monthly income (aOR 2.854,95% CI: 1.561–5.281), low scores of knowledge (aOR 0.917, 95% CI: 0.869–0.968) and low level of cues to action (aOR 0.773, 95% CI: 0.689–0.869) were associated with vaccine hesitancy. Compared with public social media, lower vaccine hesitancy was associated with high perceived importance of social media (aOR 0.252, 95% CI: 0.146–0.445) and official social media use (aOR 0.671, 95% CI: 0.467–0.954), while higher vaccine hesitancy was associated with traditional media use (aOR 3.718, 95% CI: 1.282–10.273). More efforts are needed to regulate the content of social media and filtering out misinformation. The role of official social media in disseminating health information should be enhanced.