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Hesitation towards COVID-19 booster vaccination among dialysis patients: a cross-sectional study in Taizhou, China

BMC Infectious Diseases volume 24, Article number: 1095 (2024) Cite this article

Abstract

Purpose

This research aimed to explore hesitation towards the COVID-19 booster vaccine among dialysis patients and study the association between COVID-19 pandemic-induced health behavior and vaccination hesitancy.

Methods

A self-administered online questionnaire evaluating dialysis patients’ hesitation to take COVID-19 booster vaccination was conducted between March 24 and 22 April 2022 in Taizhou, China. The logistic regression method was applied to identify factors associated with vaccination hesitancy, and all data were analyzed using R software.

Results

Of the 365 study participants, 272 (74.5%) individuals hesitated to take the booster dose. Health behavior was found to be a significant factor for hesitation to take COVID-19 vaccines, with OR (95% CI) of 1.09 (1.02–1.17). Influenza vaccination history was also significantly associated with the hesitation (OR (95% CI) = 0.39 (0.21–0.74)). In addition, participants with higher education levels exhibited lower vaccine hesitancy compared to those with junior secondary or below, with ORs (95% CIs) of 0.49 (0.27–0.91) for senior secondary and 0.35 (0.14–0.89) for junior college or above, respectively.

Conclusion

The proportion of hesitancy for taking the booster vaccination of the COVID-19 vaccine was high among dialysis patients. Health behaviors, influenza vaccination history, and education levels were risk factors in their vaccination hesitancy. These findings may aid efforts to help vaccinate people with underlying diseases against future pandemics.

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Introduction

COVID-19, caused by the severe acute respiratory syndrome coronavirus, is a public health challenge with its high infectivity worldwide [1]. Vaccination has been considered to be an effective way to prevent the contagious COVID-19 disease [2]. Growing epidemiological studies have investigated on the intention or willingness of COVID-19 vaccination [3, 4]. While the successful development of a vaccine is a blessing for human society, there are still varying degrees of vaccine hesitancy [5]. Vaccine hesitancy refers to people’s choice to delay or refuse vaccinations in the case of vaccination services available [6]. The greater the hesitancy, the more likely people are to decline vaccination [7].

Given the time-sensitive nature of vaccine protection, continued vaccination is needed to enhance its protective effectiveness [8]. In late September 2021, reports indicated that China was preparing to administer a COVID-19 vaccine booster [9]. However, as of March 2022, more than half of people aged 60 or older remain unvaccinated [10]. A significant proportion of unvaccinated elderly face a heightened risk of severe outcomes, which may result in considerable morbidity and mortality as infections surge rapidly in densely populated regions [11,12,13]. In addition, studies showed that people with chronic diseases, especially the elderly, are more likely to develop severe symptoms and even death after contracting COVID-19 [14,15,16]. Hence, understanding vaccination hesitancy among people with underlying diseases and identifying the possible risk factors is essential to address their hesitancy.

Several characteristics, including age, sex, address, vaccine efficacy, and concerns about side effects, have been identified as risk factors for vaccine hesitancy among individuals with underlying diseases [17, 18]. For the general public, the related epidemiological evidence indicated that women, single, lower education levels, under 50 years old, unemployed, and vaccine safety were significantly associated with vaccination hesitation [19]. Except for the above factors, individuals’ health behaviors, including hand-washing, wearing masks, and socializing, may also play a role in vaccine hesitancy. In this study, we aimed to investigate whether health-related behaviors have an effect on vaccination hesitancy of the booster dose among dialysis patients. Through this investigation, we hope to identify the potential factors that contribute to COVID-19 vaccine hesitancy.

Materials and methods

Study design and participants

The target population in this study was dialysis patients at a medical center in Taizhou, Zhejiang, China. We organized an anonymous survey of vaccine hesitancy among dialysis patients using the Wen-Juan Xing platform, which is the largest online survey platform in China. A convenience sampling method was utilized. Participants received and answered the survey via WeChat or e-mail on their mobile phones. The online investigation was performed from 24 March to 22 April 2022.

This research was exempted from the informed consent review approved by the Ethics Committee of Taizhou Hospital of Zhejiang Province in China (Approval number: K20210520). All procedures were conducted according to the guidelines of our institutional Ethics Committee and in compliance with the principles of the Declaration of Helsinki. Information about all respondents was kept anonymous.

Questionnaires

The questionnaire used in this survey was developed after a literature review [20, 21]. The contents of the questionnaire contained the following information. First, respondents were asked about their basic characteristics, including sex, age, address, education level, occupation, dialysis duration, history of vaccination allergies, influenza vaccination history, and underlying diseases. Underlying diseases included hypertension, diabetes, hyperlipemia, fatty liver, hyperuric acid, gout, chronic respiratory disease, chronic cardiovascular disease, and cancer. Second, respondents were questioned about their health behaviors during the COVID-19 pandemic, including hand-washing, mask-wearing, and social distancing. Third, the hesitation for the booster dose of the COVID-19 vaccine was measured by a question asking whether respondents had hesitation to receive the booster injection.

To ensure that the formal questionnaire was comprehensive, scientific, and clear, pilot interviews to test and verify the questionnaire were conducted. Interviewers attended a training course on the content of the questionnaire. In the early stage, we carried out a pilot test with 30 volunteers to confirm if there were any missing or unanswerable parts in the questionnaire.

Statistical analysis

Counts and percentages were shown for nominal data. Continuous variables were presented as mean (standard deviation, sd). The chi-square test was applied to analyze categorical characteristics, while the t-test was performed for continuous variables. Variables with p-values < 0.05 in the univariate analysis would be included in the multivariate logistic regression model [22]. The association between the potential risk factors and hesitation for COVID-19 vaccines was further examined via the logistic regression model. The odds ratio (OR) and 95% confidence interval (95% CI) were calculated accordingly. Factors with p-values < 0.05 or 95% CIs not containing one were considered statistically significant. All data were analyzed by R software, version 4.1.0 (R Project for Statistical Computing, https://www.R-project.org/).

Result

Basic characteristics

We collected a total of 365 respondents with valid data from March 24 to 22 April 2022 in Taizhou, Zhejiang, China. The sociodemographic data of the participants were shown in Table 1. Among the survey respondents, the mean age was 58.5(± 14.6) years old and the median was 58, with 44.4% of participants over 60 years old. More than half the interviewees (61.1%) were males. The education levels of the participants were generally low, with 74.5% of them having junior secondary or below education levels. 235 respondents (64.4%) were farmers. Participants from rural or urban areas accounted for 67.4% and 32.6%, respectively. Only 15.3% of the dialysis patients had no other underlying diseases. Respondents with dialysis duration longer than 2 years accounted for 70.1%. In addition, 16.7% of the participants had a history of vaccination allergies, while 14.5% of them had an influenza vaccination history.

Table 1 Baseline characteristics (n = 365)
Full size table

Hesitation to take the booster vaccine regarding COVID-19

Of the 365 study participants, 272 (74.5%) individuals hesitated to take the booster dose of the COVID-19 vaccine, and only 93 (25.5%) participants did not hesitate (Table 2). Among hesitant respondents, 30.14% were very hesitant about the booster dose and 44.38% were hesitant (Fig. 1). According to the univariate analysis results of factors associated with hesitation of taking the booster dose, hesitation to take the booster dose of the COVID-19 vaccine was related to participants’ age (\(\:{\chi\:}^{2}\) = 8.11, P-value = 0.004), education (\(\:{\chi\:}^{2}\) = 14.49, P-value < 0.001), influenza vaccination history (\(\:{\chi\:}^{2}\) = 8.11, P-value < 0.001), and health behavior (t = -2.19, P-value = 0.030).

Table 2 Univariate analysis of factors associated with hesitation of taking the booster dose of COVID-19 vaccine
Full size table
Fig. 1
figure 1

The hesitation of taking the booster dose of COVID-19 vaccine (n = 365)

Full size image

Factors associated with hesitation to take the COVID-19 vaccine

The effects of independent factors on hesitation to take the booster dose of COVID-19 vaccines were examined via a logistic regression model. As presented in Table 3, health behavior was a significant factor for hesitation to take the booster dose of the COVID-19 vaccine, with OR (95%CI) being 1.09 (1.02–1.17). This suggested that individuals in this research exhibiting healthier behaviors are more likely to have vaccination hesitancy. Besides, compared with participants who had junior secondary education levels or below, those who had higher education levels were less likely to be hesitant to take COVID-19 vaccines, with OR (95%CI) being 0.49 (0.27–0.91) and 0.35 (0.14–0.89) for senior secondary and junior college or above, respectively. In addition, participants with an influenza vaccination history were less likely to hesitate to take the booster dose, with OR (95%CI) being 0.39 (0.21–0.74). Furthermore, older dialysis patients (i.e., age ≥ 60) had higher hesitation than those whose age was under 60 years old (≥ 60 vs. < 60, OR = 1.65, P-value = 0.075).

Table 3 Regression results
Full size table

Discussion

In this research, we explored the hesitancy to take a booster dose of the COVID-19 vaccine among the chronic disease population with renal dialysis, and further, identified three risk factors of vaccination hesitation, including health-related behaviors, education levels, and influenza vaccination histories. To date, studies on the booster dose have mainly focused on the willingness to take COVID-19 vaccination among healthcare workers or the general population [23, 24]. To the best of our knowledge, this study is one of the few studies to investigate the hesitation of dialysis patients to take the booster COVID-19 vaccination.

Vaccination is an important strategy to prevent and control epidemics, while vaccine hesitation is a key factor influencing vaccination. Speeding up COVID-19 vaccination remains a major effort to contain the outbreak, but the hesitancy over the vaccine remains relatively widespread. The hesitation over a COVID-19 vaccine will affect the building of herd immunity to COVID-19 [25, 26]. The proportion of dialysis patients’ hesitation to take the booster dose was 74.5% in this cross-sectional research. The hesitancy rate was higher than other populations [27,28,29,30]. According to the previous COVID-19 vaccine hesitation studies, public acceptance of COVID-19 vaccines was more than 60% in most territories and countries [31]. The high proportion of hesitation to COVID-19 vaccines among dialysis patients could be explained by the reason that the study population is characterized by a high proportion of individuals with a low-level educational background living in rural regions, which might be a potentially important confounder.

Further, we explored the potential risk factors for hesitation to take the COVID-19 vaccine. We found that individuals’ health behaviors including mask-wearing and social-distancing have been associated with COVID-19 vaccine hesitancy [32, 33]. These were not quite consistent with our finding that dialysis patients with better health behaviors were more hesitant about vaccines. Education level was the risk factor related to the acceptance of COVID-19 vaccination [34, 35]. This is consistent with our findings that higher education levels were significantly negatively associated with hesitation to booster dose. Furthermore, the influenza vaccination history was also identified as a risk factor for vaccine hesitation. This was in line with the previous research that people classified as influenza vaccinators were more likely to take COVID-19 vaccination [36].

Previous studies have displayed that older adults have less willingness to take the booster vaccination [37]. The participants in the study were all older, with a median age of 58. In this study, we also found that dialysis patients with older age were more likely to be hesitant to take booster vaccination, although this was not statistically significant in multivariate analyses. In addition, based on the existing COVID-19 vaccination recommendations for patients with chronic diseases, medical stability is the basis for vaccination [38]. Patients with end-stage kidney disease are also more likely to be infected with COVID-19 because they are frequently or occasionally on dialysis treatment and are exposed to densely populated environments with a high potential for SARS-CoV-2 transmission [39]. In addition, the risk of severe or fatal SARS-CoV-2 infection may be higher in this population, therefore, early COVID-19 vaccination is strongly suggested. Some studies have recommended that for these individuals, the booster dose of COVID-19 vaccines is necessary to produce an optimal antibody response [40,41,42]. Therefore, scientific management of patients with chronic diseases is needed to help them maintain and improve their health status, which is important for the promotion of COVID-19 vaccination.

The study was not without limitations. First, the participants we recruited in this survey were from hospitals in a single geographic area in Taizhou, China. In addition, a high proportion of study participants were from rural regions and had a low-level educational background. Therefore, future studies need more samples from more regions to verify the conclusion. Second, considering that the research population was selected on a convenient and voluntary basis, hence, there is inevitable selection bias in this investigation. Also, considering the convenience sampling used in this study, it is difficult to conduct a census of dialysis patients. Third, although we demonstrated that various factors were related to vaccination hesitancy in dialysis patients, we could not prove causation. Intervention studies need to be designed to verify some of these causal relationships. Fourth, the study was a cross-sectional study conducted at one point in time. Due to the anonymization of the data collected in our survey, including the data regarding whether study participants who exhibited hesitancy in responding to questions about COVID-19 vaccines subsequently refrained from receiving booster shots is difficult. Therefore, it is challenging to capture fluctuations in correlation with COVID-19 vaccine hesitancy within the population, particularly given the dynamic nature of factors influencing such hesitancy. As a result, it could not illustrate long-term causation or generalized results. Carrying out a series of long-term follow-up studies was expected to solve these problems.

Conclusion

In conclusion, the proportion of hesitancy for taking the booster vaccination of the COVID-19 vaccine was high among dialysis patients. Both health behaviors and education levels were associated with vaccination hesitancy. These findings may aid efforts to help vaccinate people with underlying diseases against COVID-19. At the same time, it provides a basis for promoting COVID-19 vaccination and improving the degree of immune protection of the COVID-19 vaccine in the future.

Availability of data and materials

The datasets generated and/or analysed during the current study are available from the corresponding author on request.

References

  1. Alwan N. Surveillance is underestimating the burden of the COVID-19 pandemic. Lancet. 2020;396(10252):e24.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Gao Q, Bao L, Mao H, Wang L, Xu K, Yang M, et al. Development of an inactivated vaccine candidate for SARS-CoV-2. Science. 2020;369(6499):77–81.

    Article  CAS  PubMed  Google Scholar 

  3. Dodd R, Cvejic E, Bonner C, Pickles K, McCaffery K. Group SHLLC-. Willingness to vaccinate against COVID-19 in Australia. Lancet Infect Dis. 2021;21(3):318–9.

    Article  PubMed  Google Scholar 

  4. Veronese N, Saccaro C, Demurtas J, Smith L, Dominguez L, Maggi S, et al. Prevalence of unwillingness and uncertainty to vaccinate against COVID-19 in older people: a systematic review and meta-analysis. Ageing Res Rev. 2021;72:101489.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Trogen B, Oshinsky D, Caplan A. Adverse consequences of rushing a SARS-CoV-2 vaccine: implications for public trust. JAMA. 2020;323(24):2460–1.

    Article  CAS  PubMed  Google Scholar 

  6. MacDonald N, Hesitancy SWGV. Vaccine hesitancy: definition, scope and determinants. Vaccine. 2015;33(34):4161–4.

    Article  PubMed  Google Scholar 

  7. Li Z, Ji Y, Sun X. The impact of vaccine hesitation on the intentions to get COVID-19 vaccines: the use of the health belief model and the theory of planned behavior model. Front Public Health. 2022;10:882909.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Naaber P, Tserel L, Kangro K, Sepp E, JĂĽrjenson V, Adamson A, et al. Dynamics of antibody response to BNT162b2 vaccine after six months: a longitudinal prospective study. Lancet Reg Health Eur. 2021;10:100208.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Luo C, Zhang M, Jiang E, Jin M, Tung T, Zhu J. The main decision-making competence for willingness-to-pay towards COVID-19 vaccination: a family-based study in Taizhou, China. Ann Med. 2022;54(1):2376–84.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Lewis D. Will Omicron finally overpower China’s COVID. Defences? Nat. 2022;604(7904):17–8.

    Article  CAS  Google Scholar 

  11. Lazarus J, Ratzan S, Palayew A, Gostin L, Larson H, Rabin K, et al. A global survey of potential acceptance of a COVID-19 vaccine. Nat Med. 2021;27(2):225–8.

    Article  CAS  PubMed  Google Scholar 

  12. Wang K, Wong E, Ho K, Cheung A, Yau P, Dong D, et al. Change of willingness to accept COVID-19 vaccine and reasons of vaccine hesitancy of working people at different waves of local epidemic in Hong Kong, China: repeated cross-sectional surveys. Vaccines (Basel). 2021;9(1):62.

    Article  CAS  PubMed  Google Scholar 

  13. Wang J, Jing R, Lai X, Zhang H, Lyu Y, Knoll M, et al. Acceptance of COVID-19 vaccination during the COVID-19 pandemic in China. Vaccines (Basel). 2020;8(3):482.

    Article  CAS  PubMed  Google Scholar 

  14. O’Driscoll M, Ribeiro Dos Santos G, Wang L, Cummings D, Azman A, Paireau J, et al. Age-specific mortality and immunity patterns of SARS-CoV-2. Nature. 2021;590(7844):140–5.

    Article  PubMed  Google Scholar 

  15. Reyes-Sánchez F, Basto-Abreu A, Torres-Alvarez R, Canto-Osorio F, González-Morales R, Dyer-Leal D, et al. Fraction of COVID-19 hospitalizations and deaths attributable to chronic diseases. Prev Med. 2022;155:106917.

    Article  PubMed  Google Scholar 

  16. Sertbas Y, Solak E, Dagci S, Kizilay V, Yazici Z, Elarslan S, et al. Clinical outcomes of COVID-19 in patients with chronic diseases. North Clin Istanb. 2023;10(4):401–10.

    PubMed  PubMed Central  Google Scholar 

  17. Blanchi S, Torreggiani M, Chatrenet A, Fois A, Mazé B, Njandjo L, et al. COVID-19 vaccine hesitancy in patients on dialysis in Italy and France. Kidney Int Rep. 2021;6(11):2763–74.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Abdulaziz H, Saleh M, Elrggal M, Omar M, Hawash S, Attiya A, et al. Egyptian hemodialysis patients’ willingness to receive the COVID-19 vaccine booster dose: a multicenter survey. J Nephrol. 2023;36(5):1329–40.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Fajar J, Sallam M, Soegiarto G, Sugiri Y, Anshory M, Wulandari L, et al. Global prevalence and potential influencing factors of COVID-19 vaccination hesitancy: a meta-analysis. Vaccines. 2022;10(8):1356.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Lin X, Zhang M, Chen Y, Xue J, Chen H, Tung T, et al. Relationship between knowledge, attitudes, and practices and COVID-19 vaccine hesitancy: a cross-sectional study in Taizhou, China. Front Med (Lausanne). 2022;9:770933.

    Article  PubMed  Google Scholar 

  21. Thanapluetiwong S, Chansirikarnjana S, Charernwat P, Saranburut K, Ittasakul P. Prevalence and factors associated with caregivers’ hesitancy in immunizing dependent older adults with COVID-19 vaccines: a cross-sectional survey. Vaccines (Basel). 2022;10(10):1748.

    Article  PubMed  Google Scholar 

  22. Zhang M, Zhang T, Shi G, Cheng F, Zheng Y, Tung T, et al. Safety of an inactivated SARS-CoV-2 vaccine among healthcare workers in China. Expert Rev Vaccines. 2021;20(7):891–8.

    Article  CAS  PubMed  Google Scholar 

  23. Pan S, Yang Y, Zhang M, Tung T. Willingness to pay for booster dose of COVID-19 vaccine among healthcare workers in Taizhou,China. Hum Vaccin Immunother. 2022;18(5):2063629.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Tung T, Lin X, Chen Y, Zhang M, Zhu J. Willingness to receive a booster dose of inactivated coronavirus disease 2019 vaccine in Taizhou, China. Expert Rev Vaccines. 2022;21(2):261–7.

    Article  CAS  PubMed  Google Scholar 

  25. Randolph H, Barreiro L. Herd immunity: understanding COVID-19. Immunity. 2020;52(5):737–41.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Wiysonge C, Ndwandwe D, Ryan J, Jaca A, Batouré O, Anya B, et al. Vaccine hesitancy in the era of COVID-19: could lessons from the past help in divining the future? Hum Vaccin Immunother. 2022;18(1):1–3.

    Article  CAS  PubMed  Google Scholar 

  27. Xu R, Shi G, Zheng S, Tung T, Zhang M. COVID-19 vaccine hesitancy between family decision-makers and non-decision-makers among college teachers. Ann Med. 2023;55(1):292–304.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Xiong Y, Zhao Y, Zhang T, Wang Q, Liu J. Factors associated with the vaccination behavior among COVID-19 vaccine hesitant college students in Wuhan, China: a survey based on social psychological dimension. Front Public Health. 2022;10:865571.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Salazar T, Pollard D, Pina-Thomas D, Benton M. Parental vaccine hesitancy and concerns regarding the COVID-19 virus. J Pediatr Nurs. 2022;65:10–5.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Hong J, Xu X, Yang J, Zheng J, Dai S, Zhou J, et al. Knowledge about, attitude and acceptance towards, and predictors of intention to receive the COVID-19 vaccine among cancer patients in Eastern China: a cross-sectional survey. J Integr Med. 2022;20(1):34–44.

    Article  PubMed  Google Scholar 

  31. Sallam M, Al-Sanafi M, Sallam M. A global map of COVID- 19 vaccine acceptance rates per country: an updated concise narrative review. J Multidiscip Healthc. 2022;15:21–45.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Latkin C, Dayton L, Yi G, Colon B, Kong X. Mask usage, social distancing, racial, and gender correlates of COVID-19 vaccine intentions among adults in the US. PLoS ONE. 2021;16(2):e0246970.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Rane M, Kochhar S, Poehlein E, You W, Robertson M, Zimba R, et al. Determinants and trends of COVID-19 vaccine hesitancy and vaccine uptake in a national cohort of US adults: a longitudinal study. Am J Epidemiol. 2022;191(4):570–83.

    Article  PubMed  Google Scholar 

  34. Gallè F, Sabella E, Roma P, Da Molin G, Diella G, Montagna M, et al. Acceptance of COVID-19 vaccination in the elderly: a cross-sectional study in Southern Italy. Vaccines (Basel). 2021;9(11):1222.

    Article  PubMed  Google Scholar 

  35. Al-Hanawi M, Alshareef N, El-Sokkary R. Willingness to receive COVID-19 vaccination among older adults in Saudi Arabia: a community-based survey. Vaccines (Basel). 2021;9(11):1257.

    Article  CAS  PubMed  Google Scholar 

  36. Parker A, Atshan S, Walsh M, Gidengil C, Vardavas R. Association of COVID-19 vaccination with influenza vaccine history and changes in influenza vaccination. JAMA Netw Open. 2022;5(11):e2241888.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Lin X, Li A, Zhang M, Lv L, Chen Y, Chen H, et al. Willingness of older adults with chronic diseases to receive a booster dose of inactivated coronavirus disease 2019 vaccine: a cross-sectional study in Taizhou, China. Vaccines (Basel). 2022;10(10):1665.

    Article  PubMed  Google Scholar 

  38. Mohseni Afshar Z, Babazadeh A, Janbakhsh A, Mansouri F, Sio T, Sullman M, et al. Coronavirus disease 2019 (Covid-19) vaccination recommendations in special populations and patients with existing comorbidities. Rev Med Virol. 2022;32(3):e2309.

    Article  CAS  PubMed  Google Scholar 

  39. Manley H, Stewart C, Ladik V, Hosford J, Lacson E, Johnson D, et al. COVID-19 among US dialysis patients: risk factors and outcomes from a national dialysis provider. Am J Kidney Dis. 2021;77(5):748–e561.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Hall V, Ferreira V, Ku T, Ierullo M, Majchrzak-Kita B, Chaparro C, et al. Randomized trial of a third dose of mRNA-1273 vaccine in transplant recipients. N Engl J Med. 2021;385(13):1244–6.

    Article  PubMed  Google Scholar 

  41. Anand S, Montez-Rath M, Han J, Garcia P, Cadden L, Hunsader P, et al. Antibody response to COVID-19 vaccination in patients receiving dialysis. J Am Soc Nephrol. 2021;32(10):2435–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Grupper A, Sharon N, Finn T, Cohen R, Israel M, Agbaria A, et al. Humoral response to the Pfizer BNT162b2 vaccine in patients undergoing maintenance hemodialysis. Clin J Am Soc Nephrol. 2021;16(7):1037–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

We would like to thank participants for their cooperation and support.

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Authors and Affiliations

  1. Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, Zhejiang, China

    Chengwen Luo & Tao-Hsin Tung

  2. Taizhou Institute of Medicine, Health and New Drug Clinical Research, Taizhou, China

    Tao-Hsin Tung

  3. Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, Zhejiang, China

    Jian-Sheng Zhu

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Contributions

CW Luo and TH Tung conceived the idea, implemented the method, and drafted the manuscript. CW Luo was responsible for the coding of the analyses. JS Zhu and TH Tung designed the questionnaire. JS Zhu collected and validated the data. All authors edited and approved the final manuscript.

Corresponding authors

Correspondence to Tao-Hsin Tung or Jian-Sheng Zhu.

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The Ethics Committee of Taizhou Hospital of Zhejiang Province in China approved the study protocol (Approval number: K20210520). This research was exempted from the informed consent review approved by the Ethics Committee of Taizhou Hospital of Zhejiang Province in China. All procedures were conducted according to the guidelines of our institutional Ethics Committee and in compliance with the principles of the Declaration of Helsinki.

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Luo, C., Tung, TH. & Zhu, JS. Hesitation towards COVID-19 booster vaccination among dialysis patients: a cross-sectional study in Taizhou, China. BMC Infect Dis 24, 1095 (2024). https://doi.org/10.1186/s12879-024-09917-6

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