Social networks, environmental, and individual factors associated with COVID-19 vaccination and booster uptake– The prospective PRIME cohort study

Abstract

Background

Social networks (a person's social relationships) are important for health and in health behavior, including infection prevention behavior. This study aims to identify factors associated with coronavirus disease 2019 (COVID-19) vaccine and booster uptake, focusing on social networks and community participation factors, the physical environment, and individual level factors.

Methods

In the PRIME longitudinal cohort study, we used online questionnaires to collect baseline data at the end of 2021, including participants' COVID-19 vaccination status and various factors, i.e., structural and functional social network characteristics (interpersonal factors), societal (social and physical living environment) community (work and social participation), and individual (sociodemographics, health) factors. At follow-up (summer of 2022), we measured COVID-19 booster uptake. Associations between the factors and vaccine and booster uptake were analyzed using multivariable logistic regression analyses.

Results

At baseline (N = 9501), COVID-19 vaccine uptake was 94 %. In vaccinated participants at follow-up (N = 3620), booster uptake was 91 %. Community and societal factors associated with (booster) vaccine uptake included social participation, higher neighborhood livability and walkability scores, and a moderate level of urbanization. Interpersonal factors included a larger social network size, network diversity, network density, and not living alone. Associated individual factors included age ≥ 60 years, male sex, college/university education, being born in the Netherlands, having chronic conditions, being a never/former smoker, higher health literacy, and no loneliness.

Conclusion

The social and physical environment are key in COVID-19 vaccine and booster uptake. Health promotion and vaccination strategies should address the environmental context (community, societal and interpersonal factors) alongside individual-level factors to contribute to pandemic preparedness.