Osong Public Health Res Perspect.  2025 Apr;16(2):169-180. 10.24171/j.phrp.2024.0254.

Multilevel analysis of individual, household, and community factors influencing COVID-19 vaccination intention: evidence from the 2021 Korea Community Health Survey

• Seong Js
• Kim JY

• KMID: 2568046
• DOI: http://doi.org/10.24171/j.phrp.2024.0254

Abstract

Objectives
This study aimed to investigate the combined effects of individual, household, and community-level factors on coronavirus disease 2019 (COVID-19) vaccination intention using a multilevel analysis.
Methods
This cross-sectional study analyzed raw data from the 2021 Korea Community Health Survey and regional statistics from 255 health centers, with a final sample of 229,216 individuals. Multilevel analysis was conducted, focusing on individual, household, and community-level factors. Individual-level factors included demographics, health status, and COVID-19 concerns; household-level factors included income and marital status; and community-level factors included city type and vaccination rates.
Results
At the individual level, significant differences were observed across all variables. At the household level, higher vaccination intention was associated with households of 4 or more members and a monthly income of 4 million Korean won or more. At the community level, higher flu vaccination rates, greater concern about COVID-19 infection, and higher COVID-19 vaccination rates were linked to increased vaccination intention.
Conclusion
This study highlights that COVID-19 vaccination intention is influenced by factors at the individual, household, and community levels. Vaccination strategies that integrate household and community-level approaches may be more effective. Policymakers should consider both individual and social health factors when designing vaccination policies.

Keyword

COVID-19; Intention; Multilevel analysis; Vaccination