This study investigates the dynamic predictors of COVID-19 vaccination uptake in Hong Kong over a two-year period, focusing on multi-level determinants and their interconnections. Using repeated cross-sectional surveys, the study maps these determinants and examines their interconnections in a sample of 15,179 participants. Key findings include: 1. **Dynamic Nature of Vaccine Hesitancy**: Vaccine hesitancy is dynamic and evolves with the pandemic. Initially, vaccine safety was a primary concern, but this shifted to vaccine effectiveness later. 2. **Role of Vaccine Confidence**: Vaccine confidence attitudes play a crucial role in vaccination uptake, with their importance changing over time. Initially, vaccine safety was more important, but this shifted to vaccine effectiveness later. 3. **Impact of Demographic and Contextual Factors**: Chronic conditions, age, COVID-19 case numbers, and non-pharmaceutical preventive behaviors significantly influence vaccine uptake. Higher educational attainment and being married are associated with higher primary and booster vaccine uptake. 4. **Trust in Government**: Trust in the government acts as a bridging factor, linking various variables to vaccine confidence attitudes and ultimately to vaccine uptake. 5. **Network Analysis**: A mixed graphical network model was used to depict the complex interconnections between these variables. The network explained a varying proportion of variance in vaccine uptake across different periods, with the highest explainability in the post-fourth wave period. 6. **Verbal Reasons for Vaccine Hesitancy**: Participants' verbal reasons for vaccine hesitancy varied by age group. Younger participants cited concerns about vaccine safety and effectiveness, while older participants mentioned worries about chronic diseases and lack of recommendation from healthcare providers. 7. **Sensitivity Check**: The study's findings were robust to changes in the time window for COVID-19 case and death data. The study provides insights for designing effective vaccination programs, emphasizing the need to address vaccine hesitancy through tailored strategies that consider the evolving pandemic situation and public concerns.This study investigates the dynamic predictors of COVID-19 vaccination uptake in Hong Kong over a two-year period, focusing on multi-level determinants and their interconnections. Using repeated cross-sectional surveys, the study maps these determinants and examines their interconnections in a sample of 15,179 participants. Key findings include: 1. **Dynamic Nature of Vaccine Hesitancy**: Vaccine hesitancy is dynamic and evolves with the pandemic. Initially, vaccine safety was a primary concern, but this shifted to vaccine effectiveness later. 2. **Role of Vaccine Confidence**: Vaccine confidence attitudes play a crucial role in vaccination uptake, with their importance changing over time. Initially, vaccine safety was more important, but this shifted to vaccine effectiveness later. 3. **Impact of Demographic and Contextual Factors**: Chronic conditions, age, COVID-19 case numbers, and non-pharmaceutical preventive behaviors significantly influence vaccine uptake. Higher educational attainment and being married are associated with higher primary and booster vaccine uptake. 4. **Trust in Government**: Trust in the government acts as a bridging factor, linking various variables to vaccine confidence attitudes and ultimately to vaccine uptake. 5. **Network Analysis**: A mixed graphical network model was used to depict the complex interconnections between these variables. The network explained a varying proportion of variance in vaccine uptake across different periods, with the highest explainability in the post-fourth wave period. 6. **Verbal Reasons for Vaccine Hesitancy**: Participants' verbal reasons for vaccine hesitancy varied by age group. Younger participants cited concerns about vaccine safety and effectiveness, while older participants mentioned worries about chronic diseases and lack of recommendation from healthcare providers. 7. **Sensitivity Check**: The study's findings were robust to changes in the time window for COVID-19 case and death data. The study provides insights for designing effective vaccination programs, emphasizing the need to address vaccine hesitancy through tailored strategies that consider the evolving pandemic situation and public concerns.