Wagner Abram L, Huang Zhuoying, Ren Jia, Laffoon Megan, Ji Mengdi, Pinckney Leah C, Sun Xiaodong, Prosser Lisa A, Boulton Matthew L, Zikmund-Fisher Brian J
Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan.
Department of Immunization Program, Shanghai Municipal Centers for Disease Control and Prevention, Shanghai, China.
Am J Prev Med. 2021 Jan;60(1 Suppl 1):S77-S86. doi: 10.1016/j.amepre.2020.09.003. Epub 2020 Nov 12.
Rapidly urbanizing communities in middle-income countries could be sources of vaccine hesitancy, and may create hot spots of low vaccination coverage. This study characterizes vaccine hesitancy in Shanghai and identifies disparities in vaccine safety and efficacy concerns by residency status-a marker for recent migration into the city.
Parents of children aged ≤18 years from immunization clinics in Shanghai were enrolled in summer 2019, with the data analyzed during winter 2019-2020. The paper questionnaire used the Parental Attitudes towards Childhood Vaccines scale, which included questions about vaccine safety and efficacy concerns. The primary independent variable was residency-whether an individual was a Shanghai local or a recent migrant (i.e., non-local). Linear regression models assessed the relationship between residency and vaccine safety and efficacy concerns.
Among 1,021 participants, 65.4% had local residency, and the remainder were urban non-locals (13.1%) or rural non-locals (21.5%). A majority of parents expressed concerns about vaccine side effects (73.8%), vaccine safety (63.9%), and vaccine effectiveness (52.4%). Compared with locals, rural non-locals were more concerned about vaccine side effects (β=0.26, 95% CI=0.07, 0.46), vaccine safety (β=0.42, 95% CI=0.19, 0.65), and vaccine effectiveness (β=0.37, 95% CI=0.16, 0.58).
Differences in vaccine hesitancy by residency could lead to geographical and sociodemographic disparities in vaccination coverage and outbreaks of vaccine-preventable disease.
This article is part of a supplement entitled Global Vaccination Equity, which is sponsored by the Global Institute for Vaccine Equity at the University of Michigan School of Public Health.
中等收入国家快速城市化的社区可能是疫苗犹豫的源头，并可能造成疫苗接种覆盖率低的热点地区。本研究描述了上海的疫苗犹豫情况，并通过居住状况（这是近期迁入该市的一个标志）确定了在疫苗安全性和有效性担忧方面的差异。
2019年夏季，招募了来自上海免疫诊所的18岁及以下儿童的家长，并于2019 - 2020年冬季对数据进行分析。纸质问卷采用了《家长对儿童疫苗的态度》量表，其中包括有关疫苗安全性和有效性担忧的问题。主要自变量是居住状况——个人是上海本地人还是新移民（即非本地人）。线性回归模型评估了居住状况与疫苗安全性和有效性担忧之间的关系。
在1021名参与者中，65.4%具有本地居住身份，其余为城市非本地人（13.1%）或农村非本地人（21.5%）。大多数家长对疫苗副作用（73.8%）、疫苗安全性（63.9%）和疫苗有效性（52.4%）表示担忧。与本地人相比，农村非本地人更担心疫苗副作用（β = 0.26，95%置信区间 = 0.07，0.46）、疫苗安全性（β = 0.42，95%置信区间 = 0.19，0.65）和疫苗有效性（β = 0.37，95%置信区间 = 0.16，0.58）。
因居住状况导致的疫苗犹豫差异可能会导致疫苗接种覆盖率在地理和社会人口统计学上的差异以及疫苗可预防疾病的爆发。
本文是名为《全球疫苗公平》的增刊的一部分，该增刊由密歇根大学公共卫生学院全球疫苗公平研究所赞助。
