Rehati Palizhati, Amaerjiang Nubiya, Yang Liping, Xiao Huidi, Li Menglong, Zunong Jiawulan, Wang Long, Vermund Sten H, Hu Yifei
Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, China.
Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT 06510-3201, USA.
Vaccines (Basel). 2022 Mar 15;10(3):452. doi: 10.3390/vaccines10030452.
To address the novel coronavirus disease (COVID-19) pandemic, development and regulatory evaluations have been accelerated for vaccines, authorizing emergency use. To anticipate vaccine preparedness in adolescents, we studied COVID-19 vaccination awareness and willingness to vaccinate before the vaccine became available. We conducted a cross-sectional survey among 9153 (4575 boys, 50%) students with a mean age of 14.2 years old in four cities in China to collect information on demographic characteristics and their COVID-19 vaccination concerns. Multinomial logistic regression was used to analyze the influencing factors of vaccine hesitancy ("not sure") and resistance ("do not want it"). The results showed that 2891 (31.6%) were hesitant and 765 (8.4%) were resistant to being vaccinated. Additionally, multivariable analyses showed that vaccine hesitancy and vaccine resistance were associated with living in the Beijing area (OR = 1.62; 95% CI: 1.40-1.88; OR = 1.81; 95% CI: 1.44-2.28), lack of influenza vaccination experience (OR = 1.33; 95% CI: 1.14-1.55; OR = 1.57; 95% CI: 1.25-1.98), no perceived susceptibility (OR = 1.72; 95% CI: 1.50-1.97; OR = 3.57; 95% CI: 2.86-4.46), and perceiving no cues to action (OR = 3.24; 95% CI: 2.56-4.11; OR = 27.68; 95% CI: 21.81-35.13). Postulating a highly effective vaccine (OR = 0.84; 95% CI: 0.72-0.98; OR = 0.66; 95% CI: 0.52-0.83) decreased both vaccine hesitancy and resistance. Vaccine hesitancy alone was associated with girls (OR = 1.21; 95% CI: 1.09-1.36) and was less common among students boarding at school (OR = 0.79; 95% CI: 0.68-0.92), postulating convenient vaccine access (OR = 0.84; 95% CI: 0.73-0.96), and having doctors' recommendation (OR = 0.86; 95% CI: 0.76-0.98). In conclusion, the results of the study showed that vaccine hesitancy among students in China was associated with limited health literacy and lower risk awareness. Our findings in China suggest that educating youth regarding COVID-19 and the safety and effectiveness of immunization help reduce concerns and increase vaccine confidence and acceptance.
为应对新型冠状病毒肺炎（COVID-19）大流行，疫苗的研发和监管评估加速推进，并获得了紧急使用授权。为了解青少年的疫苗接种准备情况，我们在疫苗可用之前研究了COVID-19疫苗接种意识和接种意愿。我们在中国四个城市对9153名（4575名男生，占50%）平均年龄为14.2岁的学生进行了横断面调查，以收集人口统计学特征信息及其对COVID-19疫苗接种的担忧。采用多项逻辑回归分析疫苗犹豫（“不确定”）和抵触（“不想接种”）的影响因素。结果显示，2891名（31.6%）学生存在犹豫，765名（8.4%）学生抵触接种。此外，多变量分析表明，疫苗犹豫和疫苗抵触与居住在北京地区（OR = 1.62；95%CI：1.40 - 1.88；OR = 1.81；95%CI：1.44 - 2.28）、缺乏流感疫苗接种经验（OR = 1.33；95%CI：1.14 - 1.55；OR = 1.57；CI：1.25 - 1.98）、未感知到易感性（OR = 1.72；95%CI：1.50 - 1.97；OR = 3.57；95%CI：2.86 - 4.46）以及未感知到行动线索（OR = 3.24；95%CI：2.56 - 4.11；OR = 27.68；95%CI：21.81 - 35.13）有关。假定疫苗高效（OR = 0.84；95%CI：0.72 - 0.98；OR = 0.66；95%CI：0.52 - 0.83）可降低疫苗犹豫和抵触。仅疫苗犹豫与女生有关（OR = 1.21；95%CI：1.09 - 1.36），在住校学生中较不常见（OR = 0.79；95%CI：0.68 - 0.92），假定疫苗接种方便（OR = 0.84；95%CI：0.73 - 0.96）以及有医生推荐（OR = 0.86；95%CI：0.76 - 0.98）。总之，研究结果表明，中国学生的疫苗犹豫与健康素养有限和风险意识较低有关。我们在中国的研究结果表明，对青少年进行COVID-19及免疫接种安全性和有效性的教育有助于减少担忧，增强疫苗信心和接受度。
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