School of Public Health, Peking University, Beijing 100191, China; China Center for Health Development Studies, Peking University, Beijing 100191, China.
School of Public Health, Peking University, Beijing 100191, China.
Vaccine. 2022 Jun 23;40(29):3975-3983. doi: 10.1016/j.vaccine.2022.05.023. Epub 2022 May 28.
Seasonal influenza can cause serious harm to children under five years of age, while caregivers are still hesitant to vaccinate children against influenza. This study aimed to investigate caregivers' hesitancy regarding influenza vaccination and assess the associated factors.
From August to October 2019, a cross-sectional survey was conducted in ten provinces in China. The questionnaire collected information about sociodemographic characteristics and caregivers' knowledge, perceptions and attitudes toward influenza vaccination. Caregivers were identified as not hesitating, hesitating or refusing to vaccinate children. Multinomial logistic regression was adopted to determine factors related to vaccine hesitancy based on the 3C model with three dimensions namely complacency, convenience and confidence.
A total of 6668 valid questionnaires were collected, among which 38.57% did not hesitate to vaccinate children against influenza, 56.03% were hesitant, and 5.40% refused. Multinomial logistic regression showed that caregivers perceiving high importance (AOR = 0.68 for hesitancy; 0.15 for refusal), safety (AOR = 0.42; 0.46) or efficacy (AOR = 0.73; 0.65) of influenza vaccination, knowing children as a priority group (AOR = 0.80; 0.48), and trusting vaccination advice from medical staff (AOR = 0.65; 0.51) had lower odds of hesitancy or refusal. Those considering price as a hindering factor had higher odds of hesitancy (AOR = 1.66) or refusal (AOR = 1.47), and those viewing time or distance as a hindering factor (AOR = 1.45) or having heard of vaccine-related negative information (AOR = 1.78) had higher odds of hesitancy. Sociodemographic characteristics were associated with vaccine hesitancy or refusal, and the associations varied for hesitators and refusers.
A large proportion of caregivers in China reported their hesitancy for influenza vaccination, and the associated factors of such hesitancy were complicated. Health professionals are recommended to spread relevant scientific knowledge and give vaccine-related suggestions to caregivers in doctor visits to promote caregivers' trust in influenza vaccination and therefore expand childhood vaccine coverage.
季节性流感可对 5 岁以下儿童造成严重危害，而照护者对接种儿童流感疫苗仍持犹豫态度。本研究旨在调查照护者对流感疫苗接种的犹豫情况，并评估相关因素。
2019 年 8 月至 10 月，在中国 10 个省份进行了一项横断面调查。调查问卷收集了照护者的社会人口学特征、以及他们对流感疫苗接种的知识、看法和态度等信息。将照护者分为不犹豫、犹豫或拒绝为儿童接种疫苗三种情况。基于包含自满、便利和信心三个维度的 3C 模型，采用多项逻辑回归分析确定与疫苗犹豫相关的因素。
共收集了 6668 份有效问卷，其中 38.57%的照护者毫不犹豫地为儿童接种流感疫苗，56.03%的照护者持犹豫态度，5.40%的照护者拒绝接种。多项逻辑回归显示，照护者认为流感疫苗接种非常重要（犹豫的优势比[OR] = 0.68；拒绝的 OR = 0.15）、安全（OR = 0.42；OR = 0.46）或有效（OR = 0.73；OR = 0.65）、认为儿童是优先接种人群（OR = 0.80；OR = 0.48）、信任医务人员的疫苗接种建议（OR = 0.65；OR = 0.51），则其犹豫或拒绝的可能性较低。认为价格是阻碍因素的照护者更有可能犹豫不决（OR = 1.66）或拒绝接种（OR = 1.47），认为时间或距离是阻碍因素的照护者（OR = 1.45）或听说过疫苗相关负面信息的照护者（OR = 1.78）更有可能犹豫不决。社会人口学特征与疫苗犹豫或拒绝有关，且犹豫者和拒绝者的相关因素存在差异。
中国有很大比例的照护者对接种流感疫苗持犹豫态度，且其犹豫的相关因素较为复杂。建议卫生专业人员在就诊时向照护者传播相关科学知识并提供疫苗相关建议，以增进照护者对流感疫苗接种的信任，从而扩大儿童疫苗的接种覆盖率。
