Qin Chenyuan, Yan Wenxin, Tao Liyuan, Liu Min, Liu Jue
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing 100191, China.
Research Center of Clinical Epidemiology, Peking University Third Hospital, No. 49 Huayuan North Road, Haidian District, Beijing 100083, China.
Vaccines (Basel). 2022 Jul 12;10(7):1112. doi: 10.3390/vaccines10071112.
Given the prevalence of the omicron variant and decreased immunity provided by vaccines, it is imperative to enhance resistance to COVID-19 in the old population. We planned to explore the hesitancy rate toward the booster dose of the COVID-19 vaccine and the association between risk perception and the abovementioned rate among people aged 60 and older.
This national cross-sectional study was conducted in mainland China from 25 May to 8 June 2022, targeting people who were 60 years old or above. Four dimensions were extracted from the Health Belief Model (HBM) to assess participants' perceived risk levels, including perceived susceptibility, perceived severity, perceived barriers, and perceived benefit. An independent Chi-square test was used to compare the vaccine hesitancy rates among different groups stratified by characteristics. Univariable and multivariable logistic regression models were performed to explore the associations between risk perception and hesitancy rate.
Of 3321 participants, 17.2% (95% CI: 15.9-18.5%) were hesitant about booster shots of COVID-19 vaccines. Believing that they were ineligible for vaccination due to certain illnesses (38.3%), concern about vaccine safety (32.0%), believing the booster shots were unnecessary (33.1%), and their limitation on movements (28.0%) were the main reasons for vaccine hesitation. Adjusted by all the selected covariates, people with low perception level of susceptibility (aOR = 1.39, 95% CI: 1.00-1.92) and benefit (low: aOR = 3.31, 95% CI: 2.01-5.45; moderate: aOR = 2.23, 95% CI: 1.75-2.85) were less likely to receiving the booster dose, and the same results were found in people with higher perceived barriers (moderate: aOR = 2.67, 95% CI: 2.13-3.35; high: aOR = 2.04, 95% CI: 1.14-3.67). Our estimates were stable in all four models.
In total, 17.2% of the people aged 60 years and older in China were hesitant about booster dose of COVID-19 vaccines, and it was closely associated with a lower level of perceived susceptibility and benefit, as well as a higher level of perceived barriers. Concerns about contraindications, vaccine safety, and limited movements were the main reasons for vaccine hesitancy. Targeted public health measure is a priority to improve the understanding of the elderly on their own susceptibility and vulnerability and clear the obstacles to vaccination.
鉴于奥密克戎变异株的流行以及疫苗提供的免疫力下降，增强老年人群对新冠病毒的抵抗力势在必行。我们计划探讨60岁及以上人群对新冠疫苗加强针的犹豫率，以及风险认知与上述比率之间的关联。
这项全国性横断面研究于2022年5月25日至6月8日在中国大陆进行，目标人群为60岁及以上的人群。从健康信念模型（HBM）中提取四个维度来评估参与者的感知风险水平，包括感知易感性、感知严重性、感知障碍和感知益处。采用独立卡方检验比较不同特征分层组之间的疫苗犹豫率。进行单变量和多变量逻辑回归模型以探讨风险认知与犹豫率之间的关联。
在3321名参与者中，17.2%（95%CI：15.9 - 18.5%）对新冠疫苗加强针犹豫不决。认为因某些疾病不适合接种疫苗（38.3%）、担心疫苗安全（32.0%）、认为加强针不必要（33.1%）以及出行受限（28.0%）是疫苗犹豫的主要原因。在所有选定协变量进行调整后，感知易感性水平低（aOR = 1.39，95%CI：1.00 - 1.92）和感知益处水平低（aOR = 3.31，95%CI：2.01 - 5.45；中等：aOR = 2.23，95%CI：1.75 - 2.85）的人群接种加强针的可能性较小，在感知障碍较高的人群中也发现了相同结果（中等：aOR = 2.67，95%CI：2.13 - 3.35；高：aOR = 2.04，95%CI：1.14 - 3.67）。我们的估计在所有四个模型中都很稳定。
总体而言，中国60岁及以上人群中17.2%对新冠疫苗加强针犹豫不决，这与较低的感知易感性和益处水平以及较高的感知障碍水平密切相关。对禁忌证、疫苗安全和出行受限的担忧是疫苗犹豫的主要原因。有针对性的公共卫生措施是提高老年人对自身易感性和脆弱性的认识并清除接种障碍的当务之急。
