Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, China.
Trop Med Int Health. 2022 Oct;27(10):864-872. doi: 10.1111/tmi.13809. Epub 2022 Aug 27.
To estimate the coverage and willingness of pneumococcal vaccination and further explore the influencing factors of vaccination willingness among people in mainland China.
Literature searches were conducted independently by two researchers in English- and Chinese-language databases from database inception to 6 October 2021. A random-effects meta-analysis model was used to derive summary vaccination coverage and willingness. Predefined subgroup analysis and meta-regression were performed to explore the sources of heterogeneity.
A total of 97 studies were included in this meta-analysis. The summary vaccination coverage in 76 included studies was 21.7% (95% confidence interval [CI]: 17.2%-26.5%). Subgroup analysis shows that the summary coverage was 29.0% (95% CI, 20.4%-39.1%) among the permanent residents and 20.7% (95% CI, 12.4%-35.9%) among the floating residents. The eastern and central regions presented higher coverage than the western region. Notable differences were observed between the various study populations. A total of 27 studies provided an estimation of vaccination willingness, with a summary willingness of 51.2% (95% CI, 40.4%-61.9%). In subgroup analysis, the summary willingness was 57.9% (95% CI, 48.3%-67.2%) in urban areas and 52.3% (95% CI, 40.8%-63.8%) in rural areas. Parents with children and people with a history of pneumonia were more willing to be vaccinated than the elderly. Recommendations by family members and physicians, previous pneumococcal and influenza vaccination, perceived vaccination effectiveness and severity of disease and a history of pneumonia contributed to vaccination willingness.
Compared to global estimates and other countries, pneumococcal vaccination coverage and willingness are at a lower level in mainland China. Recommendations for vaccination by family members and doctors, a history of vaccination and the perception of pneumonia and vaccination are associated with greater willingness to be vaccinated.
评估肺炎球菌疫苗接种的覆盖范围和意愿，并进一步探讨中国大陆人群疫苗接种意愿的影响因素。
研究者于数据库建立起至 2021 年 10 月 6 日，分别在英文和中文数据库中独立检索文献，采用随机效应荟萃分析模型获取疫苗接种覆盖率和意愿的综合估计值。进行了预设的亚组分析和荟萃回归，以探索异质性的来源。
共有 97 项研究纳入本荟萃分析。76 项纳入研究的综合疫苗接种覆盖率为 21.7%（95%置信区间[CI]：17.2%-26.5%）。亚组分析显示，常住居民的综合覆盖率为 29.0%（95% CI：20.4%-39.1%），流动居民为 20.7%（95% CI：12.4%-35.9%）。东部和中部地区的覆盖率高于西部地区。不同研究人群之间存在显著差异。共有 27 项研究提供了疫苗接种意愿的估计值，综合意愿率为 51.2%（95% CI：40.4%-61.9%）。在亚组分析中，城市地区的综合意愿率为 57.9%（95% CI：48.3%-67.2%），农村地区为 52.3%（95% CI：40.8%-63.8%）。有子女的父母和有肺炎病史的人比老年人更愿意接种疫苗。家庭成员和医生的推荐、既往肺炎球菌和流感疫苗接种、对疫苗有效性和疾病严重程度的认知以及肺炎史与接种意愿相关。
与全球估计值和其他国家相比，中国内地的肺炎球菌疫苗接种覆盖率和意愿都较低。家庭成员和医生的疫苗接种建议、既往疫苗接种史以及对肺炎和疫苗接种的认知与更高的接种意愿相关。
