城乡居住与 COVID-19 疫苗犹豫的关系：一项大规模的全国性中国研究。
How urban versus rural residency relates to COVID-19 vaccine hesitancy: A large-scale national Chinese study.
机构信息
Department of Health Management, College of Public Health, Zhengzhou University, Henan, People's Republic of China; Henan Province Engineering, Research Center of Health Economy & Health Technology Assessment, Zhengzhou, Henan, People's Republic of China.
Department of Health Management, College of Public Health, Zhengzhou University, Henan, People's Republic of China; Henan Province Engineering, Research Center of Health Economy & Health Technology Assessment, Zhengzhou, Henan, People's Republic of China; Department of Science and Laboratory Technology, Dar es salaam Institute of Technology, Dar es Salaam, Tanzania.
出版信息
Soc Sci Med. 2023 Mar;320:115695. doi: 10.1016/j.socscimed.2023.115695. Epub 2023 Jan 18.
RATIONALE
Although urban-rural residency has been shown to influence individual COVID-19 vaccine hesitancy, the differences between urban and rural China have yet to be uncovered.
OBJECTIVE
This study aims to assess the current prevalence and factors associated with COVID-19 vaccine hesitancy in urban and rural areas and explore whether the rural versus urban residency is associated with COVID-19 vaccine hesitancy.
METHODS
A national, cross-sectional, online survey among Chinese urban and rural adults (≥18 years old) was conducted from 6th to August 9, 2021. A questionnaire was used to collect data on sociodemographic factors, perceptions of the COVID-19 pandemic and vaccination status. A multivariable logistic regression model was used to identify the factors that influence COVID-19 vaccine hesitancy. Propensity score matching (PSM) analysis was performed to explore the association between urban versus rural residency and COVID-19 vaccine hesitancy.
RESULTS
In total, 29,925 participants (80.56% urban participants) were recruited. Urban participants had a higher COVID-19 vaccine hesitancy than their rural counterparts (9.39% vs. 4.26%). After adjusting for potential confounders, we found that COVID-19 vaccine hesitancy among females was lower than that in males in both urban (aOR = 0.78, 95% CI [0.69-0.88]) and rural areas (aOR = 0.54, 95% CI [0.39-0.75]). The lack of trust towards vaccine producers was found to be associated with vaccine hesitancy among the urban participants (aOR = 2.76, 95% CI [2.22-3.43]). The rural floating population had a lower COVID-19 vaccine hesitancy than the rural permanent residents (aOR = 0.58, 95% CI [0.42-0.80]). PSM analysis revealed a 2.38% difference in COVID-19 vaccine hesitancy between urban and rural participants.
CONCLUSIONS
Urban participants were more hesitant to receive the COVID-19 vaccine than rural participants. Priority should be placed on boosting confidence in the healthcare system to reduce COVID-19 vaccine hesitancy among urban residents. Furthermore, we advocate for extra incentives and vaccination education for rural permanent residents.
背景
尽管城乡居住状况已被证明会影响个体对 COVID-19 疫苗的犹豫程度，但中国城乡之间的差异尚未被揭示。
目的
本研究旨在评估城乡地区 COVID-19 疫苗犹豫的当前流行率和相关因素，并探讨城乡居住状况是否与 COVID-19 疫苗犹豫有关。
方法
2021 年 8 月 6 日至 9 日，我们在中国城乡成年人（≥18 岁）中进行了一项全国性、横断面、在线调查。使用问卷收集社会人口统计学因素、对 COVID-19 大流行和疫苗接种状况的认知数据。采用多变量逻辑回归模型确定影响 COVID-19 疫苗犹豫的因素。进行倾向评分匹配（PSM）分析以探讨城乡居住状况与 COVID-19 疫苗犹豫之间的关联。
结果
共招募了 29925 名参与者（80.56%为城市参与者）。城市参与者的 COVID-19 疫苗犹豫程度高于农村参与者（9.39%比 4.26%）。在调整了潜在混杂因素后，我们发现城市参与者的女性 COVID-19 疫苗犹豫程度低于男性（比值比 [aOR] = 0.78，95%置信区间 [0.69-0.88]），农村参与者的女性 COVID-19 疫苗犹豫程度也低于男性（aOR = 0.54，95% CI [0.39-0.75]）。我们发现，城市参与者对疫苗生产商的信任缺乏与疫苗犹豫有关（aOR = 2.76，95% CI [2.22-3.43]）。农村流动人口的 COVID-19 疫苗犹豫程度低于农村常住居民（aOR = 0.58，95% CI [0.42-0.80]）。PSM 分析显示，城乡参与者的 COVID-19 疫苗犹豫程度存在 2.38%的差异。
结论
城市参与者比农村参与者更不愿意接种 COVID-19 疫苗。应优先增强城市居民对医疗保健系统的信心，以降低城市居民对 COVID-19 疫苗的犹豫程度。此外，我们主张为农村常住居民提供额外的激励措施和疫苗接种教育。
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