School of Public Health, Peking University, Beijing, China.
Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China.
Hum Vaccin Immunother. 2023 Dec 31;19(1):2186108. doi: 10.1080/21645515.2023.2186108. Epub 2023 Mar 9.
Coronavirus disease 2019 (COVID-19) has wreaked havoc across the globe for approximately three years. Vaccination is a key factor to ending this pandemic, but its protective effect diminishes over time. A second booster dose at the right time is needed. To explore the willingness to receive the fourth dose of the COVID-19 vaccine and its influencing factors, we commenced a national, cross-sectional and anonymous survey in mainland China among people aged 18 and above from October 24 to November 7, 2022. A total of 3,224 respondents were eventually included. The acceptance rate of the fourth dose was 81.1% (95% CI: 79.8-82.5%), while it was 72.6% (95% CI: 71.1-74.2%) for a heterologous booster. Confidence in current domestic situation and the effectiveness of previous vaccinations, and uncertainty about extra protection were the main reasons for vaccine hesitancy. Perceived benefit (aOR = 1.29, 95% CI: 1.159-1.40) and cues to action (aOR = 1.73, 95% CI: 1.60-1.88) were positively associated with the vaccine acceptance, whereas perceived barriers (aOR = 0.78, 95% CI: 0.72-0.84) and self-efficacy (aOR = 0.79, 95% CI: 0.71-0.89) were both negatively associated with it. Additionally, sex, age, COVID-19 vaccination history, time for social media, and satisfaction with the government's response to COVID-19 were also factors affecting vaccination intention. Factors influencing the intention of heterologous booster were similar to the above results. It is of profound theoretical and practical significance to clarify the population's willingness to vaccinate in advance and explore the relevant influencing factors for the subsequent development and promotion of the fourth-dose vaccination strategies.
新型冠状病毒肺炎（COVID-19）肆虐全球已近三年。疫苗接种是结束这场大流行的关键因素，但随着时间的推移，其保护作用会逐渐减弱。需要在适当的时候接种第二剂加强针。为了探讨人们接种第四剂 COVID-19 疫苗的意愿及其影响因素，我们于 2022 年 10 月 24 日至 11 月 7 日在中国大陆开展了一项全国性、横断面和匿名调查，调查对象为 18 岁及以上人群。最终共纳入 3224 名受访者。第四剂疫苗的接种意愿率为 81.1%（95%CI：79.8-82.5%），而异源加强针的接种意愿率为 72.6%（95%CI：71.1-74.2%）。对当前国内形势和以往疫苗有效性的信心，以及对额外保护的不确定性，是疫苗犹豫的主要原因。感知益处（aOR=1.29，95%CI：1.159-1.40）和行动线索（aOR=1.73，95%CI：1.60-1.88）与疫苗接种意愿呈正相关，而感知障碍（aOR=0.78，95%CI：0.72-0.84）和自我效能感（aOR=0.79，95%CI：0.71-0.89）与疫苗接种意愿呈负相关。此外，性别、年龄、COVID-19 疫苗接种史、社交媒体使用时间和对政府应对 COVID-19 措施的满意度也是影响接种意愿的因素。影响异源加强针接种意愿的因素与上述结果相似。提前明确人群的接种意愿，并探讨相关影响因素，对后续制定和推广第四剂疫苗接种策略具有重要的理论和现实意义。
