Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China.
Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China.
JMIR Public Health Surveill. 2023 Aug 1;9:e44822. doi: 10.2196/44822.
COVID-19 vaccine hesitancy reduces vaccination rates, which is detrimental to building herd immunity and halting the spread of COVID-19 and its variations. Most researches have simply identified the reasons affecting COVID-19 vaccination reluctance without delving into its dynamics, which makes forecasting future trends difficult.
This study aimed to examine the current COVID-19 vaccine booster hesitancy rate in Chinese adults as well as the dynamics of vaccine hesitancy and its influencing factors. The results of this study will have practical implications for policy responses in mainland China, and effective COVID-19 booster vaccination in specific populations.
The web-based survey was completed by creating questionnaires and using a stratified random sampling method to collect information from adults (≥18 years old) among 2556 households in 4 geographical regions of China. We collected sociodemographic information, health status, awareness of COVID-19 and its vaccine, self-perceptions, trust in medical staff and vaccine developers, and so on. The odds ratios and 95% CI for the statistical associations were estimated using logistic regression models.
Overall, 6659 participants (females: n=3540, 53.2%; males: n=3119, 46.8%) responded. In total, 533 (8%; 95% CI 7.4%-8.7%) participants presented a clear hesitancy in receiving the COVID-19 booster vaccination, while 736 (11.1%; 95% CI 10.3%-11.8%) expressed hesitancy in regular booster vaccination. A higher prevalence of vaccine hesitancy in both booster vaccination and regular booster vaccination was observed among participants with a history of allergies, experiencing chronic disease, lower levels of public health prevention measures or susceptibility or benefits or self-efficiency, higher levels of severity or barriers, and lower trust in both medical staff and vaccine developers (P<.05). The females and participants with higher education levels, higher levels of barriers, lower levels of susceptibility, and lower trust in vaccine developers preferred to have attitudinal changes from acceptance to hesitancy, while people with higher education levels, lower self-report health conditions, experiencing chronic disease, history of allergies, and lower trust in medical staff and developers were all positively associated with constant COVID-19 booster hesitancy.
The prevalence of COVID-19 vaccine booster hesitancy is not high in mainland China. However, there is a slight increment in hesitancy on regular booster vaccination. Conducting targeted information guidance for people with higher education levels and chronic diseases, as well as improving accessibility to booster vaccination and increasing trust in medical staff and vaccine producers may be highly effective in reducing vaccine hesitancy.
新冠病毒疫苗犹豫会降低疫苗接种率，这不利于建立群体免疫并阻止新冠病毒及其变异的传播。大多数研究只是简单地确定了影响新冠病毒疫苗接种犹豫的原因，而没有深入研究其动态变化，这使得预测未来的趋势变得困难。
本研究旨在调查中国成年人目前对新冠病毒疫苗加强针的犹豫率，以及疫苗犹豫的动态变化及其影响因素。本研究的结果将对中国内地的政策应对措施以及特定人群中有效的新冠病毒加强针接种具有实际意义。
通过创建问卷并使用分层随机抽样方法，从中国 4 个地理区域的 2556 户家庭中的成年人（≥18 岁）中收集信息，完成了这项基于网络的调查。我们收集了社会人口统计学信息、健康状况、对新冠病毒及其疫苗的认识、自我认知、对医务人员和疫苗开发商的信任等信息。使用逻辑回归模型估计统计关联的优势比和 95%置信区间。
共有 6659 名参与者（女性：n=3540，53.2%；男性：n=3119，46.8%）做出了回应。共有 533 名（8%；95%CI 7.4%-8.7%）参与者明确表示对接受新冠病毒加强针疫苗犹豫不决，而 736 名（11.1%；95%CI 10.3%-11.8%）参与者对定期加强针疫苗犹豫不决。在有过敏史、患有慢性病、对公共卫生预防措施或易感性或益处或自我效能感较低、对严重程度或障碍的感知较高以及对医务人员和疫苗开发商的信任度较低的参与者中，两种加强针疫苗接种和定期加强针疫苗接种的疫苗犹豫率均较高（P<.05）。女性和受教育程度较高、障碍感知较高、易感性较低以及对疫苗开发商信任度较低的参与者更倾向于从接受转为犹豫，而受教育程度较高、自我报告健康状况较差、患有慢性病、有过敏史以及对医务人员和开发商的信任度较低的参与者则与持续的新冠病毒加强针犹豫呈正相关。
在中国内地，新冠病毒疫苗加强针犹豫的流行率并不高。然而，定期加强针接种的犹豫程度略有增加。针对受教育程度较高和患有慢性病的人群进行有针对性的信息指导，以及提高加强针接种的可及性并增加对医务人员和疫苗生产者的信任，可能是降低疫苗犹豫的有效措施。
