Yao Xuelin, Fu Mao, Peng Jin, Feng Da, Ma Yue, Wu Yifan, Feng Liuxin, Fang Yu, Jiang Minghuan
Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.
Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.
Hum Vaccin Immunother. 2025 Dec;21(1):2444008. doi: 10.1080/21645515.2024.2444008. Epub 2025 Jan 8.
Parental vaccine hesitancy is a major obstacle to childhood vaccination. We examined parental socioeconomic status (SES) disparities in vaccine hesitancy, and the potential mediating roles of perceived social support and health literacy. A questionnaire survey was given to parents with children aged below 6 years from six provinces in China. SES was examined by educational attainment, annual household income, and a subjective measure of SES (using a scale of 1-10). Linear regression was applied to assess the association between SES and vaccine hesitancy. Bootstrapping mediation analysis was performed with 5,000 samples bootstrapped. A total of 1,638 parents were included. Using annual household income > 200,000 Chinese yuan (CNY) as a reference, parents with lower household income (CNY 100,001-150,000) experienced higher vaccine hesitancy. Educational attainment was not associated with vaccine hesitancy. Subjective SES had a U-shaped relationship with vaccine hesitancy. Perceived social support and health literacy independently and sequentially mediated the effects of subjective SES (indirect effect: -0.240) and annual household income (indirect effect: 1.250 for ≤ CNY 100,000 and 0.759 for CNY 100,001-150,000) on vaccine hesitancy. Socioeconomic disparities influenced parental vaccine hesitancy in China, which were mediated by perceptions of social support and health literacy.
家长对疫苗的犹豫态度是儿童疫苗接种的主要障碍。我们研究了家长在疫苗犹豫方面的社会经济地位（SES）差异，以及感知社会支持和健康素养的潜在中介作用。对来自中国六个省份的6岁以下儿童的家长进行了问卷调查。通过教育程度、家庭年收入和SES主观测量指标（采用1 - 10分制）来考察SES。应用线性回归评估SES与疫苗犹豫之间的关联。采用5000个样本进行自抽样中介分析。共纳入1638名家长。以家庭年收入>20万元人民币（CNY）为参照，家庭收入较低（100,001 - 150,000元人民币）的家长疫苗犹豫程度更高。教育程度与疫苗犹豫无关。主观SES与疫苗犹豫呈U型关系。感知社会支持和健康素养分别且依次中介了主观SES（间接效应：-0.240）和家庭年收入（间接效应：年收入≤10万元人民币时为1.250，年收入为100,001 - 150,000元人民币时为0.759）对疫苗犹豫的影响。社会经济差异影响了中国家长的疫苗犹豫态度，这种影响通过对社会支持和健康素养的感知来介导。
