Access to Vaccination Information and Confidence/Hesitancy Towards Childhood Vaccination: A Cross-Sectional Survey in China.

Fanxing Du,Shiyi Tu,Fiona Yueqian Sun,Tracey Chantler,Xuan Zhang,Hongjie Yu,Heidi Larson,Zhiyuan Hou,Kaiyi Han,Mark R Francis,Lance Rodewald

doi:10.3390/vaccines9030201

Abstract

Access to vaccination information could influence public attitudes towards vaccination. This study investigated the number and types of vaccination-related information sources, and estimated their associations with vaccine confidence and hesitancy in China. In January 2019, we conducted a cross-sectional survey in China, and 2122 caregivers with children <6 years completed self-administered questionnaires. Logistic regressions were used to assess associations between caregivers’ primary information sources and vaccine confidence/hesitancy. A majority (72%) of caregivers had multiple sources of vaccination-related information. The proportions of caregivers reporting professional sources, media, and peers as primary information sources were 81%, 63%, and 26%. Internal migrants were less likely to get information from professional sources; more educated and wealthier caregivers reported more information sources and were more likely to get information from media and peers. Caregivers who reported professional information sources had significantly higher odds of being confident about the safety of vaccines and lower odds of being hesitant toward vaccination than those who did not. Caregivers who reported the media as a primary information source had significantly higher odds of being hesitant toward vaccination than those who did not. To address vaccine hesitancy, it is essential to promote universal access to professional vaccination-related information sources, and to use the media to disseminate evidence-based information and clarify misinformation. Health communication should target internal migrants, and more educated and wealthier caregivers.

Highlights

Vaccination is recognized as an effective public health intervention [1,2,3], this success is being challenged by waning vaccine confidence and growing vaccine hesitancy [4,5]
This study aimed to investigate the number and types of primary sources of vaccination-related information the public accesses, and estimate associations between the reported primary information sources and vaccine confidence and hesitancy in China
Prioritizing professional sources to access vaccination information was associated with higher vaccine confidence, whereas caregivers who relied on the media for vaccination information were more likely to report vaccine hesitancy

Summary

Introduction

Vaccination is recognized as an effective public health intervention [1,2,3], this success is being challenged by waning vaccine confidence and growing vaccine hesitancy [4,5]. Access to appropriate information is essential to guide vaccination decisions, especially given the increased circulation of misinformation and negative information about vaccines and the proliferation of anti-vaccination movements [6]. In Japan, misinformation about adverse reactions following the human papillomavirus vaccination spread globally across media platforms in 2013, significantly undermining the uptake of this vaccine [7]. In Italy, misinformation about the measles–mumps–rubella vaccine and autism on the internet was associated with reduced vaccination coverage during

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