Abstract
Vaccination against coronavirus disease 2019 (COVID-19) is paramount to curtailing the pandemic. However, the impact of the Non-Expanded Program on Immunization (non-EPI) and COVID-19 vaccine hesitancy on vaccine uptake among Chinese adults remain unclear. This study was an online survey performed in Eastern, Central, and Western China between February 2021 and March 2021 using proportional sampling (n = 7381). Adults aged ≥ 18 years were included, especially younger people (aged < 65). Vaccine hesitancy was assessed using the 3C model and relative scales; logistic regression was used to explore the factors affecting vaccination uptake; structural equation modeling was used to evaluate the correlations between variables. Overall, 67.6% and 24.7% of adults reported vaccine hesitancy toward the non-EPI and COVID-19 vaccines, respectively. Participants (66.3%) reported taking the vaccine mainly based on recommendations from medical staff. Vaccine-hesitant participants (60.5%) reported a fear of side effects as the deciding factor in vaccine rejection. Vaccine hesitancy interacted negatively with confidence (β = −0.349, p < 0.001) and convenience (β = −0.232, p < 0.001), and positively with complacence (β = 0.838, p < 0.001). Nonmedical personnel, adults who had previously received the influenza vaccine, and older people had lower vaccine hesitancy than their counterparts. Most Chinese adults have non-EPI but not COVID-19 vaccine hesitancy. Vaccine safety remains a concern.
Highlights
Vaccination against coronavirus disease 2019 (COVID-19) is paramount to curtailing the pandemic
This study aimed to examine the rate of vaccine hesitancy among adults in Eastern, Central, and Western China using online questionnaires; the factors associated with this hesitancy were examined
70.9% of the participants were younger people aged 18–35 years old, and older people merely accounted for very small proportion (Table 2); over 75% and 34.5% of the participants had a college or equivalent degree and an annual family income in the range of 50,000–100,000
Summary
Vaccination against coronavirus disease 2019 (COVID-19) is paramount to curtailing the pandemic. The impact of the Non-Expanded Program on Immunization (non-EPI) and COVID-19 vaccine hesitancy on vaccine uptake among Chinese adults remain unclear. Vaccine hesitancy was assessed using the 3C model and relative scales; logistic regression was used to explore the factors affecting vaccination uptake; structural equation modeling was used to evaluate the correlations between variables. 67.6% and 24.7% of adults reported vaccine hesitancy toward the non-EPI and COVID-19 vaccines, respectively. (66.3%) reported taking the vaccine mainly based on recommendations from medical staff. Vaccinehesitant participants (60.5%) reported a fear of side effects as the deciding factor in vaccine rejection. Nonmedical personnel, adults who had previously received the influenza vaccine, and older people had lower vaccine hesitancy than their counterparts. Most Chinese adults have non-EPI but not COVID-19 vaccine hesitancy. Global media misinformation about adverse reactions to the human papilloma virus (HPV)
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