Seasonal Influenza Vaccine Hesitancy Profiles and Determinants Among Chinese Children's Guardians and the Elderly

Abstract

Background: Seasonal influenza imposes a significant clinical and economic burden, yet vaccine coverage remains low in China due to possible influenza vaccine hesitancy (IVH) and practical issues. We sought to investigate IVH and its determinants among children’s guardians and the elderly for better understanding of the situation and for future intervention. Methods: We performed two cross-sectional studies to identify the profiles and determinants of IVH using stratified cluster random sampling in an eastern China province in 2019. Results: Of the 1,564 guardians and 522 elders, 43·2% (95%CI: 40·4–46·0%) of guardians and 33·5% of elders (95%CI: 29·5–37·6%) had IVH, whereas 31·3% of the guardians and 5·5% of the elderly had Influenza vaccine demand. ‘From rural area’ (Odds ratio: 1·36), ‘don’t know government recommendation for flu vaccination’ (1·39), ‘don’t know flu vaccine is vaccinated annually’ (1·93), ‘family members (0·22), friends and neighbors had positive attitude toward flu vaccine’(0·58) were related factors of the guardians’ IVH. ‘Aged 70–79 years’ (0·46), ‘had flu before’ (0·35), and ‘once had been vaccinated’ (0·42) were related to the elderly’s IVH. Interpretation: Poor awareness of influenza and vaccination, relatives’ negative/positive attitude, lack of government recommendations, anxiety about vaccine quality, and practical issues such as short supply are related to IVH in China. Precision education aiming hesitancy in wider groups are anticipated to increase vaccine confidence and coverage in influenza-vulnerable groups. Funding Statement: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: Zhejiang Chinese Medical University Ethnics Committee reviewed and approved this protocol and informed consent was obtained from each subject.