Non-EPI Vaccine Hesitancy among Chinese Adults: A Cross-Sectional Study

doi:10.3390/vaccines9070772

. 2021 Jul 10;9(7):772.

doi: 10.3390/vaccines9070772.

Non-EPI Vaccine Hesitancy among Chinese Adults: A Cross-Sectional Study

Jianli Wang^{1

2}, Yan Zhang^{1

2}, Sigui Long^{1

2}, Xin Fu^{1

2}, Xiaoxuan Zhang^{1

2}, Shuangyu Zhao^{1

2}, Shixin Xiu³, Xuwen Wang³, Bing Lu³, Hui Jin^{1

2}

Affiliations

¹ Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China.
² Key Laboratory of Environmental Medicine Engineering, School of Public Health, Southeast University, Ministry of Education, Nanjing 210009, China.
³ Wuxi Center for Disease Control and Prevention, Wuxi 214023, China.

PMID: 34358188
PMCID: PMC8310190
DOI: 10.3390/vaccines9070772

Non-EPI Vaccine Hesitancy among Chinese Adults: A Cross-Sectional Study

Jianli Wang et al. Vaccines (Basel). 2021.

. 2021 Jul 10;9(7):772.

doi: 10.3390/vaccines9070772.

Authors

Jianli Wang^{1

2}, Yan Zhang^{1

2}, Sigui Long^{1

2}, Xin Fu^{1

2}, Xiaoxuan Zhang^{1

2}, Shuangyu Zhao^{1

2}, Shixin Xiu³, Xuwen Wang³, Bing Lu³, Hui Jin^{1

2}

Affiliations

¹ Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China.
² Key Laboratory of Environmental Medicine Engineering, School of Public Health, Southeast University, Ministry of Education, Nanjing 210009, China.
³ Wuxi Center for Disease Control and Prevention, Wuxi 214023, China.

PMID: 34358188
PMCID: PMC8310190
DOI: 10.3390/vaccines9070772

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.

Keywords: COVID-19 vaccine; Chinese adults; non-EPI vaccine; vaccine hesitancy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
Impact of peer groups on vaccination attitudes. (a) Attitudes towards non-EPI vaccinations recommended by family, friends, or doctors. (b) Impact of family members on non-EPI vaccination decisions (N = 7318).

**Figure 2**
Primary sources of information on non-EPI vaccinations (N = 7318).

**Figure 3**
Participants declaring COVID-19 vaccination (a) intention and (b) uptake.

**Figure 4**
Reasons for COVID-19 vaccination (a) willingness and (b) refusal.

**Figure 5**
Structural equation model of vaccine hesitancy among adults.

See this image and copyright information in PMC

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[1] Lane S., MacDonald N.E., Marti M., Dumolard L. Vaccine hesitancy around the globe: Analysis of three years of WHO/UNICEF Joint Reporting Form data-2015–2017. Vaccine. 2018;36:3861–3867. doi: 10.1016/j.vaccine.2018.03.063. - DOI - PMC - PubMed

[2] Lane S., MacDonald N.E., Marti M., Dumolard L. Vaccine hesitancy around the globe: Analysis of three years of WHO/UNICEF Joint Reporting Form data-2015–2017. Vaccine. 2018;36:3861–3867. doi: 10.1016/j.vaccine.2018.03.063. - DOI - PMC - PubMed

[3] Larson H.J., Wilson R., Hanley S., Parys A., Paterson P. Tracking the global spread of vaccine sentiments: The global response to Japan’s suspension of its HPV vaccine recommendation. Hum. Vaccines Immunother. 2014;10:2543–2550. doi: 10.4161/21645515.2014.969618. - DOI - PMC - PubMed

[4] Larson H.J., Wilson R., Hanley S., Parys A., Paterson P. Tracking the global spread of vaccine sentiments: The global response to Japan’s suspension of its HPV vaccine recommendation. Hum. Vaccines Immunother. 2014;10:2543–2550. doi: 10.4161/21645515.2014.969618. - DOI - PMC - PubMed

[5] Jama A., Lindstrand A., Ali M., Butler R., Kulane A. Nurses’ Perceptions Of MMR Vaccine Hesitancy In An Area With Low Vaccination Coverage. Pediatr. Health Med. Ther. 2019;10:177–182. doi: 10.2147/PHMT.S212921. - DOI - PMC - PubMed

[6] Jama A., Lindstrand A., Ali M., Butler R., Kulane A. Nurses’ Perceptions Of MMR Vaccine Hesitancy In An Area With Low Vaccination Coverage. Pediatr. Health Med. Ther. 2019;10:177–182. doi: 10.2147/PHMT.S212921. - DOI - PMC - PubMed

[7] Wong L.P., Wong P.F., AbuBakar S. Vaccine hesitancy and the resurgence of vaccine preventable diseases: The way forward for Malaysia, a Southeast Asian country. Hum. Vaccines Immunother. 2020;16:1511–1520. doi: 10.1080/21645515.2019.1706935. - DOI - PMC - PubMed

[8] Wong L.P., Wong P.F., AbuBakar S. Vaccine hesitancy and the resurgence of vaccine preventable diseases: The way forward for Malaysia, a Southeast Asian country. Hum. Vaccines Immunother. 2020;16:1511–1520. doi: 10.1080/21645515.2019.1706935. - DOI - PMC - PubMed

[9] He Q., Wang H., Ma Y., Wang Z., Zhang Z., Li T., Yang Z. Changes in parents’ decisions pertaining to vaccination of their children after the Changchun Changsheng vaccine scandal in Guangzhou, China. Vaccine. 2020;38:6751–6756. doi: 10.1016/j.vaccine.2020.08.039. - DOI - PubMed

[10] He Q., Wang H., Ma Y., Wang Z., Zhang Z., Li T., Yang Z. Changes in parents’ decisions pertaining to vaccination of their children after the Changchun Changsheng vaccine scandal in Guangzhou, China. Vaccine. 2020;38:6751–6756. doi: 10.1016/j.vaccine.2020.08.039. - DOI - PubMed

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Non-EPI Vaccine Hesitancy among Chinese Adults: A Cross-Sectional Study

Affiliations

Non-EPI Vaccine Hesitancy among Chinese Adults: A Cross-Sectional Study

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

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References

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