Who is more likely to hesitate to accept COVID-19 vaccine: a cross-sectional survey in China

Abstract

Background: The aim of our study was to identify factors associated with coronavirus disease 2019 (COVID-19)vaccine willingness in China to aid future public health actions to improve vaccination.

Research design and methods: This study was conducted in August 2020 using a mixed-method approach, including a cross-sectional self-administered anonymous questionnaire survey and in-depth interviews with community residents in China.

Results: Of the participants, 30.9% showedCOVID-19 vaccine hesitancy. Being female(OR = 1.297), having poor health(OR = 1.312), having non-health or medical-related occupations (OR = 1.129), no COVID-19 infection experience(OR = 1.523), living with vulnerable family members(OR = 1.294), less knowledge(OR = 1.371), less attention to COVID-19 information(OR = 1.430), less trust in official media(OR = 1.336), less perceived susceptibility to COVID-19(OR = 1.367), and less protective behavior(OR = 1.195) were more likely to hesitate. Qualitative research has shown that they doubt the importance and necessity, as well as the effectiveness and safety of the vaccination. The economic and service accessibility of the vaccination was an impediment to their vaccine acceptance.

Conclusion: Nearly one-thirdof people showed hesitancy to accept COVID-19 vaccination in China. Our findings highlight that health communication and publicity should be performed for the targeted population, and immunization programs should be designed to remove underlying barriers to vaccine uptake.

Keywords: COVID-19; China; vaccination; vaccine acceptance; vaccine hesitancy; vaccine willingness.