Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Oct 7;12(1):91.
doi: 10.1186/s40249-023-01142-8.

Factors associated with recommendation behaviors of four non-National Immunization Program vaccines: a cross-sectional survey among public health workers in China

Yun Lyu #  1 , Xiaozhen Lai #  1   2 , Yidi Ma  1 , Hai Fang  3   4   5
Affiliations

Factors associated with recommendation behaviors of four non-National Immunization Program vaccines: a cross-sectional survey among public health workers in China

Yun Lyu et al. Infect Dis Poverty. .

Abstract

Background: Immunization is a crucial preventive measure to safeguard children under five years old against a range of diseases. In China, the coverage rate of non-National Immunization Program (non-NIP) vaccines can be improved by leveraging the recommendation from public health workers. Hence, understanding the influencing factors of recommendation behaviors assume paramount importance. This study aims to investigate influencing factors of public health workers' recommendation behaviors towards non-NIP vaccines, with a particular emphasis on financial incentives.

Methods: A cross-sectional survey was conducted using a multi-stage sampling method in 2019 from August to October. 627 public health workers were recruited from 148 community healthcare centers in ten provincial-level administrative divisions in China. An anonymous questionnaire was used to collect demographic information, attitudes towards vaccination, and recommendation behaviors towards non-NIP vaccines, including Haemophilus influenzae type b (Hib) vaccine, pneumococcal conjugate vaccine, varicella vaccine, and rotavirus vaccine. Descriptive analysis and multivariate logistic regression analysis were adopted in this study.

Results: Of the 610 public health workers with complete survey data, 53.8%, 57.4%, 84.1%, and 54.1% often recommended Hib vaccine, pneumococcal pneumonia vaccine (PCV), varicella vaccine, and rotavirus vaccine, respectively. Logistic regression revealed that gender (Hib vaccine: OR = 0.4, 95% CI: 0.2-0.8; PCV: OR = 0.4, 95% CI: 0.2-0.8; rotavirus vaccine: OR = 0.3, 95% CI: 0.2-0.6), financial incentives for non-NIP vaccination (Hib vaccine: OR = 1.9, 95% CI: 1.1-3.6; PCV: OR = 2.1, 95% CI: 1.1-3.9; rotavirus vaccine: OR = 2.0, 95% CI: 1.1-3.8) and perception of vaccine safety (Hib vaccine: OR = 2.7, 95% CI: 1.1-7.0; PCV: OR = 3.2, 95% CI: 1.2-8.0; rotavirus vaccine: OR = 3.0, 95% CI: 1.2-7.7) were associated with public health workers' recommendation towards Hib vaccine, PCV and rotavirus vaccine.

Conclusions: The findings highlighted public health workers' recommendation behaviors of non-NIP vaccines in China and revealed strong association between vaccine recommendation and financial incentives. This highlights the importance of financial incentives in public health workers' recommendation toward non-NIP vaccines in China. Proper incentives are recommended for public health workers to encourage effective health promotion in immunization practices.

Keywords: China; Cross-sectional survey; National Immunization Program; Public health workers; Recommendation; Vaccination.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Recommendation behaviors of the 610 public health workers on four non-NIP vaccines based on five-point Likert scale
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. WHO Immunization dashboard China 2019. https://immunizationdata.who.int/pages/profiles/chn.html. Accessed 10 April 2023.
    1. Piot P, Larson HJ, O’Brien KL, N’Kengasong J, Ng E, Sow S, Kampmann B. Immunization: vital progress, unfinished agenda. Nature. 2019;575:119–129. - PubMed
    1. Muloiwa R, Kagina BM, Engel ME, Hussey GD. The burden of laboratory-confirmed pertussis in low-and-middle-income countries since the inception of th'e Expanded Programme on Immunisation (EPI) in 1974: a systematic review and meta-analysis. BMC Med. 2020;18:233. - PMC - PubMed
    1. He C, Liu L, Chu Y, Perin J, Dai L, Li X, et al. National and subnational all-cause and cause-specific child mortality in China, 1996–2015: a systematic analysis with implications for the Sustainable Development Goals. Lancet Glob Health. 2017;5:e186–e197. - PMC - PubMed
    1. Vaccine administration law of the People’s Republic of China. http://www.npc.gov.cn/npc/c30834/201907/11447c85e05840b9b12c62b5b645fe9d.... Accessed 12 April 2023.

LinkOut - more resources