BackgroundVaccine hesitancy has been little studied in low- and middle-income countries but is a potential concern because vaccine refusal may increase the burden of infectious diseases and impede control efforts. The aim of this study was to compare vaccine hesitancy between locals, long-time city residents, and non-locals, who have more recently moved to the city from either other urban or rural areas, in Shanghai, China.MethodsParents of infants ≤3 months of age were surveyed at immunization clinics in Shanghai, China. Participants completed a paper questionnaire utilizing the 10-item Vaccine Hesitancy Scale, which was developed by the World Health Organization Strategic Advisory Group of Experts on Immunization. Items were grouped based on internal consistency, and regressed onto demographic variables using a negative binomial model.ResultsIn total, 1,188 (92.5%) individuals participated. For most items on the scale, parents expressed positive beliefs about vaccines. However, about half of parents somewhat or strongly agreed that new vaccines carried more risks than older vaccines, and 71.6% somewhat or strongly agreed that they were concerned about serious adverse effects. Seven items from the Vaccine Hesitancy Scale were highly correlated and mapped onto “lack of confidence”; the other three items were analysed separately. Compared to mothers, fathers had less lack of confidence (β: -0.06, 95% CI: -0.12, -0.01), and individuals living in the outer suburbs (β: 0.13, 95% CI: 0.01, 0.25) and rural non-locals (β: 0.10, 95% CI: 0.02, 0.18) had greater lack of confidence in vaccines compared to their urban or local counterparts, respectively.DiscussionShanghai parents professed confidence in certain vaccine benefits, but vaccine messaging could focus on addressing misconceptions about vaccines for diseases no longer common, newer vaccines, and adverse effects associated with vaccination. These messages may need to be separately tailored to locals and non-locals, who have differing concerns.

Properties of the radical anions of three R-nitrocumenes (R-nitrocumene, p-cyano-R-nitrocumene, and p-nitro-R-nitrocumene, 1a-c) have been determined by electrochemical methods. In particular, the standard potentials of the neutral/radical anion couples were found to be -2.20, -2.04, and -1.43 V with respect to the ferrocenium ion/ferrocene potential and the rate constants for expulsion of nitrite from the radical anions were 3 × 10 6 , 5 × 10 6 , and 240 s -1 for 1a-c, respectively. Comparison of these potentials with those of related compounds demonstrates that reduction of the nitroalkyl portion of the molecule occurs in 1a and 1b while in 1c the electron is added to the nitrophenyl group. Thus, using previously defined terminology, the cleavage of the radical anions of 1a and 1b to give nitrite and the corresponding cumyl radicals are examples of homolytic cleavage reactions but the cleavage of the radical anion of 1c is heterolytic. The driving force for the three cleavage reactions has been estimated and it is concluded that the large decrease in magnitude of the cleavage rate constants on going from 1a and 1b to 1c is mainly due to the much larger driving force for the first two.

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