COVID-19 Vaccine Hesitancy and Associated Factors among Diabetes Patients: A Cross-Sectional Survey in Changzhi, Shanxi, China

Abstract

Patients with diabetes are more susceptible to severe acute respiratory syndrome-associated coronavirus (SARS-CoV)-2 infection, but vaccine hesitancy is a problem in this population. We investigated the prevalence of SARS-CoV-2 vaccine hesitancy among diabetes patients in China through a cross-sectional survey from April and August 2021 using a questionnaire administered to patients at two hospitals affiliated with Changzhi Medical College (Shanxi, China). The health belief model (HBM) is used examining factors influencing vaccine hesitancy. After adjusting for potential confounders, a multivariate logistic regression model was used to analyze correlations between vaccine hesitancy and associated factors. Of the 483 participants, 56.4% (273/483) had vaccine hesitancy, including 58.2% (159/273) who were unsure of being vaccinated and 41.8% (114/273) who were unwilling. Although patients considered SARS-CoV-2 infection to be serious (adjusted odds ratio [aOR] = 3.90, 95% confidence interval [CI]: 2.36–6.42; p < 0.001), they had concerns about vaccine safety (aOR = 3.05, 95% CI: 1.89–4.91; p < 0.001). Relatives’ vaccination status did not influence participants’ willingness to be vaccinated (aOR = 2.43, 95% CI: 1.39–4.25; p < 0.001). Disagreement with physicians’ view that vaccination can reduce SARS-CoV-2 infection risk was independently correlated with vaccine hesitancy (aOR = 2.25, 95% CI: 1.28–3.95; p < 0.001). Diabetes patients in China need to be educated on SARS-CoV-2 vaccine safety and protective effects to increase the vaccination rate in this population.

Prevalence and Determinants of COVID-19 Vaccination Uptake Were Different between Chinese Diabetic Inpatients with and without Chronic Complications: A Cross-Sectional Survey

“…This study was a cross-sectional study conducted among inpatients diagnosed with DM which was carried out at the endocrinology departments of Heping and Heji Hospitals, Changzhi Medical College (Changzhi, Shanxi, China) between April and August 2021. This study was a continuation of our published studies [22,24].…”

The Health Belief Model Applied to COVID-19 Vaccine Hesitancy: A Systematic Review

“…Perceived benefits was inversely associated with COVID-19 vaccine hesitancy in twelve studies [6,[11][12][13][15][16][17][18]20,22,23]. A positive association between perceived barriers and vaccine hesitancy was reported by twelve studies [6,[11][12][13][15][16][17][18][19][20]22,24]. Perceived susceptibility was negatively correlated with COVID-19 vaccine hesitancy in eight studies [10,12,14,[16][17][18]20,23]; however, Chen et al [11] reported a positive correlation between perceived susceptibility and vaccine hesitancy.…”

The COVID-19 Vaccination Behavior and Correlates in Diabetic Patients: A Health Belief Model Theory-Based Cross-Sectional Study in China, 2021

“…Through COVID-19 vaccination and other comprehensive measures, the spread of COVID-19 [ 12 ] and the occurrence of severe disease after SARS-CoV-2 infection can be effectively decreased [ 13 ]. Vaccination usually has certain benefits in reducing the risk of severe SARS-CoV-2 infection and fatality according to published literature [ 14 ], but there were still concerns about the potential harmfulness of COVID-19 vaccination in some patients with diabetes in China (56.4%) [ 15 ], Saudi Arabia (29.0%) [ 16 ], Malaysia (24.7%) [ 17 ] and Italy (14.2%) [ 18 ]. The main factors correlated to the willingness to vaccinate against COVID-19 include fear of the adverse reactions to COVID-19 vaccination [ 17 ], uncertainty about the genetic composition of COVID-19 vaccines [ 16 ], and concern about the safety of COVID-19 vaccines [ 18 ].…”