Public Willingness and Determinants of COVID-19 Vaccination at the Initial Stage of Mass Vaccination in China

Abstract

The present study assessed the willingness of the general population to receive COVID-19 vaccines and identified factors that influence vaccine hesitancy and resistance. A national online survey was conducted from 29 January 2021 to 26 April 2021 in China. Multinomial logistic regression analyses were conducted to identify factors that influence vaccine hesitancy and resistance. Of the 34,041 participants surveyed, 18,810 (55.3%) were willing to get vaccinated, 13,736 (40.3%) were hesitant, and 1495 (4.4%) were resistant. Rates of vaccine acceptance increased over time, with geographical discrepancies in vaccine hesitancy and resistance between provinces in China. Vaccine safety was the greatest concern expressed by most participants (24,461 [71.9%]), and the major reason for participants’ refusing vaccination (974 [65.2%]). Government agencies (23,131 [68.0%]) and social media (20,967 [61.6%]) were the main sources of COVID-19 vaccine information. Compared with vaccination acceptance, female, young and middle-aged, high income, and perceived low-risk of infection were associated with vaccine hesitancy. Histories of allergic reactions to other vaccines and depression symptoms were related to vaccine resistance. Common factors that influenced vaccine hesitancy and resistance were residing in cities and perceiving less protection with vaccines than with other protective measures. The results indicate that the rate of vaccine resistance is relatively low, but vaccine hesitancy is common. Individuals who are female, young and middle-aged, with a high income, and residing in cities are more likely to be hesitant for vaccination and should be the target populations for vaccination campaigns. Specific vaccine messaging from the government and social media could alleviate public concerns about vaccine safety and efficacy.

The Impact of Quarantine on Pain Sensation among the General Population in China during the COVID-19 Pandemic

“…A total of 250 respondents who were younger than 18 years were also excluded because obtaining online informed consent from their parents may not be realistic. Finally, a total of 34,041 respondents were included, with a response rate of 51.6% and an effective response rate of 99.3% [ 20 ].…”

“…PHQ-9, GAD-7 and ISI inquires about depression, anxiety and insomnia symptoms in the past 2 weeks while PCL-5 inquires about PTSD symptoms in the recent month. The cutoff scores were 5, 5, 8, and 33 for detecting depression, anxiety, insomnia and posttraumatic stress disorder (PTSD) symptoms, respectively, according to a previous study [ 7 , 19 , 20 ]. Scores of participants greater than cutoff threshold indicate potential mental health symptoms.…”

Factors Associated with COVID-19 Vaccine Hesitancy after Implementation of a Mass Vaccination Campaign

“…As the pandemic progressed, people reporting their intention to be vaccinated against COVID-19 varied [4,6,7,[13][14][15][16][17][18][19]. However, most studies on COVID-19 vaccine acceptance were conducted before the first vaccine's approval or vaccination program rollout.…”

“…Several cross-sectional studies have since explored COVID-19 vaccine acceptance and hesitancy and their determinants after the respective countries' vaccination program implementation, namely in European countries [2], such as the United Kingdom [15,16,20,21], Germany [15,22], Denmark [15,23], France [15], Hungary [15], Sweden [15], Italy [15], Norway [21], Poland [24], the Netherlands [25], Spain [26] and Greece [27]. Additional studies were also conducted in Saudi Arabia [28], the United States of America [13,17,21,29], South Africa [21,30], Jordan [31], Israel [32], Chile [33], China [18,21,34,35], Japan [21,36] and Australia [21], among others [21]. These studies have not only reported variation in the refusal rate of COVID-19 vaccination over sequential waves [13][14][15]18], but also on the characteristics of the individuals that reported hesitancy in getting vaccinated [13,14,18] and on the reasons behind this refusal…”

“…Additional studies were also conducted in Saudi Arabia [28], the United States of America [13,17,21,29], South Africa [21,30], Jordan [31], Israel [32], Chile [33], China [18,21,34,35], Japan [21,36] and Australia [21], among others [21]. These studies have not only reported variation in the refusal rate of COVID-19 vaccination over sequential waves [13][14][15]18], but also on the characteristics of the individuals that reported hesitancy in getting vaccinated [13,14,18] and on the reasons behind this refusal [14].…”