The association between lifestyle and COVID-19 vaccine hesitancy in China: A large-scale cross-sectional survey

Determinants Associated with COVID-19 Vaccination among Korean Adults: Based on Andersen's Model

COVID-19 vaccination is a critical public health measure to control the pandemic, but disparities in vaccination uptake remain a concern. This study investigates the determinants of COVID-19 vaccination among Korean adults using the Andersen model. Data from 231,784 participants in the community health survey were analyzed using chi-square testing and logistic regression. The risk of non-vaccination was higher among those aged 19-64 (95% CI: 1.52-1.74), males (95% CI: 1.11-1.24), the unemployed (95% CI: 2.21-2.47), unmarried individuals (95% CI: 1.12-1.24), those with unmet healthcare needs (95% CI: 1.41-1.67), recipients of national basic livelihood guarantees (95% CI: 1.45-1.73), those with lower subjective health (95% CI: 1.20-1.30), individuals with depression (95% CI: 1.28-1.44), current smokers (95% CI: 1.13-1.30), and those skipping breakfast (95% CI: 1.04-1.16). Conversely, the risk was lower for those with less than a high school education (95% CI: 0.72-0.81), individuals with psychological concerns about infection (0.87, 95% CI: 0.82-0.92) or public criticism (0.91, 95% CI: 0.86-0.97), individuals with chronic diseases (95% CI: 0.64-0.72), and current alcohol consumers (95% CI: 0.52-0.58). These findings underscore the need for targeted intervention strategies and support systems to promote vaccination in vulnerable populations. Further research should explore the long-term impact of these interventions on vaccination uptake.

Examining Vaccine Hesitancy Among Ghanaian Parents for the R21/Matrix-M Malaria Vaccine

INTRODUCTION

This study aimed to assess Ghanaian parental attitudes toward a new malaria vaccine, R21/Matrix-M, and its associated determinants.

METHOD

A cross-sectional survey was conducted anonymously in July and August 2023 using snowball and convenience sampling techniques, using the Parental Attitude about Children Vaccination Scale.

RESULTS

A total of 818 individuals were included, 67.2% were females, their median age was 32 years, and 29.01% were hesitant to vaccinate their children. People living in forests, with younger children, having the youngest child aged 1-3 years, skipping antenatal care or scheduled vaccinations, and not being willing to give the R21/Matrix-M vaccine to children, were vaccine-hesitant. However, healthcare workers, those having a relative who died from malaria, and those who vaccinated their child against malaria were less hesitant.

DISCUSSION

A large sector of parents expressed willingness to vaccinate their children against malaria. Addressing parental hesitancy requires intervention programs targeting the identified factors and enhancing parental knowledge.

The effect of alcohol, tobacco, and other drug use on vaccine acceptance, uptake, and adherence: a systematic review

BACKGROUND

Vaccine hesitancy is increasingly recognized as a health challenge affecting populations worldwide. Given the biological vulnerabilities and structural barriers people who use substances and/or have behavioral addictions face, this systematic review aims to evaluate whether this subpopulation is less prone to adhere to vaccination recommendations.

METHODS

Electronic searches of published original research were conducted in PubMed, EMBASE, Scopus, and PsycINFO from database inception to December 2022. Our strategy encompassed retrievals regardless of languages and date of publication. Animal studies, abstracts without a full manuscript, and studies which were considered to have lower robustness of scientific evidence were excluded. Outcomes measured were vaccine acceptance, uptake, and adherence. Results were interpreted through a narrative synthesis.

RESULTS

The search yielded 103 retrievals encompassing data collected on 5 576 374 persons who were predominantly residents of Europe (n = 39) and North America (n = 27). Tobacco use, the substance for which many studies were found (n = 91), was significantly associated with poorer vaccine acceptance, uptake and adherence for influenza, COVID-19, human papillomavirus (HPV), and maternal and childhood vaccines. Peri-natal and parental substance use was identified as a risk factor for suboptimal vaccine-related outcomes concerning maternal COVID-19 and childhood vaccines. Finally, people identified as 'using', 'abusing', or 'misusing' drugs or substances may be at decreased odds of all outcomes in various vaccines.

CONCLUSIONS

Collectively, the studies identified several groups with statistically significant greater vaccine hesitancy and decreased engagement among whom targeted measures could be beneficial. Timely evidence, especially on behavioral addictions and substances besides tobacco, is lacking, and warrants urgent attention.

Dataset on a reliability generalization meta-analysis of the Oxford COVID-19 vaccine hesitancy scale

The Oxford COVID-19 Vaccine Hesitancy Scale is a 7-item psychometric scale developed by Freeman and colleagues a year after detecting the first case of the disease in 2019. The scale assesses people's thoughts, feelings, and behavior toward COVID-19 vaccines. A comprehensive search of major electronic databases, including Scopus, Clarivate Analytics, and PubMed, was conducted to extract eligible articles for inclusion in this meta-analysis. This paper reports information on data collected for a reliability generalization meta-analysis of the Oxford COVID-19 Vaccine Hesitancy Scale. The dataset incorporates information on the average reliability of the scale as measured with Cronbach's alpha in 20 studies included in the meta-analysis. Several benefits can be derived from the dataset. In particular, the research community would find this dataset beneficial as it can enhance their understanding of the health challenges of COVID-19, helping them come up with better solutions to eradicate the disease.

Hesitancy towards R21/Matrix-M malaria vaccine among Ghanaian parents and attitudes towards immunizing non-eligible children: a cross-sectional survey

BACKGROUND

The newly developed malaria vaccine called "R21/Matrix-M malaria vaccine" showed a high safety and efficacy level, and Ghana is the first country to approve this new vaccine. The present study aimed to evaluate the rate of vaccine hesitancy (VH) towards the newly developed malaria vaccine among parents who currently have children who are not eligible for the vaccine but may be eligible in the near future. Additionally, the study aimed to identify the factors that could potentially influence VH.

METHODS

A cross-sectional survey using both online-based questionnaires and face-to-face interviews was conducted in Ghana from June to August 2023. The survey specifically targeted parents of ineligible children for vaccination, including those aged less than 5 months or between 3 and 12 years. The Parent Attitudes about Childhood Vaccination (PACV) scale was used to assess parental VH.

RESULTS

A total of 765 people participated in this study. Their median age was 36.0 years with an interquartile range of 31.0-41.0 years, 67.7% were females, 41.8% completed their tertiary education, 63.3% were married, 81.6% worked in non-healthcare sectors, and 59.7% reported that their monthly income was insufficient. About one-third (34.5%) of the parents were hesitant to give their children the R21/Matrix-M malaria vaccine. The following predictors were associated with VH: working in the healthcare sector (adjusted odds ratio (AOR) = 0.50; 95% confidence interval (CI) 0.30-0.80; p = 0.005), having the other parent working in the healthcare sector (AOR = 0.54; 95% CI 0.30-0.94; p = 0.034), and not taking scheduled routine vaccinations (AOR = 1.90; 95% CI 1.27-2.84; p = 0.002).

CONCLUSIONS

Addressing VH is crucial for optimizing R21/Matrix-M vaccine coverage in Ghana's malaria control strategy. By tackling VH issues, Ghana can effectively safeguard children's health in malaria-prone areas.

Association of prepregnancy body mass index and gestational weight gain trajectory with adverse pregnancy outcomes-a prospective cohort study in Shanghai

OBJECTIVES

The objective was to investigate the associations of maternal prepregnancy body mass index (BMI) and gestational weight gain (GWG) trajectories with adverse pregnancy outcomes (APOs).

DESIGN

This was a prospective cohort study.

SETTING

This study was conducted in Shanghai Pudong New Area Health Care Hospital for Women and Children, Shanghai, China.

PRIMARY AND SECONDARY OUTCOME MEASURES

A cohort study involving a total of 2174 pregnant women was conducted. Each participant was followed to record weekly weight gain and pregnancy outcomes. The Institute of Medicine classification was used to categorise prepregnancy BMI, and four GWG trajectories were identified using a latent class growth model.

RESULTS

The adjusted ORs for the risks of large for gestational age (LGA), macrosomia, gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) were significantly greater for women with prepregnancy overweight/obesity (OR=1.77, 2.13, 1.95 and 4.24; 95% CI 1.3 to 2.42, 1.32 to 3.46, 1.43 to 2.66 and 2.01 to 8.93, respectively) and lower for those who were underweight than for those with normal weight (excluding HDP) (OR=0.35, 0.27 and 0.59; 95% CI 0.22 to 0.53, 0.11 to 0.66 and 0.36 to 0.89, respectively). The risk of small for gestational age (SGA) and low birth weight (LBW) was significantly increased in the underweight group (OR=3.11, 2.20; 95% CI 1.63 to 5.92, 1.10 to 4.41; respectively) compared with the normal-weight group; however, the risk did not decrease in the overweight/obese group (p=0.942, 0.697, respectively). GWG was divided into four trajectories, accounting for 16.6%, 41.4%, 31.7% and 10.3% of the participants, respectively. After adjustment for confounding factors, the risk of LGA was 1.54 times greater for women in the slow GWG trajectory group than for those in the extremely slow GWG trajectory group (95% CI 1.07 to 2.21); the risk of SGA and LBW was 0.37 times and 0.46 times lower for women in the moderate GWG trajectory group and 0.14 times and 0.15 times lower for women in the rapid GWG trajectory group, respectively; the risk of macrosomia and LGA was 2.65 times and 2.70 times greater for women in the moderate GWG trajectory group and 3.53 times and 4.36 times greater for women in the rapid GWG trajectory group, respectively; and the women in the other three trajectory groups had a lower risk of GDM than did those in the extremely slow GWG trajectory group, but there was not much variation in the ORs. Notably, different GWG trajectories did not affect the risk of HDP.

CONCLUSIONS

As independent risk factors, excessively high and low prepregnancy BMI and GWG can increase the risk of APOs.

Covid-19 vaccination coverage and associated factors among older hypertensive patients in Hangzhou, China

BACKGROUND

Vaccination could provide effective protection against coronavirus disease 2019 (COVID-19). This study aims to describe the COVID-19 vaccination coverage and influential factors in Chinese older hypertensive patients.

METHODS

Using a cross-sectional design, participants were randomly selected from the electronic health records system during the pandemic era in Hangzhou, China. Logistic regression models were employed to compute the OR and 95% CI in order to assess the relationships between variables and the extent of COVID-19 vaccination coverage.

RESULTS

As of 3 August 2022, among a sample of 77 970 individuals, 75.11% had completed the full COVID-19 vaccination, while 57.66% had received a booster dose. Disparities in coverage were observed across genders, regions and age groups. Unhealthy lifestyles, cardiovascular disease, cancer, uncontrolled blood pressure, abnormal fasting plasma glucose, dyslipidemia and renal dysfunction were risk factors for COVID-19 vaccination coverage. The coverage rates continuously declined along with the number of risk factors. The ORs for full and booster vaccination in subjects with ≥4 risk factors were 2.55 (2.12∼3.07) and 2.60 (2.16∼3.13), compared to individuals without risk factors.

CONCLUSION

The COVID-19 vaccination program for older hypertensive patients must be strengthened further. Emphasis should be placed on patients who reside in urban areas, have comorbidities or multiple risk factors.

The relationship of intent to be COVID-19 vaccinated with depression, anxiety, insomnia, pain and smoking among Chinese patients with a pacemaker

Background

This study examined the intent to be COVID-19 vaccinated and its correlates among patients with a pacemaker.

Methods

This observational study was carried out between July 1, 2021, and May 17, 2022 in Beijing, China. Patients with a pacemaker were consecutively invited by a research physician to participate in the study. Intent to be COVID-19 vaccinated, depression, anxiety, insomnia, pain and smoking were measured with standard scales or questions.

Results

Of the 206 participating patients, 72.82% (N = 150; 95% confidence interval [CI]: 66.74%-78.89%) expressed an intention to be COVID-19 vaccinated. Intent to be COVID-19 vaccinated was not significantly associated with severity of depression, anxiety, and insomnia. Multiple logistic regression analysis revealed that patients believing that COVID-19 vaccines provided protection and smokers were more likely to express an intention to receive COVID-19 vaccines. In contrast, older patients and those with higher level of physical pain were less likely to express an intention to be vaccinated against COVID-19.

Conclusions

Specific vaccination promotion strategies should be implemented targeting this vulnerable segment of the population.

Quantifying the benefits of healthy lifestyle behaviors and emotional expressivity in lowering the risk of COVID-19 infection: a national survey of Chinese population

BACKGROUND

COVID-19 is still prevalent in most countries around the world at the low level. Residents' lifestyle behaviors and emotions are critical to prevent COVID-19 and keep healthy, but there is lacking of confirmative evidence on how residents' lifestyle behaviors and emotional expressivity affected COVID-19 infection.

METHODS

Baseline study was conducted in August 2022 and follow-up study was conducted in February 2023. Baseline survey collected information on residents' basic information, as well as their lifestyle behaviors and emotions. Follow-up study was carried out to gather data on COVID-19 infection condition. Binary logistic regression was utilized to identify factors that may influence COVID-19 infection. Attributable risk (AR) was computed to determine the proportion of unhealthy lifestyle behaviors and emotional factors that could be attributed to COVID-19 infection. Sensitivity analysis was performed to test the robustness of the results.

RESULTS

A total of 5776 participants (46.57% males) were included in this study, yielding an overall COVID-19 infection rate of 54.8% (95%CI: 53.5 - 56.0%). The findings revealed that higher stress levels [aOR = 1.027 (95%CI; 1.005-1.050)] and lower frequency in wearing masks, washing hands, and keeping distance [aOR = 1.615 (95%CI; 1.087-2.401)], were positively associated with an increased likelihood of COVID-19 infection (all P < 0.05). If these associations were causal, 8.1% of COVID-19 infection would have been prevented if all participants had normal stress levels [Attributable Risk Percentage: 8.1% (95%CI: 5.9-10.3%)]. A significant interaction effect between stress and the frequency in wearing masks, washing hands, and keeping distance on COVID-19 infection was observed (β = 0.006, P < 0.001), which also was independent factor of COVID-19 infection.

CONCLUSIONS

The overall COVID-19 infection rate among residents is at a medium level. Residents' increasing stress and decreasing frequency in wearing masks and washing hands and keeping distance contribute to increasing risk of infection, residents should increase the frequency of mask-wearing, practice hand hygiene, keep safe distance from others, ensure stable emotional state, minimize psychological stress, providing evidence support for future responses to emerging infectious diseases.

Factors for hesitancy towards vaccination against COVID-19 among the adult population in Puducherry, India - a cross sectional study

BACKGROUND

Vaccine hesitancy is a complex phenomenon that threatens global health. Present-day communication technology has paved the way for self-education but also contributed to the infodemic surrounding vaccination. This has resulted in pockets of people who are reluctant, refuse recommended vaccinations, or choose to delay being vaccinated. The present study was designed to estimate the magnitude of hesitancy towards the COVID-19 vaccination and determine its associated factors in the community.

METHODS

This cross-sectional study was conducted among 776 adults aged ≥ 18 years in 15 clusters in Puducherry district, India, between March 2022 and May 2022. Face-to-face interviews were conducted using a validated, structured questionnaire. Socio-demographic variables, co-morbidities, attitudes towards vaccination, etc., were expressed as frequencies and percentages. Vaccine hesitancy was dichotomized with the median score as the cut-off and reported as a proportion with a 95% confidence interval. Univariate and multivariate analyses were carried out to determine the factors associated with vaccine hesitancy.

RESULTS

The mean age of participants was 43.3 ± 14.8 years, with the majority being female (67.0%). Nearly 92.4%, 74.4%, and 0.5% of participants received their first, second, and precautionary doses, respectively, during the study period. Among the unvaccinated, 93.2% were unwilling to receive any dose of vaccination. More than half of the participants were hesitant towards vaccination, according to the vaccine hesitancy scale. Participants aged above 45 years were less hesitant, while those educated up to school level, belonging to the upper socio-economic class, never tested for COVID-19 in the past, and having a negative attitude towards vaccination were significantly associated with higher vaccine hesitancy.

CONCLUSIONS

It is imperative to address vaccine hesitancy by alleviating existing fears and misconceptions in the community through efficient communication strategies to win the fight against current as well as future public health emergencies.

Perception and willingness toward various immunization routes for COVID-19 vaccines: a cross-sectional survey in China

Background

To date, most vaccines, including the COVID-19 vaccine, are mainly administered by intramuscular injection, which might lead to vaccine hesitancy in some populations due to needle fear. Alternatively, needle-free immunization technology is extensively developed to improve the efficacy and acceptance of vaccination. However, there is no study to report the perception and willingness toward various immunization routes of the COVID-19 vaccine in the general population.

Methods

A cross-sectional survey was conducted nationwide using an online questionnaire. Bivariate analyses were undertaken to assess variable associations among the participants who reported a hesitancy to receive the COVID-19 booster vaccination. Multivariable logistic regression with a backward step-wise approach was used to analyze the predicted factors associated with the willingness to receive the COVID-19 booster vaccination.

Results

A total of 3,244 valid respondents were included in this survey, and 63.2% of participants thought they had a good understanding of intramuscular injection, but only 20.7, 9.2, 9.4, and 6.0% of participants had a self-perceived good understanding of inhalation vaccine, nasal spray vaccine, oral vaccine, and microneedle patch vaccine. Correspondingly, there was high acceptance for intramuscular injection (76.5%), followed by oral inhalation (64.4%) and nasal spray (43.0%). Those participants who were only willing to receive an intramuscular vaccine had less vaccine knowledge (OR = 0.78; 95% CI: 0.65-0.94) than those who were willing to receive a needle-free vaccine (OR = 1.97; 95% CI: 1.52-2.57). Some factors were found to be associated with vaccine hesitancy toward booster COVID-19 vaccination.

Conclusion

Needle-free vaccination is a promising technology for the next generation of vaccines, but we found that intramuscular injection was still the most acceptable immunization route in this survey. One major reason might be that most people lack knowledge about needle-free vaccination. We should strengthen the publicity of needle-free vaccination technology, and thus improve the acceptance and coverage of vaccination in different populations.

Immunogenicity and reactogenicity of inactivated SARS-CoV-2 vaccines in healthy adults

Introduction

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is highly pathogenic to humans and has caused the ongoing coronavirus disease 2019 (COVID-19) pandemic. Vaccines are one of the efficient ways to prevent the viral infection. After COVID-19 vaccination, the monitoring of the dynamic change in neutralizing antibodies is necessary to determine booster requirements.

Methods

We estimated the effectiveness of the inactivated vaccines by monitoring dynamic SARS-CoV-2 neutralizing antibodies for over 2 years. Additionally, we also investigated the activation of T lymphocytes (CD3+ T cells) after three doses of the inactivated vaccine.

Result

The results showed that the rate of reduction of SARS-CoV-2 neutralizing antibody levels gradually showed after each booster dose. The IgG/IgM level at 9 months after the third vaccination were significantly higher than those at 6 months after the second dose (p<0.0001). The expression of CD25+T cell in 18-35 age group was significantly higher than that in the other groups. Nine months after the third dose (the time of last blood sample collection), the expression of CD25+T cell in the 18-35 age group was significantly higher than that at 6 months after the second dose. CD25+T cell in the 18-35 years old group was significantly higher than 6 months after the second vaccination.

Conclusion

CD25, a late activation marker of lymphocytes and high-activity memory T cell subgroup, exhibited higher levels at the later stages after vaccination. COVID-19 booster vaccination in older adults and regular testing of SARS-CoV-2 neutralizing antibodies are recommended. Booster doses should be administered if the antibody level falls below the 30% inhibition rate.

Knowledge and identity antecedents of COVID-19 vaccine status: a study of South Carolina residents

Introduction

Despite over three years of learning about SARS-CoV-2 and extensive work to develop vaccines, vaccination rates remain suboptimal, thereby preventing our society from reaching herd immunity.

Purpose

Extant literature on vaccine hesitancy led us to hypothesize that specific socio/political variables may be contributing to low vaccination rates, particularly in South Carolina.

Methods

By use of Qualtrics surveys, we collected data from people across all counties in South Carolina regarding vaccine status, plans to vaccinate, and a host of demographics.

Results

Findings revealed that those less likely to be vaccinated against COVID-19 tended to be younger, female, republican. Interestingly, COVID-19 knowledge did not appear to differ between vaccination status groups, although COVID-19 vaccine and general vaccine knowledge did differ.

Conclusions

Our results suggest that while understanding of COVID-19 was relatively similar across groups, targeted and tailored interventions aimed at enhancing the public's general and COVID-19-specific vaccine knowledge may aid efforts to reach herd immunity.

The pattern from the first three rounds of vaccination: declining vaccination rates

Introduction

Vaccination rates for the COVID-19 vaccine have recently been stagnant worldwide. We aim to analyze the potential patterns of vaccination development from the first three doses to reveal the possible trends of the next round of vaccination and further explore the factors influencing vaccination in the selected populations.

Methods

On July 2022, a stratified multistage random sampling method in the survey was conducted to select 6,781 people from 4 provinces China, who were above the age of 18 years. Participants were divided into two groups based on whether they had a chronic disease. The data were run through Cochran-Armitage trend test and multivariable regression analyses.

Results

A total of 957 participants with chronic disease and 5,454 participants without chronic disease were included in this survey. Vaccination rates for the first, second and booster doses in chronic disease population were93.70% (95% CI: 92.19-95.27%), 91.12% (95%CI: 94.43-95.59%), and 83.18% (95%CI: 80.80-85.55%) respectively. By contrast, the first, second and booster vaccination rates for the general population were 98.02% (95% CI: 97.65-98.39%), 95.01% (95% CI: 94.43-95.59%) and 85.06% (95% CI: 84.11-86.00%) respectively. The widening gap in vaccination rates was observed as the number of vaccinations increases. Higher self-efficacy was a significant factor in promoting vaccination, which has been observed in all doses of vaccines. Higher education level, middle level physical activity and higher public prevention measures play a positive role in vaccination among the general population, while alcohol consumption acts as a significant positive factor in the chronic disease population (p < 0.05).

Conclusion

As the number of vaccinations increases, the trend of decreasing vaccination rate is becoming more pronounced. In future regular vaccinations, we may face low vaccination rates as the increasing number of infections and the fatigue associated with the prolonged outbreak hamper vaccination. Measures need to be found to counter this downward trend such as improving the self-efficacy of the population.

How urban versus rural residency relates to COVID-19 vaccine hesitancy: A large-scale national Chinese study

RATIONALE

Although urban-rural residency has been shown to influence individual COVID-19 vaccine hesitancy, the differences between urban and rural China have yet to be uncovered.

OBJECTIVE

This study aims to assess the current prevalence and factors associated with COVID-19 vaccine hesitancy in urban and rural areas and explore whether the rural versus urban residency is associated with COVID-19 vaccine hesitancy.

METHODS

A national, cross-sectional, online survey among Chinese urban and rural adults (≥18 years old) was conducted from 6th to August 9, 2021. A questionnaire was used to collect data on sociodemographic factors, perceptions of the COVID-19 pandemic and vaccination status. A multivariable logistic regression model was used to identify the factors that influence COVID-19 vaccine hesitancy. Propensity score matching (PSM) analysis was performed to explore the association between urban versus rural residency and COVID-19 vaccine hesitancy.

RESULTS

In total, 29,925 participants (80.56% urban participants) were recruited. Urban participants had a higher COVID-19 vaccine hesitancy than their rural counterparts (9.39% vs. 4.26%). After adjusting for potential confounders, we found that COVID-19 vaccine hesitancy among females was lower than that in males in both urban (aOR = 0.78, 95% CI [0.69-0.88]) and rural areas (aOR = 0.54, 95% CI [0.39-0.75]). The lack of trust towards vaccine producers was found to be associated with vaccine hesitancy among the urban participants (aOR = 2.76, 95% CI [2.22-3.43]). The rural floating population had a lower COVID-19 vaccine hesitancy than the rural permanent residents (aOR = 0.58, 95% CI [0.42-0.80]). PSM analysis revealed a 2.38% difference in COVID-19 vaccine hesitancy between urban and rural participants.

CONCLUSIONS

Urban participants were more hesitant to receive the COVID-19 vaccine than rural participants. Priority should be placed on boosting confidence in the healthcare system to reduce COVID-19 vaccine hesitancy among urban residents. Furthermore, we advocate for extra incentives and vaccination education for rural permanent residents.

COVID-19 vaccine uptake and vaccine hesitancy in rural-to-urban migrant workers at the first round of COVID-19 vaccination in China

BACKGROUND

Migration can be linked to the transmission of COVID-19. COVID-19 vaccine uptake and hesitancy among rural-to-urban migrant workers in China, the largest group of internal migrants in the world, has not been characterized.

OBJECTIVE

To investigate COVID-19 vaccine uptake and identify vaccine hesitancy-associated factors among rural-to-urban migrant workers in the first round of COVID-19 vaccination in China.

METHODS

A cross-sectional questionnaire-based survey was conducted, including 14,917 participants. Socio-demographics, COVID-19 vaccine uptake, vaccine hesitancy and its associated factors based on Vaccine Hesitancy Determinants Matrix (VHDM) were applied for the survey. Data were principally analyzed by logistic regression analysis.

RESULTS

The COVID-19 vaccine uptake and vaccine hesitancy rates were 7.1% and 57.7%, respectively. Vaccine hesitancy was strongly associated with VHDM, including individual factors (female, higher annual income and fewer medical knowledge), group factors (less family support, friend support and public opinion support), COVID-19 epidemic factors (lower fatality, infection and emotional distress) and vaccine factors (less vaccine necessity, vaccine safety, vaccine efficacy, vaccine importance and vaccine reliability).

CONCLUSION

The VHDM model has the potential utility in efforts to reduce COVID-19 vaccine hesitancy. Greater efforts should be put into addressing positive predictors associated with vaccine hesitancy.

The Re-Emergence of COVID-19 in 2022 Has Affected People's Views on Vaccines

The recurrence of the COVID-19 pandemic in 2022 has had a great impact on people's mentality, although the government has controlled it through a series of effective measures. What is noteworthy is that the public opinion on vaccines has changed significantly, and at present, the level of public's trust in the COVID-19 vaccine is what we are concentrating on. For the current situation, new measures should be explored. Vaccines have been proven to be effective in reducing the rate of serious cases and death among infected people. However, vaccination rates still need to be improved, especially among the elderly. For people with low antibody levels, the fourth injection is recommended. Studying vaccines effective against virus mutation is the focus of future research.