| Objectives:High vaccination rate of COVID-19 vaccine is critical for controlling the COVID-19 pandemic,preventing infection with variant strains of COVID-19,and improving the prognosis after infection of COVID-19,whereas vaccine hesitancy may be a barrier to establishing adequate herd immunity.The aim of this study is to investigate the status of COVID-19 vaccine hesitancy in China,to explore factors influencing COVID-19 vaccine hesitancy,and to analyze barriers and facilitators of COVID-19 vaccination.This study provided a basis for developing promotional and educational materials and communication strategies to effectively enhance people’s willingness to receive the COVID-19 vaccine.Methods:The survey was conducted with a web-based survey among students,public health professionals,medical workers,and the general population in 7 cities in China from January to March 2021.The questionnaire included sociodemographic information,concerns about the COVID-19 infection,general vaccination behaviors and attitudes,the General Vaccine Hesitancy Scale,the COVID-19 Vaccine Hesitancy Scale,factors associated with HBM,and other potential factors.Descriptive statistics were performed for relevant factors,and t-test or ANOVA was utilized for quantitative variables comparisons,and chi-square test was used for categorical variables comparisons.Variables with significant univariate analysis or whose P-values for univariate analysis were less than 0.10 were then included in the multivariate regression model.Results:COVID-19 vaccine hesitancy was 15.64%of the 4227 study participants in this investigation.Among the populations surveyed,23.90%of students,21.20%of the general population,13.14%of medical workers and 10.42%of public health professionals had COVID-19 vaccine hesitancy.The older individuals were less likely to have COVID-19 vaccine hesitancy;female was more likely to have COVID-19 vaccine hesitancy compared to male(P<0.01).Among the variables related to general vaccination behavior,participants who did not believe that the vaccine would protect them from disease attack(OR:2.26,95%CI:1.67-3.04)were more likely to have COVID-19 vaccine hesitancy.Participants who had not hesitated to receive the vaccine(OR:0.59,95%CI:0.46-0.75)were less likely to have COVID-19 vaccine hesitancy.In addition,participants with higher scores on the General Vaccine Hesitancy Scale were more likely to have COVID-19 vaccine hesitancy(OR:1.03,95%CI:1.01-1.04).Participants who did not follow their doctor’s recommendation for vaccination were more likely to be hesitant to receive the COVID-19 vaccine(OR:5.12,95%CI:3.85-6.81).Participants who were not influenced by the opinions of family members and friends to receive the COVID-19 vaccine(OR:0.66,95%CI:0.52-0.84),who were not doubt about the source of information about the COVID19 vaccine(OR:0.47,95%CI:0.37-0.63),and had not received or heard negative information about the COVID-19 vaccine(OR:0.63,95%CI:0.50-0.81)were less likely to be hesitant about the COVID-19 vaccine.Among the Health Belief Model correlates,participants with higher perceived benefits scores were less likely to have COVID-19 vaccine hesitancy(OR:0.92,95%CI:0.86-0.99);participants with high perceived barriers scores were more likely to have COVID-19 vaccine hesitancy(OR:1.18,95%CI:1.111.25).Conclusions:Given that increasing the perceived benefits could reduce COVID-19 vaccine hesitancy,relevant public health authorities should conduct vaccine-related campaigns to provide the public with adequate and appropriate information about the COVID-19 vaccine and to increase the perceived benefits of the vaccine with reliable evidence of its safety,efficacy,and benefits.While perceived barriers can make people more likely to be hesitant about the COVID-19 vaccine,the relevant authorities should communicate and be prepared to improve access for those who may have barriers to the actual vaccination process.Medical workers’ advice on vaccination can motivate people to get vaccinated with the COVID-19 vaccine,it is necessary to train them on proper vaccine knowledge and communication skills,and to improve the public’s willingness to be vaccinated by delivering the correct information to the public through medical workers.In addition,reducing the spread of misinformation and disseminating facts in a timely and accurate manner will likely reduce vaccine hesitancy.Establishing appropriate communication strategies and information exchange platforms between the government and the public,as well as establishing an early warning system for infodemic,will help increase public confidence in vaccination. |
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