Background
Methods
Study design and participants
Measurements
Sociodemographic information
Concerns about infection with COVID-19
The General Vaccine Hesitancy Scale
The COVID-19 Vaccine Hesitancy Scale
General vaccination behavior and attitudes
Potential factors of COVID-19 vaccine hesitancy
Statistical analysis
Results
Sociodemographic characteristics
Variables | Medical workers (n = 2656) | Students (n = 753) | General population (n = 434) | Public health professionals (n = 384) | Total (n = 4227) |
---|---|---|---|---|---|
Age (years) (\(mean\pm SD)\) | 35.89 \(\pm\) 9.33 | 22.47 \(\pm\) 3.13 | 29.73 \(\pm\) 7.78 | 37.52 \(\pm\) 9.03 | 33.02 \(\pm\) 9.90 |
Gender, n (%) | |||||
Male | 732 (27.6) | 334 (44.4) | 193 (44.5) | 150 (39.1) | 1409 (33.3) |
Female | 1924 (72.4) | 419 (55.6) | 241 (55.5) | 234 (60.9) | 2818 (66.7) |
Ethnicity, n (%) | |||||
Han | 2339 (88.1) | 654 (86.9) | 415 (95.6) | 357 (93.0) | 3765 (89.1) |
Other | 317 (11.9) | 99 (13.1) | 19 (4.4) | 27 (7.0) | 462 (10.9) |
Residence place, n (%) | |||||
Urban | 2408 (90.7) | 496 (65.9) | 355 (81.8) | 361 (94.0) | 3620 (85.6) |
Rural | 248 (9.3) | 257(34.1) | 79 (18.2) | 23 (6.0) | 607 (14.4) |
Marital status, n (%) | |||||
Single | 667 (25.1) | 721 (95.8) | 263 (60.6) | 93 (24.2) | 1744 (41.3) |
Married | 1927 (72.6) | 27 (3.6) | 165 (38.0) | 285 (74.2) | 2404 (56.9) |
Others | 62 (2.3) | 5 (0.7) | 6 (1.4) | 6 (1.6) | 79 (1.9) |
Education level, n (%) | |||||
≤ High school | 160 (6.0) | 25 (3.3) | 53 (12.2) | 22 (5.7) | 260 (6.2) |
College and above | 2496 (94.0) | 728 (96.7) | 381 (87.8) | 362 (94.3) | 3967 (93.8) |
Household income (past 1 year), n (%) | |||||
≤ 40,000 Yuan | 431 (16.2) | 256 (34.0) | 84 (19.4) | 43 (11.2) | 814 (19.3) |
50,000–100,000 Yuan | 1233 (46.4) | 285 (37.8) | 185 (42.6) | 132 (34.4) | 1835 (43.4) |
110,000–350,000 Yuan | 920 (34.6) | 178 (23.6) | 137 (31.6) | 193 (50.3) | 1428 (33.8) |
> 350,000 Yuan | 72 (2.7) | 34 (4.5) | 28 (6.5) | 16 (4.2) | 150 (3.5) |
Ever smoking, n (%) | |||||
No | 2369 (89.2) | 679 (90.2) | 347 (80.0) | 339 (88.3) | 3734 (88.3) |
Yes | 287 (10.8) | 74 (9.8) | 87 (20.0) | 45 (11.7) | 493 (11.7) |
Ever drinking, n (%) | |||||
No | 2276 (85.7) | 668 (88.7) | 329 (75.8) | 303 (78.9) | 3576 (84.6) |
Yes | 380 (14.3) | 85 (11.3) | 105 (24.2) | 81 (21.1) | 651 (15.4) |
COVID-19 test results, n (%) | |||||
Positive | 12 (0.5) | 19 (2.5) | 6 (1.4) | 2 (0.5) | 39 (0.9) |
Negative | 2056 (77.4) | 438 (58.2) | 272 (62.7) | 332 (86.5) | 3098 (73.3) |
Haven’t tested | 588 (22.1) | 296 (39.3) | 156 (35.9) | 50 (13.0) | 1090 (25.8) |
Comparison of general vaccination behavior and vaccine hesitancy among different population groups
Variables | Medical workers | Students | General population | Public health professionals | P |
---|---|---|---|---|---|
n (%) | n (%) | n (%) | n (%) | ||
Do you agree that vaccines can protect you from diseases? | |||||
No | 253 (9.5) | 94 (12.5) | 49 (11.3) | 22 (5.7) | 0.002 |
Yes | 2403 (90.5) | 659 (87.5) | 385 (88.7) | 362 (94.3) | |
Do you agree that you will get all vaccines that the National Immunization Program or government recommended? | |||||
No | 530 (20.0) | 177 (23.5) | 119 (27.4) | 96 (25.0) | 0.001 |
Yes | 2126 (80.0) | 576 (76.5) | 315 (72.6) | 288 (75.0) | |
Have you ever hesitated to get vaccination? | |||||
No | 1806 (68.0) | 506 (67.2) | 263 (60.6) | 257 (66.9) | 0.026 |
Yes | 850 (32.0) | 247 (32.8) | 171 (39.4) | 127 (33.1) | |
Have you ever refused to get vaccination? | |||||
No | 2222 (83.7) | 646 (85.8) | 365 (84.1) | 320 (83.3) | 0.542 |
Yes | 434 (16.3) | 107 (14.2) | 69 (15.9) | 64 (16.7) | |
Have you ever hesitated or refused to get Pneumococcal Vaccine? | |||||
No | 1759 (66.2) | 509 (67.6) | 293 (67.5) | 267 (69.5) | < 0.001 |
Ever hesitated | 636 (23.9) | 204 (27.1) | 119 (27.4) | 82 (21.4) | |
Ever refused | 261 (9.8) | 40 (5.3) | 22 (5.1) | 35 (9.1) | |
Have you ever hesitated or refused to get Influenza Vaccine? | |||||
No | 1789 (67.4) | 514 (68.3) | 294 (67.7) | 274 (71.4) | 0.180 |
Ever hesitated | 622 (23.4) | 188 (25.0) | 109 (25.1) | 84 (21.9) | |
Ever refused | 245 (9.2) | 51 (6.8) | 31 (7.1) | 26 (6.8) | |
The General Vaccine Hesitancy Scale scores | |||||
\(m\pm SD\) | 20.33 \(\pm\) 8.59 | 20.32 \(\pm\) 8.11 | 19.87 \(\pm\) 7.61 | 18.48 \(\pm\) 7.51 | 0.001 |
Comparison of COVID-19 vaccine hesitancy and potential factors among different population groups
Variables | Medical workers | Students | General population | Public health professionals | P |
---|---|---|---|---|---|
n (%) | n (%) | n (%) | n (%) | ||
Have COVID-19 vaccine hesitancy | |||||
No | 2307 (86.9) | 573 (76.1) | 342 (78.8) | 344 (89.6) | < 0.001 |
Yes | 349 (13.1) | 180 (23.9) | 92 (21.2) | 40 (10.4) | |
Concerns about infection with COVID-19 | |||||
\(m\pm SD\) | 9.83 \(\pm\) 2.10 | 9.80 \(\pm\) 2.13 | 10.06 \(\pm\) 1.79 | 9.56 \(\pm\) 1.88 | 0.007 |
Do you agree that COVID-19 epidemic is a severe problem affecting the health of the community? | |||||
No | 698 (26.3) | 242 (32.1) | 146 (33.6) | 93 (24.2) | < 0.001 |
Yes | 1958 (73.7) | 511 (67.9) | 288 (66.4) | 291 (75.8) | |
Do you agree that COVID-19 will be a great threat to your health if you are infected? | |||||
No | 269 (10.1) | 108 (14.3) | 47 (10.8) | 46 (12.0) | 0.012 |
Yes | 2387 (89.9) | 645 (85.7) | 387 (89.2) | 338 (88.0) | |
Do you agree that you will get COVID-19 vaccine if doctors recommend? | |||||
No | 221 (8.3) | 101 (13.4) | 68 (15.7) | 22 (5.7) | < 0.001 |
Yes | 2435 (91.7) | 652 (86.6) | 366 (84.3) | 2435 (94.3) | |
Do you agree that the advice of your family members or friends will affect your intention of getting COVID-19 vaccine? | |||||
No | 1721 (64.8) | 319 (42.4) | 237 (54.6) | 254 (66.1) | < 0.001 |
Yes | 935 (35.2) | 434 (57.6) | 197 (45.4) | 130 (33.9) | |
Do you need transparent information about COVID-19 vaccine development, efficacy and safety? | |||||
No | 456 (17.2) | 142 (18.9) | 62 (14.3) | 38 (9.9) | 0.001 |
Yes | 2200 (82.8) | 611 (81.1) | 372 (85.7) | 346 (90.1) | |
Do you have doubts about the source of information about the COVID-19 vaccine? | |||||
No | 2064 (77.7) | 437 (58.0) | 276 (63.6) | 308 (80.2) | < 0.001 |
Yes | 592 (22.3) | 316 (42.0) | 158 (36.4) | 76 (19.8) | |
Have you ever received negative information about getting the COVID-19 vaccine? | |||||
No | 1260 (47.4) | 373 (49.5) | 203 (46.8) | 140 (36.5) | < 0.001 |
Yes | 1396 (52.6) | 380 (50.5) | 231 (53.2) | 244 (63.5) | |
Would you like to get the COVID-19 vaccine after receiving the negative information about it? | |||||
No | 932 (35.1) | 357 (47.4) | 205 (47.2) | 104 (27.1) | < 0.001 |
Yes | 1724 (64.9) | 396 (52.6) | 229 (52.8) | 280 (72.9) | |
Do you agree that the time costs in waiting for the vaccination or staying at the clinic will be a barrier for you to get COVID-19 vaccine? | |||||
No | 2033 (76.5) | 444 (59.0) | 290 (66.8) | 281 (73.2) | < 0.001 |
Yes | 623 (23.5) | 309 (41.0) | 144 (33.2) | 103 (26.8) | |
Do you agree that the environment of the clinic will be a barrier for you to get COVID-19 vaccine? | |||||
No | 1708 (64.3) | 331 (44.0) | 208 (47.9) | 217 (56.5) | < 0.001 |
Yes | 948 (35.7) | 422 (56.0) | 226 (52.1) | 167 (43.5) | |
Do you agree that the costs of going to the clinic will be a barrier for you to get COVID-19 vaccine? | |||||
No | 2011 (75.7) | 376 (49.9) | 271 (62.4) | 270 (70.3) | < 0.001 |
Yes | 645 (24.3) | 377 (50.1) | 163 (37.6) | 114 (29.7) | |
Do you agree that you have no need of getting COVID-19 vaccine because you are healthy? | |||||
No | 2364 (89.0) | 582 (77.3) | 354 (81.6) | 347 (90.4) | < 0.001 |
Yes | 292 (11.0) | 171 (22.7) | 80 (18.4) | 37 (9.6) | |
Have you gotten emergency COVID-19 vaccination for some reasons? | |||||
No | 1610 (60.6) | 638 (84.7) | 373 (85.9) | 222 (57.8) | < 0.001 |
Yes | 1046 (39.4) | 115 (15.3) | 61 (14.1) | 162 (42.2) |
The predictors for COVID-19 vaccine hesitancy among participants
Variables | Univariate analysis | Multivariate analysis | |||
---|---|---|---|---|---|
No Hesitancy (n = 3566) | Hesitancy (n = 661) | P | OR* (95%CI*) | P | |
Age (years), (\(mean\pm SD)\) | 33.59 \(\pm\) 10.04 | 29.92 \(\pm\) 8.48 | < 0.001 | 0.974 (0.956–0.993) | 0.006 |
Gender, n (%) | |||||
Male | 1219 (34.2) | 190 (28.7) | 0.006 | 1.000 | |
Female | 2347 (65.8) | 471 (71.3) | 1.331 (1.050–1.687) | 0.018 | |
Ethnicity, n (%) | |||||
Han | 3169 (88.9) | 596 (90.2) | 0.325 | ─ | |
Other | 397 (11.1) | 65 (9.8) | |||
Residence place, n (%) | |||||
Urban | 3085 (86.5) | 535 (80.9) | < 0.001 | 1.000 | |
Rural | 481 (13.5) | 126 (19.1) | 0.959 (0.710–1.295) | 0.785 | |
Marital status, n (%) | 0.822 | ||||
Single | 1392 (39.0) | 352 (53.3) | < 0.001 | 1.000 | |
Married | 2102 (58.9) | 302 (45.7) | 1.039 (0.745–1.449) | 0.820 | |
Others | 72 (2.1) | 7 (1.0) | 0.774 (0.285–2.107) | 0.617 | |
Education level, n (%) | |||||
≤ High school | 208 (5.8) | 52 (7.9) | 0.046 | 1.000 | |
College and above | 3358 (94.2) | 609 (92.1) | 0.771 (0.503–1.181) | 0.232 | |
Population groups | 0.779 | ||||
General population | 342 (9.6) | 92 (13.9) | < 0.001 | 1.000 | |
Students | 573 (16.1) | 180 (27.2) | 1.219 (0.834–1.781) | 0.306 | |
Medical workers | 2307 (64.7) | 349 (52.8) | 1.140 (0.801–1.624) | 0.466 | |
Public health professionals | 344 (9.6) | 40 (6.1) | 1.177 (0.704–1.966) | 0.535 | |
Household income (past 1 year), n (%) | 0.344 | ||||
> 350,000 | 116 (3.3) | 34 (5.1) | 0.001 | 1.000 | |
110,000–350,000 | 1230 (34.5) | 198 (30.0) | 0.621 (0.362–1.063) | 0.082 | |
50,000–100,000 | 1562 (43.8) | 273 (41.3) | 0.627 (0.370–1.065) | 0.084 | |
≤ 40,000 | 658 (18.5) | 156 (23.6) | 0. 675 (0.386–1.179) | 0.167 | |
Ever smoking, n (%) | |||||
No | 3156 (88.5) | 578 (87.4) | 0.436 | ─ | |
Yes | 410 (11.5) | 83 (12.6) | |||
Ever drinking, n (%) | |||||
No | 3027 (84.9) | 549 (83.1) | 0.231 | ─ | |
Yes | 539 (15.1) | 112 (16.9) | |||
COVID-19 test results, n (%) | 0.581 | ||||
Positive | 22 (0.6) | 17 (2.6) | < 0.001 | 1.000 | |
Negative | 2669 (74.8) | 429 (64.9) | 0.631 (0.256–1.558) | 0.318 | |
Haven’t tested | 875 (24.5) | 215 (32.5) | 0.617 (0.249–1.531) | 0.298 | |
Do you agree that vaccines can protect you from diseases? | |||||
No | 268 (7.5) | 150 (22.7) | < 0.001 | 1.000 | |
Yes | 3298 (92.5) | 511 (77.3) | 0.404 (0.301–0.543) | < 0.001 | |
Do you agree that you will get all vaccines that National Immunization Program or government recommended? | |||||
No | 654 (18.3) | 268 (40.5) | < 0.001 | 1.000 | |
Yes | 2912 (81.7) | 393 (59.5) | 0.783 (0.619–0.991) | 0.042 | |
Have you ever hesitated to get vaccination? | |||||
No | 2551 (71.5) | 281 (42.5) | < 0.001 | 1.000 | |
Yes | 1015 (28.5) | 380 (57.5) | 1.656 (1.302–2.106) | < 0.001 | |
Have you ever refused to get vaccination? | |||||
No | 3117 (87.49) | 436 (66.0) | < 0.001 | 1.000 | |
Yes | 449 (12.6) | 225 (34.0) | 1.340 (1.022–1.756) | 0.034 | |
Have you ever hesitated or refused to be get Pneumococcal Vaccine? | 0.042 | ||||
No | 2516 (70.6) | 312 (47.2) | < 0.001 | 1.000 | |
Ever hesitated | 784 (22.0) | 257 (38.9) | 1.450 (1.083–1.941) | 0.013 | |
Ever refused | 266 (7.5) | 92 (13.9) | 1.340 (0.862–2.083) | 0.193 | |
Have you ever hesitated or refused to get Influenza Vaccine? | 0.805 | ||||
No | 2525 (70.8) | 346 (52.3) | < 0.001 | 1.000 | |
Ever hesitated | 781 (21.9) | 222 (33.6) | 0.939 (0.698–1.262) | 0.674 | |
Ever refused | 260 (7.3) | 93 (14.1) | 0.870 (0.563–1.344) | 0.531 | |
The General Vaccine Hesitancy Scale scores | |||||
\(m\pm SD\) | 19.12 \(\pm\) 7.91 | 25.46 \(\pm\) 8.52 | < 0.001 | 1.043 (1.029–1.056) | < 0.001 |
Concerns about infection with COVID-19 | |||||
\(m\pm SD\) | 9.77 \(\pm\) 2.05 | 10.10 \(\pm\) 2.05 | 0.001 | 1.086 (1.032–1.143) | 0.002 |
Do you agree that COVID-19 epidemic is a severe problem affecting the health of the community? | |||||
No | 962 (27.0) | 217 (32.8) | 0.002 | 1.000 | |
Yes | 2604 (73.0) | 444 (67.2) | 0.946 (0.741–1.208) | 0.656 | |
Do you agree that COVID-19 will be a great threat to your health if you are infected? | |||||
No | 377 (10.6) | 93 (14.1) | 0.009 | 1.000 | |
Yes | 3189 (89.4) | 568 (85.9) | 1.212 (0.856–1.714) | 0.279 | |
Do you agree that you will get COVID-19 vaccine if doctors recommend? | |||||
No | 171 (4.8) | 241 (36.5) | < 0.001 | 1.000 | |
Yes | 3395 (95.2) | 420 (63.5) | 0.176 (0.132–0.234) | < 0.001 | |
Do you agree that the advice of your family members or friends will affect your intention of getting COVID-19 vaccine? | |||||
No | 2260 (63.4) | 271 (41.0) | < 0.001 | 1.000 | |
Yes | 1306 (36.6) | 290 (59.0) | 1.533 (1.212–1.940) | < 0.001 | |
Do you agree that you have no need of getting COVID-19 vaccine because you are healthy? | |||||
No | 3209 (90.0) | 438 (66.3) | < 0.001 | 1.000 | |
Yes | 357 (10.0) | 223 (33.7) | 1.938 (1.495–2.512) | < 0.001 | |
Do you need transparent information about COVID-19 vaccine development, efficacy and safety? | |||||
No | 557 (15.6) | 141 (21.3) | < 0.001 | 1.000 | |
Yes | 3009 (84.4) | 520 (78.7) | 0.722 (0.535–0.973) | 0.032 | |
Do you have doubts about the source of information about the COVID-19 vaccine? | |||||
No | 2788 (78.2) | 297 (44.9) | < 0.001 | 1.000 | |
Yes | 778 (21.8) | 364 (55.1) | 2.157(1.697–2.742) | < 0.001 | |
Have you ever received negative information about getting the COVID-19 vaccine? | |||||
No | 1725 (48.4) | 251 (38.0) | < 0.001 | 1.000 | |
Yes | 1841 (51.6) | 410 (62.0) | 1.563 (1.229–1.986) | < 0.001 | |
Would you like to get the COVID-19 vaccine after receiving the negative information about it? | |||||
No | 1131 (31.7) | 467 (70.7) | < 0.001 | 1.000 | |
Yes | 2435 (68.3) | 194 (29.3) | 0.315 (0.249–0.398) | < 0.001 | |
Do you agree that the time costs in waiting for the vaccination or staying at the clinic will be a barrier for you to get COVID-19 vaccine? | |||||
No | 2658 (74.5) | 390 (59.0) | < 0.001 | 1.000 | |
Yes | 908 (25.) | 271 (41.0) | 1.137 (0.870–1.487) | 0.348 | |
Do you agree that the environment of the clinic will be a barrier for you to get COVID-19 vaccine? | |||||
No | 2166 (60.7) | 298 (45.1) | < 0.001 | 1.000 | |
Yes | 1400 (39.3) | 363 (54.9) | 1.286 (0.986–1.679) | 0.064 | |
Do you agree that the cost of going to the clinic will be a barrier for you to get COVID-19 vaccine? | |||||
No | 2561 (71.8) | 367 (55.5) | < 0.001 | 1.000 | |
Yes | 1005 (28.2) | 294 (44.5) | 1.097 (0.839–1.434) | 0.498 | |
Have you gotten emergency COVID-19 vaccination for some reasons? | |||||
No | 2343 (65.7) | 500 (75.6) | < 0.001 | 1.000 | |
Yes | 1223 (34.3) | 161 (24.4) | 0.807 (0.626–1.040) | 0.097 |