Abram L Wagner1, Zhuoying Huang2, Jia Ren2, Megan Laffoon3, Mengdi Ji4, Leah C Pinckney4, Xiaodong Sun2, Lisa A Prosser5, Matthew L Boulton6, Brian J Zikmund-Fisher7. 1. Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan. Electronic address: awag@umich.edu. 2. Department of Immunization Program, Shanghai Municipal Centers for Disease Control and Prevention, Shanghai, China. 3. Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan. 4. Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan. 5. Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Michigan. 6. Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan; Department of Internal Medicine, Division of Infectious Disease, University of Michigan Medical School, Ann Arbor, Michigan. 7. Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan; Department of Internal Medicine, Division of General Medicine, University of Michigan Medical School, Ann Arbor, Michigan.
Abstract
INTRODUCTION: Rapidly urbanizing communities in middle-income countries could be sources of vaccine hesitancy, and may create hot spots of low vaccination coverage. This study characterizes vaccine hesitancy in Shanghai and identifies disparities in vaccine safety and efficacy concerns by residency status-a marker for recent migration into the city. METHODS: Parents of children aged ≤18 years from immunization clinics in Shanghai were enrolled in summer 2019, with the data analyzed during winter 2019-2020. The paper questionnaire used the Parental Attitudes towards Childhood Vaccines scale, which included questions about vaccine safety and efficacy concerns. The primary independent variable was residency-whether an individual was a Shanghai local or a recent migrant (i.e., non-local). Linear regression models assessed the relationship between residency and vaccine safety and efficacy concerns. RESULTS: Among 1,021 participants, 65.4% had local residency, and the remainder were urban non-locals (13.1%) or rural non-locals (21.5%). A majority of parents expressed concerns about vaccine side effects (73.8%), vaccine safety (63.9%), and vaccine effectiveness (52.4%). Compared with locals, rural non-locals were more concerned about vaccine side effects (β=0.26, 95% CI=0.07, 0.46), vaccine safety (β=0.42, 95% CI=0.19, 0.65), and vaccine effectiveness (β=0.37, 95% CI=0.16, 0.58). CONCLUSIONS: Differences in vaccine hesitancy by residency could lead to geographical and sociodemographic disparities in vaccination coverage and outbreaks of vaccine-preventable disease. SUPPLEMENT INFORMATION: This article is part of a supplement entitled Global Vaccination Equity, which is sponsored by the Global Institute for Vaccine Equity at the University of Michigan School of Public Health.
INTRODUCTION: Rapidly urbanizing communities in middle-income countries could be sources of vaccine hesitancy, and may create hot spots of low vaccination coverage. This study characterizes vaccine hesitancy in Shanghai and identifies disparities in vaccine safety and efficacy concerns by residency status-a marker for recent migration into the city. METHODS: Parents of children aged ≤18 years from immunization clinics in Shanghai were enrolled in summer 2019, with the data analyzed during winter 2019-2020. The paper questionnaire used the Parental Attitudes towards Childhood Vaccines scale, which included questions about vaccine safety and efficacy concerns. The primary independent variable was residency-whether an individual was a Shanghai local or a recent migrant (i.e., non-local). Linear regression models assessed the relationship between residency and vaccine safety and efficacy concerns. RESULTS: Among 1,021 participants, 65.4% had local residency, and the remainder were urban non-locals (13.1%) or rural non-locals (21.5%). A majority of parents expressed concerns about vaccine side effects (73.8%), vaccine safety (63.9%), and vaccine effectiveness (52.4%). Compared with locals, rural non-locals were more concerned about vaccine side effects (β=0.26, 95% CI=0.07, 0.46), vaccine safety (β=0.42, 95% CI=0.19, 0.65), and vaccine effectiveness (β=0.37, 95% CI=0.16, 0.58). CONCLUSIONS: Differences in vaccine hesitancy by residency could lead to geographical and sociodemographic disparities in vaccination coverage and outbreaks of vaccine-preventable disease. SUPPLEMENT INFORMATION: This article is part of a supplement entitled Global Vaccination Equity, which is sponsored by the Global Institute for Vaccine Equity at the University of Michigan School of Public Health.
Authors: Abram L Wagner; Aubree Gordon; Veronica L Tallo; Artan Simaku; Rachael M Porter; Laura J Edwards; Enkeleda Duka; Ilham Abu-Khader; Lionel Gresh; Cristina Sciuto; Eduardo Azziz-Baumgartner; Silvia Bino; Felix Sanchez; Guillermina Kuan; Joanne N de Jesus; Eric A F Simões; Danielle R Hunt; Ali K Arbaji; Mark G Thompson Journal: Vaccine Date: 2020-05-06 Impact factor: 3.641
Authors: Zhuoying Huang; Abram L Wagner; Muzi Lin; Xiaodong Sun; Brian J Zikmund-Fisher; Matthew L Boulton; Jia Ren; Lisa A Prosser Journal: Hum Vaccin Immunother Date: 2020-01-24 Impact factor: 3.452
Authors: Jia Ren; Abram L Wagner; Anna Zheng; Xiaodong Sun; Matthew L Boulton; Zhuoying Huang; Brian J Zikmund-Fisher Journal: PLoS One Date: 2018-12-13 Impact factor: 3.240
Authors: Jessica M Finlay; Lindsay C Kobayashi; Abram L Wagner; Julia M Porth; Zhenke Wu; Matthew L Boulton Journal: J Community Health Date: 2022-01-25