BACKGROUND: The control of vaccine hesitancy and the promotion of vaccination are key protective measures against COVID-19. OBJECTIVE: This study assesses the prevalence of vaccine hesitancy and the vaccination rate and examines the association between factors of the health belief model and vaccination. METHODS: A convenience sample of 2,531 valid participants from 31 provinces and autonomous regions of mainland China was enrolled in this online survey study from January 1st to 24th, 2021. Multivariable logistic regression was used to identify the associations of the vaccination rate and health belief model factors with the prevalence of vaccine hesitancy after other covariates were controlled. RESULTS: The prevalence of vaccine hesitancy was 44.3% (95% CI: 42.3%-46.2%), and the vaccination rate was 10.4% (9.2%-11.6%). The direct promoting factors of vaccination behaviour were a lack of vaccine hesitancy (OR=7.75, 95% CI: 5.03-11.93), agreement with recommendations from friends/family for vaccination (OR=3.11, 95% CI: 1.75-5.52) and absence of perceived barriers to COVID-19 vaccination (OR=0.51, 95% CI: 0.35-0.75). The direct factors associated with a higher vaccine hesitancy rate were a high level of perceived barriers (OR=1.63, 95% CI: 1.36-1.95), and perceived benefits (OR=0.51, 95% CI: 0.32-0.79). A mediating effect of self-efficacy, influenced by perceived barriers (SSC = -0.71, p < 0.001), perceived benefits (SSC = 0.58, p < 0.001), agreement with recommendations from authorities (SSC = 0.27, p < 0.001), and agreement with recommendations from friends/family (SSC = 0.31, p < 0.001), was negatively associated with vaccination (SSC = -0.45, p < 0.001), via vaccine hesitancy (SSC = -0.32, p < 0.001). CONCLUSIONS: It may be beneficial to increase the vaccination rate by reducing vaccine hesitancy and perceived barriers to vaccination and encouraging volunteers to advocate vaccination to their friends and family members. It is also important to reduce vaccine hesitancy by enhancing self-efficacy for vaccination due to its crucial mediating function.
BACKGROUND: The control of vaccine hesitancy and the promotion of vaccination are key protective measures against COVID-19. OBJECTIVE: This study assesses the prevalence of vaccine hesitancy and the vaccination rate and examines the association between factors of the health belief model and vaccination. METHODS: A convenience sample of 2,531 valid participants from 31 provinces and autonomous regions of mainland China was enrolled in this online survey study from January 1st to 24th, 2021. Multivariable logistic regression was used to identify the associations of the vaccination rate and health belief model factors with the prevalence of vaccine hesitancy after other covariates were controlled. RESULTS: The prevalence of vaccine hesitancy was 44.3% (95% CI: 42.3%-46.2%), and the vaccination rate was 10.4% (9.2%-11.6%). The direct promoting factors of vaccination behaviour were a lack of vaccine hesitancy (OR=7.75, 95% CI: 5.03-11.93), agreement with recommendations from friends/family for vaccination (OR=3.11, 95% CI: 1.75-5.52) and absence of perceived barriers to COVID-19 vaccination (OR=0.51, 95% CI: 0.35-0.75). The direct factors associated with a higher vaccine hesitancy rate were a high level of perceived barriers (OR=1.63, 95% CI: 1.36-1.95), and perceived benefits (OR=0.51, 95% CI: 0.32-0.79). A mediating effect of self-efficacy, influenced by perceived barriers (SSC = -0.71, p < 0.001), perceived benefits (SSC = 0.58, p < 0.001), agreement with recommendations from authorities (SSC = 0.27, p < 0.001), and agreement with recommendations from friends/family (SSC = 0.31, p < 0.001), was negatively associated with vaccination (SSC = -0.45, p < 0.001), via vaccine hesitancy (SSC = -0.32, p < 0.001). CONCLUSIONS: It may be beneficial to increase the vaccination rate by reducing vaccine hesitancy and perceived barriers to vaccination and encouraging volunteers to advocate vaccination to their friends and family members. It is also important to reduce vaccine hesitancy by enhancing self-efficacy for vaccination due to its crucial mediating function.
Authors: Konstadina Griva; Kevin Y K Tan; Frederick H F Chan; Ramanathan Periakaruppan; Brenda W L Ong; Alexius S E Soh; Mark Ic Chen Journal: Vaccines (Basel) Date: 2021-11-30