Acceptance of seasonal influenza vaccination and associated factors among pregnant women in the context of COVID-19 pandemic in China: a multi-center cross-sectional study based on health belief model

Abstract

Background Seasonal influenza can circulate in parallel with coronavirus disease (COVID-19) in winter. In the context of COVID-19 pandemic, the risk of co-infection and the burden it poses on healthcare system calls for timely influenza vaccination among pregnant women, who are the priority population recommended for vaccination. We aimed to evaluate the acceptance of influenza vaccination and associated factors among pregnant women during COVID-19 pandemic, provide evidence to improve influenza vaccination among pregnant women, help reduce the risk of infection and alleviate the burden of healthcare system for co-infected patients. Methods We conducted a multi-center cross-sectional study among pregnant women in China. Sociodemographic characteristics, health status, knowledge on influenza, attitude towards vaccination, and health beliefs were collected. Locally weighted scatterplot smoothing regression analysis was used to evaluate the trends in the acceptance of influenza vaccine. Logistic regression was applied to identify factors associated with vaccination acceptance. Results The total acceptance rate was 76.5% (95%CI: 74.8–78.1%) among 2568 pregnant women enrolled. Only 8.3% of the participants had a history of seasonal influenza vaccination. In the logistic regression model, factors associated with the acceptance of influenza vaccine were western region, history of influenza vaccination, high knowledge of influenza infection and vaccination, high level of perceived susceptibility, perceived benefit, cues to action and low level of perceived barriers. Among 23.5% of the participants who had vaccine hesitancy, 48.0% of them were worried about side effect, 35.6% of them lacked confidence of vaccine safety. Conclusions Our findings highlighted that tailored strategies and publicity for influenza vaccination in the context of COVID-19 pandemic are warranted to reduce pregnant women’s concerns, improve their knowledge, expand vaccine uptake and alleviate pressure for healthcare system.

Acceptance of a Third Dose of COVID-19 Vaccine and Associated Factors in China Based on Health Belief Model: A National Cross-Sectional Study

“…In both univariable and multivariable analyses, most constructs in HBM models were significantly associated with vaccination intentions for a third dose of COVID-19. Our results are generally consistent with previous studies in China on the impact of health beliefs on vaccination acceptance [17,18,20]. Baccolini et al found higher perceived COVID-19 severity was negatively associated with vaccine hesitancy (aOR = 0.89, 95% CI: 0.85-0.94) among Italian university students [22].…”

“…Based on our previous COVID-19 vaccination willingness questionnaire [17,18], we specifically focused on the acceptance of the third dose of COVID-19 vaccine and its associated factors with health beliefs in this study. we investigated information including basic personal characteristics, attitudes towards a third dose of COVID-19 vaccine, knowledge of COVID-19 infection and vaccines, and vaccine-related health beliefs.…”

“…Based on the principle of HBM and previous literature [17,18,20], we set 13 questions from five HBM dimensions, which were answered by all participants. HBM hypothesizes that susceptibility to disease, severe outcome, beneficial behavior, and few obstacles are positive factors that promote individuals to adopt disease-prevention behaviors, such as vaccination [21].…”

Using the Health Belief Model to Identify Predictors of COVID-19 Vaccine Acceptance among a Sample of Pregnant Women in the U.S.: A Cross-Sectional Survey

“…The HBM has been used to evaluate health behaviors in various contexts, and the use of HBM with pregnant women's acceptance of vaccines is not novel. Few studies have examined pregnant women's acceptance of the influenza vaccine while pregnant [18,19] and others have used the HBM to assess acceptance of the Pertussis vaccine while pregnant [20]. In China, researchers applied the HBM to pregnant women's COVID-19 vaccine intentions [21].…”

Associations between new health conditions and healthcare service utilizations among older adults in the United Kingdom: effects of COVID-19 risks, worse financial situation, and lowered income

“…The main relationships of interest were motivated on the basis of Health Belief Model (HBM). HBM empowers researchers to explain and predict health promoting behaviour in terms of patterns of belief by addressing the association between personal threat of an illness or disease and health services utilisation [ 46 – 48 ]. Facing the susceptible risk of COVID-19 pandemic, the public population with new health conditions would like to perform care/treatment-seeking behaviors when considering the related severity and barriers.…”