Measuring parents’ acceptance of non-national immunization program vaccines for children and its influencing factors during the COVID-19 pandemic in Shanghai, China

Abstract

This study aimed to understand the willingness of and affecting factors of non-national immunization program (non-NIP) vaccines among children’s parents during the COVID-19 era in Shanghai, China. A cross-sectional survey was conducted with parents who attended vaccination clinics in four out of 16 districts in Shanghai, China. Data was obtained using a self-administered structured questionnaire. A multivariate logistic regression model was used to analyze factors associated with vaccination acceptability. In total, 1691 valid questionnaires were obtained. Of the participants, 69.5% (1,176/1,691) reported being interested in non-NIP vaccines for their children. Further, respondents were more likely to be willing to get non-NIP vaccines for their children if they had an income of 10,000–20,000CNY or more, an educational level of college or above, and if getting the vaccination was moderately convenient or convenient. Respondents were less likely to be willing to get the vaccines if they were in the 30–39 age group and had moderate or low satisfaction with the vaccine. Many parents are willing to get non-NIP vaccines for their children. However, some demographic factors, perceived convenience and satisfaction of vaccination, perceived necessity, safety and price barrier of non- NIP influenced the acceptability of non-NIP vaccines in Shanghai. Our findings can help guide future efforts to increase non-NIP vaccines acceptability.

Changes in COVID-19 Vaccine Acceptability among Parents with Children Aged 6–35 Months in China—Repeated Cross-Sectional Surveys in 2020 and 2021

“…Characteristics between participants and refusals could not be compared as no information was collected from refusals. Nonetheless, our response rate in both rounds was higher than in studies with similar topics [ 29 , 30 , 31 , 34 , 37 , 38 , 40 , 41 , 49 ]. Last but not least, the study was cross-sectional and so it could not establish causal relationships.…”

“…The levels of parental acceptability in both rounds were higher than that reported in the United States (39.7%) [ 26 ] and the United Kingdom (48.2%) [ 27 ]. However, such levels of parental acceptability among our participants were lower when compared to Chinese parents having older children [ 31 , 33 , 34 , 37 , 38 , 40 , 49 ]. Younger age of the children and the availability of vaccines might be reasons to explain such differences.…”

“…Common concerns, such as vaccine safety, effectiveness, and rapid vaccine development, were negatively associated with vaccine acceptability [ 27 ]. In China, most studies investigating parental vaccine acceptability for children focused on children aged 6–18 years [ 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ]. Our previous work investigated the changes in parental COVID-19 vaccine hesitancy for children aged 3–17 years [ 41 ].…”

Factors associated with recommendation behaviors of four non-National Immunization Program vaccines: a cross-sectional survey among public health workers in China

“…Lack of national financing also contributed to a relatively higher market cost of vaccination, especially for the payers (caregivers of children). This higher cost of non-NIP vaccination might be closely connected to the hesitation observed in public health workers who “used to recommend but not accepted”, as the cost often exceeds the caregivers’ willingness to pay for non-NIP vaccines [ 40 ].…”

Vaccine pricing strategies in China

“…A survey conducted in Shanghai, China revealed that factors such as income, education and convenience influence the acceptability of non-NIP vaccines. The survey also found that half of the participants who would not have opted for non-NIP vaccines would change their decision if non-NIP vaccines were covered by health insurance 17. The largest factor contributing to inequality in non-NIP vaccines is monthly household income per capita 6.…”