Perception and willingness toward various immunization routes for COVID-19 vaccines: a cross-sectional survey in China

Abstract

BackgroundTo date, most vaccines, including the COVID-19 vaccine, are mainly administered by intramuscular injection, which might lead to vaccine hesitancy in some populations due to needle fear. Alternatively, needle-free immunization technology is extensively developed to improve the efficacy and acceptance of vaccination. However, there is no study to report the perception and willingness toward various immunization routes of the COVID-19 vaccine in the general population.MethodsA cross-sectional survey was conducted nationwide using an online questionnaire. Bivariate analyses were undertaken to assess variable associations among the participants who reported a hesitancy to receive the COVID-19 booster vaccination. Multivariable logistic regression with a backward step-wise approach was used to analyze the predicted factors associated with the willingness to receive the COVID-19 booster vaccination.ResultsA total of 3,244 valid respondents were included in this survey, and 63.2% of participants thought they had a good understanding of intramuscular injection, but only 20.7, 9.2, 9.4, and 6.0% of participants had a self-perceived good understanding of inhalation vaccine, nasal spray vaccine, oral vaccine, and microneedle patch vaccine. Correspondingly, there was high acceptance for intramuscular injection (76.5%), followed by oral inhalation (64.4%) and nasal spray (43.0%). Those participants who were only willing to receive an intramuscular vaccine had less vaccine knowledge (OR = 0.78; 95% CI: 0.65–0.94) than those who were willing to receive a needle-free vaccine (OR = 1.97; 95% CI: 1.52–2.57). Some factors were found to be associated with vaccine hesitancy toward booster COVID-19 vaccination.ConclusionNeedle-free vaccination is a promising technology for the next generation of vaccines, but we found that intramuscular injection was still the most acceptable immunization route in this survey. One major reason might be that most people lack knowledge about needle-free vaccination. We should strengthen the publicity of needle-free vaccination technology, and thus improve the acceptance and coverage of vaccination in different populations.

Rapid Induction of Long-Lasting Systemic and Mucosal Immunity via Thermostable Microneedle-Mediated Chitosan Oligosaccharide-Encapsulated DNA Nanoparticles

“…To date, the World Health Organization has approved at least fifteen COVID-19 vaccines for clinical use, with the majority administered via intramuscular injection (IM). However, there are several disadvantages to IM-based vaccination, which usually requires strict storage conditions under cold-chain distribution and professional administration by medical personnel and typically results in weak mucosal immunity. − In addition, many people are reluctant to receive this vaccine modality due to fear of needles, stemming from the trauma and pain associated with IM. , The COVID-19 pandemic has emphasized the urgent need for a platform that can rapidly develop mucosa-targeted vaccine technology. Therefore, it is of great significance to explore alternative vaccine modalities that can improve effectiveness and coverage of vaccination across different populations.…”

“…1−3 In addition, many people are reluctant to receive this vaccine modality due to fear of needles, stemming from the trauma and pain associated with IM. 4,5 The COVID-19 pandemic has emphasized the urgent need for a platform that can rapidly develop mucosa-targeted vaccine technology. Therefore, it is of great significance to explore alternative vaccine modalities that can improve effectiveness and coverage of vaccination across different populations.…”