The COVID-19 Vaccination Behavior and Correlates in Diabetic Patients: A Health Belief Model Theory-Based Cross-Sectional Study in China, 2021

Abstract

The population with diabetes is more susceptible to severe acute respiratory syndrome-associated coronavirus (SARS-CoV)-2, and have a significantly higher coronavirus disease-2019 (COVID-19) mortality rate. Previous studies have shown low willingness for the COVID-19 vaccination, and there are limited reports on the behavior and relevance of the COVID-19 vaccination. This study aimed to determine the uptake behavior and associated factors of the COVID-19 vaccine. In our cross-sectional questionnaire-based clinical study, 645 diabetes patients affiliated with two affiliated hospitals of Changzhi Medical College completed the questionnaire between June to October 2021. The health belief model (HBM) was used in examining factors influencing vaccination behavior. After adjusting for covariates with significant differences in social background characteristics, a multivariable logistic regression was used to determine predictors related to uptake in COVID-19 vaccination. A total of 162 vaccinated and 483 unvaccinated eligible diabetic patients were recruited. Patients who believed that the COVID-19 syndrome is severe (aOR3.67, 95%CI 1.88–7.17; p < 0.001), believe that vaccination can significantly reduce the risk of SARS-Cov-2 infection (aOR3.48, 95%CI 1.80–6.73; p < 0.001), believe that vaccination is beneficial to themselves and others (aOR 4.53, 95%CI 1.71–11.99; p = 0.002), think that relatives’ vaccination status has a positive impact on their vaccination behavior (aOR 5.68, 95%CI 2.83–11.39; p < 0.001), and were more likely to be vaccinated; worrying about the adverse health effects of COVID-19 vaccination (aOR 0.18, 95%CI 0.09–0.35; p < 0.001) was negatively correlated with COVID-19 vaccination behavior. Health care workers should provide targeted informative interventions based on the safety and protective effects theory of HBM to improve vaccination behavior in patients with diabetes.

Prevalence and Determinants of COVID-19 Vaccination Uptake Were Different between Chinese Diabetic Inpatients with and without Chronic Complications: A Cross-Sectional Survey

“…This study was a cross-sectional study conducted among inpatients diagnosed with DM which was carried out at the endocrinology departments of Heping and Heji Hospitals, Changzhi Medical College (Changzhi, Shanxi, China) between April and August 2021. This study was a continuation of our published studies [ 22 , 24 ].…”

“…To the best of our knowledge, three studies have investigated actual uptake of COVID-19 vaccination among people with DM. The prevalence of uptake was 21.5% in India [ 23 ], 25.2%% in China [ 24 ], and 84.8% in Saudi Arabia [ 25 ]. The main reasons for vaccine hesitancy among people with DM included concerns about vaccine safety and side effects, perceived consequences of COVID-19 infection, relatives’ vaccination status, and suggestions made by physicians [ 4 , 20 , 21 , 22 , 23 , 24 , 25 ].…”

“…The prevalence of uptake was 21.5% in India [ 23 ], 25.2%% in China [ 24 ], and 84.8% in Saudi Arabia [ 25 ]. The main reasons for vaccine hesitancy among people with DM included concerns about vaccine safety and side effects, perceived consequences of COVID-19 infection, relatives’ vaccination status, and suggestions made by physicians [ 4 , 20 , 21 , 22 , 23 , 24 , 25 ]. It is possible that people with DM who have chronic complications have different perceptions related to COVID-19 compared to their counterparts without such complications.…”

Acceptance Rates of COVID-19 Vaccine Highlight the Need for Targeted Public Health Interventions

“…Duan et al [ 45 ] explored COVID-19 vaccination behavior and correlates in 645 diabetic patients from two hospitals in China between June and October 2021. They used multivariable logistic regression to determine predictors related to COVID-19 vaccine uptake.…”

“…A total of 162 vaccinated and 483 unvaccinated eligible diabetic patients were included. Patients who believed that the COVID-19 syndrome is severe believed that vaccination can significantly reduce the risk of SARS-CoV-2 infection thought that vaccination is beneficial to themselves and others, and believed that relatives’ vaccination status has a positive impact on their vaccination behavior and were more likely to be vaccinated; worrying about the adverse health effects of COVID-19 vaccine was negatively correlated with the COVID-19 vaccination rate [ 45 ].…”