Understanding COVID-19 vaccine demand and hesitancy: A nationwide online survey in China

Abstract

Background This study attempts to understand coronavirus disease 2019 (COVID-19) vaccine demand and hesitancy by assessing the public’s vaccination intention and willingness-to-pay (WTP). Confidence in COVID-19 vaccines produced in China and preference for domestically-made or foreign-made vaccines was also investigated. Methods A nationwide cross-sectional, self-administered online survey was conducted on 1–19 May 2020. The health belief model (HBM) was used as a theoretical framework for understanding COVID-19 vaccination intent and WTP. Results A total of 3,541 complete responses were received. The majority reported a probably yes intent (54.6%), followed by a definite yes intent (28.7%). The perception that vaccination decreases the chances of getting COVID-19 under the perceived benefit construct (OR = 3.14, 95% CI 2.05–4.83) and not being concerned about the efficacy of new COVID-19 vaccines under the perceived barriers construct (OR = 1.65, 95% CI 1.31–2.09) were found to have the highest significant odds of a definite intention to take the COVID-19 vaccine. The median (interquartile range [IQR]) of WTP for COVID-19 vaccine was CNY¥200/US$28 (IQR CNY¥100–500/USD$14–72). The highest marginal WTP for the vaccine was influenced by socio-economic factors. The majority were confident (48.7%) and completely confident (46.1%) in domestically-made COVID-19 vaccine. 64.2% reported a preference for a domestically-made over foreign-made COVID-19 vaccine. Conclusions The findings demonstrate the utility of HBM constructs in understanding COVID-19 vaccination intent and WTP. It is important to improve health promotion and reduce the barriers to COVID-19 vaccination.

COVID-19 Vaccination Willingness among Chinese Adults under the Free Vaccination Policy

“…Income had no influence on COVID-19 VWR in the paid vaccine model, but the low-income group had a higher COVID-19 VWR than the high-income group in the free vaccine model (86.2% vs. 78.97%, OR = 1.536), which was different from previous research [5,6,[22][23][24][25]. The VWR growth rate of free vaccinations for the low-income group was 17.37% (from 73.44% to 86.2%), but that for the high-income group was only 6.64% (from 74.05% to 78.97%).…”

“…Previous vaccination studies have shown that many factors are responsible for the COVID-19 vaccination willingness rate (VWR), such as socio-economic factors, awareness of the severity and susceptibility to the disease and trust in the vaccine [4][5][6][7][8]. From a survey in Japan, Yoda and Katsuyama found that males, older age people, rural residents and chronic disease sufferers displayed the highest willingness toward COVID-19 vaccination [4].…”

“…Several studies have also been carried out on special populations, such as healthcare workers, long-term care staff and caregivers, which found that concerns about vaccine safety, side effects and effectiveness were the primary reasons for vaccine hesitancy [7,[10][11][12][13]. A Chinese national online survey found that participants that perceived the benefits and were unconcerned about the efficacy of COVID-19 vaccines had the highest intention to vaccinate [6]. Their willingness-to-pay (WTP) for COVID-19 vaccines was influenced by social and demographic factors, such as occupation and region.…”

COVID-19 Vaccine Hesitancy Worldwide: A Concise Systematic Review of Vaccine Acceptance Rates

“…This includes more than 90% acceptance rates in Indonesia, Malaysia and one study from China [51,52,59]. Another two surveys on the general public in China reported vaccine acceptance rates of more than 80%, with an additional survey in South Korea that reported a rate of 79.8% [46,63]. A later survey from Shenzhen, China, by Zhang et al, which surveyed parents/guardians who were factory workers, on their acceptability of children COVID-19 vaccination reported a lower rate of 72.5% compared to previous studies [71].…”

The development and validation of the Motors of COVID-19 Vaccination Acceptance Scale: Psychometric evaluation among mainland Chinese university students

“…Third, the MoVac-COVID19S can be used to explore and understand why a population reports lower levels of motivation to get vaccinated. Although many studies have reported the high willingness of COVID-19 vaccinating uptake [e.g., 21,[35][36][37][38], low acceptance can still be observed [39][40][41]. Therefore, with the use of MoVac-COVID19S, healthcare providers and researchers can obtain in-depth information regarding the underlying mechanism of individuals who are unwilling to get vaccinated.…”