Vaccination coverage among COVID-19 prevention and control management teams at primary healthcare facilities in China and their attitudes towards COVID-19 vaccine: a cross-sectional online survey

Abstract

ObjectiveTo investigate the COVID-19 vaccination coverage rate and differences among various COVID-19 prevention primary healthcare (PHC) facilities in China and understand their attitudes towards COVID-19 vaccine. These findings are helpful to provide important suggestions to further improve national COVID-19 vaccination rate.DesignA nationwide cross-sectional online survey was designed and conducted among COVID-19 prevention and control management teams at PHC facilities in mainland China. In the self-designed questionnaires, each subject was asked to evaluate on a 1–10 scale (10=extremely important/acceptable/influential) the COVID-19 vaccination importance, acceptance and factors related to vaccine hesitancy.SettingSubjects from 31 provinces and autonomous regions including minorities across mainland China were invited to complete the questionnaire between 22 February 2021 and 2 March 2021.ParticipantsWere selected by multistage stratified sampling, 998 valid questionnaires (valid rate 99.11%) were collected. The respondents were divided into group A (≤5 respondents within each PHC facility, n1=718) and group B (>5 respondents within each PHC facility, n2=280).Outcome measuresSurvey on vaccination rate and attitude towards COVID-19 vaccine included the following: (1) if the subjects think the vaccination is important in containment of COVID-19 pandemic (1–10 scale, 10=extremely important), (2) if they would accept COVID-19 vaccine (1–10 scale, 10=extremely acceptable) and (3) their opinions on 7 factors possibly related to vaccine hesitancy (1–10 scale, 10=extremely influential). All the items were designed based on the previous expert interviews.ResultsOur results showed vaccination rate was greater in group A (85.93%) than in group B (66.43%) (p<0.001). Detailed analyses revealed that in group A, male members were twice as likely to get vaccinated as compared with female members (adjusted OR (aOR): 2.07; 95% CI: 1.26 to 3.43, p=0.004). In group B, those who were at or under the median age had twice the odds of vaccination coverage compared with those who were over the median age (aOR: 2.29; 95% CI: 1.22 to 4.33, p=0.010). In addition, those who were specialised in traditional Chinese medicine were less likely to get vaccinated against COVID-19 compared with those who were specialised in general medicine, with the aOR: 0.10 (95% CI: 0.01 to 0.83, p=0.033). By analysing the factors that influenced the vaccination attitudes among the 998 respondents, we found no significant difference between the vaccinated and unvaccinated participants. However, further detailed analyses found that team members with undergraduate college education were less likely to score higher in COVID-19 vaccination importance than those with technical secondary school education (aOR: 0.35; 95% CI: 0.13 to 0.93, p=0.035); Furthermore, those with non-medical job titles had nearly twice the odds of giving a higher score for the uncertainty of vaccine efficacy compared with those with junior medical titles (aOR: 1.70; 95% CI: 1.02 to 2.85, p=0.016). Team members with a non-medical title were more likely to give a higher score for advice on social sources compared with those with a junior medical title (aOR: 1.70; 95% CI: 1.02 to 2.85, p=0.042).ConclusionIn PHC facilities, although there was a higher COVID-19 vaccination rate among COVID-19 prevention and control teams, some subgroups with different descriptive characters showed negative attitudes towards COVID-19 vaccination. Because primary care workers in China are highly expected to receive the vaccination, and support and educate the public for COVID-19 vaccination. Thus, it is important and necessary to continue to educate them about their vaccination concerns and change their attitudes towards vaccination. Our findings are highly beneficial for designing public vaccination education strategies.

The factors correlated with COVID-19 vaccination coverage in Chinese hypertensive patients managed by community general practitioner

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Within-Country Inequality in COVID-19 Vaccination Coverage: A Scoping Review of Academic Literature

“…In contrast, the opposite pattern—higher vaccination among younger groups—was reported in 8 articles (6%). These articles focused on adult populations across different settings, including health care workers in China [ 29 ] and Egypt [ 30 ]; university students or staff in the United States [ 31 , 32 ]; active military personnel in Israel [ 33 ]; pregnant or postpartum women in the United States [ 34 ]; and general adult populations in Singapore [ 35 ] and the United States [ 36 ].…”

Vaccination against coronavirus disease 2019 in patients with pulmonary hypertension: A national prospective cohort study

“…[ 10 ] Such patients have higher risks than the general population during the COVID-19 pandemic, with a similar cumulative incidence of infection but worse outcomes, [ 11 , 12 ] which is why vaccination is essential. Despite inactivated whole-virion SARS-CoV-2 vaccines and recombinant protein subunit vaccines having been approved by World Health Organization (WHO) for emergency use in numerous countries and widely inoculated in China, [ 13 ] hesitancy due to safety concerns have hampered the acceptance of vaccinations among the population with PH. Most studies evaluated vaccination effectiveness without considering patients with pre-existing cardiopulmonary problems such as PH.…”