Delays in routine childhood vaccinations and their relationship with parental vaccine hesitancy: a cross-sectional study in Wuxi, China

ABSTRACT

Objectives

This study aimed to examine childhood vaccination delay, explore the association between vaccination delay and parental vaccine hesitancy, and assess childhood vaccination delays during the coronavirus disease (COVID)-19 pandemic in China.

Methods

This cross-sectional survey was conducted in Wuxi City. Participants were recruited from local vaccination clinics. Questionnaires were used to collect information about socio-demographics, vaccine hesitancy, and immunization clinic evaluations. Vaccination records were obtained from the Jiangsu Information Management System of Vaccination Cases.

Results

Overall, 2728 participants were included. The coverage for seven category A vaccines (Expanded Program on Immunization (EPI)) was more than 95% at 24 months. The proportion of children vaccinated in a timely manner was the highest for the first dose of the hepatitis B vaccine (91.6%) and the lowest for the Bacillus-Calmette-Guerin vaccine (44.6%). More than 50% of the planned vaccinations were delayed in February and March 2020. The Vaccine Hesitancy Scale scores were not associated with vaccination delay (P = 0.842). Children’s vaccination delays were negatively associated with parents who reported convenient access to clinics and satisfaction with immunization services (P = 0.020, P = 0.045).

Conclusions

EPI is highly successful in China. Despite vaccination delays due to the COVID-19 pandemic, coverage was recovered after lockdown restrictions were eased.

KEYWORDS:

• Childhood vaccination
• delay
• timeliness
• vaccine hesitancy
• COVID-19 pandemic

Declaration of Interests

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

A reviewer on this paper has received investigator-initiated grant funding from Merck Sharpe and Dohme, Inc. for unrelated research. Peer reviewers on this manuscript have no other relevant financial or other relationships to disclose.

Supplementary material

Supplemental data for this article can be accessed here.

Author contributions

Q Wang, SX Xiu, H Jin, B Lu, and L Lin conceptualized and designed the study, drafted the initial manuscript, and reviewed and revised the manuscript; Q Wang, SX Xiu, LQ Yamg, Y Han, JX Huang, TT Cui, NY Shi, MQ Liu, and XW Wang designed the data collection instruments and collected data; Q Wang and SX Xiu carried out the initial analyses. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Additional information

Funding

This manuscript was funded by Wuxi City Technology Development Fund [grant number N20191007]; Postgraduate Research & Practice Innovation Program of Jiangsu Province [grant number KYCX20_0153]; the Fundamental Research Funds for the Central Universities [grant number 3225002102D]; Public Health Research Center of Jiangnan University [grant number JUPH201845]; and Uk Foreign, Commonwealth and Development Office and Wellcome [grant number 215373/A/19/Z]. The funder/sponsor did not participate in the work.