Parental category B vaccine hesitancy and associated factors in China: an online cross-sectional survey

ABSTRACT

Background

Vaccine hesitancy is one of the top ten health threats. We aimed to (1) assess parental Category B vaccines hesitancy and associated sociodemographic factors in China, and (2) explore the association between attitude toward vaccines and self-reported hesitant behavior.

Methods

A cross-sectional study was performed through a web-based anonymous online questionnaire survey between 9 February and 7 April 2021. Chinese parents aged ≥ 18 years with one child aged < 6 years were included to assess vaccine hesitancy using the vaccine-hesitancy scale (VHS). Structural equation model was used to determine relationships between variables.

Results

Of 2952 Chinese parents included in the analysis, 17.5% were highly hesitant in Category B vaccines. Parents who were younger, less educated, engaged in health-related occupations, and had been vaccinated against influenza in the past year were more hesitant when vaccinating their children (P < 0.001). VHS score accuracy to identify vaccine-hesitant behavior was acceptable, and the optimal cutoff was 37.50 (with 61.96% parental vaccine hesitancy). Parents who lack confidence or believe vaccines were risk were more likely to show vaccine hesitant behavior (P < 0.001).

Conclusions

In China, effective interventions need to be implemented to eliminate parental Category B vaccines hesitancy.

KEYWORDS:

• Vaccine hesitancy
• Parents
• Structural equation model
• Online survey
• China

Author Contributions

Conceptualization, Y.H., and H.J.; methodology, H.J.; software, H.J.; validation, H.J.; formal analysis, Y.H., Q.W., and H.J.; investigation, Y.H., Q.W., S.Z., J.W., S.D., T.C., M.L., N.S., L.Y., Y.H., S.X., and X.W.; writing— original draft preparation, Y.H., Q.W., and H.J.; writing—review and editing, Y.H., and H.J. All authors have read and agreed to the published version of the manuscript.

Declaration of interest

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.

Informed Consent Statement

Informed consent was obtained from all participants.

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki, and the protocol was approved by the Ethics Committee of the Wuxi Centre for Disease Control and Prevention (2020No10).

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Supplementary Material

Supplemental data for this article can be accessed here.

Additional information

Funding

This manuscript was funded by Wuxi City Technology Development Fund (N20191007); Postgraduate Research and Practice Innovation Program of Jiangsu Province (KYCX20_0153); Jiangsu Provincial Six Talent Peak (grant number: WSN‐002); Public Health Research Center of Jiangnan University (No. JUPH201845).