Who is more likely to hesitate to accept COVID-19 vaccine: a cross-sectional survey in China

Figures & data

Table 1. Characteristics of respondents and their hesitancy to accept vaccine (n = 19,132)

Characteristics	Respondents (n [%])	Hesitation (n [%])	χ^2weighted	Pweighted values
Sex			56.448	0.000
Female	10,021(52.4%)	3200(31.9%)
Male	9111(47.6%)	2576(28.3%)
Age			1171.039	0.000
46 and above	1562(8.3%)	558 (35.7%)
26–45	9383(50.0%)	2081(22.2%)
18–25	7808(41.6%)	2932(37.6%)
Education			448.721	0.000
Master and above	1255(6.6%)	515(41.0%)
Junior college or bachelor	10,892(56.9%)	2867(26.3%)
High school and below	6985(36.5%)	2394(34.3%)
Marital status			1156.789	0.000
Married	9838(51.4%)	2266(23.0%)
Others(single, divorced or widowed)	9294(48.6%)	3510(37.8%)
Residency			182.015	0.000
Urban	10,818(56.5%)	3018(27.9%)
Rural	8314(43.5%)	2758(33.2%)
Monthly income			1389.168	0.000
Higher	1253(6.5%)	307(24.5%)
High	6602(34.5%)	1422(21.5%)
Middle	4723(24.7%)	1383(29.3%)
Low	6554(34.3%)	2664(40.6%)
Risk level of sample provinces			69.292	0.000
High-risk	10,041(52.5%)	3251(32.4%)
Low-risk	9091(47.5%)	2525(27.8%)
Self-reported health			341.822	0.000
Good	15,962(83.4%)	4517(28.3%)
Poor	3170(16.6%)	1259(39.7%)
Living with vulnerable family members			317.374	0.000
No	5809(30.4%)	2130(36.7%)
Yes	13,323(69.6%)	3646(27.4%)
Health or medical-related staff			219.947	0.000
No	16,887(88.3%)	5293(31.3%)
Yes	2245(11.7%)	483(21.5%)
COVID-19 infection experience			202.331	0.000
No	17,356(90.7%)	5407(31.2%)
Yes	1776(9.3%)	369(20.8%)
Knowledge			343.003	0.000
High	15,312(80.0%)	4300(28.1%)
Low	3820(20.0%)	1476(38.6%)
Information attention			267.176	0.000
High	14,998(78.4%)	5291(29.5%)
Low	4134(26.1%)	1685(40.8%)
Trust in official media			277.589	0.000
High	15,230(79.6%)	4288(28.2%)
Low	3902(20.4%)	1488 (38.1%)
Perceived severity			0.094	0.760
High	14,973 (78.3%)	4503(30.1%)
Low	4159 (27.1%)	1273(30.6%)
Perceived susceptibility			82.735	0.000
High	3698(19.3%)	968(26.2%)
Low	15,434(80.7%)	4808(31.2%)
Perceived controllability			62.768	0.000
High	15,517(81.1%)	4091(27.3%)
Low	3615(18.9%)	954(26.4%)
Non-medication protection behaviors			488.317	0.000
Good	15,003(78.4%)	4158(27.7%)
Bad	4129(21.6%)	1618(39.2%)

Table 2. Factors associated with hesitancy to accept COVID-19 vaccine in multivariate logistic regression

Variables	OR(95% CI)	ORweighted(95% CI)
Sex
Male(reference)
Female	1.189(1.111, 1.273)	1.297(1.213, 1.387)
Age
>45(reference)
26–45	0.599(0.530, 0.676)	0.614 (0.565, 0.667)
18–25	0.805(0.693, 0.936)	0.911(0.803,1.033)
Education
Master and above(reference)
Junior college or bachelor	0.578(0.508, 0.658)	0.578 (0.507, 0.659)
High school and below	0.641(0.559, 0.736)	0.562(0.488, 0.647)
Marriage
Others(single, divorced or widowed) (reference)
Married	0.764(0.689, 0.847)	0.800(0.718, 0.891)
Residency
Urban(reference)
Rural	0.979(0.911, 1.051)	0.912(0.850,0.978)
Monthly income
Higher (reference)
High	0.866(0.747,1.005)	0.931(0.805,1.077)
Middle	1.085(0.929,1.268)	1.130(0.971,1.314)
Low	1.283(1.090, 1.509)	1.194(1.017, 1.403)
Risk level of provinces
High-risk(reference)
Low-risk	0.796(0.745, 0.851)	0.760(0.711, 0.812)
Self-reported health
Good (reference)
Poor	1.382(1.268, 1.506)	1.312(1.211, 1.421)
Health or medical-related staff
Yes(reference)
No	1.129(1.007, 1.266)	1.129(1.010, 1.262)
Living with vulnerable family members
Yes(reference)
No	1.206(1.123, 1.296)	1.294(1.209, 1.384)
COVID-19 infection experience
Yes(reference)
No	1.499(1.320, 1.703)	1.523(1.336, 1.736)
Knowledge
High(reference)
Low	1.246(1.147, 1.354)	1.371(1.260, 1.492)
Information attention
High(reference)
Low	1.480(1.368,1.601)	1.430(1.322, 1.546)
Trust in official media
High(reference)
Low	1.264(1.164, 1.372)	1.336(1.234, 1.46)
Perceived susceptibility
High(reference)
Low	1.281(1.173, 1.399)	1.367(1.255, 1.489)
Perceived controllability
High(reference)
Low	0.845(0.774, 0.922)	0.805(0.741, 0.875)
Non-medication protection behavior
High(reference)
Low	1.293(1.192, 1.402)	1.195(1.100, 1.297)

Table 3. Key concepts emerging from qualitative analysis of the interviews

Category	Concept	Representative quote(s)
Self-conceit	Necessity Importance	I am in good physical health situation, so I neednot vaccinate I do not think I am susceptible to COVID-19, maintaining precaution is enough. China has gained great achievements in pandemic prevention and control, so it is unnecessary to vaccinate
Confidence	Effectiveness	Because it is a new product, I would like to know if this is effective(5). I am worried if I will still be infected with COVID-19 after vaccination(4). I am concerned about the duration time of preventive function after vaccination.
	Safety	I will consider vaccination. But I will see if there is an adverse reaction and side effects(8). I will have influenza vaccination, because it has been developed for a long time. So I believe it is safe. I am prone to allergic reactions, so I will not vaccinate. I am worried that the adverse reaction will decrease my immunity.
	Trust in COVID-19 vaccination decision makers	If the government declares that it is necessary to vaccinate, I will vaccinate. I will vaccinate when government says a large scale of vaccination is necessary.
Accessibility	Economic accessibility	I hope that the price will be rational, and it willnot be too expensive(4). I am concerned about the price and supply amount, because I am afraid that I could not afford it. I want to vaccinate immediately, but I am afraid that I could not secure a vaccination appointment.
	Information accessibility	I have not heard of influenza vaccine. Is COVID-19 vaccine well developed, and has it appeared on the market?