From COVID-19 Vaccination Intention to Actual Vaccine Uptake: A Longitudinal Study Among Chinese Adults After Six Months of a National Vaccination Campaign

ABSTRACT

Background

Mass COVID-19 vaccination campaigns have been launched globally, but the translation from vaccination intention to actual vaccine uptake by the public remains unknown, hindering the evaluation of present promotion strategies.

Methods

Six months after the national vaccination campaign in China, a longitudinal study was conducted among the Chinese adult population, whose vaccination intention has been previously surveyed, to examine the vaccine uptake, the relationship between intention and actual vaccination, and factors associated with actual vaccination behaviors with multiplelogistic models.

Results

Among the total 1047 participants, 81.8% (834/936) of those who had a prior COVID-19 vaccination intention before the campaign actually received the vaccine, while 61.3% (68/111) of those without a prior intention got vaccinated. Having a prior vaccination intention, believing in vaccine safety and receiving frequent recommendations from community sources were significant predictors of vaccine uptake, while the shortage of vaccine supply would reduce the likelihood of getting vaccinated.

Conclusions

Promotion interventions for vaccination intentions need to be launched well before the availability of the vaccine. Sustaining vaccination attitudes and intentions, reducing barriers (e.g. vaccine safety concerns, accessibility, affordability) and shaping vaccination behavior would be effective in closing the intention-action gap and motivating vaccine uptake.

KEYWORDS:

• SARS-CoV-2
• COVID-19
• vaccination intention
• vaccine uptake
• longitudinal study
• China

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

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

Author contributions

JH Wang and H Zhu contributed equally to this paper. H Fang and JH Wang conceived the presented idea. JH Wang, XZ Lai, and H Fang developed the design and the questionnaire. JH Wang conducted the survey. JH Wang and H Zhuperformed the analysis. JH Wang wrote the first draft. H Zhu, HJ Zhang, YZ Huang, HYF Feng, Y Lyu, RZ Jing, J Guo, and H Fang commented on the draft and revised the manuscript. All authors discussed the results and contributed to the final manuscript.

Ethical approval

The study was approved by the Peking University Institutional Review Board (IRB00001052-20,011). Informed consent was implied on the completion of the questionnaire from each participant.

Supplementary material

Supplemental data for this article can be accessed here

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This manuscript was funded by National Key R&D Program of China, Grant ID: 2021YFC2301603.