Barriers to influenza vaccination among different populations in Shanghai

Figures & data

Figure 1. Completion of enrollment survey questions collected in 48 communities in Shanghai, China, 2019

Table 1. Characteristics of respondents in Pudong New Area, Shanghai, China, 2018–2019

			Different population, n(%)
		Overall	Children	Adults	Elderly
	Demographic characteristics	N = 11053, n(%)	2341(21.2)	4828(43.7)	3884(35.1)
Gender
	Male	5260(47.6)	1165(49.8)	2252(46.6)	1843(47.5)
	Female	5793(52.4)	1176(50.2)	2576(53.4)	2041(52.5)
	Age, median (IQR^a, years)	43.7(18.8–67.1)	7.2(3.7–10.2)	37.5(27.0–48.7)	73.7(66.0–79.8)
	Residence address
	Shanghai	9388(84.9)	1794(76.6)	3939(81.6)	3655(94.1)
	Other province in China	1665(15.1)	547(23.4)	889(18.4)	229(5.9)
Living status
	Live alone	366(3.3)	2(0.1)	90(1.9)	274(7.1)
	Live with family or friends	10687(96.7)	2339(99.9)	4738(98.1)	3610(92.9)
Education attainment^b
	Primary school	1770(22.1)	–	135(3.3)	1635(42.1)
	Secondary school^c	2151(26.9)	–	824(20.0)	1327(34.2)
	High school	1373(17.2)	–	702(17.1)	671(17.2)
	Bachelor’s degree or above	2701(33.8)	–	2450(59.6)	251(6.5)
	Self-evaluation of health situation
	Very healthy	1800(16.3)	693(29.6)	932(19.3)	175(4.5)
	Healthy	5521(49.9)	1383(59.1)	2649(54.9)	1489(38.3)
	Normal	3382(30.6)	261(11.1)	1208(25.0)	1913(49.3)
	Unhealthy	350(3.2)	4(0.2)	39(0.8)	307(7.9)
Monthly household income, (Chinese yuan)^d
	<2000	309(2.8)	10(0.4)	36(0.7)	263(6.8)
	2000–4999	1994(18.0)	160(6.8)	594(12.3)	1240(31.9)
	5000–7999	1208(10.9)	247(10.6)	656(13.6)	305(7.9)
	≥8000	1192(10.8)	391(16.7)	648(13.4)	153(3.9)
	Unknown	6350(57.5)	1533(65.5)	2894(60.0)	1923(49.5)
Specific underlying diseases
	Chronic respiratory diseases	589(5.3)	128(5.5)	135(2.8)	326(8.4)
	Diabetes	816(7.4)	2(0.1)	112(2.3)	702(18.1)
	Cardiovascular disease	2819(25.5)	6(0.3)	505(10.5)	2308(59.4)

^aIQR: interquartile range.

^bChildren and students were not included.

^cIn China, secondary school education refers to the three-year period between primary school and high school. The ages of secondary school students are approximately 12 to 15 years old.

^d1 US dollar6.43 Chinese yuan.

Figure 2. Coverage rates and 95% CI of seasonal influenza vaccination among different populations in Pudong New Area, Shanghai, in the 2018–2019 influenza season

Table 2. Coverage rates of seasonal influenza vaccination among different populations in Pudong New Area, Shanghai, in the 2018–19 influenza season (n = 11053)

			OR
Characteristics	No. of Vaccinated Individuals	VCR (95% CI)	Children	Adults	The elderly
Total	1301	11.8(11.2–12.4)
Gender
Male	603	11.5(10.6–12.4)	Ref	Ref	Ref
Female	698	12.0(11.2–12.9)	0.92(0.76–1.10)	1.49(1.18–1.89)**	1.22(0.95–1.57)
Residence address
Shanghai	1080	11.5(10.9–12.2)	Ref	Ref	Ref
Other province in China	221	13.3(11.7–15.0)	1.11(0.86–1.38)	1.01(0.74–1.36)	0.51(0.25–1.01)
Age group^a
Group1	623	26.6(24.8–28.5)	Ref	0.76(0.52–1.11)	0.99(0.69–1.42)
Group2	396	8.2(7.4–9.0)	2.60(1.92–3.52)**	0.97(0.72–1.32)	1.05(0.75–1.47)
Group3	282	7.3(6.5–8.1)	1.55(1.17–2.05)**	Ref	Ref
Living status
Live alone	24	6.6(4.2–9.6)	–	Ref	Ref
Live with family or friends	1277	11.9(11.3–12.6)	–	1.09(0.46–2.56)	0.95(0.57–1.59)
Education attainment^b
Primary school	95	5.4(4.4–6.5)	–	0.38(0.16–0.91)*	Ref
Secondary school^c	159	7.4(6.3–8.6)	–	0.46(0.32–0.68)**	1.77(1.29–2.43)**
High school	80	5.8(4.6–7.2)	–	0.47(0.32–0.69)**	1.28(0.86–1.90)
Bachelor’s degree or above	281	10.4(9.3–11.6)	–	Ref	2.65(1.68–4.19)**
Self-evaluation of health situation
Very healthy	243	13.5(12.0–15.2)	Ref	Ref	Ref
Healthy	676	12.2(11.4–13.1)	1.17(0.94–1.45)	1.13(0.81–1.57)	0.84(0.45–1.58)
Normal	342	10.1(9.1–11.2)	1.46(1.05–2.02)*	1.29(0.90–1.87)	0.98(0.52–1.83)
Unhealthy	40	11.4(8.3–15.2)	1.03(0.11–10.13)	2.22(0.79–6.19)	1.43(0.69–2.95)
Monthly household income, (Chinese yuan)^d
<2000	13	4.2(2.2–7.1)	–	0.32(0.04–2.39)	0.44(0.20–0.97)*
2000–4999	168	8.4(7.2–9.7)	0.88(0.57–1.33)	0.63(0.41–0.98)*	0.64(0.36–1.12)
5000–7999	163	13.5(11.6–15.6)	0.89(0.62–1.28)	0.85(0.58–1.23)	0.78(0.41–1.49)
≥8000	212	17.8(15.7–20.1)	Ref	Ref	Ref
Specific underlying diseases
Premature	46	42.2(32.8–52.0)	2.04(1.37–3.04)**	–	–
Chronic respiratory diseases	96	16.3(13.4–19.5)	1.34(0.91–1.99)	1.18(0.61–2.25)	1.37(0.92–2.04)
Diabetes	55	6.7(5.1–8.7)	–	0.43(0.16–1.21)	0.90(0.65–1.25)
Cardiovascular disease	239	8.5(7.5–9.6)	5.18(0.91–29.41)*	1.43(0.98–2.07)	1.39(1.06–1.83)*

^aAge group among total respondents referred to children(group1), adults (group2) and elderly(group3); Age group in children referred to scattered children (group1), nursery children (group2) and school students (group3) respectively; age group in adults referred to 15–29 years (group1), 30–44 years (group2) and 45–59 years (group3); age group in the elderly referred to 60–69 years (group1), 70–79 years (group2) and ≥80 years(group3). in children referred to scattered children, nursery children and school students respectively; age group in adults referred to 15–29 years, 30–44 years and 45–59 year s; age group in the elderly referred to 60–69 years, 70–79 years and ≥80 years.

^bChildren and students were not included.

^cIn China, secondary school education refers to the three-year period between primary school and high school. The ages of secondary school students are approximately 12 to 15 years old.

^d1 US dollar6.43 Chinese yuan.

* p < 0.05; ** p < 0.01

Figure 3. Coverage rates and 95% CI of seasonal influenza vaccination among different populations in Pudong New Area, Shanghai, in the 2018–2019 influenza season

Figure 4. Reasons for receiving or not receiving the influenza vaccine among adults in Pudong New Area during the 2018–2019 influenza season

Figure 5. Reasons for receiving or not receiving the influenza vaccine among the elderly in Pudong New Area during the 2018–19 influenza season