Factors influencing COVID-19 vaccination intention among overseas and domestic Chinese university students: a cross-sectional survey

Figures & data

Table 1. Sociodemographic characteristics of the study population

Sociodemographic characteristics	Total (N = 833) N (%)	Overseas students (N = 370) N (%)	Domestic students (N = 463) N (%)	^χCitation2/t	p
Gender				0.005	0.946
Male	314(37.7)	139(37.6)	175(37.8)
Female	519(62.3)	231(62.4)	288(62.2)
Age, years (Mean, SD)	23.6(3.3)	25.1(3.2)	22.4(2.9)	12.44	<0.001
Degree currently pursuing				197.4	<0.001
Bachelor’s degree	449(53.9)	99(26.8)	350(75.6)
Master’s or Doctorate degree	384(46.1)	271(73.2)	113(24.4)
Average monthly household income (RMB)				199.3	<0.001
≤10,000	327(39.3)	59(15.9)	268(57.9)
10,001–30,000	307(36.9)	151(40.8)	156(33.7)
≥30,001	199(23.9)	160(43.2)	39(8.4)
Present location				/	/
China	463(55.6)	/	463(100.0)
America	79(9.5)	79(21.4)	/
the United Kingdom	77(9.2)	77(20.8)	/
Canada	37(4.4)	37(10.0)	/
Australia	25(3.0)	25(6.8)	/
European Union countries	103(12.4)	103(27.8)	/
Asian countries	49(5.9)	49(13.2)	/

Table 2. The distribution of health belief items and vaccination intention by study groups (N = 833)

Items of Health Belief Model and vaccination intention	Overseas students (N = 370) N (%)	Domestic students (N = 463) N (%)	χ^Citation2/t	P	OR (95% CI)
Perceived Susceptibility^a
Perceived susceptibility score (Mean, SD)	3.25(0.84)	2.91(0.93)	5.549	<0.001
I may get COVID-19.	108(29.2)	103(22.2)	5.241	0.025	1.44(1.05–1.97)
Contacting with COVID-19 patients or close contacts of COVID-19 patients is possible for me.	171(46.2)	164(35.4)	9.968	0.002	1.57(1.19–2.07)
COVID-19 may break out in the area where I live.	182(49.2)	116(25.1)	52.14	<0.001	2.90(2.16–3.88)
Even with good hygiene practices (wearing a mask, etc.), I may still get COVID-19.	174(47.0)	221(47.7)	0.041	0.889	0.97(0.74–1.28)
Perceived Severity^a
Perceived severity score (Mean, SD)	3.01(0.82)	3.11(0.85)	1.719	0.086
I am afraid of getting COVID-19.	202(54.6)	257(55.5)	0.069	0.833	0.96(0.73–1.27)
I may probably die if I get COVID-19.	87(23.5)	167(36.1)	15.30	<0.001	0.55(0.40–0.74)
I will be gravely ill if I get COVID-19.	79(21.4)	123(26.6)	3.044	0.088	0.75(0.54–1.04)
My financial situation will get worse if I get COVID-19.	119(32.2)	161(34.8)	0.628	0.461	0.89(0.67–1.19)
Perceived Benefits^a
Perceived benefits score (Mean, SD)	3.77(0.71)	3.75(0.68)	0.411	0.681
I can reduce the risk of my family/friends getting COVID-19 after COVID-19 vaccination.	270(73.0)	324(70.0)	0.901	0.356	1.16(0.86–1.57)
I will feel more secure in my daily life after COVID-19 vaccination.	237(64.1)	294(63.5)	0.027	0.885	1.02(0.77–1.36)
In general, I will benefit from COVID-19 vaccination.	259(70.0)	327(70.6)	0.039	0.879	0.97(0.72–1.31)
Perceived Barriers^a
Perceived barriers score (Mean, SD)	3.51(0.71)	3.37(0.67)	2.884	0.004
I worry about the efficacy of the COVID-19 vaccine.	180(48.6)	183(39.5)	6.963	0.009	1.45(1.10–1.91)
I worry about the safety of the COVID-19 vaccine.	198(53.5)	207(44.7)	6.383	0.012	1.42(1.08–1.87)
I think the protection duration of the COVID-19 vaccine is too short.	173(46.8)	139(30.0)	24.59	<0.001	2.05(1.54–2.72)
I worry about the side effects of the COVID-19 vaccine.	223(60.3)	247(53.3)	4.008	0.049	1.33(1.01–1.75)
I worry that COVID-19 virus has mutated, and vaccines could not work.	216(58.4)	244(52.7)	2.682	0.107	1.26(0.96–1.66)
Cues to action^a
Cues to action score (Mean, SD)	3.70(0.69)	3.56(0.66)	3.099	0.002
My family members recommend me to get the COVID-19 vaccine.	196(53.0)	172(37.1)	20.88	<0.001	1.91(1.44–2.52)
My classmates/friends recommend me to get the COVID-19 vaccine.	185(50.0)	169(36.5)	15.34	<0.001	1.74(1.32–2.30)
Healthcare experts recommend me to get the COVID-19 vaccine.	272(73.5)	292(63.1)	10.27	0.001	1.63(1.21–2.19)
The local government advocates COVID-19 vaccination.	238(64.3)	312(67.4)	0.860	0.377	0.87(0.65–1.16)
Media advocate COVID-19 vaccination.	230(62.2)	263(56.8)	2.445	0.119	1.25(0.95–1.65)
Intention^b
I intend to get COVID-19 vaccination.	237(64.1)	299(64.6)	0.025	0.884	0.98(0.74–1.30)

^aAll health belief items used the five-point Likert scale (1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree, 5 = strongly agree), the study population who choose strongly agree/agree were included in the form, and the mean scores from the HBM variables were calculated.

^bIntention item used the five-point Likert scale (1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree, 5 = strongly agree), the study populations who have already been vaccinated and choose strongly agree/agree were included in the form.

Table 3. Factors associated with the COVID-19 vaccination uptake intention of study population

	Total participants (N = 833)		Overseas students (N = 370)		Domestic students (N = 463)
	aOR (95% CI)^a	P	aOR^a (95% CI)	P	aOR^a (95% CI)	P
Sociodemographic characteristics
Group
Overseas students	Reference		/	/	/	/
Domestic students	0.89(0.56–1.43)	0.632	/	/	/	/
Gender
Male	Reference		Reference		Reference
Female	1.06(0.73–1.54)	0.775	0.87(0.47–1.60)	0.656	1.19(0.73–1.96)	0.485
Age (Mean, SD)	1.05(0.98–1.11)	0.156	1.05(0.94–1.17)	0.411	1.05(0.96–1.14)	0.320
Degree currently pursuing
Bachelor’s degree	Reference		Reference		Reference
Master’s or Doctorate degree	0.70(0.44–1.12)	0.137	1.62(0.75–3.53)	0.222	0.44(0.24–0.83)	0.011
Average monthly household income (RMB)
≤10,000	Reference		Reference		Reference
10,001–30,000	0.92(0.60–1.42)	0.715	0.65(0.27–1.54)	0.323	0.99(0.60–1.67)	0.994
≥30,001	0.90(0.53–1.55)	0.711	0.66(0.27–1.58)	0.355	1.03(0.41–2.59)	0.947
Present location
China	/	/	/	/	/	/
America	/	/	Reference	/	/	/
the United Kingdom	/	/	0.57(0.23–1.43)	0.234	/	/
Canada	/	/	1.42(0.44–4.63)	0.558	/	/
Australia	/	/	0.61(0.18–2.14)	0.443	/	/
European Union countries	/	/	0.57(0.23–1.44)	0.230	/	/
Asian countries	/	/	0.59(0.21–1.60)	0.296	/	/
HBM variables^b
Perceived susceptibility	1.16(0.91–1.46)	0.228	1.34(0.90–1.99)	0.154	1.09(0.80–1.50)	0.572
Perceived severity	1.12(0.87–1.45)	0.371	1.16(0.76–1.76)	0.503	1.09(0.77–1.54)	0.626
Perceived benefits	3.56(2.54–4.98)	<0.001	6.74(3.72–12.23)	<0.001	2.63(1.72–4.02)	<0.001
Perceived barriers	0.39(0.28–0.55)	<0.001	0.29(0.16–0.50)	<0.001	0.48(0.31–0.74)	0.001
Cues to action	4.55(3.11–6.68)	<0.001	3.94(2.18–7.13)	<0.001	5.84(3.43–9.96)	<0.001

^aaOR, Adjusted odds ratio; CI, confidence interval

^bAll health belief items used the five-point Likert scale (1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree, 5 = strongly agree) and the mean scores from the HBM variables were calculated.

Figure 1. Standardized solutions for the structural model among university students based on health belief model.

Loomba S, de Figueiredo A, Piatek SJ, de Graaf K, Larson HJ. Measuring the impact of COVID-19 vaccine misinformation on vaccination intent in the UK and USA. Nat Hum Behav. 2021 Mar 5;5(3):337–48. PMID: 33547453. doi:10.1038/s41562-021-01056-1.

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