COVID-19 vaccine hesitancy and resistance in an urban Chinese population of Hong Kong: a cross-sectional study

Figures & data

Table 1. Sociodemographic characteristics of the respondents.

Variable	All samples (n = 883)	No hesitancy(n = 128)	Low hesitancy(n = 270)	High hesitancy(n = 242)	Vaccine rejection (n = 243)	p-value ^
Female	596 (67.5)	81 (63.3)	173 (64.1)	165 (68.2)	177 (72.8)	.13
Age						<.001
18–39 years	481 (54.5)	48 (37.5)	122 (45.2)	138 (57.0)	173 (71.2)
40–59 years	284 (32.2)	53 (41.4)	93 (34.4)	79 (32.6)	59 (24.3)
≥60 years	118 (13.4)	27 (21.1)	55 (20.4)	25 (10.3)	11 (4.5)
Marital status						<.001
Single	385 (43.6)	34 (26.6)	88 (32.6)	115 (47.5)	148 (60.9)
Separated/Divorced/Widowed	45 (5.1)	3 (2.3)	16 (5.9)	10 (4.1)	16 (6.6)
Married/Cohabitated	453 (51.3)	91 (71.1)	166 (61.5)	117 (48.4)	79 (32.5)
Child caring burden (youngest child in household)						.27
Kindergarten	48 (5.4)	3 (2.3)	21 (7.8)	14 (5.8)	10 (4.1)
Primary school	57 (6.5)	12 (9.4)	14 (5.2)	17 (7.0)	14 (5.8)
Secondary school	96 (10.9)	14 (10.9)	31 (11.5)	30 (12.4)	21 (8.6)
No child rearing/adults	682 (77.2)	99 (77.3)	204 (75.6)	181 (74.8)	198 (81.5)
Co-residence	836 (94.7)	123 (96.1)	255 (94.4)	230 (95.0)	228 (93.8)	.81
Educational attainment (n = 881)						.39
Junior form of Secondary school or below	29 (3.3)	4 (3.1)	9 (3.4)	8 (3.3)	8 (3.3)
Senior form of Secondary school	263 (29.9)	36 (28.1)	93 (34.7)	60 (24.8)	74 (30.5)
Tertiary education	589 (66.9)	88 (68.8)	166 (61.9)	174 (71.9)	161 (66.3)
Employment status						.08
Employed	521 (59.0)	87 (68.0)	154 (57.0)	152 (62.8)	128 (52.7)
Unemployed	27 (3.1)	4 (3.1)	7 (2.6)	6 (2.5)	10 (4.1)
Economically inactive	335 (37.9)	37 (28.9)	109 (40.4)	84 (34.7)	105 (43.2)
With chronic disease	127 (14.4)	22 (17.2)	49 (18.2)	31 (12.8)	25 (10.3)	.05
With regular exercise^#	386 (42.9)	61 (47.7)	125 (46.3)	103 (42.6)	97 (39.9)	.38
At least monthly exposure to nature	283 (32.1)	49 (38.3)	102 (37.8)	75 (31.0)	57 (23.5)	.002

Note: Data presented as number (percentage).

^ Group comparisons were made using Chi-square test.

#Regular exercise was defined as having at least three days of moderate or vigorous physical activities in a week.

Table 2. Clinical characteristics and COVID-19 responses of the respondents.

Variable	All samples (n = 883)	No hesitancy(n = 128)	Low hesitancy(n = 270)	High hesitancy(n = 242)	Vaccine rejection (n = 243)	p-value ^
Time spent on browsing COVID-19 information						.37
Less than an hour per day	730 (82.7)	106 (82.8)	229 (84.8)	200 (82.6)	195 (80.3)
1–2 hours per day	108 (12.2)	19 (14.8)	28 (10.4)	31 (12.8)	30 (12.4)
More than 2 hours per day	45 (5.1)	3 (2.3)	13 (4.8)	11 (4.6)	18 (7.4)
Exposure to COVID-19 virus	335 (37.9)	46 (35.9)	94 (34.8)	106 (43.8)	89 (36.6)	.17
Mental health^#
ISI score, 0–28	7.9 ± 5.6	7.3 ± 5.6	7.1 ± 5.0	7.8 ± 5.6	9.3 ± 5.9	<.001
Clinical insomnia, ISI score ≥10	287 (32.5)	42 (32.8)	70 (25.9)	76 (31.4)	99 (40.7)	.005
GAD-7 score, 0–21	4.9 ± 5.2	4.2 ± 4.7	4.0 ± 4.1	5.1 ± 5.4	6.1 ± 5.9	<.001
Clinical anxiety, GAD-7 score ≥10	144 (16.3)	17 (13.3)	26 (9.6)	43 (17.8)	58 (23.9)	<.001
PHQ-9 score, 0–27	6.0 ± 5.4	5.0 ± 5.0	4.9 ± 4.2	5.9 ± 5.4	7.8 ± 6.4	<.001
Clinical Depression, PHQ-9 score ≥10	176 (19.9)	22 (17.2)	29 (10.7)	51 (21.1)	74 (30.5)	<.001
UCLA loneliness score, 0–9	2.7 ± 2.7	2.4 ± 2.5	2.5 ± 2.5	2.6 ± 2.6	3.4 ± 2.8	<.001
Loneliness, UCLA loneliness score ≥3	444 (50.3)	54 (42.2)	127 (47.0)	113 (46.7)	150 (61.7)	<.001
COVID-19 responses
Interference to daily living¶	3.0 ± 1.1	2.9 ± 1.1	2.8 ± 1.0	3.0 ± 1.1	3.1 ± 1.1	.06
Perceived stress¶	2.5 ± 1.1	2.4 ± 1.0	2.4 ± 1.0	2.6 ± 1.1	2.8 ± 1.1	<.001
Financial pressure ¶	2.0 ± 1.1	2.0 ± 1.2	1.8 ± 1.0	2.0 ± 1.1	2.3 ± 1.3	<.001
Worry about being infected (n = 881)Ω	2.4 ± 1.0	2.3 ± 1.0	2.3 ± 0.9	2.6 ± 0.9	2.5 ± 1.1	.01
Worry about family members being infected (n = 866)Ω	2.7 ± 1.1	2.7 ± 1.0	2.6 ± 1.1	2.9 ± 1.0	2.8 ± 1.2	.02
Worry about workplace infection (n = 878)Ω	2.8 ± 1.1	2.5 ± 1.0	2.7 ± 1.1	2.9 ± 1.0	2.9 ± 1.3	<.001
Worry about infection in residential buildings (n = 877)Ω	2.6 ± 1.1	2.4 ± 0.9	2.5 ± 1.0	2.7 ± 1.0	2.8 ± 1.2	<.001
Confidence in health professionals^ʊ	3.1 ± 1.0	3.2 ± 1.0	3.2 ± 1.0	3.0 ± 1.0	3.0 ± 1.0	.09
Confidence in the government^ʊ	2.0 ± 1.1	2.5 ± 1.2	2.3 ± 1.2	1.9 ± 1.0	1.5 ± 0.8	<.001

Abbreviations: COVID-19, Coronavirus Disease 2019; ISI, Insomnia Severity Index; GAD-7, Generalized Anxiety Disorder Assessment; PHQ-9, Patient Health Questionnaire-9.

Data presented as number (percentage) or mean±standard deviation.

^ Group comparisons were made using Chi-square test or ANOVA.

^#Higher scores indicated poorer sleep/mood symptoms.

^¶Higher scores indicated greater disturbance due to COVID-19.

Ω Higher scores indicated greater worry.

^ʊ Higher scores indicated higher confidence in the perceived ability against COVID-19.

Table 3. Likelihood ratio test of the main effect of each predictor included in this study.

Variables	p-value
Age	.001
Marital status	<.001
Employment status	.10
Chronic disease	.87
Exposure to nature	.22
Clinical insomnia	.56
Clinical anxiety	.72
Clinical depression	.25
Loneliness	.11
Daily interference	.26
Perceived stress	.68
Financial pressure	.06
Worry about self	.28
Worry about family members	.43
Worry of workplace infection	.23
Worry of residential building infection	.32
Confidence in health professionals	.82
Confidence in government	<.001

Table 4. Multinomial logistic regression for vaccine hesitancy (n = 858)^#.

Variable, N (%)	Low vaccine hesitancy			High vaccine hesitancy			Vaccine rejection
	aOR	95% CI	Wald	aOR	95% CI	Wald	aOR	95% CI	Wald
Intercept	3.53	0.76, 16.53	1.60	4.41	0.91, 21.37	1.84	5.81*	1.02, 33.20	1.98
Age
18–39 years	2.1	0.91, 4.81	1.75	2.99*	1.23, 7.30	2.41	11***	3.64, 33.24	4.25
40–59 years	1.58	0.75, 3.34	1.21	2.42*	1.07, 5.47	2.12	7.02***	2.48, 19.83	3.68
≥60 years (reference group)
Marital status
Married/cohabitated	0.73	0.42, 1.29	−1.09	0.51*	0.29, 0.88	−2.39	0.37**	0.21, 0.65	−3.40
Divorced/separated/widowed	2.28	0.55, 9.49	1.14	1.54	0.35, 6.83	0.57	3.87	0.87, 17.14	1.78
Never married (reference group)
Employment status
Employed (full time)	0.46**	0.26, 0.82	−2.63	0.55*	0.30, 0.99	−2.00	0.41**	0.22, 0.75	−2.89
Unemployed	0.65	0.16, 2.70	−0.59	0.59	0.14, 2.48	−0.71	0.81	0.20, 3.24	−0.30
Economically inactive (reference group)
Chronic physical health condition
Yes	1.21	0.64, 2.29	0.59	1.11	0.56, 2.18	0.30	1.35	0.64, 2.86	0.78
No (reference group)
At least monthly exposure to nature
Yes	0.98	0.62, 1.56	−0.09	0.80	0.49, 1.29	−0.93	0.64	0.38, 1.08	−1.68
No (reference group)
Clinical Insomnia
Yes	0.77	0.42, 1.40	−0.85	0.81	0.44, 1.50	−0.67	1.07	0.56, 2.01	0.20
No (reference group)
Clinical anxiety
Yes	0.61	0.24, 1.55	−1.03	0.87	0.36, 2.09	−0.31	0.77	0.32, 1.88	−0.57
No (reference group)
Clinical depression
Yes	0.66	0.28, 1.57	−0.94	1.07	0.47, 2.47	0.17	1.35	0.58, 3.13	0.70
No (reference group)
Loneliness
Yes	1.5	0.88, 2.55	1.49	0.98	0.57, 1.69	−0.08	1.49	0.84, 2.64	1.37
No (reference group)
Interference to daily living	0.95	0.72, 1.25	−0.36	0.86	0.65, 1.13	−1.06	0.78	0.58, 1.04	−1.71
Perceived stress	1.01	0.74, 1.38	0.09	1.03	0.76, 1.41	0.21	0.89	0.64, 1.23	−0.70
Financial pressure	0.8	0.62, 1.03	−1.76	0.83	0.65, 1.06	−1.48	1.01	0.78, 1.30	0.06
Worry about being infected	0.92	0.64, 1.33	−0.42	1.14	0.79, 1.65	0.07	0.87	0.59, 1.27	−0.73
Worry about family members being infected	0.78	0.55, 1.10	−1.41	0.79	0.56, 1.12	−1.34	0.75	0.52, 1.06	−1.62
Worry about workplace infection	1.45*	1.00, 2.11	1.97	1.31	0.90, 1.91	1.41	1.21	0.82, 1.79	0.97
Worry about infection in residential building	1.1	0.75, 1.61	0.50	1.19	0.81, 1.74	0.89	1.39	0.94, 2.07	1.66
Confidence in health professionals	1.08	0.84, 1.39	0.58	1.00	0.77, 1.28	−0.03	1.07	0.82, 1.39	0.51
Confidence in government	0.83	0.66, 1.04	−1.60	0.68**	0.54, 0.86	−3.18	0.43***	0.33, 0.56	−6.26

Abbreviations: aOR, Adjusted Odds Ratio; CI, Confidence Interval.

^#“No vaccine hesitancy” was used as the reference category of outcome.

* p < .05, ** p < .01, *** p < .001.