Perceptions about respiratory syncytial virus (RSV) and attitudes toward the RSV vaccine among the general public in China: A cross-sectional survey

Figures & data

Table 1. Characteristics of participants.

Characteristics	No. (%)(N = 2133)
Age group, years
18–≤30	911 (42.7)
31–≤40	817 (38.3)
41–≤50	290 (13.6)
>50	115 (5.4)
Sex
Male	996 (46.7)
Female	1137 (53.3)
Marital status
Unmarried	1398 (65.5)
Married	698 (32.7)
Divorce	37 (1.7)
Education level
Junior high school or below	125 (5.9)
High school graduate or equivalent	180 (8.4)
Undergraduate or equivalent	1564 (73.3)
Postgraduate or above	264 (12.4)
Occupation
Healthcare-related	732 (34.3)
Others	1401 (65.7)
Living with children aged ≤6 years or old adults aged ≥60 years
Yes	1314 (61.6)
No	819 (38.4)
Annual household income
<50,000 CNY	198 (9.3)
50,000–≤149,999 CNY	879 (41.2)
150,000–≤299,999 CNY	746 (35.0)
≥300,000 CNY	310 (14.5)
Having chronic diseases
Yes	266 (12.5)
No	1780 (83.5)
Unclear	87 (4.1)
Self-reported health
Very poor	27 (1.3)
Poor	80 (3.8)
Neutral	974 (45.7)
Well	811 (38.0)
Very well	241 (11.3)
Experiencing side effects following previous vaccination
Yes	163 (7.6)
No	1859 (87.2)
Unclear	111 (5.2)
Awareness of RSV
I have never heard of it	518 (24.3)
I have heard of it, but don’t really know what it is	856 (40.1)
I know some facts about what it is	689 (32.3)
I have a good understanding about RSV	70 (3.3)
Perceptions of susceptibility of RSV infection
Extremely unlikely	63 (3.0)
Unlikely	186 (8.7)
Neutral/not sure	939 (44.0)
Likely	846 (39.7)
Extremely likely	99 (4.6)
Perceptions of severity of RSV infection
Not at all	51 (2.4)
Slightly	312 (14.6)
Somewhat	1276 (59.8)
Moderately	419 (19.6)
Extremely	75 (3.5)
If the RSV vaccine is available in the future, would you be willing to receive it?
Strongly disagreement	25 (1.2)
Disagreement	107 (5.0)
Neither agree nor disagree	542 (25.4)
Agreement	1119 (52.5)
Strongly agreement	340 (15.9)

*50,000 CNY was equal to 6957 USD; 150,000 CNY was equal to 20,871 USD; and 300,000 CNY was equal to 41,742 USD.

Figure 1. Knowledge of RSV among participants.

Table 2. Factors associated with perceptions of susceptibility of RSV infection.

Variables	Univariate analysis		Multivariate analysis
	OR	P value	OR	P value
Age group, years (18–≤30 as reference)
31–≤40	1.010 (0.829–1.230)	.921	1.015 (0.823–1.251)	.890
41–≤50	0.791 (0.597–1.048)	.102	0.844 (0.623–1.143)	.273
>50	0.494 (0.316–0.774)	.002	0.589 (0.362–0.957)	.033
Sex (Male as reference)
Female	0.918 (0.768–1.097)	.347	NA	NA
Marital status (Unmarried as reference)
Married	1.017 (0.841–1.231)	.860	NA	NA
Divorce	1.598 (0.788–3.240)	.194	NA	NA
Education level (Junior high school or below as reference)
High school graduate or equivalent	2.358 (1.300–4.276)	.005	1.959 (1.063–3.611)	.031
Undergraduate or equivalent	4.648 (2.809–7.691)	<.001	2.974 (1.754–5.044)	<.001
Postgraduate or above	4.104 (2.361–7.135)	<.001	2.328 (1.284–4.220)	.005
Occupation (Others as reference)
Healthcare-related	1.753 (1.454–2.113)	<.001	1.306 (1.059–1.610)	.013
Living with children aged ≤6 years or old adults aged ≥60 years (No as reference)
Yes	1.113 (0.927–1.337)	.253	NA	NA
Annual household income (CNY) (<50,000 as reference)
50,000–≤149,999	1.788 (1.261–2.536)	.001	1.393 (0.959–2.025)	.082
150,000–≤299,999	2.351 (1.652–3.347)	<.001	1.681 (1.145–2.467)	.008
≥300,000	1.560 (1.048–2.323)	.029	1.194 (0.771–1.848)	.426
Chronic diseases (Yes as reference)
No	1.072 (0.821–1.400)	.610	NA	NA
Self-reported health (Very poor as reference)
Poor	1.684 (0.638–4.444)	.292	NA	NA
Neutral	1.509 (0.639–3.564)	.348	NA	NA
Well	1.924 (0.814–4.548)	.136	NA	NA
Very well	1.296 (0.533–3.150)	.568	NA	NA
Experiencing side effects following previous vaccination (Yes as reference)
No	0.790 (0.571–1.093)	.154	NA	NA
Awareness of RSV (“I have never heard of it” as reference)
I have heard of it, but don’t really know what it is	1.626 (1.272–2.078)	<.001	1.377 (1.064–1.783)	.015
I know some facts about what it is	3.138 (2.437–4.041)	<.001	2.184 (1.656–2.881)	<.001
I have a good understanding about RSV	2.900 (1.727–4.873)	<.001	1.947 (1.127–3.366)	.017
Knowledge level (Low level as reference)
High level	2.148 (1.788–2.581)	<.001	1.572 (1.288–1.919)	<.001

NA: Not applicable; the OR  >1 indicated that the presence of the factor was associated with an increased likelihood of the high level of perceptions to susceptibility of RSV infection.

Table 3. Factors associated with perceptions of severity of RSV infection.

Variables	Univariate analysis		Multivariate analysis
	OR	P value	OR	P value
Age group, years (18–≤30 as reference)
31–≤40	0.664 (0.528–0.835)	<.001	0.664 (0.519–0.851)	.001
41–≤50	0.550 (0.389–0.778)	.001	0.633 (0.441–0.908)	.013
>50	0.505 (0.293–0.869)	.014	0.551 (0.311–0.976)	.041
Sex (Male as reference)
Female	0.754 (0.612,0.928)	.008	0.829 (0.667–1.031)	.092
Marital status (Unmarried as reference)
Married	1.151 (0.924–1.435)	.209	NA	NA
Divorce	1.313 (0.601–2.869)	.494	NA	NA
Education level (Junior high school or below as reference)
High school graduate or equivalent	1.234 (0.698–2.179)	.470	NA	NA
Undergraduate or equivalent	1.177 (0.743–1.864)	.488	NA	NA
Postgraduate or above	0.701 (0.402–1.222)	.210	NA	NA
Occupation (Others as reference)
Healthcare-related	0.644 (0.513–0.809)	<.001	0.514 (0.398–0.662)	<.001
Living with children aged ≤6 years or old adults aged ≥60 years (No as reference)
Yes	1.352 (1.087–1.683)	.007	1.237 (0.976–1.566)	.078
Annual household income (CNY) (<50,000 as reference)
50,000–≤149,999	1.214 (0.810–1.820)	.348	1.127 (0.738–1.721)	.581
150,000–≤299,999	1.556 (1.037–2.333)	.033	1.463 (0.955–2.241)	.081
≥300,000	0.924 (0.575–1.487)	.746	0.980 (0.596–1.611)	.937
Having chronic diseases (Yes as reference)
No	0.498 (0.376–0.660)	<.001	0.449 (0.324–0.622)	<.001
Self-reported health (Very poor as reference)
Poor	0.617 (0.240–1.582)	.315	0.625 (0.227–1.719)	.363
Neutral	0.312 (0.137–0.707)	.005	0.440 (0.180–1.076)	.072
Well	0.393 (0.173–0.892)	.026	0.543 (0.219–1.346)	.187
Very well	0.417 (0.177–0.979)	.045	0.534 (0.210–1.362)	.189
Experiencing side effects following previous vaccination (Yes as reference)
No	0.639 (0.450–0.907)	.012	0.678 (0.461–0.997)	.048
Awareness of RSV (“I have never heard of it” as reference)
I have heard of it, but don’t really know what it is	2.154 (1.592–2.913)	<.001	2.114 (1.540–2.901)	<.001
I know some facts about what it is	1.911 (1.399–2.611)	<.001	2.257 (1.611–3.162)	<.001
I have a good understanding about RSV	2.365 (1.322–4.232)	.004	2.978 (1.571–5.645)	.001
Knowledge level (Low level as reference)
fHigh level	1.147 (0.930–1.415)	.200	NA	NA

NA: Not applicable; the OR  >1 indicated that the presence of the factor was associated with an increased likelihood of the high level of perceptions of severity of RSV infection.

Table 4. Factors associated with willingness to receive the RSV vaccination.

Variables	Univariate analysis		Multivariate analysis
	OR	P value	OR	P value
Age group, years (18–≤30 as reference)
31–≤40	0.637 (0.512–0.792)	<.001	0.674 (0.501–0.906)	.009
41–≤50	0.571 (0.424–0.769)	<.001	0.682 (0.466–0.999)	.049
>50	0.518 (0.336–0.800)	.003	0.685 (0.408–1.151)	.153
Sex (Male as reference)
Female	0.865 (0.712–1.050)	.143	NA	NA
Marital status (Unmarried as reference)
Married	1.372 (1.109–1.698)	.004	1.200 (0.880–1.635)	.249
Divorce	0.600 (0.296–1.219)	.158	0.630 (0.285–1.392)	.253
Education level (Junior high school or below as reference)
High school graduate or equivalent	0.737 (0.432–1.256)	.262	0.516 (0.287–0.928)	.027
Undergraduate or equivalent	0.934 (0.606–1.441)	.758	0.494 (0.302–0.806)	.005
Postgraduate or above	0.514 (0.315–0.837)	.008	0.278 (0.160–0.485)	<.001
Occupation (Others as reference)
Healthcare-related	0.919 (0.751–1.124)	.409	NA	NA
Living with children aged ≤6 years or old adults aged ≥60 years (No as reference)
Yes	1.327 (1.089–1.615)	.005	1.407 (1.118–1.770)	.004
Annual household income (CNY) (<50,000 as reference)
50,000–≤149,999	1.379 (0.971–1.956)	.072	NA	NA
150,000–≤299,999	1.243 (0.873–1.770)	.227	NA	NA
≥300,000	0.786 (0.530–1.165)	.230	NA	NA
Having chronic diseases (Yes as reference)
No	0.998 (0.747–1.333)	.990	NA	NA
Self-reported health (Very poor as reference)
Poor	1.269 (0.499–3.232)	.617	1.610 (0.558–4.646)	.379
Neutral	1.683 (0.745–3.805)	.211	2.493 (0.976–6.371)	.056
Well	2.298 (1.014–5.211)	.046	2.859 (1.115–7.329)	.029
Very well	2.962 (1.253–6.999)	.013	3.805 (1.432–10.109)	.007
Experiencing side effects following previous vaccination (Yes as reference)
No	1.903 (1.368–2.646)	<.001	2.440 (1.669–3.566)	<.001
Awareness of RSV (“I have never heard of it” as reference)
I have heard of it, but don’t really know what it is	2.161 (1.696–2.754)	<.001	1.682 (1.291–2.192)	.001
I know some facts about what it is	2.747 (2.121–3.558)	<.001	1.979 (1.475–2.654)	<.001
I have a good understanding about RSV	4.304 (2.199–8.423)	<.001	2.825 (1.360–5.867)	.005
Knowledge level (Low level as reference)
High level	1.499 (1.235–1.821)	<.001	1.205 (0.959–1.512)	.109
Perceptions of susceptibility (Low perception as reference)
High perception	2.680 (2.177–3.300)	<.001	2.079 (1.647–2.624)	<.001
Perceptions of severity (Low perception as reference)
High perception	4.940 (3.599–6.781)	<.001	4.019 (2.863–5.642)	<.001

NA: Not applicable; the OR >1 indicated that the presence of the factor was associated with an increased likelihood of willingness to receive the RSV vaccination.

Figure 2. Reasons for willingness and refusal to vaccinate against RSV.

Figure 3. Main information sources for decision-making and acceptable prices for RSV vaccine.

Table A1. Distributions of respondents’ locations.

Province	No. (%) (N = 2133)
Anhui	38 (1.78)
Beijing	33 (1.55)
Chongqing	136 (6.38)
Fujian	75 (3.52)
Gansu	19 (0.89)
Guangdong	174 (8.16)
Guangxi	37 (1.73)
Guizhou	5 (0.23)
Hainan	4 (0.19)
Hebei	60 (2.81)
Heilongjiang	32 (1.50)
Henan	51 (2.39)
Hubei	46 (2.16)
Hunan	36 (1.69)
Inner Mongolia	14 (0.66)
Jiangsu	687 (32.21)
Jiangxi	44 (2.06)
Jilin	19 (0.89)
Liaoning	34 (1.59)
Ningxia	8 (0.38)
Qinghai	23 (1.08)
Shaanxi	22 (1.03)
Shandong	168 (7.88)
Shanghai	124 (5.81)
Shanxi	35 (1.64)
Sichuan	42 (1.97)
Tianjin	5 (0.23)
Tibet	1 (0.05)
Xinjiang	6 (0.28)
Yunnan	19 (0.89)
Zhejiang	136 (6.38)

Table A2. Awareness of RSV by socio-demographics.

Characteristics	Awareness of RSV		P value
	Never heard, No. (%)	Yes, No. (%)
Age group, years			<.001
18–≤30	187 (20.5)	724 (79.5)
31–≤40	196 (24.0)	621 (76.0)
41–≤50	93 (32.1)	197 (67.9)
>50	42 (36.5)	73 (63.5)
Sex			.184
Male	255 (25.6)	741 (74.4)
Female	263 (23.1)	874 (76.9)
Marital status			.056
Unmarried	341 (24.4)	1057 (75.6)
Married	162 (23.2)	536 (76.8)
Divorce	15 (40.5)	22 (59.5)
Education level			.014
Junior high school or below	45 (36.0)	80 (64.0)
High school graduate or equivalent	47 (26.1)	133 (73.9)
Undergraduate or equivalent	363 (23.2)	1201 (76.8)
Postgraduate or above	63 (23.9)	201 (76.1)
Occupation			<.001
Healthcare-related	76 (10.4)	656 (89.6)
Others	442 (31.5)	959 (68.5)
Living with children aged ≤6 years or old adults aged ≥60 years			.016
Yes	296 (22.5)	1018 (77.5)
No	222 (27.1)	597 (72.9)
Annual household income (CNY)			<.001
<50,000	73 (36.9)	125 (63.1)
50,000–≤149,999	190 (21.6)	689 (78.4)
150,000–≤299,999	157 (21.0)	589 (79.0)
≥300,000	98 (31.6)	212 (68.4)
Having chronic diseases			.005
Yes	63 (23.7)	203 (76.3)
No	421 (23.7)	1359 (76.3)
Unclear	34 (39.1)	53 (60.9)
Self-reported health			<.001
Very poor	9 (33.3)	18 (66.7)
Poor	25 (31.3)	55 (68.8)
Neutral	287 (29.5)	687 (70.5)
Well	151 (18.6)	660 (81.4)
Very well	46 (19.1)	195 (80.9)
Experiencing side effects following previous vaccination			.001
Yes	38 (23.3)	125 (76.7)
No	437 (23.5)	1422 (76.5)
Unclear	43 (38.7)	68 (61.3)

Table A3. Knowledge of RSV by socio-demographics.

Characteristics	Knowledge of RSV		P value
	Low level, No. (%)	High level, No. (%)
Age group, years			.012
18–≤30	446 (49.0)	465 (51.0)
31–≤40	349 (42.7)	468 (57.3)
41–≤50	124 (42.8)	166 (57.2)
>50	62 (53.9)	53 (46.1)
Sex			.001
Male	497 (49.9)	499 (50.1)
Female	484 (42.6)	653 (57.4)
Marital status			<.001
Unmarried	600 (42.9)	798 (57.1)
Married	364 (52.1)	334 (47.9)
Divorce	17 (45.9)	20 (54.1)
Education level			<.001
Junior high school or below	94 (75.2)	31 (24.8)
High school graduate or equivalent	103 (57.2)	77 (42.8)
Undergraduate or equivalent	690 (44.1)	874 (55.9)
Postgraduate or above	94 (35.6)	170 (64.4)
Occupation			<.001
Healthcare-related	232 (31.7)	500 (68.3)
Others	749 (53.5)	652 (46.5)
Living with children aged ≤6 years or old adults aged ≥60 years			.881
Yes	606 (46.1)	708 (53.9)
No	375 (45.8)	444 (54.2)
Annual household income (CNY)			<.001
<50,000	122 (61.6)	76 (38.4)
50,000–≤149,999	408 (46.4)	471 (53.6)
150,000–≤299,999	293 (39.3)	453 (60.7)
≥300,000	158 (51.0)	152 (49.0)
Having chronic diseases			<.001
Yes	134 (50.4)	132 (49.6)
No	783 (44.0)	997 (56.0)
Unclear	64 (73.6)	23 (26.4)
Self-reported health			.022
Very poor	18 (66.7)	9 (33.3)
Poor	42 (52.5)	38 (47.5)
Neutral	468 (48.0)	506 (52.0)
Well	347 (42.8)	464 (57.2)
Very well	106 (44.0)	135 (56.0)
Experiencing side effects following previous vaccination			.008
Yes	89 (54.6)	74 (45.4)
No	831 (44.7)	1028 (55.3)
Unclear	61 (55.0)	50 (45.0)
Awareness of RSV			<.001
I have never heard of it	348 (67.2)	170 (32.8)
I have heard of it, but don’t really know what it is	430 (50.2)	426 (49.8)
I know some facts about what it is	188 (27.3)	501 (72.7)
I have a good understanding about RSV	15 (21.4)	55 (78.6)

Figure A1. Reasons for willingness and refusal to vaccinate against RSV by level of awareness.

Figure A2. Reasons for willingness and refusal to vaccinate against RSV by level of knowledge.

Figure A3. Reasons for willingness and refusal to vaccinate against RSV by level of perceptions of susceptibility.

Figure A4. Reasons for willingness and refusal to vaccinate against RSV by level of perceptions of severity.

Data availability statement

Data may be available from the corresponding author on reasonable request depending on the policy and procedures of the institutions that participate in the consortiums.