Assessing the Knowledge, Attitudes, and Vaccination Practices Towards COVID-19 Vaccination Among Mainland Chinese Nursing Students and Interns: A Multicenter Cross-Sectional Study

Figures & data

Table 1 Comparison of Demographic Characteristics and Vaccine Acceptance

Characteristic and Category	All Participants (n=3180)	Vaccine Acceptance (n=2873)	Vaccine Hesitancy (n=307)	P
Age (years)
<18	1355(42.6)	1089(37.9)	266(86.6)	<0.001
18–20	1594(50.1)	1558(54.2)	36(11.7)
>20	231(7.3)	226(7.9)	5(1.6)
Education
High school or under	848(26.7)	599(20.8)	249(81.1)	<0.001
College	2131(67.0)	2078(72.3)	53(17.3)
Bachelor or above	201(6.3)	196(6.8)	5(1.6)
Race
Han	3041(95.6)	2742(95.4)	299(97.4)	0.111
Others	139(4.4)	131(4.6)	8(2.6)
Personal religion
No	2998(94.3)	2713(94.4)	285(92.8)	0.252
Yes	182(5.7)	160(5.6)	22(7.2)
Average monthly income of family (CNY)
<2000	936(29.4)	849(29.6)	87(28.3)	<0.05
2000–4000	1341(42.2)	1200(41.8)	141(45.9)
4001–6000	555(17.5)	500(17.4)	55(17.9)
6001–8000	185(5.8)	166(5.8)	19(6.2)
>8000	163(5.1)	158(5.5)	5(1.6)
Health condition
Well	2981(93.7)	2692(93.7)	289(94.1)	0.852
General	180(5.7)	164(5.7)	16(5.2)
Not well	19(0.6)	17(0.6)	2(0.7)
Risk level of residence
High	5(0.2)	5(0.2)	0(0.0)	0.074
Median	67(2.1)	55(1.9)	12(3.9)
Low	3108(97.7)	2813(97.9)	295(96.1)
Identity
Nursing interns	132(4.2)	127(4.4)	5(1.6)	0.020
Nursing students	3048(95.8)	2746(95.6)	302(98.4)

Abbreviation: CNY, Chinese Yuan.

Figure 1 COVID-19 vaccination status and intention (A) and sources of vaccine information (B).

Table 2 Comparison of Subjects’ Knowledge, Attitudes, and Practice Regarding the COVID-19 Vaccine

Characteristic and Category	All Participants (n=3180)	Vaccine Acceptance (n=2873)	Vaccine Hesitancy (n=307)	P
Familiarity of COVID-19 vaccine
Sufficient knowledge	261(8.2)	254(8.8)	7(2.3)	<0.001
General knowledge	2706(85.1)	2469(85.9)	237(77.2)
Limited knowledge	213(6.7)	150(5.2)	63(20.5)
Vaccination interval of the domestic COVID-19
Correct	1766(55.5)	1670(58.1)	96(31.3)	<0.001
Error	972(30.6)	872(30.4)	100(32.6)
Do not know	442(13.9)	331(11.5)	111(36.2)
Protective time of domestic COVID-19 vaccine
Correct	1558(49.0)	1437(50.0)	121(39.4)	<0.001
Error	574(18.1)	545(19.0)	29(9.4)
Do not know	1048(33.0)	891(31.0)	157(51.1)
Should people take personal protective measures such as wearing masks after receiving vaccines
Yes	2991(94.1)	2739(95.3)	252(82.1)	<0.001
No	40(1.3)	32(1.1)	8(2.6)
Do not know	149(4.7)	102(3.6)	47(15.3)
The COVID-19 epidemic is currently under control
Agreement	1537(48.3)	1453(50.6)	84(27.4)	<0.001
Uncertain	1373(43.2)	1177(41.0)	196(63.8)
Disagreement	270(8.5)	243(8.5)	27(8.8)
To protect your family you should get the seasonal flu vaccine
Agreement	520(16.4)	486(16.9)	34(11.1)	0.009
Disagreement	2660(83.6)	2387(83.1)	273(88.9)
Confidence of vaccines
High	2987(93.9)	2735(95.2)	252(82.1)	<0.001
Uncertain	182(5.7)	130(4.5)	52(16.9)
Low	11(0.3)	8(0.3)	3(1.0)
Reasons affecting vaccination
Government recommendation
Agreement	2921(91.9)	2693(93.7)	228(74.3)	<0.001
Uncertain	213(6.7)	146(5.1)	67(21.8)
Disagreement	46(1.4)	34(1.2)	12(3.9)
News media publicity
Agreement	2633(82.8)	2462(85.7)	171(55.7)	<0.001
Uncertain	448(14.1)	336(11.7)	112(36.5)
Disagreement	99(3.1)	75(2.6)	24(7.8)
Medical experts recommendation
Agreement	2866(90.1)	2648(92.2)	218(71.0)	<0.001
Uncertain	268(8.4)	194(6.8)	74(24.1)
Disagreement	46(1.4)	31(1.1)	15(4.9)
Recommended by around people
Agreement	2481(78.0)	2345(81.6)	136(44.3)	<0.001
Uncertain	539(16.9)	410(14.3)	129(42.0)
Disagreement	160(5.0)	118(4.1)	42(13.7)
Responsibility to reduce the chance of transmission
Agreement	2854(89.7)	2633(91.6)	221(72.0)	<0.001
Uncertain	235(7.4)	163(5.7)	72(23.5)
Disagreement	91(2.9)	77(2.7)	14(4.6)
High-risk need to be vaccinated
Agreement	2940(92.5)	2694(93.8)	246(80.1)	<0.001
Uncertain	188(5.9)	138(4.8)	50(16.3)
Disagreement	52(1.6)	41(1.4)	11(3.6)
Perfect vaccine management
Agreement	2754(86.6)	2563(89.2)	191(62.2)	<0.001
Uncertain	394(12.4)	294(10.2)	100(32.6)
Disagreement	32(1.0)	16(0.6)	16(5.2)
Sufficient vaccines supply
Agreement	1948(61.3)	1832(63.8)	116(37.8)	<0.001
Uncertain	1104(34.7)	930(32.4)	174(56.7)
Disagreement	128(4.0)	111(3.9)	17(5.5)
Vaccines are not effective
Agreement	836(26.3)	774(26.9)	62(20.2)	0.028
Uncertain	1750(55.0)	1562(54.4)	188(61.2)
Disagreement	594(18.7)	537(18.7)	57(18.6)
Not need to be vaccinated in health
Agreement	414(13.0)	368(12.8)	46(15.0)	<0.001
Uncertain	541(17.0)	409(14.2)	132(43.0)
Disagreement	2225(70.0)	2096(73.0)	129(42.0)
Do not know where to vaccinate
Agreement	502(15.8)	444(15.5)	58(18.9)	<0.001
Uncertain	824(25.9)	663(23.1)	161(52.4)
Disagreement	1854(58.3)	1766(61.5)	88(28.7)
Fearness of injection
Agreement	854(26.9)	749(26.1)	105(34.2)	<0.001
Uncertain	480(15.1)	407(14.2)	73(23.8)
Disagreement	1846(58.1)	1717(59.8)	129(42.0)
Frequent outings require vaccination
Agreement	1915(60.2)	1778(61.9)	137(44.6)	<0.001
Uncertain	597(18.8)	491(17.1)	106(34.5)
Disagreement	668(21.0)	604(21.0)	64(20.8)
No time for vaccination
Agreement	344(10.8)	306(10.7)	38(12.4)	<0.001
Uncertain	592(18.6)	482(16.8)	110(35.8)
Disagreement	2244(70.6)	2085(72.6)	159(51.8)
Contraindications
Agreement	1628(51.2)	1519(52.9)	109(35.5)	<0.001
Uncertain	687(21.6)	556(19.4)	131(42.7)
Disagreement	865(27.2)	798(27.8)	67(21.8)
Have you been regularly vaccinated against the seasonal flu
Yes	969(30.5)	937(32.6)	32(10.4)	<0.001
No	2211(69.5)	1936(67.4)	275(89.6)
Obtained training on vaccine
Yes	1359(42.7)	1304(45.4)	55(17.9)	<0.001
No	1821(57.3)	1569(54.6)	252(82.1)
I will take the initiative to consult a doctor about COVID-19 to avoid contracting the virus
Approve	1074(33.8)	973(33.9)	101(32.9)	0.911
Some favor	800(25.2)	720(25.1)	80(26.1)
Not really in favor	1306(41.1)	1180(41.1)	126(41.0)
When I have suspected symptoms of COVID-19, I seek help from medical professionals
Approve	2320(73.0)	2101(73.1)	219(71.3)	0.772
Some favor	606(19.1)	545(19.0)	61(19.9)
Not really in favor	254(8.0)	227(7.9)	27(8.8)
I will stay healthy by getting the COVID-19 vaccine
Approve	851(26.8)	778(27.1)	73(23.8)	0.130
Some favor	1168(36.7)	1062(37.0)	106(34.5)
Not really in favor	1161(36.5)	1033(36.0)	128(41.7)

Figure 2 Forest plots for multivariate logistic regression analysis of vaccination behavior and intention.