Vaccination willingness, vaccine hesitancy, and estimated coverage at the first round of COVID-19 vaccination in China: A national cross-sectional study

Chao Wang; Bingfeng Han; Tianshuo Zhao; Hanyu Liu; Bei Liu; Linyi Chen; Mingzhu Xie; Jiang Liu; Hui Zheng; Sihui Zhang; Yu Wang; Ninghua Huang; Juan Du; Ya-Qiong Liu; Qing-Bin Lu; Fuqiang Cui

doi:10.1016/j.vaccine.2021.04.020

Vaccination willingness, vaccine hesitancy, and estimated coverage at the first round of COVID-19 vaccination in China: A national cross-sectional study

Vaccine. 2021 May 18;39(21):2833-2842. doi: 10.1016/j.vaccine.2021.04.020. Epub 2021 Apr 13.

Authors

Chao Wang¹, Bingfeng Han¹, Tianshuo Zhao¹, Hanyu Liu¹, Bei Liu¹, Linyi Chen¹, Mingzhu Xie¹, Jiang Liu¹, Hui Zheng¹, Sihui Zhang¹, Yu Wang¹, Ninghua Huang², Juan Du², Ya-Qiong Liu², Qing-Bin Lu³, Fuqiang Cui⁴

Affiliations

¹ Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, PR China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, PR China.
² Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, PR China.
³ Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, PR China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, PR China. Electronic address: qingbinlu@bjmu.edu.cn.
⁴ Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, PR China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, PR China. Electronic address: cuifuq@bjmu.edu.cn.

Abstract

Background: Vaccination against coronavirus disease 2019 (COVID-19) has become an important public health solution. To date, there has been a lack of data on COVID-19 vaccination willingness, vaccine hesitancy, and vaccination coverage in China since the vaccine has become available.

Methods: We designed and implemented a cross-sectional, population-based online survey to evaluate the willingness, hesitancy, and coverage of the COVID-19 vaccine among the Chinese population. 8742 valid samples were recruited and classified as the vaccine-priority group (n = 3902; 44.6%) and the non-priority group (n = 4840; 55.4%).

Results: The proportion of people's trust in the vaccine, delivery system, and government were 69.0%, 78.0% and 81.3%, respectively. 67.1% of the participants were reportedly willing to accept the COVID-19 vaccination, while 9.0% refused it. 834 (35.5%) reported vaccine hesitancy, including acceptors with doubts (48.8%), refusers (39.4%), and delayers (11.8%). The current coverage was 34.4%, far from reaching the requirements of herd immunity. The predicted rate of COVID-19 vaccination was 64.9%, 68.9% and 81.1% based on the rates of vaccine hesitancy, willingness, and refusal, respectively.

Conclusions: The COVID-19 vaccine rate is far from reaching the requirements of herd immunity, which will require more flexible and comprehensive efforts to improve the population's confidence and willingness to vaccinate. It should be highlighted that vaccination alone is insufficient to stop the pandemic; further efforts are needed not only to increase vaccination coverage but also to maintain non-specific prevention strategies.

Keywords: COVID-19 vaccine; Confidence; Vaccination; Vaccine hesitancy; Willingness.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19 Vaccines
COVID-19*
China
Cross-Sectional Studies
Humans
SARS-CoV-2
Vaccination
Vaccines*

Substances

COVID-19 Vaccines
Vaccines