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Vaccination coverage among COVID-19 prevention and control management teams at primary healthcare facilities in China and their attitudes towards COVID-19 vaccine: a cross-sectional online survey.
BMJ Open. 2022 04 07; 12(4):e056345.BO

Abstract

OBJECTIVE

To investigate the COVID-19 vaccination coverage rate and differences among various COVID-19 prevention primary healthcare (PHC) facilities in China and understand their attitudes towards COVID-19 vaccine. These findings are helpful to provide important suggestions to further improve national COVID-19 vaccination rate.

DESIGN

A nationwide cross-sectional online survey was designed and conducted among COVID-19 prevention and control management teams at PHC facilities in mainland China. In the self-designed questionnaires, each subject was asked to evaluate on a 1-10 scale (10=extremely important/acceptable/influential) the COVID-19 vaccination importance, acceptance and factors related to vaccine hesitancy.

SETTING

Subjects from 31 provinces and autonomous regions including minorities across mainland China were invited to complete the questionnaire between 22 February 2021 and 2 March 2021.

PARTICIPANTS

Were selected by multistage stratified sampling, 998 valid questionnaires (valid rate 99.11%) were collected. The respondents were divided into group A (≤5 respondents within each PHC facility, n1=718) and group B (>5 respondents within each PHC facility, n2=280).

OUTCOME MEASURES

Survey on vaccination rate and attitude towards COVID-19 vaccine included the following: (1) if the subjects think the vaccination is important in containment of COVID-19 pandemic (1-10 scale, 10=extremely important), (2) if they would accept COVID-19 vaccine (1-10 scale, 10=extremely acceptable) and (3) their opinions on 7 factors possibly related to vaccine hesitancy (1-10 scale, 10=extremely influential). All the items were designed based on the previous expert interviews.

RESULTS

Our results showed vaccination rate was greater in group A (85.93%) than in group B (66.43%) (p<0.001). Detailed analyses revealed that in group A, male members were twice as likely to get vaccinated as compared with female members (adjusted OR (aOR): 2.07; 95% CI: 1.26 to 3.43, p=0.004). In group B, those who were at or under the median age had twice the odds of vaccination coverage compared with those who were over the median age (aOR: 2.29; 95% CI: 1.22 to 4.33, p=0.010). In addition, those who were specialised in traditional Chinese medicine were less likely to get vaccinated against COVID-19 compared with those who were specialised in general medicine, with the aOR: 0.10 (95% CI: 0.01 to 0.83, p=0.033). By analysing the factors that influenced the vaccination attitudes among the 998 respondents, we found no significant difference between the vaccinated and unvaccinated participants. However, further detailed analyses found that team members with undergraduate college education were less likely to score higher in COVID-19 vaccination importance than those with technical secondary school education (aOR: 0.35; 95% CI: 0.13 to 0.93, p=0.035); Furthermore, those with non-medical job titles had nearly twice the odds of giving a higher score for the uncertainty of vaccine efficacy compared with those with junior medical titles (aOR: 1.70; 95% CI: 1.02 to 2.85, p=0.016). Team members with a non-medical title were more likely to give a higher score for advice on social sources compared with those with a junior medical title (aOR: 1.70; 95% CI: 1.02 to 2.85, p=0.042).

CONCLUSION

In PHC facilities, although there was a higher COVID-19 vaccination rate among COVID-19 prevention and control teams, some subgroups with different descriptive characters showed negative attitudes towards COVID-19 vaccination. Because primary care workers in China are highly expected to receive the vaccination, and support and educate the public for COVID-19 vaccination. Thus, it is important and necessary to continue to educate them about their vaccination concerns and change their attitudes towards vaccination. Our findings are highly beneficial for designing public vaccination education strategies.

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Authors+Show Affiliations

Yan YY
Department of General Practice, Zhongshan Hospital of Fudan University, Shanghai, China.
Wang HT
Department of General Practice, Pudong New District Shanggang Community Healthcare Center, Shanghai, China.
Fan TY
Department of General Practice, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China.
Sun XJ
Department of General Practice, Leshan Township Health Center, Bozhou District, Zunyi, Guizhou, China.
Du ZH
Pudong New District Shanggang Community Healthcare Center, Shanghai, China xm_sun2003@163.com pdsg2019@163.com.
Sun XM
Department of General Practice, Zhongshan Hospital of Fudan University, Shanghai, China xm_sun2003@163.com pdsg2019@163.com.

MeSH

AttitudeCOVID-19COVID-19 VaccinesChinaCross-Sectional StudiesFemaleHumansMalePandemicsPrimary Health CareSARS-CoV-2VaccinationVaccination Coverage

Pub Type(s)

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

Language

eng

PubMed ID

35393315

Citation

Yan, Yun-Yun, et al. "Vaccination Coverage Among COVID-19 Prevention and Control Management Teams at Primary Healthcare Facilities in China and Their Attitudes Towards COVID-19 Vaccine: a Cross-sectional Online Survey." BMJ Open, vol. 12, no. 4, 2022, pp. e056345.
Yan YY, Wang HT, Fan TY, et al. Vaccination coverage among COVID-19 prevention and control management teams at primary healthcare facilities in China and their attitudes towards COVID-19 vaccine: a cross-sectional online survey. BMJ Open. 2022;12(4):e056345.
Yan, Y. Y., Wang, H. T., Fan, T. Y., Sun, X. J., Du, Z. H., & Sun, X. M. (2022). Vaccination coverage among COVID-19 prevention and control management teams at primary healthcare facilities in China and their attitudes towards COVID-19 vaccine: a cross-sectional online survey. BMJ Open, 12(4), e056345. https://doi.org/10.1136/bmjopen-2021-056345
Yan YY, et al. Vaccination Coverage Among COVID-19 Prevention and Control Management Teams at Primary Healthcare Facilities in China and Their Attitudes Towards COVID-19 Vaccine: a Cross-sectional Online Survey. BMJ Open. 2022 04 7;12(4):e056345. PubMed PMID: 35393315.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vaccination coverage among COVID-19 prevention and control management teams at primary healthcare facilities in China and their attitudes towards COVID-19 vaccine: a cross-sectional online survey. AU - Yan,Yun-Yun, AU - Wang,Hai-Tang, AU - Fan,Teng-Yang, AU - Sun,Xian-Jin, AU - Du,Zhao-Hui, AU - Sun,Xiao-Ming, Y1 - 2022/04/07/ PY - 2022/4/8/entrez PY - 2022/4/9/pubmed PY - 2022/4/12/medline KW - COVID-19 KW - primary care KW - public health SP - e056345 EP - e056345 JF - BMJ open JO - BMJ Open VL - 12 IS - 4 N2 - OBJECTIVE: To investigate the COVID-19 vaccination coverage rate and differences among various COVID-19 prevention primary healthcare (PHC) facilities in China and understand their attitudes towards COVID-19 vaccine. These findings are helpful to provide important suggestions to further improve national COVID-19 vaccination rate. DESIGN: A nationwide cross-sectional online survey was designed and conducted among COVID-19 prevention and control management teams at PHC facilities in mainland China. In the self-designed questionnaires, each subject was asked to evaluate on a 1-10 scale (10=extremely important/acceptable/influential) the COVID-19 vaccination importance, acceptance and factors related to vaccine hesitancy. SETTING: Subjects from 31 provinces and autonomous regions including minorities across mainland China were invited to complete the questionnaire between 22 February 2021 and 2 March 2021. PARTICIPANTS: Were selected by multistage stratified sampling, 998 valid questionnaires (valid rate 99.11%) were collected. The respondents were divided into group A (≤5 respondents within each PHC facility, n1=718) and group B (>5 respondents within each PHC facility, n2=280). OUTCOME MEASURES: Survey on vaccination rate and attitude towards COVID-19 vaccine included the following: (1) if the subjects think the vaccination is important in containment of COVID-19 pandemic (1-10 scale, 10=extremely important), (2) if they would accept COVID-19 vaccine (1-10 scale, 10=extremely acceptable) and (3) their opinions on 7 factors possibly related to vaccine hesitancy (1-10 scale, 10=extremely influential). All the items were designed based on the previous expert interviews. RESULTS: Our results showed vaccination rate was greater in group A (85.93%) than in group B (66.43%) (p<0.001). Detailed analyses revealed that in group A, male members were twice as likely to get vaccinated as compared with female members (adjusted OR (aOR): 2.07; 95% CI: 1.26 to 3.43, p=0.004). In group B, those who were at or under the median age had twice the odds of vaccination coverage compared with those who were over the median age (aOR: 2.29; 95% CI: 1.22 to 4.33, p=0.010). In addition, those who were specialised in traditional Chinese medicine were less likely to get vaccinated against COVID-19 compared with those who were specialised in general medicine, with the aOR: 0.10 (95% CI: 0.01 to 0.83, p=0.033). By analysing the factors that influenced the vaccination attitudes among the 998 respondents, we found no significant difference between the vaccinated and unvaccinated participants. However, further detailed analyses found that team members with undergraduate college education were less likely to score higher in COVID-19 vaccination importance than those with technical secondary school education (aOR: 0.35; 95% CI: 0.13 to 0.93, p=0.035); Furthermore, those with non-medical job titles had nearly twice the odds of giving a higher score for the uncertainty of vaccine efficacy compared with those with junior medical titles (aOR: 1.70; 95% CI: 1.02 to 2.85, p=0.016). Team members with a non-medical title were more likely to give a higher score for advice on social sources compared with those with a junior medical title (aOR: 1.70; 95% CI: 1.02 to 2.85, p=0.042). CONCLUSION: In PHC facilities, although there was a higher COVID-19 vaccination rate among COVID-19 prevention and control teams, some subgroups with different descriptive characters showed negative attitudes towards COVID-19 vaccination. Because primary care workers in China are highly expected to receive the vaccination, and support and educate the public for COVID-19 vaccination. Thus, it is important and necessary to continue to educate them about their vaccination concerns and change their attitudes towards vaccination. Our findings are highly beneficial for designing public vaccination education strategies. SN - 2044-6055 UR - https://www.unboundmedicine.com/medline/citation/35393315/Vaccination_coverage_among_COVID_19_prevention_and_control_management_teams_at_primary_healthcare_facilities_in_China_and_their_attitudes_towards_COVID_19_vaccine:_a_cross_sectional_online_survey_ DB - PRIME DP - Unbound Medicine ER -