Factors Associated with the Acceptance and Willingness of COVID-19 Vaccination among Chinese Healthcare Workers (preprint)

ABSTRACT

Background: Vaccination is a crucial measure in preventing the spread of epidemic. Vaccines targeting coronavirus disease 2019 (COVID-19) have been developed in a wide range of countries. Objective: This study aims to examine factors influencing vaccination rate and willingness to vaccinate against COVID-19 among Chinese healthcare workers (HCWs). Methods: From 3rd February to 18th February, 2021, an online cross-sectional survey was conducted among HCWs to investigate factors associated with the acceptance and willingness of COVID-19 vaccination. Respondents were classified into two categories, vaccinated and unvaccinated, and, the willingness of vaccination was assessed in the unvaccinated group. Information on socio-demographics and the psychological process of the participants for accepting the vaccine were evaluated. Results: A total of 2156 HCWs from 21 provinces in China responded to this survey (response rate 98.99%)), among whom 1433 (66.5%) were vaccinated at least one dose. Higher vaccination rates were associated with older age (40-50 years vs. less than 30 years, OR=1.63, 95%CI 1.02-2.58; >50 years vs. 30 years, OR=1.90, 95%CI 1.02-3.52), working as a clinician (OR=1.54, 95% CI 1.05-2.27), having no personal religion (OR=1.35, 95%CI 1.06-1.71), working in a fever clinic (OR=4.50 , 95%CI1.54-13.17) or higher hospital level(Municipal vs. County, OR=2.01, 95%CI 1.28-3.16; Provincial vs. County, OR=2.01, 95%CI 1.25-3.22) and having knowledge training of vaccine (OR=1.67, 95%CI1.27-2.22), family history for influenza vaccination (OR=1.887, 95%CI1.49-2.35) and strong familiarity with the vaccine (OR=1.43, 95%CI1.05-1.95) (All P<0.05). Strong willingness for vaccination was related to having a working in midwestern China (OR=1.89, 95%CI1.24-2.89), considerable knowledge of the vaccine (familiar vs. not familiar, OR=1.67, 95%CI 1.17-2.39; strongly familiar vs. not familiar, OR=2.47, 95%CI 1.36-4.49), knowledge training of vaccine(OR=1.61, 95%CI 1.05-2.48) and strong confidence in the vaccine (OR=3.84 , 95%CI 2.09-7.07). Conclusion: Personal characteristics, working environments, familiarity and confidence in the vaccine were related to vaccination rates and willingness to get vaccinated among healthcare workers. Results of this study could provide evidence for the government to improve vaccine coverage by addressing vaccine hesitancy in the COVID-19 pandemic and future public health emergencies.