Portable spirometer-based pulmonary function test willingness in China: A nationwide cross-sectional study from the "Happy Breathing Program".

BACKGROUND: Understanding willingness to undergo pulmonary function tests (PFTs) and the factors associated with poor uptake of PFTs is crucial for improving early detection and treatment of chronic obstructive pulmonary disease (COPD). This study aimed to understand willingness to undergo PFTs among high-risk populations and identify any barriers that may contribute to low uptake of PFTs. METHODS: We collected data from participants in the "Happy Breathing Program" in China. Participants who did not follow physicians' recommendations to undergo PFTs were invited to complete a survey regarding their willingness to undergo PFTs and their reasons for not undergoing PFTs. We estimated the proportion of participants who were willing to undergo PFTs and examined the various reasons for participants to not undergo PFTs. We conducted univariable and multivariable logistic regressions to analyze the impact of individual-level factors on willingness to undergo PFTs. RESULTS: A total of 8475 participants who had completed the survey on willingness to undergo PFTs were included in this study. Out of these participants, 7660 (90.4%) were willing to undergo PFTs. Among those who were willing to undergo PFTs but actually did not, the main reasons for not doing so were geographical inaccessibility ( n  = 3304, 43.1%) and a lack of trust in primary healthcare institutions ( n  = 2809, 36.7%). Among the 815 participants who were unwilling to undergo PFTs, over half ( n  = 447, 54.8%) believed that they did not have health problems and would only consider PFTs when they felt unwell. In the multivariable regression, individuals who were ≤54 years old, residing in rural townships, with a secondary educational level, with medical reimbursement, still working, with occupational exposure to dust, and aware of the abbreviation "COPD" were more willing to undergo PFTs. CONCLUSIONS: Willingness to undergo PFTs was high among high-risk populations. Policymakers may consider implementing strategies such as providing financial incentives, promoting education, and establishing community-based programs to enhance the utilization of PFTs.

Factors Associated with PCV13 Vaccine Hesitancy in Parents under an Innovative Immunization Strategy: a Cross-Sectional Study - Weifang City, Shandong Province, China, 2021.

What is already known on this topic?: Pneumococcal diseases (PDs) are serious threats to child health. Although vaccination is one of the most effective ways to prevent these diseases, the pneumococcal vaccination coverage rate is still relatively low in China. What is added by this report?: This study investigated the factors associated with 13-valent pneumococcal conjugate vaccine (PCV13) vaccine hesitancy in parents under an innovative immunization strategy. This study found that 29.7% of the participants hesitated to vaccinate their children against PCV13 and the main reasons for vaccine hesitancy were individual and group influences. What are the implications for public health practice?: This study can provide scientific evidence for further improving children's PCV13 vaccination rate and improving the prevention and control strategy for PDs.

Seroprevalence and dynamics of anti-SARS-CoV-2 antibodies: a longitudinal study based on patients with underlying diseases in Wuhan.

BACKGROUND: Assessing the humoral immunity of patients with underlying diseases after being infected with SARS-CoV-2 is essential for adopting effective prevention and control strategies. The purpose of this study is to analyze the seroprevalence of people with underlying diseases and the dynamic change features of anti-SARS-CoV-2 antibodies. METHODS: We selected 100 communities in Wuhan using the probability-proportional-to-size sampling method. From these 100 communities, we randomly selected households according to a list provided by the local government. Individuals who have lived in Wuhan for at least 14 days since December 2019 and were ≥ 40 years old were included. From April 9-13, 2020, community staff invited all selected individuals to the community healthcare center in batches by going door-to-door or telephone. All participants completed a standardized electronic questionnaire simultaneously. Finally, 5 ml of venous blood was collected from all participants. Blood samples were tested for the presence of pan-immunoglobulins, IgM, IgA, and IgG antibodies against SARS-CoV-2 nucleocapsid protein and neutralising antibodies were assessed. During the period June 11-13, 2020 and October 9-December 5, 2020, all family members of a positive family and matched negative families were followed up twice. RESULTS: The seroprevalence of anti-SARS-CoV-2 antibodies in people with underlying diseases was 6.30% (95% CI [5.09-7.52]), and that of people without underlying diseases was 6.12% (95% CI [5.33-6.91]). A total of 313 people were positive for total antibodies at baseline, of which 97 had underlying disease. At the first follow-up, a total of 212 people were positive for total antibodies, of which 66 had underlying disease. At the second follow-up, a total of 238 people were positive for total antibodies, of which 68 had underlying disease. A total of 219 participants had three consecutive serum samples with positive total antibodies at baseline. The IgG titers decreased significantly with or without underlying diseases (P < 0.05) within the 9 months at least, while the neutralizing antibody titer remained stable. The titer of asymptomatic patients was lower than that of symptomatic patients (baseline, P = 0.032, second follow-up, P = 0.018) in the underlying diseases group. CONCLUSION: Our research focused on the serological changes of people with and without underlying diseases in a state of single natural infection. Regardless of the underlying diseases, the IgG titer decreased significantly over time, while there was no significant difference in the decline rate of IgG between with and without underlying diseases. Moreover, the neutralizing antibody titer remained relatively stable within the 9 months at least.

Willingness of Caregivers to Have Their Children Vaccinated with Pneumococcal Vaccines in the Context of an Innovative Immunization Strategy - Weifang City, Shandong Province, 2021.

What is already known about this topic?: Pneumococcal diseases (PDs) pose a serious health threat to children. Vaccination is the most cost-effective intervention to prevent PDs, but pneumococcal vaccines coverage among children is low in China. What is added by this report?: This study investigated the willingness of children's caregivers to have their children vaccinated with pneumococcal vaccines under an innovative policy to offer 1-dose of the 13-valent pneumococcal conjugate vaccines at no charge to families. The research found that 70.51% of caregivers were willing to have their infants receive pneumococcal vaccines and that reducing the cost of vaccines may increase caregivers' willingness. What are the implications for public health practice?: This is the first evaluation in China of acceptance of pneumococcal vaccines among children under a 1-dose, cost-free policy. The results provide scientific evidence for updating local and national pneumococcal immunization strategies to promote the use of the pneumococcal vaccine.

COVID-19 vaccination in Chinese children: a cross-sectional study on the cognition, psychological anxiety state and the willingness toward vaccination.

It is important to understand the cognition, willingness, and psychological anxiety state of Chinese guardians toward COVID-19 vaccination for their children to predict the future vaccination rate and to help the design of policies that aim to expand the population with immunity against COVID-19. This study collected data with a professional vaccination registration platform for children named "Xiao Dou Miao" in February 2021. The psychological anxiety state of the guardians was self-evaluated using the psychological anxiety scale. Factors that might influence the willingness of guardians to vaccinate their children were identified using logistic regression analysis. This study included 12,872 questionnaires with 70.9% of guardians showing willingness to vaccinate their children. Guardians who were male, aged 40-49 and from rural area were more willing to vaccinate their children. Fathers, guardians with higher education and income, whose children have a history of adverse vaccine reactions and allergies were less willing to vaccinate their children (p < .001). More than 80% of the guardians expressed a high level of trust for vaccine information released by official and health-related agencies. Guardians who were not vaccinated were more anxious than those who were vaccinated (χ2 = 27.99, p < .001). To protect children from COVID-19, vaccine coverage in children should be expanded rapidly and public awareness on vaccine safety and effectiveness should be improved.

A Scenario-Based Evaluation of COVID-19-Related Essential Clinical Resource Demands in China.

The coronavirus disease 2019 (COVID-19) pandemic is a global crisis, and medical systems in many countries are overwhelmed with supply shortages and increasing demands to treat patients due to the surge in cases and severe illnesses. This study aimed to assess COVID-19-related essential clinical resource demands in China, based on different scenarios involving COVID-19 spreads and interventions. We used a susceptible-exposed-infectious-hospitalized/isolated-removed (SEIHR) transmission dynamics model to estimate the number of COVID-19 infections and hospitalizations with corresponding essential healthcare resources needed. We found that, under strict non-pharmaceutical interventions (NPIs) or mass vaccination of the population, China would be able to contain community transmission and local outbreaks rapidly. However, under scenarios involving a low intensity of implemented NPIs and a small proportion of the population vaccinated, the use of a peacetime-wartime transition model would be needed for medical source stockpiles and preparations to ensure a normal functioning healthcare system. The implementation of COVID-19 vaccines and NPIs in different periods can influence the transmission of COVID-19 and subsequently affect the demand for clinical diagnosis and treatment. An increased proportion of asymptomatic infections in simulations will not reduce the demand for medical resources; however, attention must be paid to the increasing difficulty in containing COVID-19 transmission due to asymptomatic cases. This study provides evidence for emergency preparations and the adjustment of prevention and control strategies during the COVID-19 pandemic. It also provides guidance for essential healthcare investment and resource allocation.