Determinants of COVID-19 vaccination status and hesitancy among older adults in China

IF 58.7 1区医学 Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY

Nature Medicine Pub Date : 2023-01-31 DOI:10.1038/s41591-023-02241-7

Gewei Wang, Yao Yao, Yafeng Wang, Jinquan Gong, Qinqin Meng, Hui Wang, Wenjin Wang, Xinxin Chen, Yaohui Zhao

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引用次数: 16

Abstract

Vaccination is the primary defense against severe acute respiratory syndrome coronavirus 2, especially among older adults and those with chronic conditions. Using a nationally representative sample of 12,900 participants from the fifth wave (2021–2022) of the China Health and Retirement Longitudinal Study (CHARLS), we examined the coronavirus disease 2019 (COVID-19) vaccination status and the determinants of vaccination hesitancy in Chinese adults aged 52 and older. By July/August 2022, 92.3% of the Chinese population aged 60 years and older had received at least one COVID-19 vaccination, 88.6% had completed the primary series and 72.4% had received a booster. Those aged 80 years and older had lower vaccination rates, with 71.9% and 46.7% completing the primary series and booster shots, respectively. These statistics represent the situation before China ended the Zero-COVID policy in November 2022 because vaccination stagnated between July/August and November 2022. Multivariate regression analysis revealed that belonging to the oldest age groups (individuals aged 70 years and older and especially those aged 80 years and older) as well as being female and unmarried, residing in urban areas, being functionally dependent and having chronic conditions meant that these individuals were less likely to receive COVID-19 vaccines. Our regression analysis results were corroborated by self-reported reasons for nonvaccination. Vaccination hesitancy probably contributed to excessive mortality among vulnerable populations after China ceased its Zero-COVID policy. Our study provides important lessons on how to balance containment efforts with vaccination and treatment measures, as well as highlighting the need to clarify the side effects and contraindications of vaccines early on. Analysis of a longitudinal cohort revealed that only 72% of Chinese adults aged 60 years and older received a booster coronavirus disease 2019 vaccination by July 2022, with contraindications, advanced age and living with chronic conditions being the main determinants of vaccine hesitancy in this population.

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中国老年人接种 COVID-19 疫苗情况和犹豫不决的决定因素

接种疫苗是预防严重急性呼吸道综合征冠状病毒2的主要方法，尤其是在老年人和慢性病患者中。我们利用中国健康与退休纵向研究（CHARLS）第五次调查（2021-2022 年）中具有全国代表性的 12900 名参与者样本，调查了 52 岁及以上中国成年人的冠状病毒病 2019（COVID-19）疫苗接种情况以及疫苗接种犹豫的决定因素。截至 2022 年 7 月/8 月，92.3% 的 60 岁及以上中国人至少接种过一次 COVID-19 疫苗，88.6% 的人完成了初免，72.4% 的人接受了加强免疫。80 岁及以上人群的接种率较低，分别为 71.9% 和 46.7% 的人完成了初种和加强接种。这些统计数据代表了中国在 2022 年 11 月结束零接种率政策之前的情况，因为在 2022 年 7/8 月至 11 月期间，疫苗接种率停滞不前。多变量回归分析表明，高龄人群（70 岁及以上，尤其是 80 岁及以上）、女性、未婚、居住在城市地区、功能依赖者和慢性病患者接种 COVID-19 疫苗的可能性较低。我们的回归分析结果得到了不接种疫苗的自我报告原因的证实。在中国停止零接种疫苗政策后，疫苗接种的犹豫不决可能是导致易感人群死亡率过高的原因之一。我们的研究为如何平衡遏制工作与疫苗接种和治疗措施之间的关系提供了重要经验，同时也强调了尽早明确疫苗副作用和禁忌症的必要性。对纵向队列的分析表明，到2022年7月，仅有72%的60岁及以上中国成年人接种了2019年冠状病毒疾病强化疫苗，而禁忌症、高龄和慢性病患者是这一人群对疫苗犹豫不决的主要决定因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nature Medicine 医学-生化与分子生物学

CiteScore

100.90

自引率

0.70%

发文量

525

审稿时长

1 months

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