背景:疫苗接种在预防COVID-19感染和降低疾病严重程度方面发挥着重要作用。城市和农村地区的疫苗接种率通常存在差异。衡量这些差异有助于制定更加协调和可持续的解决方案。这些信息也可作为未来预防和控制新发传染病的参考。
目的:本研究旨在评估当前中国居民COVID-19(第二次加强)疫苗接种率和影响因素,以及中国城乡之间的差距。
方法:这项横断面研究采用分层随机抽样方法,从东部(常州)的11个社区和10个村庄中选择代表性样本,中部(郑州),西部(西宁),和东北(牡丹江)中国大陆,2023年2月1日至2月18日。问卷是由经验丰富的流行病学家开发的,包含以下内容:社会人口统计信息,健康状况,疫苗相关信息,与保护动机理论(PMT)相关的信息,以及对医疗保健系统的信任程度。根据提供的自我报告信息评估参与者的疫苗接种率。采用二元logistic回归模型探讨城乡人群疫苗接种的影响因素。使用倾向评分匹配(PSM)评估了疫苗接种率的城乡差异。
结果:共纳入5780名参与者,53.04%(3066/5780)为女性。总样本的疫苗接种率为12.18%(704/5780;95%CI11.34-13.02),农村参与者中13.76%(341/2478;95%CI12.40-15.12),城市参与者中的10.99%(363/3302;95%CI9.93-12.06)。对于农村参与者来说,自我报告的健康状况,自我效能感,教育水平,疫苗知识,易感性,好处,对卫生保健系统的信任是影响接种的独立因素(均P<0.05)。对于城市参与者来说,慢性疾病,COVID-19感染,主观社区水平,疫苗知识,自我效能感,对卫生保健系统的信任是影响接种的独立因素(均P<0.05)。PSM分析发现,城乡参与者的疫苗接种率差异为3.42%。
结论:中国人群中第四次COVID-19疫苗接种率(第二次加强)极低,显著低于以往的疫苗覆盖率。鉴于COVID-19感染仍然处于低水平,应着力提高自我效能,以扩大中国人群的疫苗覆盖率。对于农村居民来说,建立对疫苗的益处的认识和改善他们的整体健康状况应优先考虑。在城市地区,更大比例的COVID-19患者和慢性病患者应该接种疫苗。
BACKGROUND: Vaccination plays an important role in preventing COVID-19 infection and reducing the severity of the disease. There are usually differences in vaccination rates between urban and rural areas. Measuring these differences can aid in developing more coordinated and sustainable solutions. This information also serves as a reference for the prevention and control of emerging infectious diseases in the future.
OBJECTIVE: This study aims to assess the current coverage rate and influencing factors of COVID-19 (second booster) vaccination among Chinese residents, as well as the disparities between urban and rural areas in
China.
METHODS: This cross-sectional study used a stratified random sampling approach to select representative samples from 11 communities and 10 villages in eastern (Changzhou), central (Zhengzhou), western (Xining), and northeast (Mudanjiang) Mainland
China from February 1 to February 18, 2023. The questionnaires were developed by experienced epidemiologists and contained the following: sociodemographic information, health conditions, vaccine-related information, information related to the Protective Motivation Theory (PMT), and the level of trust in the health care system. Vaccination rates among the participants were evaluated based on self-reported information provided. Binary logistic regression models were performed to explore influencing factors of vaccination among urban and rural participants. Urban-rural disparities in the vaccination rate were assessed using propensity score matching (PSM).
RESULTS: A total of 5780 participants were included, with 53.04% (3066/5780) being female. The vaccination rate was 12.18% (704/5780; 95% CI 11.34-13.02) in the total sample, 13.76% (341/2478; 95% CI 12.40-15.12) among the rural participants, and 10.99% (363/3302; 95% CI 9.93-12.06) among the urban participants. For rural participants, self-reported health condition, self-efficacy, educational level, vaccine knowledge, susceptibility, benefits, and trust in the health care system were independent factors associated with vaccination (all P<.05). For urban participants, chronic conditions, COVID-19 infection, subjective community level, vaccine knowledge, self-efficacy, and trust in the health care system were independent factors associated with vaccination (all P<.05). PSM analysis uncovered a 3.42% difference in vaccination rates between urban and rural participants.
CONCLUSIONS: The fourth COVID-19 vaccination coverage rate (second booster) among the Chinese population was extremely low, significantly lower than the previous vaccine coverage rate. Given that COVID-19 infection is still prevalent at low levels, efforts should focus on enhancing self-efficacy to expand the vaccine coverage rate among the Chinese population. For rural residents, building awareness of the vaccine\'s benefits and improving their overall health status should be prioritized. In urban areas, a larger proportion of people with COVID-19 and patients with chronic illness should be vaccinated.