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Article ; Online: Impact of implementing a free varicella vaccination policy on incidence in Wuxi City, China: an interrupted time series analysis.

Xiu, Shixin / Wang, Xuwen / Wang, Qiang / Jin, Hui / Shen, Yuan

2023 Volume 151, Page(s) e125

Abstract: Varicella vaccination is optional and requires self-payment. On 1 December 2018, Wuxi City launched a free varicella vaccination program for children. This study aimed to evaluate the changes in varicella incidence before and after the implementation of ... ...

Abstract	Varicella vaccination is optional and requires self-payment. On 1 December 2018, Wuxi City launched a free varicella vaccination program for children. This study aimed to evaluate the changes in varicella incidence before and after the implementation of the policy. The data were obtained from official information systems and statistical yearbooks. We divided the period into chargeable (January 2017 to November 2018) and free (December 2018 to December 2021) periods. Interrupt time series analysis was used to conduct a generalised least-squares regression analysis for the two periods. A total of 51,071 varicella cases were reported between January 2017 and December 2021. After the implementation of the policy, there was a statistically significant decrease in the incidence of varicella (β2 = -0.140, P = 0.017), and the slope of the incidence also decreased by 0.012 (P = 0.015). Following policy implementation, the incidence decreased in all age groups, with the largest decline observed among children aged 8-14 years (β2 = -1.109, P = 0.009), followed by children aged ≤7 years (β2 = -0.894, P = 0.013). Our study found a significant reduction in the incidence of varicella in the total population after the introduction of free varicella vaccination in Wuxi City.
MeSH term(s)	Child ; Humans ; Infant ; Chickenpox/epidemiology ; Chickenpox/prevention & control ; Interrupted Time Series Analysis ; Incidence ; Vaccination ; China/epidemiology ; Policy ; Chickenpox Vaccine
Chemical Substances	Chickenpox Vaccine
Language	English
Publishing date	2023-07-20
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	632982-2
ISSN	1469-4409 ; 0950-2688
ISSN (online)	1469-4409
ISSN	0950-2688
DOI	10.1017/S0950268823001152
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Article ; Online: Perceptions about respiratory syncytial virus (RSV) and attitudes toward the RSV vaccine among the general public in China: A cross-sectional survey.

Wang, Qiang / Xiu, Shixin / Yang, Liuqing / Li, Lan / Yang, Min / Wang, Xuwen / Shen, Yuan / Wang, Weibing / Lin, Leesa

Human vaccines & immunotherapeutics

2024 Volume 20, Issue 1, Page(s) 2310916

Abstract: Our study aims to assess the public's perceptions of respiratory syncytial virus (RSV) and attitudes toward the RSV vaccine and to identify associated factors in China. A nationwide cross-sectional survey conducted using an online platform between August ...

Abstract	Our study aims to assess the public's perceptions of respiratory syncytial virus (RSV) and attitudes toward the RSV vaccine and to identify associated factors in China. A nationwide cross-sectional survey conducted using an online platform between August 16 and September 14, 2023. Questions related to socio-demographics, awareness, knowledge, perceptions of susceptibility and severity of RSV, and attitudes toward the RSV vaccine were included in the questionnaire. We used the chi-square test and logistic regression model to explore the associated factors. Overall, 2133 individuals were included in this study. Nearly a quarter of participants (24.3%) indicated that they had never heard of RSV. The proportion of individuals aged over 50 years reporting never having heard of RSV (36.5%) and having a low knowledge level of RSV (55.3%) was significantly higher that of other younger age groups. More than half of individuals (55.7%) exhibited low level of perceptions of susceptibility concerning RSV infection. A total of 68.4% of the participants expressed willingness to receive the RSV vaccine. Younger age was positively associated with a higher willingness to be vaccinated. The most frequent reason for declining the vaccine was "Concern about vaccine's safety or side effects." About 60% of individuals considered a price of RSV vaccine below 200 CNY (28 USD) as acceptable. The awareness and perceived susceptibility to RSV infection were limited to the Chinese public. It is necessary to take measures to address the low awareness and knowledge of RSV and acceptability of the RSV vaccine among older adults.
MeSH term(s)	Humans ; Middle Aged ; Aged ; Respiratory Syncytial Virus Infections ; Cross-Sectional Studies ; Respiratory Syncytial Virus Vaccines ; Vaccination ; Respiratory Syncytial Virus, Human ; China ; Antibodies, Viral
Chemical Substances	Respiratory Syncytial Virus Vaccines ; Antibodies, Viral
Language	English
Publishing date	2024-02-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	2664176-8
ISSN	2164-554X ; 2164-5515
ISSN (online)	2164-554X
ISSN	2164-5515
DOI	10.1080/21645515.2024.2310916
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Article ; Online: Understanding drivers of influenza vaccine hesitancy among pregnant women in China: evidence from an extended theory of planned behavior.

Yang, Liuqing / Yang, Guoping / Wang, Qiang / Cui, Tingting / Shi, Naiyang / Xiu, Shixin / Zhu, Lin / Xu, Xuepeng / Jin, Hui / Ji, Lili

Expert review of vaccines

2022 Volume 21, Issue 11, Page(s) 1655–1665

Abstract: Background: Pregnant women's influenza vaccination uptake was low, although being recommended as a priority.: Research design and methods: We conducted a cross-sectional questionnaire survey in China from June to July 2021. Hierarchical regression ... ...

Abstract	Background: Pregnant women's influenza vaccination uptake was low, although being recommended as a priority. Research design and methods: We conducted a cross-sectional questionnaire survey in China from June to July 2021. Hierarchical regression analysis and structural equation modeling were performed based on the extended theory of planned behavior, in which attitudes, subjective norms, perceived behavioral control, and intention each affect vaccine hesitancy; response efficacy, knowledge, vulnerability, and severity were added as extended dimensions; vaccination history played as a moderator. Results: Totally, 1283 pregnant women participated in this study. The intention existed as a mediator between attitude [β Conclusions: The subjective norms dimension has a strong association with influenza vaccine hesitancy. Vaccination history was limited to reduce hesitancy.
MeSH term(s)	Female ; Humans ; Pregnancy ; Pregnant Women ; Influenza Vaccines ; Influenza, Human/prevention & control ; Cross-Sectional Studies ; Vaccination Hesitancy ; China
Chemical Substances	Influenza Vaccines
Language	English
Publishing date	2022-08-30
Publishing country	England
Document type	Journal Article
ZDB-ID	2181284-6
ISSN	1744-8395 ; 1476-0584
ISSN (online)	1744-8395
ISSN	1476-0584
DOI	10.1080/14760584.2022.2117695
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Article ; Online: Understanding Drivers of Vaccine Hesitancy During the COVID-19 Pandemic Among Older Adults in Jiangsu Province, China: Cross-sectional Survey.

Yang, Liuqing / Ji, Lili / Wang, Qiang / Yang, Guoping / Xiu, Shixin / Cui, Tingting / Shi, Naiyang / Zhu, Lin / Xu, Xuepeng / Jin, Hui / Zhen, Shiqi

JMIR formative research

2023 Volume 7, Page(s) e39994

Abstract: Background: Older adults are particularly at risk from infectious diseases, including serve complications, hospitalization, and death.: Objective: This study aimed to explore the drivers of vaccine hesitancy among older adults based on the "3Cs" ( ... ...

Abstract	Background: Older adults are particularly at risk from infectious diseases, including serve complications, hospitalization, and death. Objective: This study aimed to explore the drivers of vaccine hesitancy among older adults based on the "3Cs" (confidence, complacency, and convenience) framework, where socioeconomic status and vaccination history played the role of moderators. Methods: A cross-sectional questionnaire survey was conducted in Jiangsu Province, China, between June 1 and July 20, 2021. Older adults (aged ≥60 years) were recruited using a stratified sampling method. Vaccine hesitancy was influenced by the 3Cs in the model. Socioeconomic status and vaccination history processed through the item parceling method were used to moderate associations between the 3Cs and hesitancy. Hierarchical regression analyses and structural equation modeling were used to test the validity of the new framework. We performed 5000 trials of bootstrapping to calculate the 95% CI of the pathway's coefficients. Results: A total of 1341 older adults participated. The mean age was 71.3 (SD 5.4) years, and 44.7% (599/1341) of participants were men. Confidence (b=0.967; 95% CI 0.759-1.201; P=.002), convenience (b=0.458; 95% CI 0.333-0.590; P=.002), and less complacency (b=0.301; 95% CI 0.187-0.408; P=.002) were positively associated with less vaccine hesitancy. Socioeconomic status weakened the positive effect of low complacency (b=-0.065; P=.03) on low vaccine hesitancy. COVID-19 vaccination history negatively moderated the positive association between confidence (b=-0.071; P=.02) and lower vaccine hesitancy. Conclusions: Our study identified that confidence was the more influential dimension in reducing vaccine hesitancy among older adults. COVID-19 vaccination history, as well as confidence, had a positive association with less vaccine hesitancy and could weaken the role of confidence in vaccine hesitancy. Socioeconomic status had a substitution relationship with less complacency, which suggested a competitive positive association between them on less vaccine hesitancy.
Language	English
Publishing date	2023-02-07
Publishing country	Canada
Document type	Journal Article
ISSN	2561-326X
ISSN (online)	2561-326X
DOI	10.2196/39994
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Article ; Online: Perceptions and acceptability of HPV vaccination among parents of female adolescents 9-14 in China: A cross-sectional survey based on the theory of planned behavior.

Yi, Youqin / Xiu, Shixin / Shi, Naiyang / Huang, Yue / Zhang, Shihan / Wang, Qiang / Yang, Liuqing / Cui, Tingting / Wang, Yuning / Shen, Yuan / Jin, Hui

Human vaccines & immunotherapeutics

2023 Volume 19, Issue 2, Page(s) 2225994

Abstract: HPV vaccine uptake remains low in China, especially among girls. Recently, China has initiated a pilot program on HPV immunization for girls 9-14. From November to December 2021, a cross-sectional study was conducted among parents of girls 9-14 in China ... ...

Abstract	HPV vaccine uptake remains low in China, especially among girls. Recently, China has initiated a pilot program on HPV immunization for girls 9-14. From November to December 2021, a cross-sectional study was conducted among parents of girls 9-14 in China through a web-based anonymous online questionnaire survey. Descriptive epidemiological analysis was used to analyze parental acceptability. Hierarchical regression analysis and structural equation modeling were to determine associated factors. A total of 5623 participants were included in the analysis. 21.2% girls had received HPV vaccine, and 94.3% parents intended to receive vaccination for their daughters, the Kappa values between them was -0.016. 31.9% of vaccinated mothers had received HPV vaccine for their daughters, vaccination history had a positive impact on behavior (
MeSH term(s)	Humans ; Female ; Adolescent ; Male ; Cross-Sectional Studies ; Papillomavirus Infections/prevention & control ; Theory of Planned Behavior ; Parents ; Papillomavirus Vaccines ; China ; Vaccination ; Surveys and Questionnaires ; Health Knowledge, Attitudes, Practice ; Patient Acceptance of Health Care
Chemical Substances	Papillomavirus Vaccines
Language	English
Publishing date	2023-06-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	2664176-8
ISSN	2164-554X ; 2164-5515
ISSN (online)	2164-554X
ISSN	2164-5515
DOI	10.1080/21645515.2023.2225994
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Article ; Online: Assessing vaccine literacy and exploring its association with vaccine hesitancy: A validation of the vaccine literacy scale in China.

Yang, Liuqing / Zhen, Shiqi / Li, Lan / Wang, Qiang / Yang, Guoping / Cui, Tingting / Shi, Naiyang / Xiu, Shixin / Zhu, Lin / Xu, Xuepeng / Wang, Liping / Jin, Hui / Ji, Lili

Journal of affective disorders

2023 Volume 330, Page(s) 275–282

Abstract: Background: Assessment of vaccine literacy is essential for understanding people's ability to access various vaccine information to meet health demands. Few studies have examined the role of vaccine literacy in vaccine hesitancy, which is a ... ...

Abstract	Background: Assessment of vaccine literacy is essential for understanding people's ability to access various vaccine information to meet health demands. Few studies have examined the role of vaccine literacy in vaccine hesitancy, which is a psychological state. This study aimed to validate the applicability of the HLVa-IT (Vaccine Health Literacy of Adults in Italian) scale in Chinese settings and to explore the association between vaccine literacy and vaccine hesitancy. Methods: From May to June 2022, we conducted an online cross-sectional survey in mainland China. Potential factor domains were obtained by the exploratory factor analysis. Cronbach's alpha coefficient, composite reliability values, and square root values of average variances extracted were calculated to determine the internal consistency and discriminant validity. The association between vaccine literacy, vaccine acceptance, with vaccine hesitancy was assessed using logistic regression analysis. Results: Totally, 12,586 participants completed the survey. Two potential dimensions, the functional and the interactive/critical, were identified. Cronbach's alpha coefficient and composite reliability values were >0.90. The square root values of average variances extracted exceeded the related correlations. The functional dimension (adjusted odds ratio (aOR): 0579; 95 % Confidence Interval (CI); 0.529, 0.635), interactive (aOR: 0.654; 95%CI: 0.531, 0.806)/critical (aOR: 0.709; 95%CI: 0.575, 0.873) dimension were significantly and negatively associated with vaccine hesitancy. Similar results were also found in different vaccines acceptance subgroups. Limitations: This report is limited by the convenience sampling method. Conclusions: The modified HLVa-IT is suitable for use in Chinese settings. Vaccine literacy was negatively associated with vaccine hesitancy.
MeSH term(s)	Adult ; Humans ; Vaccination Hesitancy ; Cross-Sectional Studies ; Reproducibility of Results ; China ; Vaccines
Chemical Substances	Vaccines
Language	English
Publishing date	2023-03-11
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	135449-8
ISSN	1573-2517 ; 0165-0327
ISSN (online)	1573-2517
ISSN	0165-0327
DOI	10.1016/j.jad.2023.03.014
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Article: Non-EPI Vaccine Hesitancy among Chinese Adults: A Cross-Sectional Study.

Wang, Jianli / Zhang, Yan / Long, Sigui / Fu, Xin / Zhang, Xiaoxuan / Zhao, Shuangyu / Xiu, Shixin / Wang, Xuwen / Lu, Bing / Jin, Hui

Vaccines

2021 Volume 9, Issue 7

Abstract: Vaccination against coronavirus disease 2019 (COVID-19) is paramount to curtailing the pandemic. However, the impact of the Non-Expanded Program on Immunization (non-EPI) and COVID-19 vaccine hesitancy on vaccine uptake among Chinese adults remain ... ...

Abstract	Vaccination against coronavirus disease 2019 (COVID-19) is paramount to curtailing the pandemic. However, the impact of the Non-Expanded Program on Immunization (non-EPI) and COVID-19 vaccine hesitancy on vaccine uptake among Chinese adults remain unclear. This study was an online survey performed in Eastern, Central, and Western China between February 2021 and March 2021 using proportional sampling (
Language	English
Publishing date	2021-07-10
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2703319-3
ISSN	2076-393X
ISSN	2076-393X
DOI	10.3390/vaccines9070772
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Article ; Online: Changes in Parental Attitudes Toward COVID-19 Vaccination and Routine Childhood Vaccination During the COVID-19 Pandemic: Repeated Cross-sectional Survey Study.

Wang, Qiang / Xiu, Shixin / Yang, Liuqing / Han, Ying / Cui, Tingting / Shi, Naiyang / Liu, Minqi / Yi, Youqin / Liu, Chang / Wang, Xuwen / Yang, Guoping / Ji, Lili / Zhou, Weijie / Jin, Hui / Zhen, Shiqi / Lin, Leesa

JMIR public health and surveillance

2022 Volume 8, Issue 5, Page(s) e33235

Abstract: Background: It was reported that one in four parents were hesitant about vaccinating their children in China. Previous studies have revealed a declining trend in the vaccine willingness rate in China. There is a need to monitor the level of parental ... ...

Abstract	Background: It was reported that one in four parents were hesitant about vaccinating their children in China. Previous studies have revealed a declining trend in the vaccine willingness rate in China. There is a need to monitor the level of parental vaccine hesitancy toward routine childhood vaccination and hesitancy toward the COVID-19 vaccine during the ongoing COVID-19 pandemic. Objective: This study aims to assess changes in trends of parental attitudes toward routine childhood vaccines and COVID-19 vaccinations across different time periods in China. Methods: Three waves of cross-sectional surveys were conducted on parents residing in Wuxi City in Jiangsu Province, China from September to October 2020, February to March 2021, and May to June 2021. Participants were recruited from immunization clinics. Chi-square tests were used to compare the results of the three surveys, controlling for sociodemographic factors. Binary and multivariable logistic regression analysis was used to examine factors related to parental vaccine hesitancy and COVID-19 vaccine willingness. Results: Overall, 2881, 1038, and 1183 participants were included in the survey's three waves. Using the Vaccine Hesitancy Scale, 7.8% (225/2881), 15.1% (157/1038), and 5.5% (65/1183) of parents showed hesitancy to childhood vaccination (P<.001), and 59.3% (1709/2881), 64.6% (671/1038), and 92% (1088/1183) of parents agreed to receive a COVID-19 vaccine themselves in the first, second, and third surveys, respectively (P<.001). In all three surveys, "concerns about vaccine safety and side effects" was the most common reason for refusal. Conclusions: There has been an increasing acceptance of COVID-19 vaccination in Wuxi City, China. Effective interventions are needed to mitigate public concerns about vaccine safety.
MeSH term(s)	COVID-19/epidemiology ; COVID-19/prevention & control ; COVID-19 Vaccines/therapeutic use ; Child ; Cross-Sectional Studies ; Humans ; Pandemics ; Parents ; Vaccination ; Vaccination Hesitancy ; Vaccines
Chemical Substances	COVID-19 Vaccines ; Vaccines
Language	English
Publishing date	2022-05-13
Publishing country	Canada
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2369-2960
ISSN (online)	2369-2960
DOI	10.2196/33235
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Article ; Online: Vaccination Intention and Behavior of the General Public in China: Cross-sectional Survey and Moderated Mediation Model Analysis.

Yang, Liuqing / Ji, Lili / Wang, Qiang / Xu, Yan / Yang, Guoping / Cui, Tingting / Shi, Naiyang / Zhu, Lin / Xiu, Shixin / Jin, Hui / Zhen, Shiqi

JMIR public health and surveillance

2022 Volume 8, Issue 6, Page(s) e34666

Abstract: Background: Promoting vaccination and eliminating vaccine hesitancy are key measures for controlling vaccine-preventable diseases.: Objective: We aimed to understand the beliefs surrounding and drivers of vaccination behavior, and their relationships ...

Abstract	Background: Promoting vaccination and eliminating vaccine hesitancy are key measures for controlling vaccine-preventable diseases. Objective: We aimed to understand the beliefs surrounding and drivers of vaccination behavior, and their relationships with and influence on vaccination intention and practices. Methods: We conducted a web-based survey in 31 provinces in mainland China from May 24, 2021 to June 15, 2021, with questions pertaining to vaccination in 5 dimensions: attitude, subjective norms, perceived behavioral control, intention, and behavior. We performed hierarchical regression analysis and structural equation modeling based on the theory of planned behavior-in which, the variables attitude, subjective norms, and intention each affect the variable intention; the variable intention mediates the relationships of attitude and subjective norms with behavior, and the variable perceived behavioral control moderates the strength of this mediation-to test the validity of the theoretical framework. Results: A total of 9924 participants, aged 18 to 59 years, were included in this study. Vaccination intention mediated the relationships of attitude and subjective norms with vaccination behavior. The indirect effect of attitude on vaccination behavior was 0.164 and that of subjective norms was 0.255, and the difference was statistically significant (P<.001). The moderated mediation analysis further indicated that perceived behavioral control would affect the mediation when used as moderator, and the interaction terms for attitude (β=-0.052, P<.001) and subjective norms (β=-0.028, P=.006) with perceived behavioral control were significant. Conclusions: Subjective norms have stronger positive influences on vaccination practices than attitudes. Perceived behavioral control, as a moderator, has a substitution relationship with attitudes and subjective norms and weakens their positive effects on vaccination behavior.
MeSH term(s)	China ; Cross-Sectional Studies ; Humans ; Intention ; Mediation Analysis ; Vaccination
Language	English
Publishing date	2022-06-20
Publishing country	Canada
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2369-2960
ISSN (online)	2369-2960
DOI	10.2196/34666
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Article ; Online: Validation of the World Health Organization's parental vaccine hesitancy scale in China using child vaccination data.

Wang, Qiang / Xiu, Shixin / Yang, Liuqing / Han, Ying / Cui, Tingting / Shi, Naiyang / Liu, Minqi / Yi, Youqin / Liu, Chang / Wang, Xuwen / Zhou, Weijie / Jin, Hui / Lin, Leesa

Human vaccines & immunotherapeutics

2022 Volume 18, Issue 1, Page(s) 2021060

Abstract: Evidence for the validity and reliability of the World Health Organization's 10-item vaccine hesitancy scale (VHS) in different settings is not sufficient, especially for criteria validity. This study aimed to assess the validity and reliability of the ... ...

Abstract	Evidence for the validity and reliability of the World Health Organization's 10-item vaccine hesitancy scale (VHS) in different settings is not sufficient, especially for criteria validity. This study aimed to assess the validity and reliability of the VHS using child vaccination data in China. A cross-sectional survey was performed with parents of 19-48-month-old children at six vaccination clinics in Wuxi City between September and October 2020. The VHS was revised to category A (expanded program on immunization, EPI) VHS and category B (Non-EPI) VHS. Factor analysis was used to confirm the latent domain and to assess the model structure. The average variance extracted (AVE) was calculated to assess convergent validity, and Cronbach's α and composite reliability (CR) were used to determine internal consistency. The association between VHS scores and children's vaccination status was examined to assess criteria validity using logistic regression. The survey response rate was 75.3% (n = 802). Two factors were identified, explaining 64.60% and 63.34% of the common variance in categories A and B VHS, respectively. The Cronbach's α of > 0.7 and CR of >0.7 in the scale indicated the VHS has acceptable internal consistency. The AVE values indicated that convergent validity was not ideal for the VHS. There were no statistically significant associations between VHS scores and vaccination status, indicating that the criterion validity was not ideal. The VHS needs improvement before becoming a standard survey tool.
MeSH term(s)	Child ; Child, Preschool ; China ; Cross-Sectional Studies ; Humans ; Infant ; Parents ; Patient Acceptance of Health Care ; Reproducibility of Results ; Surveys and Questionnaires ; Vaccination ; Vaccination Hesitancy ; World Health Organization
Language	English
Publishing date	2022-02-14
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2664176-8
ISSN	2164-554X ; 2164-5515
ISSN (online)	2164-554X
ISSN	2164-5515
DOI	10.1080/21645515.2021.2021060
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