Objective  To systematically examine the status of attitude towards vaccination and the willingness to have vaccination among residents in China and to provide references for implementations of immunization programs.

  Methods  We searched Chinese Biomedical Literature Database – SinoMed for studies on vaccine confidence and vaccination attitude and willingness among Chinese residents published from January 1, 2015 to March 22, 2019 for a systematic review. Relevant information were extracted and summarized from 58 literatures finally included.

  Results  Among the participants of all the studies, the reported vaccine awareness rates were generally low (6.42% – 62.31%), especially for the awareness on category II vaccines; but the rates of vaccination willingness were relatively high (17.81% – 84.97%). Obviously negative impacts of vaccine safety incidents occurred in recent years on vaccine confidence and vaccination attitude, mainly towards category II vaccines, were reported by the participants of the studies, but the impacts diminished rapidly as time went on. There was a large gap between the reported vaccine coverage and the intended vaccination rate for category II vaccines and the gap might be associated with the price and the accessibility of vaccination services of the vaccines.

  Conclusion  The awareness on the knowledge about category II vaccines was at a low level among Chinese residents. About half the surveyed residents were concerned about the safety and effectiveness of the vaccines, but the willingness to have the vaccination was high. Attention should be paid to the negative impact of vaccine safety incidents on vaccination intentions among the public, particularly for those related to vaccinations of category II vaccines.