Parental willingness for children′s influenza vaccination after COVID-19 epidemic among 1 to 18 years children in urban Shanghai
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摘要:
目的 调查后疫情时代父母对于儿童流感疫苗的意愿及影响因素,为提高儿童流感疫苗接种率提供科学依据。 方法 采用分层整群随机抽样方法,于2021年6月对2554名上海市张江社区1~18岁儿童父母进行问卷调查,收集其家庭基本信息、对流感疫苗的认知情况、2020年度(2020年9月 — 2021年1月)儿童流感疫苗接种情况及2021年度(2021年9月开始的流感季)儿童流感疫苗接种意愿,对调查结果进行描述性分析,并用多因素logistic回归分析儿童流感疫苗接种意愿的影响因素。 结果 有效问卷2448份,2020年度儿童流感疫苗接种率为51.59 %,父母对2021年度儿童流感疫苗的接种意愿率为58.66 %。多因素logistic回归分析结果显示,2020年度儿童流感疫苗接种率的影响因素有:儿童年龄(OR4~6岁 = 7.966,95 % CI = 5.410~11.729;OR7~11岁 = 0.407,95 % CI = 0.282~0.587;OR12~17岁 = 0.106,95 % CI = 0.066~0.169),父母类型(OR母亲 = 1.505,95 % CI = 1.149~1.973);父母对2021年度儿童流感疫苗接种意愿的影响因素有:父母自身接种意愿(OR有 = 12.301,95 % CI = 9.976~15.170),按照国家推荐的免疫规划为孩子接种(OR是 = 2.662,95 % CI = 1.910~3.709),父母中有参与新冠防控工作(OR是 = 1.449,95 % CI = 1.082~1.940),居住本辖区(OR是 = 0.702,95 % CI = 0.531~0.928),担心疫苗的安全性(OR担心 = 0.627,95 % CI = 0.465~0.845,OR不确定 = 0.682,95 % CI = 0.478~0.975),亲友的新冠肺炎病史(OR是 = 0.411,95 % CI = 0.192~0.878),儿童年龄(OR7~11岁 = 0.384,95 % CI = 0.240~0.615,OR12~17岁 = 0.289,95 % CI = 0.173~0.484)。 结论 父母对儿童流感疫苗接种意愿主要与父母认知、疫苗政策和家庭情况等因素有关,为维持较高的接种率,建议加强父母的疫苗相关知识宣教。 Abstract:Objective To investigate parental willingness for their children′s influenza vaccination and its influencing factors after coronavirus disease 2019 (COVID-19) epidemic and to provide evidences for improving influenza vaccination rate in children. Methods Using stratified cluster random sampling, we recruited 2 554 children aged 1 – 18 years at 12 kindergartens, 4 primary and 5 middle schools and among attendees of vaccination clinics in an urban district of Shanghai; an online survey was conducted among the parents of the selected children with a self-designed questionnaire on family status, the awareness of influenza vaccine, their children′s influenza vaccination in 2020, and the intention for their children′s vaccination in 2021 influenza season during June 2021. Descriptive statistics and multivariate logistic regression were adopted in data analyses. Results Complete information were collected from 98.85% (2 448) of the parents. The reported influenza vaccination rate was 51.59% among the respondents′ children in 2020 influenza season (September 2020 – January 2021) and the proportion of the respondents reporting the willingness to have their children′s influenza vaccination in 2021 influenza season was 58.66%. The results of multivariate logistic regression analysis showed that the influencing factors for the children′s influenza vaccination in 2020 included: children′s age (compared to the ages of 1 – 3 years: odds ratio [OR]4 – 6 = 7.966, 95% confidence interval [95% CI]: 5.410 – 11.729; OR7 – 11 = 0.407, 95% CI: 0.282 – 0.587; and OR12 – 18 = 0.106, 95% CI: 0.066 – 0.169), parent-child relationship (father vs. mother: OR = 1.505, 95% CI: 1.149 – 1.973). The influencing factors for parents′ willingness to have their children being vaccinated in 2021 influenza season included: parent′s willingness for the vaccination of himself/herself (yes vs. no: OR = 12.301, 95% CI: 9.976 – 15.170), accepting the recommendation in national immunization plan (yes vs. no: OR = 2.662, 95% CI: 1.910 – 3.709), participating in COVID-19 epidemic prevention and control (yes vs. no: OR = 1.449, 95% CI: 1.082 – 1.940), being local resident (yes vs. no: OR = 0.702, 95% CI: 0.531 – 0.928), being worried about vaccine safety (yes vs. no: OR = 0.627, 95% CI: 0.465 – 0.845 and yes vs. uncertainly: OR = 0.682, 95% CI: 0.478 – 0.975), with relatives or friends ever experiencing COVID-19 infection (yes vs. no: OR = 0.411, 95% CI: 0.192 – 0.878), and children′s age (compared to the ages of 1 – 3 years: OR7 – 11 = 0.384, 95% CI: 0.240 – 0.615, OR12 – 17 = 0.289, 95% CI: 0.173 – 0.484). Conclusion For 1 – 18 years old children in urban Shanghai, parental willingness for children′s influenza vaccination was mainly related to parents′ cognition on the vaccine, vaccine policy and family situation after COVID-19 epidemic. The results suggest that relevant education should be conducted among the children′s parents for promoting childhood influenza vaccination. -
Key words:
- children /
- influenza vaccine /
- vaccination willingness /
- influencing factor
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表 1 父母对2020年度儿童流感疫苗接种率和2021年度儿童流感疫苗的接种意愿(n = 2 448)
变量 调查人数 2020年度儿童流感疫苗接种情况 2021年度儿童流感疫苗接种意愿 接种人数 % χ2 值 P 值 有意愿
人数% χ2 值 P 值 儿童年龄(岁) 1~3 174 102 58.62 1 205.394 < 0.001 133 76.44 86.284 < 0.001 4~6 987 903 91.49 653 66.16 7~11 692 208 30.06 370 53.47 12~18 595 50 8.40 280 47.06 儿童性别 男性 1272 666 52.36 0.621 0.227 728 57.23 2.225 0.136 女性 1176 597 50.77 708 60.20 儿童身体状况 良好 2201 1103 50.11 21.279 < 0.001 1294 58.79 1.833 0.400 一般 213 134 62.91 119 55.87 差 34 26 76.47 23 67.65 独生子女 否 953 511 53.62 2.567 0.109 583 61.18 4.071 0.044 是 1495 752 50.30 853 57.06 父母类型 父亲 622 292 46.95 7.213 0.007 382 61.41 2.609 0.106 母亲 1826 971 53.18 1054 57.72 父母年龄(岁) ≤ 30 113 84 74.34 125.963 < 0.001 75 66.37 56.82 < 0.001 31~40 1784 1003 56.22 1111 62.28 41~50 532 173 32.52 237 44.55 ≥ 51 19 3 15.79 13 68.42 文化程度 初中及以下 178 32 17.98 414.693 < 0.001 116 65.17 13.061 0.011 高中 237 46 19.41 136 57.38 大专 524 190 36.26 283 54.01 本科 1023 603 58.94 592 57.87 硕士及以上 486 392 80.66 309 63.58 职业 公务员/企事业单位 784 488 62.24 85.000 < 0.001 459 58.55 0.859 0.930 医务人员 53 36 67.92 30 56.60 个体户/自由职业者 391 146 37.34 223 57.03 农民 24 5 20.83 15 62.50 其他 1196 588 49.16 709 59.28 家庭年收入(万元) ≤ 10 388 87 22.42 324.033 < 0.001 212 54.64 3.927 0.269 10~ 325 108 33.23 194 59.69 15~ 312 121 38.78 178 57.05 ≥ 20 1423 947 66.55 852 59.87 居住本辖区 否 417 152 36.45 46.145 < 0.001 265 63.55 4.954 0.026 是 2031 1111 54.70 1171 57.66 亲友的有新冠肺炎病史 否 2404 1243 51.71 0.676 0.411 1418 58.99 5.822 0.016 是 44 20 45.45 18 40.91 父母中有参与新冠肺炎防控工作 否 2056 1105 53.75 23.809 < 0.001 1168 56.81 18.136 < 0.001 是 392 158 40.31 268 68.37 倾向何种流感疫苗 进口疫苗 606 382 63.04 42.227 < 0.001 365 60.23 0.82 0.365 国产疫苗 1842 881 47.83 1071 58.14 按照国家推荐的免疫规
划程序为孩子接种疫苗否 270 132 48.89 4.909 0.086 105 38.89 74.755 < 0.001 不清楚 238 109 45.80 109 45.80 是 1940 1022 52.68 1222 62.99 担心接种疫苗后会发生
严重副反应担心 1782 891 50.00 17.553 < 0.001 997 55.95 21.539 < 0.001 不确定 150 66 44.00 92 61.33 不担心 516 306 59.30 347 67.25 担心每次的疫苗接种都
可能不安全担心 1131 541 47.83 21.415 < 0.001 596 52.70 44.501 < 0.001 不确定 363 174 47.93 202 55.65 不担心 954 548 57.44 638 66.88 担心接种的疫苗并不能
有效预防其对应的疾病担心 1085 532 49.03 15.016 0.001 591 54.47 17.118 < 0.001 不确定 471 225 47.77 277 58.81 不担心 892 506 56.73 568 63.68 父母自身流感疫苗接种意愿 否 1131 568 50.22 1.585 0.208 337 29.80 722.227 < 0.001 是 1317 695 52.77 1099 83.45 2020年度儿童流感接种史 否 1185 0 0 626 52.83 32.227 < 0.001 是 1263 1263 100 810 64.13 表 2 2020年度儿童流感疫苗接种率影响因素多因素logistic回归分析
因素 比较组 参照组 β $S_{\bar x}$ Wald χ2 值 P 值 OR 值 95 % CI 儿童年龄(岁) 4~6 1~3 2.075 0.197 110.527 < 0.001 7.966 5.41~11.729 7~11 – 0.899 0.187 23.109 < 0.001 0.407 0.282~0.587 12~17 – 2.248 0.239 88.161 < 0.001 0.106 0.066~0.169 父母类型 母亲 父亲 0.409 0.138 8.778 0.003 1.505 1.149~1.973 表 3 2021年度父母对儿童流感疫苗接种意愿影响因素多因素logistic回归分析
因素 比较组 参照组 β $S_{\bar x}$ Wald χ2 值 P 值 OR 值 95 % CI 儿童年龄(岁) 4~6 1~3 – 0.442 0.229 3.710 0.054 0.643 0.41~1.008 7~11 – 0.956 0.240 15.898 < 0.001 0.384 0.24~0.615 12~17 – 1.24 0.262 22.373 < 0.001 0.289 0.173~0.484 居住本辖区 是 否 – 0.354 0.143 6.166 0.013 0.702 0.531~0.928 父母中有参与新冠肺炎防控工作 是 否 0.371 0.149 6.184 0.013 1.449 1.082~1.940 亲友的新冠肺炎病史 是 否 – 0.890 0.388 5.264 0.022 0.411 0.192~0.878 按照国家推荐的免疫规划程序为孩子接种疫苗 不清楚 否 0.312 0.222 1.984 0.159 1.366 0.885~2.109 是 0.979 0.169 33.448 < 0.001 2.662 1.91~3.709 担心每次的疫苗接种都可能不安全 不担心 担心 0.085 0.173 0.241 0.624 1.089 0.775~1.530 不确定 0.467 0.152 9.413 0.002 1.595 1.184~2.150 父母自身流感疫苗接种意愿 有 否 2.510 0.107 550.887 < 0.001 12.301 9.976~15.170 -
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