Vaccine hesitancy among parents and its influencing factors: a cross-sectional study in Guangzhou, China

Figures & data

Figure 1. Cascade chart of sampling method for cross-sectional survey.

Table 1. Socio-demographic characteristics of participants (N = 755).

Socio-demographic characteristics	N (%)
Sex
Male	193(25.6)
Female	562(74.4)
Age group (years)
<25	43(5.7)
25–34	497(66.4)
≥35	209(27.9)
Registered residence
Local people	432(57.6)
Nonlocal people	318(42.4)
Religion
No	587(84.5)
Yes	108(15.5)
Educational background
High school/technical secondary school and below	249(33.0)
Bachelor degree/college degree	412(54.6)
Master degree and above	93(12.3)
Employment status
Employed	590(78.7)
Unemployed	160(21.3)
Monthly per capita disposable income of the household (Chinese Yuan)
≤3000	48(6.5)
3001–5000	155(20.8)
5001–7000	161(21.6)
7001–10000	165(22.2)
>10000	215(28.9)

Table 2. Individual PACV statements and 755 participants’ responses.

No	Item	Not hesitant, N(%)	Unsure, N(%)	Hesitant, N(%)
1	Have you ever delayed having your child get a shot (free vaccines from the National Immunization Program) for reasons other than illness or allergy?	595 (79.5)	-	153 (20.5%)
2	Have you ever decided not to have your child get a shot (free vaccines from the National Immunization Program) for reasons other than illness or allergy?	727 (97.3)	-	20 (2.7)
3	How sure are you that following the recommended shot schedule is a good idea for your child?	669 (88.8)	24 (3.2)	60 (8.0)
4	Children get more shots than are good for them.	174 (23.2)	292 (39.0)	283 (37.8)
5	I believe that many of the illnesses that shots prevent are severe.	291 (38.7)	158 (21.0)	302 (40.2)
6	It is better for my child to develop immunity by getting sick than to get a shot.	407 (54.1)	181 (24.0)	165 (21.9)
7	It is better for children to get fewer vaccines at the same time.	404 (53.9)	242 (32.3)	104 (13.9)
8	How concerned are you that your child might have a serious side effect from a shot?	211 (27.9)	44 (5.8)	500 (66.2)
9	How concerned are you that a ny one of the childhood shots might not be safe?	274 (36.4)	67 (8.9)	411 (54.7)
10	How concerned are you that a shot might not prevent the disease?	250 (33.4)	139 (18.6)	360 (48.1)
11	If you had another infant today, would you want him/her to get all the recommended shots?	688 (91.2)	21 (2.8)	45 (6.0)
12	Overall, how hesitant about childhood shots would you consider yourself to be?	605 (80.1)	47 (6.2)	103 (13.6)
13	I trust the information I receive about shots.	653 (86.5)	98 (13.0)	4 (0.5)
14	I am able to openly discuss my concerns about shots with my child’s doctor.	660 (88.6)	73 (9.8)	12 (1.6)
15	All things considered, how much do you trust your child’s doctor?	622 (83.3)	12 (1.6)	113 (15.1)

Table 3. Univariate and multivariate analysis of parents’ attitudes toward child vaccines in Guangzhou.

Variable	N	Hesitancy (%)	Univariate analysis		Multivariate analysis
			X^2	P value	aOR (95% CI)	P value
Sex			2.003	.179
Male	193	17 (8.8)
Female	562	33 (5.9)
Age group (years)			1.531	.465
<25	43	2 (4.7)
25–34	497	29 (5.8)
≥35	209	17 (8.1)
Number of children			0.229	.640
1	319	18 (5.6)
≥2	384	25 (6.5)
Educational background			1.975	.388
High school/technical secondary school and below	249	21 (8.4)
Bachelor degree/college degree	412	24 (5.8)
Master degree and above	93	5 (5.4)
Employment status			0.014	.905
Employed	590	39 (6.6)
Unemployed	160	11 (6.9)
Monthly per capita disposable income of the household (Chinese Yuan)			1.538	.825
≤3000	48	4 (8.3)
3001–5000	155	11 (7.1)
5001–7000	161	8 (5.0)
7001–10000	165	13 (7.9)
>10000	215	13 (6.0)
Registered residence			0.929	.371
Local people	432	25 (5.8)
Nonlocal people	318	24 (7.5)
Religion			1.015	.382
No	587	34 (5.8)
Yes	108	9 (8.3)
Reason for vaccination			17.568	<.001*
Vaccination certificate system	113	17 (15.0)			3.6 (1.7–7.7)	.001*
Not the vaccination certificate system	622	29 (4.7)			1 ^b
Trust in domestic vaccines			-	.006^a*
Very trusting	126	2 (2.4)			1 ^b
Mostly trusting	416	22 (5.3)			2.4 (0.7–8.5)	.176
Not very trusting	145	16 (11)			6.6 (1.8–24.1)	.004*
Very distrustful	11	3 (18.2)			10.9 (1.5–81.4)	.020*
Classification of domestic vaccines			8.909	.003*
Know	426	18 (4.2)			1 ^b
Don’t know	296	29 (9.8)			2.1 (1.1–4.3)	.034*

Bold values indicate significant difference (*P < .05).

^aFisher’s exact probability method.

^bReference category.

(aOR: Adjusted odds ratio,CI: confidence interval, OR: odds ratio).

Table 4. Awareness of vaccine-related knowledge among parents in Guangzhou.

No	Item	Number of answers	Number of knowers	Awareness rate (%)
1	Children with fever or diarrhea cannot be vaccinated.	729	640	87.8
2	Children should stay at the vaccination site for 30 minutes after vaccination.	728	656	90.1
3	Redness and pain at the injection site after vaccination are generally mild reactions.	755	586	77.6
4	Low fever within 24 hours after vaccination is a generally mild reaction.	755	506	67.0
5	Lymph node swelling and pain within 24 hours after vaccination is a generally mild reaction.	755	58	7.7
6	BCG vaccine belongs to required vaccine.	755	490	64.9
7	Hepatitis B vaccine belongs to required vaccine.	755	488	64.6
8	Japanese encephalitis vaccine belongs to required vaccine.	755	321	42.5
9	Poliomyelitis vaccine belongs to required vaccine.	755	405	53.6
10	Tuberculosis can be prevented by required vaccines.	755	254	33.6
11	Hepatitis B can be prevented by required vaccines.	755	488	64.6
12	Poliomyelitis can be prevented by required vaccines.	755	416	55.1
13	Diphtheria can be prevented by required vaccines.	755	267	35.4
14	Measles can be prevented by required vaccines.	755	331	43.8
15	Hepatitis A can be prevented by required vaccines.	755	193	25.6
16	Meningococcal meningitis can be prevented by required vaccines.	755	380	50.3