云南地区HIV/AIDS人群新型冠状病毒疫苗接种情况及接种意愿的调查

The Investigation and Analysis of the Situation of COVID-19 Vaccination and Vaccination Willingness in HIV/AIDS Population in Yunnan Province

目的调查分析云南地区HIV/AIDS人群新型冠状病毒疫苗接种情况、接种意愿及影响该人群接种意愿的影响因素。方法2021年10月至2022年6月期间采用自制问卷形式对云南省昆明市、曲靖市、玉溪市、昭通市、普洱市、保山市、临沧市、红河州、文山州、西双版纳州、大理州、德宏州、怒江州13个州市医院随访的2180名HIV/AIDS患者进行现场调查。问卷考评通过,内容包括年龄、性别、学历、民族、文化程度、疫苗接种情况、接种后7 d内不良反应,对新冠疫苗安全、效用认知程度,接种意愿等方面的内容。结果调查对象中2109名完成了3针新冠疫苗接种,占比96.74%,有71名未接种,占比3.26%。接种7 d内局部出现不良反应116名,占比5.50%,全身出现不良反应56名,占比2.66%。不同性别、年龄段及汉族中注射点疼痛、疲劳和肌肉疼痛是占比最高的不良症状,少数民族不良反应占比很低,不同性别及年龄不良反应占比差异无统计学意义(P>0.05)。HIV/AIDS人群不愿意接种疫苗的主要原因是(医师建议)HIV/AIDS患者不能接种疫苗(67.61%)和接种后可能有严重不良反应(19.72%),应用Logistic回归分析影响疫苗接种的因素发现是否担心感染新冠病毒(OR=0.121,95%CI=0.083~0.640,P<0.001)、对新冠疫苗了解程度(OR=28.932,95%CI=15.469~54.115,P<0.001)、接种疫苗是否安全(OR=13.953,95%CI=4.819~40.404,P<0.001)及是否相信疫苗的预防作用(OR=14.017,95%CI=4.752~41.348,P<0.001)是影响疫苗接种的显著因素,13个州市中德宏州(20人)、昭通市(21人)、临沧市(14人)未接种人数最多。结论HIV/AIDS人群大规模接种疫苗后不良反应比率低,症状轻,医师正确、科学的建议和指导以及充分了解疾病的危害性,疫苗的安全性、预防性、有效性是该影响疫苗犹豫率的关键,医务人员应主动宣传新冠疫苗的接种注意事项、不良反应和有效性。

Objective To investigate the vaccination status and vaccination willingness of novel coronavirus in HIV/AIDS population in Yunnan.Methods From October 2021 to June 2022,a questionnaire survey was conducted among 2180 HIV/AIDS patients in Kunming,Qujing,Yuxi,Zhaotong,Puer,Baoshan,Lincang,Honghe,Wenshan,Xishuangbanna,Dali,Dehong and Nujiang prefectures.The questionnaire included age,sex,education,nationality,education level,vaccination,adverse reactions within 7 days after the vaccination,safety of COVID-19 vaccine,awareness of effectiveness,vaccination willingness and so on.Results Among the subjects,2109 completed 3 injections,accounting for 96.74%,and 71 were not vaccinated,accounting for 3.26%.Within 7 days of inoculation,local adverse reactions occurred in 116 cases,accounting for 5.50%,and systemic adverse reactions occurred in 56 cases,accounting for 2.66%.Injection site pain,fatigue and muscle pain accounted for the highest proportion of adverse symptoms in different sex,age and the Han nationality,while the proportion of minority adverse reactions was very low,and there was no difference among the different sex and age(P>0.05).The main reasons for the reluctance of HIV/AIDS population to be vaccinated were(recommended by doctors)that HIV/AIDS patients could not be vaccinated(67.61%)and may have serious adverse reactions after the vaccination(19.72%).The factors affecting the vaccination were found by logistic regression analysis,whether they were worried about infecting novel coronavirus(OR=0.121,95%CI=0.083~0.640,P<0.001)and how much they knew about COVID-19 vaccine(OR=28.932,95%CI=15.469~54.115,P<0.001),safety of vaccination(OR=13.953,95%CI=4.819~40.404,P<0.001)and belief in the preventive effect of vaccine(OR=14.017,95%CI=4.752~41.348,P<0.001)were significant factors affecting vaccination.Among the 13 prefectures and cities,Dehong(20),Zhaotong(21)and Lincang(14)had the largest number of unvaccinated people.Conclusion After the mass vaccination,the rate of adverse reaction in HIV/AIDS population is low,the symptoms are mild,the correct and scientific advice and guidance from doctors and the full understanding of the harmfulness of the disease,the safety,prevention and effectiveness of the vaccine are the key to complete vaccination and put an end to vaccine hesitancy.