上海市闵行区成人9种疫苗接种率及疫苗犹豫影响因素分析

Uptake of nine vaccines and influencing factors of vaccine hesitancy among adults in Minhang district,Shanghai

目的了解上海市闵行区成人9种疫苗的接种情况、犹豫程度及影响因素,为人群干预提供参考依据。方法采用横断面调查方法,通过方便抽样的方式收集2021年1月10日—3月9日上海市闵行区成人接种乙肝疫苗、水痘减毒活疫苗、流感疫苗、肺炎球菌多糖疫苗、人乳头瘤病毒疫苗、麻风/麻腮风疫苗、甲肝疫苗、戊肝疫苗、狂犬病疫苗情况的问卷。调查内容包括人口学特征、疫苗犹豫以及“3Cs”模型的3个维度[分别是信任(confidence)、自满(complacency)和便利(convenience)]。运用R软件,进行χ^(2)检验分析人口学特征和其对疫苗犹豫的影响。通过多因素logistic回归分析“3Cs”模型各维度与疫苗犹豫之间的关系。结果本研究共完成6433份有效调查问卷,调查对象的平均年龄为(36.84±9.18)岁,男女比例为1∶0.93,9种疫苗接种率分别为乙肝疫苗52.63%(3386/6433)、水痘减毒活疫苗50.57%(3253/6433)、流感疫苗24.93%(1604/6433)、肺炎球菌多糖疫苗18.16%(1168/6433)、人乳头瘤病毒疫苗8.74%(562/6433)、麻风/麻腮风疫苗22.35%(1438/6433)、甲肝疫苗21.16%(1361/6433)、戊肝疫苗8.81%(567/6433)、狂犬病疫苗17.01%(1094/6433);不同性别(χ^(2)=55.77,P<0.01)、年龄(χ^(2)=68.27,P<0.01)、职业(χ^(2)=191.32,P<0.01)、学历(χ^(2)=20.58,P<0.01)的调查对象疫苗犹豫差异有统计学意义;性别(女性:OR=1.63,95%CI:1.43~1.85)、年龄(40~<50岁:OR=1.46,95%CI:1.22~1.74;50~<60岁:OR=1.58,95%CI:1.26~1.98)、职业类型(教育工作者:OR=2.20,95%CI:1.75~2.76;服务业人员OR=2.22,95%CI:1.62~3.04;党政机关、事业单位人员:OR=1.62,95%CI:1.27~2.07;劳动密集型行业人员:OR=2.10,95%CI:1.57~2.82;其他人员:OR=2.16,95%CI:1.51~3.11)以及“3Cs”模型中的信任(OR=0.50,95%CI:0.44~0.59)和自满(OR=2.23,95%CI:1.62~3.04)对疫苗犹豫的影响差异有统计学意义。结论上海市闵行区成人疫苗犹豫程度与“3Cs”模型的信任和自满维度有明显关联,可采取措施提升成年人对疫苗的信任,减少自满情绪,提高成人疫苗的接种率。上海市闵行区成人疫苗接种率较高,表明此部分人群对传染病的防患有较高的认识,值得鼓励和宣传。

Objective To understand the uptake of nine vaccines,the level of vaccine hesitancy and its influencing factors among adults in Minhang district,Shanghai,so as to provide reference for population intervention.Methods A cross-sectional survey was conducted to recruit adults from January 10 to March 9,2021 in Minhang district,Shanghai,using convenience sampling method.The participants were interviewed with a question⁃naire to collect information regarding uptake of hepatitis B vaccine,live attenuated varicella vaccine,influenza vaccine,pneumococcal polysaccharide vaccine,human papilloma virus vaccine,leprosy/mumps vaccine,hepati⁃tis A vaccine,hepatitis E vaccine,and rabies vaccine.The survey also collected information on demographic characteristics,vaccine hesitancy,and confidence,complacency,and convenience of the“3Cs”model.The distributions of demographic characteristics and their effect on vaccine hesitancy were analyzed byχ^(2)test using R software.The relationship between the dimensions of the“3Cs”model and vaccine hesitancy was analyzed with multivariable logistic regression.Results In this study,6433 valid questionnaires were completed,and the average age of the respondents was(36.84±9.18)years,with a male to female ratio of 1∶0.93.The uptake proportions of the nine vaccines were 52.63%(3386/6433)for hepatitis B vaccine,50.57%(3253/6433)for live attenuated varicella vaccine,24.93%(1604/6433)for influenza vaccine,18.16%(1168/6433)for pneu⁃mococcal polysaccharide vaccine,8.74%(562/6433)for human papillomavirus vaccine,22.35%(1438/6433)for leprosy/mumps vaccine,21.16%(1361/6433)for hepatitis A vaccine,8.81%(567/6433)for hepatitis E vaccine,and 17.01%(1094/6433)for rabies vaccine.The vaccine uptake varied statistically significantly by sex(χ^(2)=55.77,P<0.01),age(χ^(2)=68.27,P<0.01),occupation(χ^(2)=191.32,P<0.01),and education(χ^(2)=20.58,P<0.01).Sex(OR_(female)=1.63,95%CI:1.43-1.85),age(OR40-<50=1.46,95%CI:1.22-1.74;OR_(50-<60)=1.58,95%CI:1.26-1.98),type of occupation(OR_(education sector)=2.20,95%CI:1.75-2.76;OR_(service industry)=2.22,95%CI:1.62-3.04;OR_(civial servants)=1.62,95%CI:1.27-2.07;OR_(labor-intensive industry)=2.10,95%CI:1.57-2.82;OR_(other sectors)=2.16,95%CI:1.51-3.11),and confidence(OR=0.50,95%CI:0.44-0.59)and complacency(OR=2.23,95%CI:1.62-3.04)in the“3Cs”model had statistically significant impact on vaccine hesitancy.Conclusions The degree of vaccine hesitancy in adults in Minhang district,Shanghai city,is significantly associated with the confidence and complacency dimensions of the“3Cs”model.Measures can be taken to improve adult vaccination rates by boosting confidence in vaccines and reducing complacency in this population.The high vaccination rate among adults at high risk of infectious diseases in Minhang district,Shanghai,indicates that this popula⁃tion has a high awareness of infectious disease prevention,which is worth encouraging and promoting.