Association between risk perception and influenza vaccine hesitancy for children among reproductive women in China during the COVID-19 pandemic: a national online survey

Background In China, the national prevalence of parental influenza vaccine hesitancy (IVH) during the pandemic of coronavirus disease 2019 (COVID-19), and the association between risk perception and parental IVH are still unclear.

We aimed to explore the association between risk perception and IVH for children among reproductive women in China, a poorly studied area.

Methods From December 14, 2020, to January 31, 2021, we conducted a national anonymous online survey on IVH for children among reproductive women in China.

We assessed risk perception including perceived susceptibility, severity, barriers, and benefits using the Health Belief Model and then classified each variable into three groups based on tertiles.

Logistic regression models were used to calculate the adjusted odds ratio (aOR) of risk perception related to vaccine hesitancy after controlling for sociodemographic characteristics, health status, and knowledge of influenza, among other factors.

Additionally, subgroup analysis was performed.

Results Among 3,011 reproductive women, 9.13% reported IVH.

In multivariable models, vaccine hesitancy was associated with low perceived susceptibility (aOR = 2.55, 95% CI: 1.79–3.65), higher perceived barriers (moderate: aOR = 1.47, 95% CI: 1.04–2.08; high: aOR = 2.20, 95% CI: 1.47–3.30), and low perceived benefit (moderate: aOR = 1.40, 95% CI: 1.03–1.92; low: aOR = 2.10, 95% CI: 1.43–3.07).

Subgroup analysis showed that vaccine hesitancy was more likely to occur among women with high perceived barriers aged < 30 years compared with those older than 30 years (P for difference = 0.041) and among women with moderate perceived benefit who had never conceived compared with those had a history of pregnancy (P for difference = 0.048).

Conclusions Nearly one in 10 reproductive women was hesitant about influenza vaccination for their children during the COVID-19 pandemic.

To mitigate vaccine hesitancy, our findings highlight a need for tailored public health measures to increase perceived disease susceptibility and vaccine benefit and decrease perceived barriers.

Furthermore, the effect of high perceived barriers and moderate perceived benefit on vaccine hesitancy was higher among younger women and women who had never conceived.