Abstract / Summary
Background: As SARS-CoV-2 continues to evolve and vaccine-induced protection wanes over time, future annual or periodic COVID-19 vaccination may become important for long-term disease control. China's adjustment of national COVID-19 response policies provided an opportunity to assess vaccination attitudes after extensive prior vaccination and widespread SARS-CoV-2 exposure. Evidence remains limited on physicians' and medical trainees' willingness to receive future COVID-19 vaccination and to support COVID-19 vaccination for older adults and young children.
Objective: This study aimed to evaluate willingness to receive future annual COVID-19 vaccination among physicians and medical trainees in China, identify factors associated with hesitancy toward future vaccination, and assess willingness to support COVID-19 vaccination for older adults and young children.
Methods: A nationwide, multicenter cross-sectional survey was conducted from February to April 2023, shortly after China adjusted its national COVID-19 response policies. Physicians and medical trainees were recruited from 21 public hospitals across 7 regions of China using prespecified recruitment targets for each hospital and career-stage group. Participants completed a confidential, self-administered electronic questionnaire. Modified Poisson regression models with robust SEs were used to estimate adjusted prevalence ratios (aPRs) and 95% CIs.
Results: The analysis included 3169 participants comprising 2877 physicians (90.8%) and 292 medical trainees (9.2%). Overall, 1899 participants (59.9%) were willing to receive future annual COVID-19 vaccination, although 3074 (97%) had previously received at least 1 dose of a COVID-19 vaccine. Among previously vaccinated participants, 2862 (93.1%) had received an inactivated vaccine. Overall, 2857 participants (90.2%) were willing to support COVID-19 vaccination for older adults, and 2320 (73.2%) were willing to support vaccination for young children. Lack of willingness to receive influenza vaccination was strongly associated with hesitancy toward future annual COVID-19 vaccination (aPR 4.11; 95% CI 3.71-4.55), as was no prior COVID-19 vaccination (aPR 1.27; 95% CI 1.11-1.46). Participants with hesitancy toward future annual COVID-19 vaccination were more likely to report hesitancy to support vaccination for older adults (aPR 5.13; 95% CI 3.95-6.66) and young children (aPR 2.88; 95% CI 2.54-3.27). Among participants hesitant about future annual vaccination, the most commonly reported concerns were vaccine effectiveness (674/1270, 53.1%), vaccine safety (424/1270, 33.4%), and insufficient disclosure of clinical trial data (368/1270, 29%).