An exploration on COVID-19 vaccination motivation patterns from the perspective of the Chaxu culture in metropolis of China: A multi-center study.

Objectives: Chaxugeju is a very special Chinese culture following a self-centered and outward expanding social network, which might be a significant culture factor for vaccination behavior. This study aimed to identify the motivation pattern in China, and paid special focus on socio-economic status (SES), region, and migration. Methods: We used a latent class analysis, with a sample of 12,432 participants collected in China from April to June, to identify the COVID-19 vaccination motivation patterns. Multinomial logistic regression models were utilized to separately explore associations between SES, migration, region, and COVID-19 vaccination motivation patterns. Results: Three COVID-19 vaccination motivation patterns were identified: Self-protection (41.9%), Trust and Self-protection (38.5%), and Trust and Differential Protection (19.6%). Participants with higher income were more likely to be Trust and Self-protection, and when income is more than 50,000 CNY per month, they are more likely to be self-protection. Professional/white collar were more likely to be Self-protection. Participants from Shenzhen were more likely to be Trust and Differential protection. The moderating effects of gender were found for income and region. Gender does not moderate the associations of occupation or migration and COVID-19 vaccination motivation patterns. Conclusion: Three motivational patterns were identified in which the Trust & Differential Pattern followed the traditional self-family-community Chaxu circle. However, the Chaxu motivation pattern was not the dominant one which might be weakened by SES. Migration and Shenzhen preserved the traditional social network, keeping in the trust and differential pattern. All of these factors in various cultural contexts should be considered when promoting vaccines.

Accelerate the process of getting vaccinated: factors associated with consideration of and accessibility to COVID-19 vaccination in metropolises of China.

BACKGROUND: Rapid mutation of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus is sweeping the world and delaying the full reopening of society. Acceleration of the vaccination process may be the key element in winning the race against this virus. We examine factors associated with personal considerations of and accessibility to the corona virus disease 2019 (COVID-19) vaccination in metropolises of China. METHODS: This multi-center, cross-sectional research was conducted using online questionnaires from April 1 to June 1, 2021, in community health service centers of Shanghai, Chengdu and Fuzhou. 9,047 vaccinated participants were included and data for 8,990 individuals were eligible for analysis. Chi-square test was conducted to find potential predictors, which were included in the logistic regressions. The odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the influence of region, socio-economic status (SES), and attitudes on vaccination process. RESULTS: In consideration phase, participants in Fuzhou (OR:2.26, 95%CI: 1.90 to 2.68) and Chengdu (OR: 2.48, 95%CI: 2.17 to 2.83) were more likely than those in Shanghai to consider longer than one month. These odds increased for participants with master or above degree (reference: illiteracy and primary school), higher monthly household income (reference: < ¥5000), and greater vaccination hesitancy (reference: low hesitancy). Unemployed and household-based participants (OR: 3.37, 95%CI: 1.69 to 6.75, reference: farmer) and participants without brand preference (OR:1.13, 95%CI:1.02 to 1.26) may take longer time of consideration. In the accessibility phase, participants in Fuzhou (OR: 8.82, 95%CI: 7.28 to 10.68) and Chengdu (OR: 2.28, 95%CI: 1.98 to 2.63) were more likely to wait longer than one week. These odds decreased for participants with master or above degree (reference: illiteracy and primary school), monthly household income from ¥5000 to ¥10,000 (reference: < ¥5000), and teacher or student (reference: farmer). Participants without brand preference (OR: 0.86, 95%CI: 0.77 to 0.95) were likely to wait shorter after appointment, while participants with higher risk awareness of domestic epidemic (medium, OR: 1.24, 95%CI: 1.12 to 1.37, reference: low) may wait longer. CONCLUSIONS: The influential factors changed over two phases of vaccination process. Regional disparity affected both consideration and accessibility phases. Expect that, SES, and hesitancy were major factors of the consideration phase, but had limited impact on accessibility phase.