Application of Multidisciplinary Diagnosis and Treatment (MDT) Clinical Teaching Model in the Clinical Teaching of Some Undergraduates of Breast Diseases in Surgery (preprint)

Background Breast surgery, emerging as an independent discipline with a wealth of specialist cases and an extensive case resource library in medical history. Contemporary clinical teaching faces challenges with traditional methods unable to address students' theoretical strength and practical limitations. The COVID-19 pandemic further strained learning environments, limiting students' exposure to patient diagnosis and treatment. Conventional clinical teaching, organized by disciplines, often results in technical isolation and a narrow clinical perspective, impeding the development of well-rounded medical professionals. Multidisciplinary Comprehensive Diagnosis and Treatment (MDT) emerges as a patient-centric, collaborative approach involving various medical departments in clinical decision-making. Despite its success in clinical settings, the effectiveness of MDT in undergraduate medical education remains largely unexplored.Methods This study conducted at the Breast Department of the First Affiliated Hospital of Zhengzhou University, aimed to compare the learning outcomes of clinical interns under traditional and MDT teaching modes. In a randomized controlled trial with 140 participants, the MDT group received comprehensive training from diverse healthcare professionals, while the traditional group had standard teaching. Evaluation included pre-test and post-test assessments on knowledge acquisition, skill acquisition, and clinical decision-making. Longitudinal analysis and statistical tests, including t-tests and multiple regression, were employed.Results A total of 140 clinical medicine students participated, randomly assigned to MDT (n = 70) and Traditional Teaching Mode (n = 70) groups. Key baseline characteristics, such as age, gender, and completion rates, were comparable between groups. For each group’s pre- and post-test scores, MDT group means consistently surpassed Traditional Teaching Mode, with significant differences (p < 0.05).Correlation analysis showed that there were no significant variable correlations between individual performance characteristics and test scores. Post-training, significant score improvements were observed in both groups across all tests (p < 2.2e-16). Utilizing the Wilcoxon rank sum test, pre-test differences were not significant. However, post-test scores favored the MDT group significantly (p = 0.0016, 2.8e-09, 3.6e-07). For students pursuing a master's, no statistically significant differences in specialty choice were observed between groups, though a trend towards more MDT students choosing surgical specialties was noted.Conclusion This study pioneers the application of the MDT teaching method in breast cancer clinical education, comparing its efficacy against traditional teaching modes. Findings demonstrate that MDT-based breast cancer diagnosis and treatment education is more efficient and optimized, offering a transformative basis for clinical undergraduate education reform in China. The results advocate for the reconfiguration of multidisciplinary consultation clinical teaching and traditional methods, promising enhanced educational outcomes and heightened medical student knowledge.

Exploring the Factors Influencing the Impact of the COVID-19 Pandemic on Global Shipping: A Case Study of the Baltic Dry Index (preprint)

The outbreak of COVID-19 in 2020 caused significant disruptions to global shipping and the world economy. This paper aims to investigate the impact of the pandemic on global shipping by analyzing the Baltic Dry Index (BDI). The BDI is a metric that reflects the worldwide shipping costs and directs related to supply and demand conditions, making it an indicator of economic production. The study utilizes data from 2019 to 2021, before and after the outbreak of COVID-19, and considers 13 independent variables, including raw materials, energy, stock market indexes, global port calls, and confirmed COVID-19 cases to investigate how to influent the BDI. The study employs stepwise regression to select variables and build models before and after the pandemic. The findings reveal that the key factors affecting the freight index BDI before the outbreak are: international scrap steel prices, iron ore prices, and the Commodity Research Bureau Index. However, after the COVID-19 outbreak, the factors affecting the BDI changed to the Shanghai Index, global port calls, and the number of confirmed COVID-19 cases.

Globalization and the Future of Medical Writing

Medical writers play a key role in global regulatory submissions across the pharmaceutical industry. Before the COVID pandemic, many companies were working toward development of global regulatory submissions, with their medical writers playing a key role in this process. During the pandemic, the need for greater collaboration in fully remote working conditions, inclusion and transparency, and the unprecedented demand for speed and quality of clinical development has brought global ways of working into even greater focus. A panel of medical writers, including department and regional heads and subject matter experts, were invited to consider how other influences on our industry may drive the evolution of medical writing yet further as a global profession in the coming years. This article summarizes the panel's responses to 5 questions on the future direction of the profession.

Effectiveness of inactivated and Ad5-nCoV COVID-19 vaccines against SARS-CoV-2 Omicron BA. 2 variant infection, severe illness, and death (preprint)

ABSTRACT Background Limited data are available on effectiveness of inactivated and Ad5-nCoV COVID-19 vaccines in real-world use - especially against Omicron variants in SARS-CoV-2 infection-naïve population. During an outbreak in Shanghai’s SARS-CoV-2 infection-naïve population, we evaluated vaccine effectiveness (VE) against Omicron infection, severe or critical COVID-19, and COVID-19-related death. Methods A matched case-control study was conducted among people aged ≥3 years between 2 December 2021 through 13 May 2022. Cases were SARS-CoV-2 infected individuals, individuals with severe/critical COVID-19, or COVID-19-related deaths. Controls were selected from consecutively test negative individuals at the same time as cases were diagnosed and were exact-matched on year-of-age, gender, birthplace, illness onset date, and residency district in ratios of 1:1 with infected individuals and 4:1 with severe/critical COVID-19 and COVID-19-related deaths. Results Our study included 612597 documented SARS-CoV-2 infections, among which 1485 progressed to severe or critical illness and 568 died. Inactivated vaccine was 16.3% (95% CI: 15.4%-17.2%) effective against infection, 88.6% (95% CI: 85.8%-90.9%) effective against severe/critical COVIID-19 and 91.7% (95% CI: 86.9%-94.7%) against COVID-19 death. Ad5-vectored vaccine was 13.2% (95% CI: 10.9%-15.5%) effective against infection and 77.9% (95% CI: 15.6%-94.2%) effective against severe/critical COVIID-19. Booster vaccination with inactivated vaccines enhanced protection against severe COVID-19 (92.7%, 95% CI: 90.1%-94.6%) and COVID-19 death (95.9%, 95% CI: 91.4%-98.1%). Inactivated VE against infection began to wane 12 weeks after the last dose but two- and three-dose sustained high protection levels (>80%) against severe/critical illness and death. Conclusions Our real-world study found high and durable two- and three-dose inactivated VE against Omicron-associated severe/critical illness and death across all age groups, but lower effectiveness against Omicron infection. High direct protection from severe/fatal Omicron COVID-19 provided by inactivated vaccines, and a consequent potential reduction in health-care utilization, reinforces the critical importance of full-series vaccination and timely booster dose administration for all eligible individuals.

Analysis of mortality surveillance of residents in Minhang district of Shanghai from January to April in 2016-2020

Objective: To characterize the mortality rate of residents in Minhang District of Shanghai from January to April in 2016-2020, and to determine the change in the epidemic Coronavirus Disease 2019 (COVID-19) in 2020.

Evaluating Interventions in Response to COVID-19 Outbreak by Multiple-Criteria Decision-Making Models

The COVID-19 outbreak has currently led to serious social and economic consequences. In poor and developing countries, there are more challenges and barriers to tackling the pandemic. The study’s aim is to propose a hybrid approach to multiple-criteria decision-making (MCDM) models for determining the most efficient intervention strategies. The methodology is a combination between the Best-Worst Model (BWM) and Group Best-Worst Model (GBWM) to estimate the efficiency score of intervention. Based on the background of knowledge, five groups of stakeholders including Academicians, Entrepreneurs, Commons Residents, Social Workers, Health Workers are considered decision-makers (DMs). A set of nine potential strategies was evaluated and prioritized by all DMs. The findings have shown that different groups of stakeholders prioritized differently the importance of criteria due to their interests. In the context of Vietnam, however, the Availability of Health Systems is prioritized as the most important intervention. The results and proposed model of this paper contributed to MCDM literature as well as a good reference to apply practically in many different countries.

Selection of Cold Chain Logistics Service Providers Based on a Grey AHP and Grey COPRAS Framework: A Case Study in Vietnam

Choosing the most suitable cold chain logistics service providers (CLPs) is a vital strategic decision for businesses aiming to achieve an effective and sustainable cold supply chain. A sustainable CLP is one that integrates sustainable practices across its whole operation cycle to achieve product quality, on-time deliveries, and satisfied customer requirements, while preventing products from going to waste, which is especially important in the context of a developing country. This study aims to evaluate and select the best CLP regarding their sustainability performance. For this evaluation, a multi-criteria decision making (MCDM)-based framework is proposed that integrates the grey analytic hierarchy process (G-AHP) and grey complex proportional assessment (G-COPRAS) methodologies, in which grey numbers are used to express the linguistic evaluation statements of experts. Initially, the evaluation criteria based on service level, economic, environmental, and social dimensions were determined by means of a literature review and experts’ opinions to employ the MCDM approach. The G-AHP was utilized to identify the criteria weights, and then, G-COPRAS was used to select the best CLP among the alternatives. A case illustration in Vietnam is presented to exhibit the presented approach’s applicability. From the G-AHP findings, product quality, logistics costs, innovation, and effectiveness of cold chain processes, customer experience, and CO emissions of refrigerated vehicle were ranked as the five most important criteria. From the G-COPRAS analysis, Yoshida Saigon Cold Logistic (CPL-05) is the best CLP. The robustness of the applied integrated MCDM approach was also tested by conducting a comparative analysis, in which the priority rankings of the best CLPs were very similar. The assessment in this study is directed towards enabling managers, practitioners, and stakeholders of cold chain businesses to assess the most efficient CLP in the supply chain in the market and also to devise suitable strategies toward sustainable development.

Multi-Layer Fuzzy Sustainable Decision Approach for Outsourcing Manufacturer Selection in Apparel and Textile Supply Chain

The apparel and textile industry are known as a key sector in the structure of many economies around the world. In particular, the influence of foreign outsourcing manufacturers on textile supply chains has been recognized for decades. The outsourcing manufacturers are multi-criteria selected and changed by supply chain managers from time to time in search of the most efficient state for the entire supply chain. This is a known concern with the community and there is large interest in studying the apparel and textile outsourcing manufacturer problems. Aiming at reinforcing the selection methods, this study develops a three-layer fuzzy multiple criteria decision-making approach that leverages the strengths from the original methods. In turn through the layers, the hierarchy and weights of criteria and sub-criteria, which includes sustainability factors, are determined by the fuzzy analytic hierarchy process (FAHP) method. Next, the results from the fuzzy technique for order of preference by similarity to ideal solution (FTOPSIS) process determine the outsourcing manufacturer’s performance via expert linguistics judgments. Then, data envelopment analysis (DEA) models are applied for the purpose of evaluating the outsourcing manufacturer’s overall performance along with other quantitative effectiveness. This approach is applied to the problem of selecting the apparel and textile outsourcing manufacturers in Vietnam, one of the places that makes the necessity of this problem grow. The third position in the world apparel and textile export ranking, as well as the trend of shifting labor-intensive production systems to Southeast Asia make the necessity of Vietnam outsourcing manufacturer selection problem grow. The results of this study also classified manufacturers into groups as a support for selection decisions. Analysis of quantitative uncertainties using simulation tools and forecasting techniques can strengthen the solutions in future related studies.

Effective Decision Making: Data Envelopment Analysis for Efficiency Evaluation in the Cloud Computing Marketplaces

Assessing business performance is a critical issue for practicing managers, and business performance has always been of interest to managers and researchers. In recent years, the world has experienced a rapid growth in the cloud computing service sector thanks to its benefits to business organizations and economic development. Therefore, the performance efficiency of this sector has been concerned as one of the keys in today’s economic environment. This study aimed to assess the performance efficiency of cloud computing service providers in the United States of America, one of the biggest global markets in terms of cloud computing, by applying the data envelopment analysis models. The efficiency of cloud computing providers was evaluated based on the assumption of the non-cooperative game among cloud computing providers in which providers selfishly choose the best strategy to maximize their payoff with three stages. In the first stage, the performance of these providers over the past period was measured by a super slack-based measure. In the second stage, the performance in the future period was predicted by the new data envelopment analysis model: the past–present–future model based on resampling. In the last stage, the efficiency improvement was investigated by adopting the Malmquist productivity index. The findings of this study indicated that the percentage of inefficient providers would increase from 10% in the period from 2017 to 2020 to 20% for 2021 and 2024. Moreover, 30% of providers showed a regress in performance efficiency over the research period of 2017 to 2024. The results of this study provide an insight picture to the decision-makers, and this research will fill the gap in the literature as the first study that measures and predicts the performance efficiency of cloud computing service providers, which will provide a helpful reference for future studies.

Structural and functional characterizations of altered infectivity and immune evasion of SARS-CoV-2 Omicron variant (preprint)

The SARS-CoV-2 Omicron with increased fitness is spreading rapidly worldwide. Analysis of cryo-EM structures of the Spike (S) from Omicron reveals amino acid substitutions forging new interactions that stably maintain an active conformation for receptor recognition. The relatively more compact domain organization confers improved stability and enhances attachment but compromises the efficiency of viral fusion step. Alterations in local conformation, charge and hydrophobic microenvironments underpin the modulation of the epitopes such that they are not recognized by most NTD- and RBD-antibodies, facilitating viral immune escape. Apart from already existing mutations, we have identified three new immune escape sites: 1) Q493R, 2) G446S and 3) S371L/S373P/S375F that confers greater resistance to five of the six classes of RBD-antibodies. Structure of the Omicron S bound with human ACE2, together with analysis of sequence conservation in ACE2 binding region of 25 sarbecovirus members as well as heatmaps of the immunogenic sites and their corresponding mutational frequencies sheds light on conserved and structurally restrained regions that can be used for the development of broad-spectrum vaccines and therapeutics.

A subset of Memory B-derived antibody repertoire from 3-dose vaccinees is ultrapotent against diverse and highly transmissible SARS-CoV-2 variants, including Omicron (preprint)

Omicron, the most heavily mutated SARS-CoV-2 variant so far, is highly resistant to neutralizing antibodies, raising unprecedented concerns about the effectiveness of antibody therapies and vaccines. We examined whether sera from individuals who received two or three doses of inactivated vaccine, could neutralize authentic Omicron. The seroconversion rates of neutralizing antibodies were 3.3% (2/60) and 95% (57/60) for 2- and 3-dose vaccinees, respectively. For three-dose recipients, the geometric mean neutralization antibody titer (GMT) of Omicron was 15, 16.5-fold lower than that of the ancestral virus (254). We isolated 323 human monoclonal antibodies derived from memory B cells in 3-dose vaccinees, half of which recognize the receptor binding domain (RBD) and show that a subset of them (24/163) neutralize all SARS-CoV-2 variants of concern (VOCs), including Omicron, potently. Therapeutic treatments with representative broadly neutralizing mAbs individually or antibody cocktails were highly protective against SARS-CoV-2 Beta infection in mice. Atomic structures of the Omicron S in complex with three types of all five VOC-reactive antibodies defined the binding and neutralizing determinants and revealed a key antibody escape site, G446S, that confers greater resistance to one major class of antibodies bound at the right shoulder of RBD through altering local conformation at the binding interface. Our results rationalize the use of 3-dose immunization regimens and suggest that the fundamental epitopes revealed by these broadly ultrapotent antibodies are a rational target for a universal sarbecovirus vaccine. One sentence summary A sub-set of antibodies derived from memory B cells of volunteers vaccinated with 3 doses of an inactivated SARS-CoV-2 vaccine work individually as well as synergistically to keep variants, including Omicron, at bay.

Determining the Optimal Offshore Wind Power Station Using a Two-Stage MCDM-Based Spherical Fuzzy Set Approach (preprint)

In response to challenges from the COVID-19 pandemic and climate change to achieve the goal of ensuring sustainable economic growth, offshore wind power development not only provides a clean and sustainable source of energy but also provides opportunities for economic growth and job creation. Offshore wind energy projects have been promptly suggested in Vietnam as a result of policy advancement, with the country's excellent wind resources. The success of an offshore wind energy project is decided mainly by choosing the best location for offshore wind power station (OWPS) construction, which is a complex multicriteria decision-making (MCDM) problem with the coexistence of conflicting factors. There is a problem with incomplete decision information use and information loss during the decision-making process, and it is easy to overlook the interaction difficulty in a fuzzy environment. To address the complex nature of the prioritization problem posed, this study proposes a hybrid MCDM framework combining the spherical fuzzy analytical hierarchy process (SF-AHP) and weighted aggregated sum product assessment (WASPAS). SF-AHP is used in the first stage to determine the significance levels of OWPS evaluation criteria. WASPAS is then utilized to rank locations of OWPS. A comprehensive set of evaluation criteria developed based on the concept of sustainable development has been recognized by reviewing the literature review and interviewing experts to practice the two-stage MCDM model. A real case study for Vietnam is conducted to test the effectiveness of the proposed method. The best location schemes have been determined by using the decision framework. The results of the sensitivity analysis and a comparison analysis demonstrate that the decision framework is practical and robust. Ultimately, the evaluation criteria and methodology presented in this work can serve as a theoretical foundation for the advancement of offshore wind energy and coastal development.

Sustainable Supplier Selection Model in Supply Chains During the COVID-19 Pandemic

As global supply chains become more developed and complicated, supplier quality has become increasingly influential on the competitiveness of businesses during the Covid-19 pandemic. Consequently, supplier selection is an increasingly important process for any business around the globe. Choosing a supplier is a complex decision that can result in lower procurement costs and increased profits without increasing the cost or lowering the quality of the product. However, these decision-making problems can be complicated in cases with multiple potential suppliers. Vietnam's textile and garment industry, for example, has made rapid progress in recent years but is still facing great difficulties as the supply of raw materials and machinery depends heavily on foreign countries. Therefore, it is extremely important for textile and garment manufacturing companies in Vietnam to implement an effective supplier evaluation and selection process. While multicriteria decision-making models are frequently employed to assist with supplier evaluation and selection problems, few of these models consider the problem under the condition of a fuzzy decision-making environment. The aim of this paper is to create a hybrid MCDM model using the Fuzzy Analytical Hierarchy Process (FAHP) model and the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) to assist the supplier selection process in the garment industry in a fuzzy decision-making environment. In this study, the FAHP method is used to evaluate the performance and the weight of each criterion. TOPSIS is then used to rank all potential suppliers. The proposed model is then applied to a real-world case study to demonstrate both the process of calculation as well as its real-world applicability. The results from the case study provide empirical evidence that the model is feasible. The proposed approach can also be used in combination with other MCDM models to better support decision makers and can be modified to be applied in similar supplier selection processes for different industries.

A third dose of inactivated vaccine augments the potency, breadth, and duration of anamnestic responses against SARS-CoV-2 (preprint)

Emergence of variants of concern (VOC) with altered antigenic structures and waning humoral immunity to SARS-CoV-2 are harbingers of a long pandemic. Administration of a third dose of an inactivated virus vaccine can boost the immune response. Here, we have dissected the immunogenic profiles of antibodies from 3-dose vaccinees, 2-dose vaccinees and convalescents. Better neutralization breadth to VOCs, expeditious recall and long-lasting humoral response bolster 3-dose vaccinees in warding off COVID-19. Analysis of 171 complex structures of SARS-CoV-2 neutralizing antibodies identified structure-activity correlates, revealing ultrapotent, VOCs-resistant and broad-spectrum antigenic patches. Construction of immunogenic and mutational heat maps revealed a direct relationship between "hot" immunogenic sites and areas with high mutation frequencies. Ongoing antibody somatic mutation, memory B cell clonal turnover and antibody composition changes in B cell repertoire driven by prolonged and repeated antigen stimulation confer development of monoclonal antibodies with enhanced neutralizing potency and breadth. Our findings rationalize the use of 3-dose immunization regimens for inactivated vaccines. One sentence summaryA third booster dose of inactivated vaccine produces a highly sifted humoral immune response via a sustained evolution of antibodies capable of effectively neutralizing SARS-CoV-2 variants of concern.

Impact of COVID-19 on the mental health of Singaporean GPs: a cross-sectional study.

BACKGROUND: COVID-19 has stressed healthcare systems and workers worldwide. GPs, as first points of contact between suspected cases and the healthcare system, have assumed frontline roles in this crisis. While the prevalence of mental health problems and illnesses arising in healthcare workers (HCWs) from tertiary care settings during the COVID-19 pandemic is well-examined,1 the impact on GPs remains understudied. AIM: To describe the prevalence and predictors of anxiety, burnout, depression, and post-traumatic stress disorder (PTSD) among GPs during the COVID-19 pandemic. DESIGN & SETTING: Survey of GPs operating in Singapore primary care clinics. METHOD: GPs completed a survey that comprised of four validated psychometric instruments. Open-ended questions asked about responders' challenges and their envisaged support. Data were analysed with multiple logistic regression with demographic data as covariates; concepts of grounded theory were used to analyse the qualitative responses. RESULTS: A total of 257 GPs participated. Fifty-five (21.4%) met the scales' criteria for anxiety, 211 (82.1%) for burnout, 68 (26.6%) for depression, and 23 (8.9%) for PTSD. Multivariate regression analysis showed working in a public primary care setting was associated with anxiety and depression. Qualitative analyses uncovered possible stressors: changes to clinical and operational practices; increased workloads; and financial difficulties. CONCLUSION: Mental health issues were found to be present in Singaporean GPs during the pandemic. Prevalence of anxiety, burnout, and depression were found to be higher than those reported pre-COVID-19. The findings also provide determinants of the issues that serve as possible foci for targeted interventions.

Cover Picture: Applications of digital PCR in COVID-19 pandemic (View 2/2021)

In article number 20200082, Yong Guo and co-workers have shown the detection of SARS-CoV-2 RNA by digital PCR.

The efficacy and safety of COVID-19 vaccine: A protocol of systematic review and meta-analysis (preprint)

Background: The coronavirus disease 2019 (COVID-19) is one of the most wide-spread and threatening infectious diseases in human history. Experts in the field of medicine and biology are working to develop methods to treat and prevent COVID-19. Currently, COVID-19 is predominantly treated with symptomatic therapy and there is still a lack of effective antiviral therapy. Therefore, the prevention and control of novel coronavirus is primarily focused on vaccine development. Several vaccines have been developed, but their relative efficacy and safety have not been proven. Therefore, the aim of this study is to investigate the efficacy and safety of COVID-19 vaccines. Methods: and analysis: The electronic databases we will use to retrieve information include PubMed, The Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Database and Weipu Electronics. The retrieval period is from the establishment of the database to March 2021. All randomized controlled trials in humans vaccinated with COVID-19 were collected, and data were independently selected and extracted according to predesigned inclusion/exclusion criteria. Full-text screening, data extraction and quality assessment were conducted independently by two reviewers. Two additional investigators will conduct report quality, risk of bias, sensitivity analysis and subgroup analysis to ensure the reliability of our study results. The software RevMan 5.3 was used for statistical analysis. Systematic review and meta-analyses will be conducted to evaluate the pooled evidence of efficacy and safety of the COVID-19 vaccines. Result: This study will evaluate the efficacy and safety of the COVID-19 vaccines. Conclusion: The conclusions of this study will provide an evidence-based analysis of the safety and efficacy of COVID-19 vaccines. Systematic review registration: PROSPERO CRD42021242581

COVID-19 Vaccination Acceptance Among Healthcare Workers and Nonhealthcare Workers in China: A Survey (preprint)

Background: The coronavirus pneumonia is still spreading around the world. Much progress has been made in vaccine development, and vaccination will become an inevitable trend in the fight against this pandemic. However, the public acceptance of COVID-19 vaccination still remains uncertain. Methods: By calculating the sample size of random sampling, anonymous questionnaire was used in Wen Juan Xing survey platform. Multinomial logistic regression analyses were performed to identify the key sociodemographic, cognitive, and attitude associations with samples of healthcare workers and nonhealth care workers. Findings: A total of 2580 respondents have completed the questionnaire, including 1,329 healthcare workers and 1,251 nonhealthcare workers. This study showed that 76.98% of healthcare workers accepted the COVID-19 vaccine, 18.28% workers were hesitant, and 4.74% workers were resistant. Among the nonhealthcare workers, 56.19% workers received the COVID-19 vaccine, 37.57% workers were hesitant, and 6.24% workers were resistant. Among the healthcare workers, compared with vaccine recipients, vaccine-hesitant individuals were more likely to be female (AOR = 1.52, 95% CI: 1.12–2.07); vaccine-resistant individuals were more likely to live in the suburbs (AOR = 2.81, 95% CI: 1.44–3.99) with an income of 10,000 RMB or greater (AOR = 2.00, 95% CI: 1.03–3.90). Among the nonhealthcare workers, vaccine-hesitant individuals were more likely to be female (AOR = 1.66, 95% CI: 1.31–2.11); vaccine-resistant individuals were also more likely to be female (AOR =1.87, 95% CI: 1.16–3.02) and older than 65 years (AOR = 4.96, 95% CI: 1.40–7.62). There are great differences between healthcare workers and nonhealthcare workers in their cognition and attitude towards vaccines. Interpretation: Our study shows that healthcare workers are more willing to be vaccinated than nonhealthcare workers. Current vaccine safety issues continue to be a major factor affecting public acceptance, and to expand vaccine coverage in response to the COVID-19 pandemic, appropriate vaccination strategies and immunization programs are essential, especially for nonhealthcare workers.Funding: Medical and Technology Project of Zhejiang ProvinceDeclaration of Interest: None to declare. Ethical Approval: This study is a nation-wide cross-sectional study in China; the ethics committee ofAffiliated Hospital of Hangzhou Normal University approved all the procedures performed.