Comparison of Vaccine Acceptance Between COVID-19 and Seasonal Influenza Among Women in China: A National Online Survey Based on Health Belief Model.

ABSTRACT

Background: Influenza could circulate in parallel with COVID-19. Studies focusing on the comparison of vaccine acceptance between COVID-19 and seasonal influenza are lacking. The aim of the study was to assess and compare vaccine acceptance of COVID-19 and influenza among reproductive women in China, in order to better understand and address factors associated with vaccine acceptance and to provide guidance for targeted measures to promote vaccination. Methods: A national anonymous cross-sectional survey on COVID-19 and influenza vaccine acceptance among reproductive women aged 18-49 years in China was conducted online based on health belief model, a model widely used to evaluate health beliefs. Sociodemographic characteristics, health status, knowledge, attitude, and health beliefs related to COVID-19 and influenza infection and vaccination were retrieved. Pearson's χ2 test was used to compare the vaccine acceptance by the factors mentioned above. Multivariable logistic regression was used to assess the adjusted associations of factors related to vaccine acceptance. Paired t-test was used to compare scores of health beliefs between influenza and COVID-19 vaccinations. Results: COVID-19 vaccine acceptance rate among reproductive women was 90.3% (95% CI 89.2-91.3%), which was significantly higher than influenza vaccine acceptance rate (85.5%, 95% CI 84.2-86.7%). Influenza and COVID-19 vaccine acceptance both had the trends to decrease with age (all p < 0.05). Living in the western region, young age, a high level of knowledge scores on disease and vaccines, a high level of perceived susceptibility, a high level of cues to action, and a low level of perceived barriers were positively associated with both COVID-19 and influenza vaccine acceptance (all p < 0.05), while influenza vaccination history was additionally associated with influenza vaccine acceptance (p < 0.05). Conclusions: Our findings suggest that tailored public health measures are needed to improve reproductive women's knowledge of COVID-19, influenza, and vaccines to alleviate women's vaccine hesitancy and expand vaccine uptake.