Seasonal influenza vaccine hesitancy profiles and determinants among Chinese children’s guardians and the elderly

Background Seasonal influenza imposes a significant clinical and economic burden, yet vaccine coverage remains low in China due to possible influenza vaccine hesitancy (IVH) and practical issues. We sought to investigate IVH and its determinants among children’s guardians and the elderly for better understanding of the situation and for future intervention. Methods IVH scales for the guardians and elderly were designed. We then performed two cross-sectional studies to identify the profiles and determinants of IVH using stratified cluster random sampling in an eastern China province in 2019. Results Of the 1,564 guardians and 522 elders, 43.2% (95% confidence interval: 40.4–46.0%) of guardians and 33.5% of elders (95% confidence interval: 29.5–37.6%) had IVH, whereas 31.3% of the guardians and 5.5% of the elderly had Influenza vaccine demand. The scales were well structured (KMO: 0.736 and 0.682; Cronbach’s α: 0.638 and 0.611). ‘From rural area’ (Odds ratio: 1.36), ‘don’t know government recommendation for flu vaccination’ (1.39), ‘don’t know flu vaccine is vaccinated annually’ (1.93), ‘family members (0.22), friends and neighbors had positive attitude toward flu vaccine’(0.58) were related factors of the guardians’ IVH. ‘Aged 70–79 years’ (0.46), ‘had flu before’ (0.35) and ‘once had been vaccinated’ (0.42) were related to the elderly’s IVH. Conclusion Poor awareness of influenza and vaccination, relatives’ negative/positive attitude, lack of government recommendations, anxiety about vaccine quality, and practical issues such as short supply are related to IVH in China. Precision education aiming hesitancy in wider groups are anticipated to increase vaccine confidence and coverage in influenza-vulnerable groups.