Factors That Impact Acceptance of COVID-19 Vaccination in Different Community-Dwelling Populations in China

Background: It is important to improve vaccination strategies and immunization programs to achieve herd immunity to infectious diseases, particularly in general community-dwelling populations.Methods: To assess the acceptance of COVID-19 vaccination, we conducted face-to-face surveys and online surveys in Shanghai, Zhejiang, and Qinghai province. A fixed effects model and a random effects model were used to analyze factors associated with acceptance of COVID-19 vaccination.Findings: The results indicated that 82·6% of participants (77·0% in Shanghai and 87·3% in Zhejiang) were willing to receive vaccination when it was available in the community, and 57·2% of deliverymen, 43·3% of medical workers, 78·2% of parents of primary and secondary school children, and 72·2% of parents of preschool children were willing to receive vaccination. The models showed that participants who were male, 60 to 69 years-old, from rural areas, had less education, had good health status, and had positive attitudes and trust in vaccines approved by National Health Commission were more likely to accept vaccination. Participants also had increased vaccination acceptance if it was recommended by government sources, doctors, relatives, or friends. Most participants learned about COVID-19 vaccination from television, radio, and newspapers, followed by community or hospital campaigns and the internet. Those who did not want to receive vaccination were mainly concerned about safety (288, 59·6%) and efficacy (196, 40·6%).Interpretations: Government sources and doctors could increase acceptance of vaccination by promoting the efficacy and safety of COVID-19 vaccination by use of mass media and emphasizing the necessity of vaccination for everyone.Funding Statement: The Bill & Melinda Gates Foundation [Grant No· INV-006277].Declaration of Interests: None.Ethics Approval Statement: The Ethics Committee of the School of Public Health of Fudan University approved this study (Approval no: IRB#2020-11-0758) and all participants provided written informed consent.