Non-EPI Vaccine Hesitancy among Chinese Adults: A Cross-Sectional Study

Vaccination against coronavirus disease 2019 (COVID-19) is paramount to curtailing the pandemic. However, the impact of the Non-Expanded Program on Immunization (non-EPI) and COVID-19 vaccine hesitancy on vaccine uptake among Chinese adults remain unclear. This study was an online survey performed in Eastern, Central, and Western China between February 2021 and March 2021 using proportional sampling (n = 7381). Adults aged ≥ 18 years were included, especially younger people (aged < 65). Vaccine hesitancy was assessed using the 3C model and relative scales; logistic regression was used to explore the factors affecting vaccination uptake; structural equation modeling was used to evaluate the correlations between variables. Overall, 67.6% and 24.7% of adults reported vaccine hesitancy toward the non-EPI and COVID-19 vaccines, respectively. Participants (66.3%) reported taking the vaccine mainly based on recommendations from medical staff. Vaccine-hesitant participants (60.5%) reported a fear of side effects as the deciding factor in vaccine rejection. Vaccine hesitancy interacted negatively with confidence (β = -0.349, p < 0.001) and convenience (β = -0.232, p < 0.001), and positively with complacence (β = 0.838, p < 0.001). Nonmedical personnel, adults who had previously received the influenza vaccine, and older people had lower vaccine hesitancy than their counterparts. Most Chinese adults have non-EPI but not COVID-19 vaccine hesitancy. Vaccine safety remains a concern.