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Differences in maternal acceptance of non-national immunization program vaccines between single-child and

Rong Xing1, Yuanling Wu2, Yanli Lin3

  • 1Department of Preventive Healthcare, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China.

Frontiers in Public Health
|August 21, 2026
PubMed

Insights

Maternal willingness to use non-National Immunization Program vaccines (non-NIPV) was lower in multiple-children households (MCH) compared to single-child households (SCH). Family structure impacts decisions on discretionary vaccinations.

Area of Science:

  • Public Health
  • Vaccinology
  • Sociology

Background:

  • Non-National Immunization Program vaccines (non-NIPV) offer protection against additional diseases beyond routine immunization schedules in China.
  • Uptake of non-NIPV is influenced by parental decision-making, as these vaccines are recommended but not publicly funded.
  • Understanding factors affecting parental decisions is crucial for improving vaccination coverage.

Purpose of the Study:

  • To assess maternal willingness to use non-National Immunization Program vaccines (non-NIPV) for their children.
  • To compare maternal willingness to use non-NIPV between single-child households (SCH) and multiple-children households (MCH).

Main Methods:

  • A cross-sectional questionnaire survey was conducted among 395 mothers of children aged 42 days to 3 years.
  • Maternal willingness to use non-NIPV (WNV) was the primary endpoint.
  • Multivariable logistic regression and propensity score overlap weighting were used to analyze differences in WNV between household types.

Main Results:

  • Overall maternal willingness to use non-NIPV was 64.81%.
  • Mothers in single-child households (SCH) showed higher willingness to use non-NIPV (67.94%) compared to those in multiple-children households (MCH) (58.65%).
  • Multiple-children households (MCH) were associated with significantly lower odds of maternal willingness to use non-NIPV (OR 0.34, p=0.001).

Conclusions:

  • Maternal willingness to use non-National Immunization Program vaccines (non-NIPV) is lower in multiple-children households (MCH) compared to single-child households (SCH).
  • Family composition is a significant contextual factor influencing discretionary vaccination decisions.
  • Communication strategies for non-NIPV should consider household context and parental perceptions to enhance uptake.
Abstract

Keywords:
health service utilizationhousehold structurematernal willingnessnon-national immunization program vaccinespreventive care decision-making

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