Postpandemic COVID-19 Vaccination Willingness Among Physicians and Medical Trainees in China: Cross-Sectional Study

As SARS-CoV-2 continues to evolve and vaccine-induced protection wanes over time, future annual or periodic COVID-19 vaccination may become important for long-term disease control. China's adjustment of national COVID-19 response policies provided an opportunity to assess vaccination attitudes after extensive prior vaccination and widespread SARS-CoV-2 exposure. Evidence remains limited on physicians' and medical trainees' willingness to receive future COVID-19 vaccination and to support COVID-19 vaccination for older adults and young children.

This study aimed to evaluate willingness to receive future annual COVID-19 vaccination among physicians and medical trainees in China, identify factors associated with hesitancy toward future vaccination, and assess willingness to support COVID-19 vaccination for older adults and young children.

A nationwide, multicenter cross-sectional survey was conducted from February to April 2023, shortly after China adjusted its national COVID-19 response policies. Physicians and medical trainees were recruited from 21 public hospitals across 7 regions of China using prespecified recruitment targets for each hospital and career-stage group. Participants completed a confidential, self-administered electronic questionnaire. Modified Poisson regression models with robust SEs were used to estimate adjusted prevalence ratios (aPRs) and 95% CIs.

The analysis included 3169 participants comprising 2877 physicians (90.8%) and 292 medical trainees (9.2%). Overall, 1899 participants (59.9%) were willing to receive future annual COVID-19 vaccination, although 3074 (97%) had previously received at least 1 dose of a COVID-19 vaccine. Among previously vaccinated participants, 2862 (93.1%) had received an inactivated vaccine. Overall, 2857 participants (90.2%) were willing to support COVID-19 vaccination for older adults, and 2320 (73.2%) were willing to support vaccination for young children. Lack of willingness to receive influenza vaccination was strongly associated with hesitancy toward future annual COVID-19 vaccination (aPR 4.11; 95% CI 3.71-4.55), as was no prior COVID-19 vaccination (aPR 1.27; 95% CI 1.11-1.46). Participants with hesitancy toward future annual COVID-19 vaccination were more likely to report hesitancy to support vaccination for older adults (aPR 5.13; 95% CI 3.95-6.66) and young children (aPR 2.88; 95% CI 2.54-3.27). Among participants hesitant about future annual vaccination, the most commonly reported concerns were vaccine effectiveness (674/1270, 53.1%), vaccine safety (424/1270, 33.4%), and insufficient disclosure of clinical trial data (368/1270, 29%).

Hesitancy toward future annual COVID-19 vaccination was substantial among physicians and medical trainees in China despite near-universal prior vaccination. The most commonly reported concerns were related to vaccine effectiveness, vaccine safety, and clinical data transparency. Clear and timely communication of vaccine evidence to clinical professionals may support future routine or periodic COVID-19 vaccination strategies and strengthen vaccination support for older adults and young children.