JMIR Publications

ABSTRACT

Background:

COVID-19 vaccines would become available in China very soon. A timely understanding of community responses to the forthcoming COVID-19 vaccines would be important.

Objective:

This study investigated prevalence of and factors associated with behavioral intention to receive self-financed and free COVID-19 vaccination among Chinese factory workers who resumed work during the pandemic. Behavioral intention to reduce compliance with some personal preventive measures after receiving COVID-19 vaccination was also investigated.

Methods:

Participants were full-time employees aged ≥18 years who had resumed work in factories in Shenzhen. Factory workers in Shenzhen are required to receive physical examination once a year. Eligible workers attending six designated physical examination sites were invited to complete an online survey during September 1-7, 2020. Out of 2653 eligible factory workers being approached, 2053 (77.4%) completed the online survey. Multivariate logistic regression models were fitted.

Results:

The prevalence of behavioral intention to receive COVID-19 vaccination was 66.6% (n=1368, conditional on 80% vaccine efficacy and market rate) and 80.6% (n=1551, conditional on 80% vaccine efficacy and free vaccines), respectively. After adjusting for significant background characteristics, positive attitudes toward COVID-19 vaccination (AOR 1.20, 95%CI 1.15-1.25 & AOR 1.26, 95%CI 1.20-1.32), perceived significant others supporting COVID-19 vaccination uptake (AOR 1.44, 95%CI 1.32-1.56 & AOR 1.40, 95%CI 1.27-1.53), and perceived behavioral control to take up COVID-19 vaccination (AOR 1.51, 95%CI 1.32-1.73 & AOR 1.31, 95%CI 1.12-1.54) were positively associated with both dependent variables. Regarding social media influence, higher frequency of exposure to positive information related to COVID-19 vaccination was associated with higher intention to receive COVID-19 vaccination at market rate (AOR 1.54, 95%CI 1.39-1.70) or receive free vaccination (AOR 1.53, 95%CI 1.36-1.72). Higher self-reported compliance with facemask wearing in workplace (AOR: 1.25, 95%CI 1.00-1.55 & AOR 1.67, 95%CI 1.24-2.24) and other public spaces (AOR 1.85, 95%CI 1.46-2.34 & AOR 1.34, 95%CI 1.01-1.77), hand hygiene (AOR 1.52, 95%CI 1.20-1.94), and avoiding social/meal gathering (AOR 1.23, 95%CI 1.02-1.49 & AOR 1.60, 95%CI 1.27-2.01) and crowed place (AOR 1.26, 95%CI 1.04-1.53 & AOR 1.79, 95%CI 1.42-2.25) were also positively associated with one or both dependent variables. Number of COVID-19 preventive measures implemented by the factory were positively associated with intention to receive COVID-19 vaccination under both scenarios (AOR 1.08, 95%CI 1.04-1.12 & AOR 1.07, 95%CI 1.03-1.12). The prevalence of behavioral intention to reduce frequency of facemask wearing, sanitizing hands, and avoiding social gathering/crowed places after receiving COVID-19 vaccination was 34.5% (n=708), 32.9% (n=675), and 28.0% (n=575), respectively.

Conclusions:

Factory workers in China reported a high behavioral intention to receive COVID-19 vaccination. The Theory of Planned Behavior is a useful framework to guide the development of future campaigns promoting COVID-19 vaccination. However, risk compensation was a concern and should be addressed during COVID-19 vaccination promotion.