JMIR Publications

ABSTRACT

Background:

SARS-CoV-2 continues to evolve multiple variants that can reduce vaccine-induced protection, underscoring the importance of annual booster doses. Healthcare workers are both priority recipients of COVID-19 vaccines and trusted sources of vaccine information for the public. In China’s post-pandemic period, healthcare workers’ willingness to receive annual COVID-19 vaccination remains uncertain.

Objective:

To evaluate Chinese healthcare workers’ willingness to receive annual COVID-19 vaccination in the post-pandemic period, identify the main reasons for any hesitancy, and to assess their recommendations for vaccinating high-risk groups.

Methods:

Between February and April 2023, a nationwide cross-sectional survey was conducted in 21 representative public hospitals across seven regions of China. Designated investigators at each hospital invited 150 healthcare workers to complete an anonymous, self-administered electronic questionnaire.Primary outcomes included healthcare workers’ willingness to receive the COVID-19 vaccine and their reasons for hesitancy. Secondary outcomes assessed their recommendations for vaccinating older adults and young children.

Results:

Among 3,169 healthcare workers (median age 30-40 years), 60% (1899/3169) were willing to receive annual COVID-19 vaccination in the post-pandemic period, and 90% (2857/3169) and 73% (2320/3169) were willing to recommend vaccination for older adults and young children, respectively. 93% (2862/3074) of respondents had received an inactivated vaccine. Not having been vaccinated was strongly associated with hesitancy (OR, 2.46; 95% CI, 1.60 to 3.78) and with lower likelihood of recommending vaccination to older adults (OR, 6.28; 95% CI, 4.72 to 8.36) and young children (OR, 4.51; 95% CI, 3.80 to 5.36). The top reasons for hesitancy were doubts about efficacy (53%, 674/1270), safety (33%, 424/1270), and insufficient disclosure of clinical trial data (29%, 368/1270).

Conclusions:

Approximately 40% of healthcare workers displayed hesitancy toward COVID-19 vaccination, despite 93% having received inactivated vaccines and the majority expressing willingness to recommend vaccination for older adults and young children. Accelerating research into more efficacious next-generation vaccines, together with rapid and transparent dissemination of clinical-trial data, will be crucial for restoring trust and minimizing hesitancy among healthcare workers. Clinical Trial: None.