JMIR public health and surveillance
Household and Community Clustering of Concurrent Vaccine Hesitancy in China: Multicenter Survey
By Zhang Y, Bhuyan SS, Wang S and 8 others.
Abstract
Background
Vaccine hesitancy remains a persistent global challenge, especially in the context of major public health emergencies. While individual-level factors have been widely studied, whether and how household and community contexts shape hesitancy clustering has received little attention.
Objective
This study aimed to assess household- and community-level clustering of COVID-19 booster vaccine hesitancy (CBVH), identify key associated factors, and explore potential intervention targets.
Methods
In March 2023, a household-based cross-sectional survey was conducted among Chinese adults across 4 provinces. Concurrent CBVH was defined as hesitancy reported for both current and future booster intentions within the same survey. The analytical samples included 5462 participants for current CBVH, 5437 for future CBVH, and 5407 for concurrent CBVH. Three-level logistic regression models were used to quantify variance attributable to individual, household, and community levels and to identify associated factors. Network analysis was also used to examine interrelationships among key factors and identify central intervention targets.