AUTHOR=Wang Haohang , Cui Mingting , Li Shunran , Wu Fan , Jiang Shiqiang , Chen Hongbiao , Yuan Jianhui , Sun Caijun 

TITLE=Perception and willingness toward various immunization routes for COVID-19 vaccines: a cross-sectional survey in China

JOURNAL=Frontiers in Public Health

VOLUME=Volume 11 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1192709

DOI=10.3389/fpubh.2023.1192709

ISSN=2296-2565

ABSTRACT=Background: To date, most vaccines, including COVID-19 vaccine, are mainly administrated by intramuscular injection, which might lead to vaccine hesitancy in some population due to the needle fear. Alternatively, needle-free immunization technology is extensively developing to improve the efficacy and acceptance of vaccination. However, there is no study to report the perception and willingness towards various immunization routes of COVID-19 vaccine in general population.A cross-sectional survey was conducted nationwide using an online questionnaire. Bivariate analyses were undertaken to assess variable associations in the participants who reported a hesitancy to receive the COVID-19 booster vaccination. Multivariable logistic regression with a backward step-wise approach was used to analyze the predicated factors associated with the willingness to receive the COVID-19 booster vaccination.Results: 3244 valid respondents were included in this survey, and 63.2% of participants thought they had a good understanding of intramuscular injection, but only 20.7%, 9.2%, 9.4% and 6.0% of participants had a self-perceived good understanding towards inhalation vaccine, nasal spray vaccine, oral vaccine, and microneedle patch vaccine. Correspondingly, there was a high acceptance for intramuscular injection (76.5%), but followed by oral inhalation (64.4%) and nasal spray (43.0%). This is a provisional file, not the final typeset article Those participants were only willing to receive an intramuscular vaccine had a less vaccine knowledge (OR= 0.78; 95% CI: 0.65-0.94) than those who are willing to receive a needle-free vaccine (OR= 1.97; 95% CI:1.52-2.57). Some factors were found to be associated with vaccine hesitancy towards booster COVID-19 vaccination.Needle-free vaccination is a promising technology for the next generation of vaccines, but we found that intramuscular injection was still the most acceptable immunization route in this survey. One major reason might be that most people lack the knowledge about needle-free vaccination. We should strengthen the publicity of needle-free vaccination technology, and thus improve the acceptance and coverage of vaccination in different population.