Influencing Factors and Enhancement Strategies for Vaccination behavior among Chinese Residents: An Empirical Analysis Based on a Nationwide Survey

Meixia Zhang¹Xiao Fang¹Wang Mingshan¹Ning Pan¹Yibo Wu²Hui Wang^3*Zheng Liu^1*

• ¹Shandong Provincial Hospital, Jinan, China
• ²Peking University, Beijing, China
• ³Shandong University Cheeloo College of Medicine, Jinan, China

Background Vaccination is a cornerstone of healthcare systems, and increasing vaccination coverage is crucial for achieving public health objectives globally. However, vaccine acceptance rates vary considerably across different regions worldwide. In China, understanding the determinants of vaccine acceptance is crucial for enhancing coverage and achieving public health goals. Objective This study examined the factors influencing vaccine acceptance among Chinese residents and proposes responsed strategies to enhance public vaccine acceptance, thereby contributing to public health development. Methods Based on the cross-sectional data from the 2023 Chinese Residents' Psychological and Behavioral Survey (PBICR), a questionnaire survey was conducted among 30,011 participants using The eHEALS-SF Scale, Health Literacy Scale (HLS-SF4), Big Five Inventory-10 (BFI-10), General Risk Tendency Scale (GRiSP), and Media Motivation Scale. Univariate analysis was performed initially, followed by logistic regression analysis for variables with P≤0.05 in the univariate analysis, to explore the impact of demographic characteristics, health literacy, personality traits, and other factors on vaccination behavior. Results Among Chinese residents, 57.23% reported receiving vaccinations, including 4,555（15.18%）received the HPV, 12,103 （40.33%）received the IFV, 2,450（8.16%）received the HZV, and 9,172（30.56%）received the Hepatitis Vaccine. Univariate analysis identified 17 factors significantly associated with overall vaccination behavior （P＜0.05）, including gender, age, education level, disease experience, health literacy, personality traits （e.g., openness, conscientiousness）, and media influence. Logistic regression analysis revealed 11 associated factors: being female, aged 45–59 years, having a high education level, being a student, experiencing disease, residing in urban areas, earning high income, possessing high health literacy, exhibiting low openness, showing low risk tendency, and demonstrating high media motivation were positively associated with vaccination behavior （P < 0.05）. Differences in the influencing factors between vac-cines and the interaction of the vaccines are also found in the research. Conclusions The acceptance of vaccines among Chinese residents was influenced by a combination of demographic characteristics, health perception, personality traits, and socioeconomic factors. To enhance vaccination coverage, it is essential to implement precise interventions, optimize information dissemination strategies, and provide personalized health services tailored to specific groups, such as those with low educational attainment, individuals residing in rural areas, and those with high openness personality traits.