The survey of 10,000 people reveals the main reasons affecting the vaccination of the elderly in my country: misunderstanding of contraindications, excessive worry of side effects

　　The Paper reporter Li Ji

　　"We have now passed the first wave of large-scale infections. What we can do now is to seize the window period and make up for the gap in the new crown vaccine for vulnerable groups such as the elderly, so as to prevent the next wave of infections in a few months. Severe illness and death." On February 7, Zhao Yaohui, a Distinguished Boya Professor of Peking University and a professor of economics at the National School of Development, said in an interview with The Paper.

　　On January 31, the China Health and Retirement Tracking Survey (CHARLS) team led by Zhao Yaohui published a research paper entitled "Determinants of COVID-19 vaccination status and hesitancy among older adults in China" in the top international journal "Nature Medicine". This study elaborated on the vaccination status of the elderly in China and the influencing factors of vaccination decision-making.

　　Zhao Yaohui introduced that in the fifth round of the China Health and Retirement Tracking Survey (CHARLS) conducted from July 2021 to August 2022, the research team specifically collected information on the vaccination status of the respondents and the reasons for not being vaccinated.

　　In this study, as of July-August 2022, a total of 12,900 participants were included in the analysis of the new crown vaccination status.

According to the research team, the study is based on the discussion of the vaccination rate of the elderly population in my country and the influencing factors of vaccination decision-making. Vaccination strategy provides decision-making reference.

　　The study shows that the misunderstanding of the contraindications of the new crown vaccine and excessive worry about the side effects of the new crown vaccine are the main factors that make the vaccination decision of the elderly population hesitant; Explain the contraindications related to vaccines.

　　The vaccination rate of the elderly in my country is relatively low, which is in stark contrast to developed countries such as Europe, America and Japan.

　　The research team believes that the survey is a representative survey of middle-aged and elderly people in mainland China. In view of the fact that the vaccination rate of my country's new crown vaccine has not changed much from August to November 2022, the data reflects the national epidemic rate when my country ends the "dynamic clearing" policy. Overall status of COVID-19 vaccination among middle-aged and elderly people.

　　The study found that the one-shot coverage of the new crown vaccine for the elderly in my country is high, but the full-course vaccination and booster coverage are still insufficient, and there is a large gap in the full-course and booster vaccinations for the elderly.

　　In this study, as of July-August 2022, a total of 12,900 participants were included in the analysis of the new crown vaccination status.

The study shows that the weighted vaccination rate (at least one dose) of the elderly aged 60 and over in my country is 92.3%; the vaccination rates of the whole course and booster injections of this population are 88.6% and 72.4%, respectively.

Vaccination rates decline with age.

In the elderly group (over 80 years old), the proportion of one-shot vaccination was 80.5%; however, the proportions of full course and booster vaccination were only 71.9% and 46.7%, respectively.

　　The CHARLS team systematically sorted out the vaccination process of the new crown vaccination of the elderly population in my country.

　　In the early stages of domestic inactivated vaccines being approved for nationwide vaccination for the first time in January 2021, due to the lack of clinical research data, the vaccination plan at that time temporarily excluded the elderly from vaccination targets.

　　From June 2021, my country will carry out a pilot project of vaccination against the new crown for the elderly and promote it nationwide, but there are still many elderly people who have not been able to complete the vaccination.

For example, due to the unclear definition of the contraindications of the new crown vaccine in the early stage, or the vaccination agencies worried that the elderly with chronic diseases would have serious side effects of vaccination, the vaccination agencies often refused to vaccinate some elderly patients with chronic diseases because of the contraindications of the new crown vaccine.

　　With Omicron becoming the main variant at the end of 2021, after January 2022, various measures have been introduced to facilitate the vaccination of the elderly, including economic incentives, material gifts, and the opening of community vaccination vehicles to increase accessibility. Some also provide vaccine adverse reaction insurance and so on.

However, vaccinators continue to exclude older adults with suspected contraindications.

　　Until November 29, 2022, after the "dynamic clearing" policy changed, the government focused on the full vaccination of the elderly, especially the elderly, in the new round of new crown vaccine popularization work.

　　China's new crown vaccination promotion process, vaccination dose and vaccination rate of 60+ people.

Data source: National Health Commission

　　The research team pointed out that since the free vaccination of the new crown vaccine was launched, a considerable number of elderly people in my country are still unwilling to be vaccinated. The vaccination rate of the elderly is much lower than that of young people. The higher inoculum ratio was in stark contrast.

　　"The process of vaccination against the new crown in my country is different from that of developed countries. When the developed countries are vaccinated, the elderly are given priority, especially the elderly. After the vaccine is released in our country, the first batch will not be vaccinated for the elderly, but will be given first. Healthy young and middle-aged people are vaccinated, because clinical trials are also given priority to young and middle-aged people." Zhao Yaohui introduced.

　　Zhao Yaohui said that one of the revelations of the study is to change the "inertia" of vaccinations for young and middle-aged people first, followed by the elderly. "When dealing with major public health emergencies in the future, as many people as possible should be included in the clinical trial stage, especially It is vulnerable groups such as the elderly, so that they can be vaccinated as soon as possible after the vaccine is approved."

　　Prevent the next wave of infections, seize the window period to fill the gap in the elderly's new crown vaccine

　　The study found that although the new crown vaccine popularization campaign for the elderly has significantly increased the vaccination rate of vulnerable groups such as the elderly, chronically ill, and disabled, the vaccination gap for the above-mentioned vulnerable groups is still relatively large.

　　The results of multiple regression analysis on the influencing factors of the new crown vaccination showed that advanced age (especially 80 years old and above), female, single, urban residents, disability and chronic diseases (including high blood pressure, heart disease, stroke, diabetes, lung disease and Cancer) patients are less likely to be vaccinated against the new crown vaccine.

　　Comparing the vaccination situation before and after the summer of 2021, it is found that in the first phase (before the summer of 2021), the proportion of women, elderly (especially 80 years old and above), single, urban residents, disabled and chronically ill adults receiving vaccination The probability is low; in the second phase (between summer 2021 and summer 2022), the probability of vaccination in high-risk groups is significantly higher, especially the elderly, disabled and patients with major chronic diseases (often mistaken as contraindications for the new crown vaccine ), which reflects the government's efforts and achievements in reducing vaccination inequalities.

　　The study found that the self-reported reasons for not being vaccinated against the new crown showed that concerns about contraindications, old age and infirmity, and vaccine accessibility issues were the main reasons why middle-aged and elderly people did not receive the new crown vaccine.

　　The data shows that from July to August 2022, the top five reasons for not being vaccinated against the new crown vaccine are mainly contraindication concerns (48%), old age/weakness/chronic diseases (21%), limited mobility or insufficient supply, etc. Vaccine accessibility issues (18%), concerns about side effects or efficacy (9%), and never heard of the new crown vaccine (6%).

In the very old age group, lack of knowledge about vaccines was an important factor.

　　The results of the study show that misunderstanding of the contraindications of the new crown vaccine and excessive worry about the side effects of the vaccine are the main factors for the hesitation of the elderly population in making vaccination decisions; Explain the contraindications related to vaccines.

　　"Some elderly people are afraid of receiving the new crown vaccine. To a certain extent, it comes from the fact that the vaccination agency overemphasizes the side effects of the vaccine on the elderly and the elderly with chronic diseases, which has caused psychological implications. Regarding the side effects of the vaccine and the data on real-world protection, It should be presented to the public as soon as possible, and information disclosure should be increased, so that ordinary people will make decisions naturally, which is much better than panic caused by opaque information.” Zhao Yaohui said.

　　The study pointed out that from March to May 2022, Hong Kong experienced an outbreak of the Omicron variant, which made Hong Kong jump from the lowest death rate of the new crown virus in the world to the highest death rate of the new crown virus in the world.

90% of the above deaths are elderly people who have not received the full COVID-19 vaccination.

Compared with neighboring countries, in Japan, the elderly and centenarians have a nearly 100% vaccination rate for the full course of the new crown vaccine.

In order to actively respond to the new round of the new crown virus epidemic, we should promote the full vaccination coverage of all people, especially the elderly and vulnerable groups, so as to reduce the harm to the health of the Chinese people from the next wave of the new crown virus epidemic.

　　"We have now passed the first wave of large-scale infections. What we can do now is to seize the window period and make up for the gap in the new crown vaccine for vulnerable groups such as the elderly, so as to prevent the next wave of infections in a few months. Severe illness and death." Zhao Yaohui said.