Behavioral intention to receive self financed and free COVID 19 vaccination among Chinese factory workers who resumed work during the pandemic: cross sectional online survey (Preprint)

BACKGROUND: COVID-19 vaccines would become available in China very soon. A timely understanding of community responses to the forthcoming COVID-19 vaccines would be important. We applied the Theory of Planned Behavior (TPB) as the theoretical framework. OBJECTIVE: This study investigated prevalence of and factors associated with behavioral intention to receive self-financed and free COVID-19 vaccination among Chinese factory workers who resumed work during the pandemic. We examined the effects of factors including socio-demographics, perceptions related to COVID-19 vaccination based on the TPB, exposure to information specific to COVID-19 vaccination through social media, and COVID-19 preventive measures implemented by individuals and factories. METHODS: Participants were full-time employees aged ≥18 years who had resumed work in factories in Shenzhen. Factory workers in Shenzhen are required to receive physical examination once a year. Eligible workers attending six designated physical examination sites were invited to complete an online survey during September 1-7, 2020. Out of 2653 eligible factory workers being approached, 2053 (77.4%) completed the online survey. Multivariate two-level logistic regression models and ordinal logistic regression models were fitted. RESULTS: The prevalence of behavioral intention to receive COVID-19 vaccination was 66.6% (n=1368, conditional on 80% vaccine efficacy and market rate) and 80.6% (n=1551, conditional on 80% vaccine efficacy and free vaccines), respectively. After adjusting for significant background characteristics, positive attitudes toward COVID-19 vaccination (AOR 1.20, 95%CI 1.15-1.25 & AOR 1.24, 95%CI 1.19-1.30), perceived significant others supporting COVID-19 vaccination uptake (AOR 1.43, 95%CI 1.32-1.55 & AOR 1.37, 95%CI 1.25-1.50), and perceived behavioral control to take up COVID-19 vaccination (AOR 1.51, 95%CI 1.32-1.73 & AOR 1.28, 95%CI 1.09-1.51) were positively associated with both dependent variables. Regarding social media influence, higher frequency of exposure to positive information related to COVID-19 vaccination was associated with higher intention to receive COVID-19 vaccination at market rate (AOR 1.53, 95%CI 1.39-1.70) or receive free vaccination (AOR 1.52, 95%CI 1.35-1.71). Higher self-reported compliance with facemask wearing in workplace (AOR: 1.27, 95%CI 1.02-1.58 & AOR 1.67, 95%CI 1.24-2.27) and other public spaces (AOR 1.80, 95%CI 1.42-2.29 & AOR 1.34, 95%CI 1.01-1.77), hand hygiene (AOR 1.21, 95%CI 1.00-1.47 & AOR 1.52, 95%CI 1.19-1.93), and avoiding social/meal gathering (AOR 1.22, 95%CI 1.01-1.47 & AOR 1.55, 95%CI 1.23-1.95) and crowed place (AOR 1.24, 95%CI 1.02-1.51 & AOR 1.73, 95%CI 1.37-2.18) were also positively associated with both dependent variables. Number of COVID-19 preventive measures implemented by the factory were positively associated with intention to receive COVID-19 vaccination under both scenarios (AOR 1.08, 95%CI 1.04-1.12 & AOR 1.06, 95%CI 1.01-1.11). CONCLUSIONS: Factory workers in China reported a high behavioral intention to receive COVID-19 vaccination. The Theory of Planned Behavior is a useful framework to guide the development of future campaigns promoting COVID-19 vaccination.