COVID-19 Vaccine Coverage, Concerns, and Preferences Among Chinese ICU Clinicians: A Nationwide Survey

Background: Health care workers in intensive care units (ICU) have been prioritized for COVID-19 vaccination. In a nationwide vaccination campaign since March in China, better understanding of concerns and preferences of COVID-19 vaccines remain crucial for improving vaccination uptake. Methods: ICU clinicians throughout China’s mainland were contacted to participate in an online survey during March 24-April 10, 2021. We compared concerns by vaccination outcome, and through a discrete choice experiment (DCE) assessed preferences for vaccines in terms of effectiveness (95% vs 80%), risk of adverse reactions (5% vs 10%), duration of immunity (6 vs 12 months), and whether or not coworkers have been vaccinated. Findings: Among 11,951 ICU respondents from 252 prefecture-level cities, vaccination coverage of COVID-19 vaccines was 75·4%, with an additional 9·2% not vaccinated but planning to, and 16·1% not vaccinated and not intending to. Among women not pregnant, vaccination coverage was 82·6%, with lower coverage in those pregnant (11·4%) or breastfeeding (19·7%). ICU clinicians not intending to be vaccinated significantly expressed more concerns about the speed of vaccine development (30·1%) and adverse reactions (65·9%), compared to those already vaccinated. In the DCE, by COVID-19 vaccination status, the only significant difference in preferences of a COVID-19 vaccine was for safety, with those not vaccinated having a stronger preference for a vaccine with fewer adverse reactions (OR=4·49) compared to those already vaccinated (OR=2·90) or those intending to vaccinate (OR=3·46) (P<0·0001). Interpretation: Increasing vaccination coverage among Chinese ICU clinicians will require strong norms surrounding vaccination and transparency about safety information.  Funding Information: This work was supported by the National Natural Science Foundation of China (#82041028) and Science and Technology Commission of Shanghai Municipality (#20692110200). Declaration of Interests: The authors declared that they have no conflict of interest to this work. Ethics Approval Statement: The study was approved by the Institutional Review Board (IRB) of the Fudan University School of Public Health (IRB 00002408 and FWA 00002399) under IRB #2021-03-0888. Secondary data analysis at the University of Michigan was deemed exempt by the University of Michigan Health Sciences and Behavioral Sciences Institutional Review Board (#HUM00198183). Online informed consent was obtained when the interviewees agreed to fulfill the online questionnaire.