Please use this identifier to cite or link to this item: https://doi.org/10.1080/21645515.2022.2030623
Title: Vaccination coverage determinants in low uptake areas of China: a qualitative study of provider perspectives in Sichuan, Guangdong, and Henan Provinces
Authors: Lin, Shi-Yu
Zhang, Shi-Ya
Chantler, Tracey
Sun, Fiona Yueqian
Zou, Jia-Tong
Cheng, Jie-Jie
Chen, Yu-Qian
Sun, Mei
Howard, Natasha 
Keywords: Science & Technology
Life Sciences & Biomedicine
Biotechnology & Applied Microbiology
Immunology
Vaccination
migrant children
left-behind children
coverage determinants
China
MEASLES VACCINATION
RURAL CHINA
CHILDREN
SCHOOL
OPPORTUNITIES
CONFIDENCE
DELIVERY
IMPACT
Issue Date: 31-Jan-2022
Publisher: TAYLOR & FRANCIS INC
Citation: Lin, Shi-Yu, Zhang, Shi-Ya, Chantler, Tracey, Sun, Fiona Yueqian, Zou, Jia-Tong, Cheng, Jie-Jie, Chen, Yu-Qian, Sun, Mei, Howard, Natasha (2022-01-31). Vaccination coverage determinants in low uptake areas of China: a qualitative study of provider perspectives in Sichuan, Guangdong, and Henan Provinces. HUMAN VACCINES & IMMUNOTHERAPEUTICS 18 (1). ScholarBank@NUS Repository. https://doi.org/10.1080/21645515.2022.2030623
Abstract: China’s immunization programme is relatively strong, with latest WHO-UNICEF monitoring rates for 2019 showing national vaccination coverage over 90%. However, vaccination coverage is heterogeneous, varying across geographic regions, rural–urban communities, and sub-populations. We conducted a qualitative study from a critical realist perspective, analyzing semi-structured interviews with 26 vaccination providers in three provinces, selected to represent regional socioeconomic disparities across Eastern, Central, and Western China. We analyzed data thematically, using deductive and inductive coding. Providers reported vaccination coverage in their areas had increased significantly, but remained lower among migrant and left-behind children. Main coverage determinants were child-related (i.e. gender, number, health status), caregiver-related (i.e. socioeconomic status, role, education level, ethnicity), institution-related (i.e. vaccinator numbers, information system, appointment process), and system-related (i.e. vaccine supply, intersectoral cooperation, vaccine ‘hesitancy’). Potentially effective measures to promote vaccination coverage included using routine maternal and child health-care visits for catch-up vaccination, providing additional health education, conducting follow-up family visits by village doctors, and requiring vaccination verification at school enrollment. This is the first qualitative study to examine potential determinants of low vaccination coverage in these areas of China. Findings can inform policies to strengthen the role of schools, develop the national immunization information system, and promote appointment apps. More consideration is needed to improve service quality and eliminating inequities, such as strengthening health education and service provision for migrant and left-behind children.
Source Title: HUMAN VACCINES & IMMUNOTHERAPEUTICS
URI: https://scholarbank.nus.edu.sg/handle/10635/224737
ISSN: 21645515
2164554X
DOI: 10.1080/21645515.2022.2030623
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