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Article(id=1241771814951649523, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241771801366299468, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202407394, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1721577600000, receivedDateStr=2024-07-22, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773991071689, onlineDateStr=2026-03-20, pubDate=1729785600000, pubDateStr=2024-10-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773991071689, onlineIssueDateStr=2026-03-20, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773991071689, creator=13701087609, updateTime=1773991071689, updator=13701087609, issue=Issue{id=1241771801366299468, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='20', pageStart='3649', pageEnd='3840', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773991068450, creator=13701087609, updateTime=1773991676896, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241774353457681403, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241771801366299468, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241774353457681404, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241771801366299468, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=3804, endPage=3809, ext={EN=ArticleExt(id=1241771815408828702, articleId=1241771814951649523, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Investigate the intention and influencing factors of herpes zoster vaccination among people aged ≥40 years,Nanjing, 2024, columnId=null, journalTitle=Modern Preventive Medicine, columnName=null, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze herpes zoster vaccine (HZV) vaccination intention and influencing factors among people aged 40 years and above.

Methods

A stratified sampling method was used to select people aged ≥40 years from 6 streets of 3 districts in Nanjing for a questionnaire survey. Multivariate Logistic regression model was used to analyze the influencing factors of HZV vaccination intention.

Results

Among those who had not been vaccinated with HZV, 27.00% (385/1 426) were willing to receive HZV vaccination. High income region (OR=1.53,95%CI:1.05-2.21), employee basic medical insurance (OR=1.52,95%CI:1.02-2.27), per capita monthly household income >10 000 yuan (OR=2.15,95%CI:1.26-3.67), currently or before retirement engaged in health care (OR=1.86,95%CI:1.05-3.30), self-assessed good or very good health status (OR=3.27,95%CI:1.50-7.09), family history of HZ (OR=1.93,95%CI:1.37-2.71), influenza vaccine immunization history (OR=2.53,95%CI:1.66-3.84), HZV willingness to pay >1 000 yuan (OR=2.49,95%CI:1.44-4.30), perceived susceptibility (OR=1.17,95%CI:1.02-1.34), and self-efficacy (OR=1.59,95%CI:1.28-1.96) were the influencing factors to promote the HZV vaccination intention.

Conclusion

The willingness rate of HZV vaccination in people ≥40 years old in Nanjing is low. Health education about Herpes zoster (HZ) and HZV should be strengthened, especially the susceptibility of HZ and the safety of HZV. According to the characteristics of HZV vaccination recipients, vaccination agencies can take various ways to publicize vaccination service information and optimize the vaccination process such as appointment and payment. Relevant departments should explore HZV immunization strategies to reduce the economic burden of HZV vaccination.

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目的

分析≥40岁人群带状疱疹疫苗（Herpes zoster vaccine, HZV）接种意愿和影响因素。

方法

采用分层抽样方法在南京市3个区6个街道选择≥40岁人群开展问卷调查，多因素logistic回归模型分析HZV接种意愿的影响因素。

结果

尚未接种HZV的调查对象中，HZV接种意愿为27.00%（385/1426）。高收入区域(OR=1.53,95%CI:1.05~2.21)、职工基本医疗保险(OR=1.52,95%CI:1.02~2.27)、家庭人均月收入>1万元(OR=2.15,95%CI:1.26~3.67)、现在或退休前从事医疗卫生行业(OR=1.86,95%CI:1.05~3.30)、健康状况自我评估好/很好(OR=3.27,95%CI:1.50~7.09)、家人HZ患病史(OR=1.93,95%CI:1.37~2.71)、流感疫苗免疫史(OR=2.53,95%CI:1.66~3.84)、HZV支付意愿>0.1万元(OR=2.49,95%CI:1.44~4.30)、感知易感性(OR=1.17,95%CI:1.02~1.34)、自我效能(OR=1.59,95%CI:1.28~1.96)为促进HZV接种意愿的影响因素。

结论

南京市≥40岁人群HZV接种意愿率较低，需加强带状疱疹（Herpes zoster, HZ）和HZV的健康宣教，尤其是HZ易感性和HZV安全性；预防接种单位可针对HZV接种对象特征，采取多种方式公示接种服务信息，优化预约缴费等接种流程；相关部门可探讨HZV免疫策略，减轻疫苗接种的经济负担。

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梁亚琼，E-mail：
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=Gv5ieabm0rnRqYtuhk1YzQ==, magXml=zzeviDOe9T/MCpTNdD9LPg==, pdfUrl=null, pdf=WDSZXDSYg8I1ZQcO7A8qZA==, pdfFileSize=654374, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=SY1626cd2eczyTlQDfDkgQ==, mapNumber=null, authorCompany=null, fund=null, authors=

黄琦敏（1980—），女，本科，副主任医师，研究方向：免疫规划

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黄琦敏（1980—），女，本科，副主任医师，研究方向：免疫规划

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黄琦敏（1980—），女，本科，副主任医师，研究方向：免疫规划

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(In Chinese), articleTitle=Investigation on the willingness of herpes zoster vaccination and its influencing factors among residents aged ≥50 years inZhengzhou city, refAbstract=null), Reference(id=1241815282344334186, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771814951649523, doi=null, pmid=null, pmcid=null, year=2024, volume=40, issue=4, pageStart=471, pageEnd=476, url=null, language=null, rfNumber=[17], rfOrder=25, authorNames=张淑华, 杨猛, 王士洪, journalName=中国公共卫生, refType=null, unstructuredReference=张淑华，杨猛，王士洪，等．滕州市≥40岁居民带状疱疹疫苗接种意愿及影响因素分析[J]．中国公共卫生，2024，40（4）：471-476．, articleTitle=滕州市≥40岁居民带状疱疹疫苗接种意愿及影响因素分析, refAbstract=null), Reference(id=1241815282424025964, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771814951649523, doi=null, pmid=null, pmcid=null, year=2024, volume=40, issue=4, pageStart=471, pageEnd=476, url=null, language=null, rfNumber=[17], rfOrder=26, authorNames=Zhang SH, Yang M, Wang SH, journalName=Chinese Journal of Public Health, refType=null, unstructuredReference=Zhang SH, Yang M, Wang SH, et al. Prevalence and influencing factors of willingness to receive herpes zoster vaccination among residents aged≥40 years inTengzhou city:a cross-sectional survey in 2023[J]. Chinese Journal of Public Health, 2024, 40(4): 471-476. (In Chinese), articleTitle=Prevalence and influencing factors of willingness to receive herpes zoster vaccination among residents aged≥40 years inTengzhou city:a cross-sectional survey in 2023, refAbstract=null), Reference(id=1241815282516300654, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771814951649523, doi=null, pmid=null, pmcid=null, year=2022, volume=56, issue=2, pageStart=125, pageEnd=131, url=null, language=null, rfNumber=[18], rfOrder=27, authorNames=陆佳, 陆昕悦, 沈钰涛, journalName=中华预防医学杂志, refType=null, unstructuredReference=陆佳，陆昕悦，沈钰涛，等．上海市闵行区50岁以上人群流感、肺炎、带状疱疹疫苗接种意愿及其相关因素分析[J]．中华预防医学杂志，2022，56（2）：125-131．, articleTitle=上海市闵行区50岁以上人群流感、肺炎、带状疱疹疫苗接种意愿及其相关因素分析, refAbstract=null), Reference(id=1241815282612769648, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771814951649523, doi=null, pmid=null, pmcid=null, year=2022, volume=56, issue=2, pageStart=125, pageEnd=131, url=null, language=null, rfNumber=[18], rfOrder=28, authorNames=Lu J, Lu XY, Shen YT, journalName=Chinese Journal of Preventive Medicine, refType=null, unstructuredReference=Lu J, Lu XY,Shen YT, et al. Analysis on vaccination willingness and related factors of influenza, pneumonia, and herpes zoster vaccine among People over 50 years old in Minhang district of Shanghai[J]. Chinese Journal of Preventive Medicine, 2022, 56(2): 125-131. (In Chinese), articleTitle=Analysis on vaccination willingness and related factors of influenza, pneumonia, and herpes zoster vaccine among People over 50 years old in Minhang district of Shanghai, refAbstract=null), Reference(id=1241815282679878514, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771814951649523, doi=null, pmid=null, pmcid=null, year=2024, volume=30, issue=2, pageStart=141, pageEnd=148, url=null, language=null, rfNumber=[19], rfOrder=29, authorNames=王迪, 孙昊, 陈娅妮, journalName=中国疫苗和免疫, refType=null, unstructuredReference=王迪，孙昊，陈娅妮，等．2023年北京市东城区≥50岁居民流感疫苗、23价肺炎球菌多糖疫苗和带状疱疹疫苗接种意愿调查[J]．中国疫苗和免疫，2024，30（2）：141-148．, articleTitle=2023年北京市东城区≥50岁居民流感疫苗、23价肺炎球菌多糖疫苗和带状疱疹疫苗接种意愿调查, refAbstract=null), Reference(id=1241815284156273524, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771814951649523, doi=null, pmid=null, pmcid=null, year=2024, volume=30, issue=2, pageStart=141, pageEnd=148, url=null, language=null, rfNumber=[19], rfOrder=30, authorNames=Wang D, Sun H, Chen YN, journalName=Chinese Journal of Vaccines and Immunization, refType=null, unstructuredReference=Wang D, Sun H, Chen YN, et al. Willingness to receive influenza vaccine,23-valent pneumococcal polysaccharidevaccine,and herpes zoster vaccine among residents over 50 years old:a cross-sectional study in Dongcheng district of Beijing in 2023[J]. Chinese Journal of Vaccines and Immunization, 2024, 30(2): 141-148. (In Chinese), articleTitle=Willingness to receive influenza vaccine,23-valent pneumococcal polysaccharidevaccine,and herpes zoster vaccine among residents over 50 years old:a cross-sectional study in Dongcheng district of Beijing in 2023, refAbstract=null)], funds=[Fund(id=1241815277898371900, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771814951649523, awardId=YKK22194, language=CN, fundingSource=南京市卫生科技发展专项资金项目(YKK22194), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241815272802292449, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771814951649523, xref=null, ext=[AuthorCompanyExt(id=1241815272810681058, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771814951649523, companyId=1241815272802292449, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu 210003, China), AuthorCompanyExt(id=1241815272819069667, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771814951649523, companyId=1241815272802292449, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=南京市疾病预防控制中心，江苏 南京 210003)])], figs=[ArticleFig(id=1241815277223088945, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771814951649523, language=EN, label=Table 1, caption=

Univariate analysis of herpes zoster vaccination intention among people aged≥40 years in Nanjing based on sociodemographic information

, figureFileSmall=null, figureFileBig=null, tableContent=
变量调查人数愿意接种人数愿意接种率χ2P值
性别10.970.001
男性52911621.93
女性89726929.99
年龄(岁)213.78<0.001
40~4920913564.59
50~592529035.71
60~694468118.16
≥705197915.22
区域141.90<0.001
中低收入区域98017217.55
高收入区域44621347.76
文化程度180.01<0.001
小学及以下3784912.96
初中3737520.11
高中3096621.36
专科及以上36619553.28
婚姻状况0.900.343
已婚1 30235627.34
未婚/离异/分居/丧偶1242923.39
户籍3.010.083
非南京市2106731.90
南京市1 21631826.15
就业170.30<0.001
否1 15522619.57
是27115958.67
基本医疗保险类型26.90<0.001
非职工基本医疗保险4949218.62
职工基本医疗保险93229331.44
家庭人均月收入(万元)201.20<0.001
<0.597016416.91
0.5~130311738.61
>115310467.97
目前或过去从事医疗卫生行业180.42<0.001
否1 27327421.52
是15311172.55
目前或过去从事疫苗相关工作45.66<0.001
否1 38535525.63
是413073.17
健康状况自我评估69.03<0.001
差/很差1061110.38
一般66613019.52
好/很好65424437.31
HZ患病史4.540.103
有3038528.05
无1 09328726.26
不详301343.33
水痘患病史58.07<0.001
有1909147.89
无104823222.14
不详1886232.98
家人HZ患病史69.29<0.001
有32014144.06
无1 04922221.16
不详572238.60
家人水痘患病史99.48<0.001
有1819451.93
无1 08522320.55
不详1606842.50
患有慢性病62.52<0.001
是82415719.05
否60222837.87
家人HZV免疫史48.27<0.001
无1 34933825.06
有342264.71
不详432558.14
流感疫苗免疫史93.38<0.001
无1 24728322.69
有17910256.98
HZV支付意愿 (万元)35.03<0.001
≤0.11 33233525.15
>0.1945053.19
), ArticleFig(id=1241815277353112371, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771814951649523, language=CN, label=表1, caption=

基于社会人口学信息的南京市≥40岁人群带状疱疹疫苗接种意愿单因素分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量调查人数愿意接种人数愿意接种率χ2P值
性别10.970.001
男性52911621.93
女性89726929.99
年龄(岁)213.78<0.001
40~4920913564.59
50~592529035.71
60~694468118.16
≥705197915.22
区域141.90<0.001
中低收入区域98017217.55
高收入区域44621347.76
文化程度180.01<0.001
小学及以下3784912.96
初中3737520.11
高中3096621.36
专科及以上36619553.28
婚姻状况0.900.343
已婚1 30235627.34
未婚/离异/分居/丧偶1242923.39
户籍3.010.083
非南京市2106731.90
南京市1 21631826.15
就业170.30<0.001
否1 15522619.57
是27115958.67
基本医疗保险类型26.90<0.001
非职工基本医疗保险4949218.62
职工基本医疗保险93229331.44
家庭人均月收入(万元)201.20<0.001
<0.597016416.91
0.5~130311738.61
>115310467.97
目前或过去从事医疗卫生行业180.42<0.001
否1 27327421.52
是15311172.55
目前或过去从事疫苗相关工作45.66<0.001
否1 38535525.63
是413073.17
健康状况自我评估69.03<0.001
差/很差1061110.38
一般66613019.52
好/很好65424437.31
HZ患病史4.540.103
有3038528.05
无1 09328726.26
不详301343.33
水痘患病史58.07<0.001
有1909147.89
无104823222.14
不详1886232.98
家人HZ患病史69.29<0.001
有32014144.06
无1 04922221.16
不详572238.60
家人水痘患病史99.48<0.001
有1819451.93
无1 08522320.55
不详1606842.50
患有慢性病62.52<0.001
是82415719.05
否60222837.87
家人HZV免疫史48.27<0.001
无1 34933825.06
有342264.71
不详432558.14
流感疫苗免疫史93.38<0.001
无1 24728322.69
有17910256.98
HZV支付意愿 (万元)35.03<0.001
≤0.11 33233525.15
>0.1945053.19
), ArticleFig(id=1241815277432804149, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771814951649523, language=EN, label=Table 2, caption=

Assignment for multivariate analysis of herpes zoster vaccination intention among people aged ≥40 years in Nanjing

, figureFileSmall=null, figureFileBig=null, tableContent=
因素变量名定义赋值
因变量
疫苗接种意愿Y不愿意接种=0；愿意接种=1
人口学因素
性别X1男=1；女=2
年龄(岁)X240~49=1；50~59=2；60~69=3；≥70=4
区域X3中低收入区域=1；高收入区域=2
文化程度X4小学及以下=1；初中=2；高中=3；专科及以上=4
就业X5否=1；是=2
基本医疗保险类型X6非职工基本医疗保险=1；职工基本医疗保险=2
家庭人均月收入(万元)X7<0.5=1；0.5~1=2：>1=3
目前或过去从事医疗卫生行业X8否=1；是=2
目前或过去从事疫苗相关工作X9否=1；是=2
健康状况自我评估X10差/很差=1；一般=2；好/很好=3
水痘患病史X11无=1；有=2；不详=3
家人HZ患病史X12无=1；有=2；不详=3
家人水痘患病史X13无=1；有=2；不详=3
患有慢性病X14是=1；否=2
家人HZV免疫史X15无=1；有=2；不详=3
流感疫苗免疫史X16无=1；有=2
HZV支付意愿 (万元)X17≤0.1=1；>0.1=2
保护动机因素及认识因素
知识X18各题项得分总分：连续变量
感知严重性X19题项平均得分：连续变量
感知易感性X20题项平均得分：连续变量
内部回报X21题项平均得分：连续变量
外部回报X22题项平均得分：连续变量
反应效能X23题项平均得分：连续变量
自我效能X24题项平均得分：连续变量
反应代价X25题项平均得分：连续变量
), ArticleFig(id=1241815277495718711, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771814951649523, language=CN, label=表2, caption=

南京市≥40岁人群带状疱疹疫苗接种意愿的多因素分析赋值

, figureFileSmall=null, figureFileBig=null, tableContent=
因素变量名定义赋值
因变量
疫苗接种意愿Y不愿意接种=0；愿意接种=1
人口学因素
性别X1男=1；女=2
年龄(岁)X240~49=1；50~59=2；60~69=3；≥70=4
区域X3中低收入区域=1；高收入区域=2
文化程度X4小学及以下=1；初中=2；高中=3；专科及以上=4
就业X5否=1；是=2
基本医疗保险类型X6非职工基本医疗保险=1；职工基本医疗保险=2
家庭人均月收入(万元)X7<0.5=1；0.5~1=2：>1=3
目前或过去从事医疗卫生行业X8否=1；是=2
目前或过去从事疫苗相关工作X9否=1；是=2
健康状况自我评估X10差/很差=1；一般=2；好/很好=3
水痘患病史X11无=1；有=2；不详=3
家人HZ患病史X12无=1；有=2；不详=3
家人水痘患病史X13无=1；有=2；不详=3
患有慢性病X14是=1；否=2
家人HZV免疫史X15无=1；有=2；不详=3
流感疫苗免疫史X16无=1；有=2
HZV支付意愿 (万元)X17≤0.1=1；>0.1=2
保护动机因素及认识因素
知识X18各题项得分总分：连续变量
感知严重性X19题项平均得分：连续变量
感知易感性X20题项平均得分：连续变量
内部回报X21题项平均得分：连续变量
外部回报X22题项平均得分：连续变量
反应效能X23题项平均得分：连续变量
自我效能X24题项平均得分：连续变量
反应代价X25题项平均得分：连续变量
), ArticleFig(id=1241815277587993401, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771814951649523, language=EN, label=Table 3, caption=

Multivariate analysis of herpes zoster vaccination intention among people aged ≥40 years in Nanjing

, figureFileSmall=null, figureFileBig=null, tableContent=
变量βWald χ2 值P值OR值(95%CI)
区域
中低收入区域1.00
高收入区域0.4230.1895.0010.0251.53(1.05~2.21)
医疗保险类型
非职工基本医疗保险1.00
职工基本医疗保险0.4190.2044.2270.0401.52(1.02~2.27)
家庭人均月收入(万元)
<0.51.00
0.5~1-0.0290.2110.0180.8920.97(0.64~1.47)
>10.7640.2747.8090.0052.15(1.26~3.67)
现在或退休前是否从事医疗卫生行业
否1.00
是0.6200.2924.4960.0341.86(1.05~3.30)
健康状况自我评估
差/很差1.00
一般0.6230.3932.5170.1131.87(0.86~4.03)
好/很好1.1830.3968.9420.0033.27(1.50~7.09)
家人HZ患病史
否1.00
是0.6580.17414.337<0.0011.93(1.37~2.71)
不详0.0850.3920.0470.8291.09(0.51~2.35)
流感疫苗免疫史
否1.00
是0.9280.21418.821<0.0012.53(1.66~3.84)
HZV支付意愿 (万元)
≤0.11.00
>0.10.9130.27910.7350.0012.49(1.44~4.30)
感知易感性0.1590.0705.1740.0231.17(1.02~1.34)
内部回报-0.2580.0878.9040.0030.77(0.65~0.92)
外部回报-0.1980.0806.1970.0130.82(0.70~0.96)
自我效能0.4610.10818.210<0.0011.59(1.28~1.96)
反应代价-0.4530.09920.897<0.0010.64(0.52~0.77)
), ArticleFig(id=1241815277738988346, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771814951649523, language=CN, label=表3, caption=

南京市≥40岁人群带状疱疹疫苗接种意愿多因素分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量βWald χ2 值P值OR值(95%CI)
区域
中低收入区域1.00
高收入区域0.4230.1895.0010.0251.53(1.05~2.21)
医疗保险类型
非职工基本医疗保险1.00
职工基本医疗保险0.4190.2044.2270.0401.52(1.02~2.27)
家庭人均月收入(万元)
<0.51.00
0.5~1-0.0290.2110.0180.8920.97(0.64~1.47)
>10.7640.2747.8090.0052.15(1.26~3.67)
现在或退休前是否从事医疗卫生行业
否1.00
是0.6200.2924.4960.0341.86(1.05~3.30)
健康状况自我评估
差/很差1.00
一般0.6230.3932.5170.1131.87(0.86~4.03)
好/很好1.1830.3968.9420.0033.27(1.50~7.09)
家人HZ患病史
否1.00
是0.6580.17414.337<0.0011.93(1.37~2.71)
不详0.0850.3920.0470.8291.09(0.51~2.35)
流感疫苗免疫史
否1.00
是0.9280.21418.821<0.0012.53(1.66~3.84)
HZV支付意愿 (万元)
≤0.11.00
>0.10.9130.27910.7350.0012.49(1.44~4.30)
感知易感性0.1590.0705.1740.0231.17(1.02~1.34)
内部回报-0.2580.0878.9040.0030.77(0.65~0.92)
外部回报-0.1980.0806.1970.0130.82(0.70~0.96)
自我效能0.4610.10818.210<0.0011.59(1.28~1.96)
反应代价-0.4530.09920.897<0.0010.64(0.52~0.77)
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2024年南京市≥40岁人群带状疱疹疫苗接种意愿和影响因素调查
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黄琦敏 , 陈健 , 王静 , 沈超 , 周夏婕 , 孟令瑞 , 梁亚琼
现代预防医学 | 疾病预防控制 2024,51(20): 3804-3809
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现代预防医学 | 疾病预防控制 2024, 51(20): 3804-3809
2024年南京市≥40岁人群带状疱疹疫苗接种意愿和影响因素调查
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黄琦敏, 陈健, 王静, 沈超, 周夏婕, 孟令瑞, 梁亚琼
作者信息
  • 南京市疾病预防控制中心，江苏 南京 210003

    • 黄琦敏（1980—），女，本科，副主任医师，研究方向：免疫规划

通讯作者:

梁亚琼，E-mail：
Investigate the intention and influencing factors of herpes zoster vaccination among people aged ≥40 years,Nanjing, 2024
Qi-min HUANG, Jian CHEN, Jing WANG, Chao SHEN, Xia-jie ZHOU, Ling-rui MENG, Ya-qiong LIANG
Affiliations
  • Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu 210003, China
出版时间: 2024-10-25 doi: 10.20043/j.cnki.MPM.202407394
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摘要
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目的

分析≥40岁人群带状疱疹疫苗（Herpes zoster vaccine, HZV）接种意愿和影响因素。

方法

采用分层抽样方法在南京市3个区6个街道选择≥40岁人群开展问卷调查，多因素logistic回归模型分析HZV接种意愿的影响因素。

结果

尚未接种HZV的调查对象中，HZV接种意愿为27.00%（385/1426）。高收入区域(OR=1.53,95%CI:1.05~2.21)、职工基本医疗保险(OR=1.52,95%CI:1.02~2.27)、家庭人均月收入>1万元(OR=2.15,95%CI:1.26~3.67)、现在或退休前从事医疗卫生行业(OR=1.86,95%CI:1.05~3.30)、健康状况自我评估好/很好(OR=3.27,95%CI:1.50~7.09)、家人HZ患病史(OR=1.93,95%CI:1.37~2.71)、流感疫苗免疫史(OR=2.53,95%CI:1.66~3.84)、HZV支付意愿>0.1万元(OR=2.49,95%CI:1.44~4.30)、感知易感性(OR=1.17,95%CI:1.02~1.34)、自我效能(OR=1.59,95%CI:1.28~1.96)为促进HZV接种意愿的影响因素。

结论

南京市≥40岁人群HZV接种意愿率较低，需加强带状疱疹（Herpes zoster, HZ）和HZV的健康宣教，尤其是HZ易感性和HZV安全性；预防接种单位可针对HZV接种对象特征，采取多种方式公示接种服务信息，优化预约缴费等接种流程；相关部门可探讨HZV免疫策略，减轻疫苗接种的经济负担。

带状疱疹疫苗  /  带状疱疹  /  接种意愿  /  影响因素
Objective

To analyze herpes zoster vaccine (HZV) vaccination intention and influencing factors among people aged 40 years and above.

Methods

A stratified sampling method was used to select people aged ≥40 years from 6 streets of 3 districts in Nanjing for a questionnaire survey. Multivariate Logistic regression model was used to analyze the influencing factors of HZV vaccination intention.

Results

Among those who had not been vaccinated with HZV, 27.00% (385/1 426) were willing to receive HZV vaccination. High income region (OR=1.53,95%CI:1.05-2.21), employee basic medical insurance (OR=1.52,95%CI:1.02-2.27), per capita monthly household income >10 000 yuan (OR=2.15,95%CI:1.26-3.67), currently or before retirement engaged in health care (OR=1.86,95%CI:1.05-3.30), self-assessed good or very good health status (OR=3.27,95%CI:1.50-7.09), family history of HZ (OR=1.93,95%CI:1.37-2.71), influenza vaccine immunization history (OR=2.53,95%CI:1.66-3.84), HZV willingness to pay >1 000 yuan (OR=2.49,95%CI:1.44-4.30), perceived susceptibility (OR=1.17,95%CI:1.02-1.34), and self-efficacy (OR=1.59,95%CI:1.28-1.96) were the influencing factors to promote the HZV vaccination intention.

Conclusion

The willingness rate of HZV vaccination in people ≥40 years old in Nanjing is low. Health education about Herpes zoster (HZ) and HZV should be strengthened, especially the susceptibility of HZ and the safety of HZV. According to the characteristics of HZV vaccination recipients, vaccination agencies can take various ways to publicize vaccination service information and optimize the vaccination process such as appointment and payment. Relevant departments should explore HZV immunization strategies to reduce the economic burden of HZV vaccination.

Herpes zoster vaccine  /  Herpes zoster  /  Vaccination will  /  Influencing factor
黄琦敏, 陈健, 王静, 沈超, 周夏婕, 孟令瑞, 梁亚琼. 2024年南京市≥40岁人群带状疱疹疫苗接种意愿和影响因素调查. 现代预防医学, 2024 , 51 (20) : 3804 -3809 . DOI: 10.20043/j.cnki.MPM.202407394
Qi-min HUANG, Jian CHEN, Jing WANG, Chao SHEN, Xia-jie ZHOU, Ling-rui MENG, Ya-qiong LIANG. Investigate the intention and influencing factors of herpes zoster vaccination among people aged ≥40 years,Nanjing, 2024[J]. Modern Preventive Medicine, 2024 , 51 (20) : 3804 -3809 . DOI: 10.20043/j.cnki.MPM.202407394
正文
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带状疱疹（Herpes zoster，HZ）是由潜伏在神经节中的水痘-带状疱疹病毒（Varicella-zoster virus，VZV）再激活引起的一种常见皮肤疾病[1]。HZ的主要症状是疼痛，起水泡[2]，并发症有带状疱疹后神经痛（Postherpetic neuralgia，PHN）、眼疱疹等[3]。HZ及其相关并发症的发病率随着年龄增长而增加[4]，终生发病风险约30%[5]，疾病负担很重[6]且严重影响生活质量[7]。HZ疫苗（Herpes zoster vaccine，HZV）可以有效预防HZ及并发症[8-10]。江苏省南京市2020年8月和2023年8月分别开始使用接种对象为≥50岁的进口重组带状疱疹疫苗和≥40岁的国产带状疱疹减毒活疫苗。本研究基于保护动机理论（Protection motivation theory，PMT）对南京市≥40岁人群开展HZV接种意愿调查，为后续更为有效开展HZV免疫策略研究提供科学依据。
1　对象与方法
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1.1　研究对象
本研究样本量计算公式为。参照既往文献研究结果，愿意接种HZ疫苗的比例为16.57%[11]，P取16.57%，容许误差δ设为0.02，α取0.05，计算最小样本量为1328人。考虑问卷质量等问题，将样本量定为1500人。按照南京市统计局2022年城镇居民人均可支配收入水平，将南京市12个区依次排序，4个区列入高收入区域、4个区列入中收入区域、4个区列入低收入区域。每个收入区域各随机抽取1个区，每个区按照抽签法抽取2个街道，每个街道随机抽取1个社区卫生服务中心。2024年3~5月，每个社区卫生服务中心按照方便抽样的方法抽取250名≥40岁南京市户籍或者无南京市户籍但居住半年及以上的居民。
1.2　问卷调查
自行编制基于PMT的《南京市社区居民带状疱疹疫苗的接种意愿调查》问卷。调查内容包括调查对象基本信息、支付意愿、接种意愿、HZ/HZV知识、基于PMT的HZ/HZV态度等。HZ/HZV知识题共计6道，每题答对得1分，答错或者不清楚得0分，总计6分。PMT分为7个维度[12-13]，本问卷PMT条目设置感知严重性5个条目、感知易感性3个条目、内部回报4个条目、外部回报3个条目、反应效能5个条目、自我效能5个条目、反应代价3个条目。PMT各条目均采用李斯特5级评分法量表。“完全不同意”、“不太同意”、“有一些同意”、“大部分同意”和“完全同意”分别赋值1、2、3、4 和5分，计算各维度得分。本次研究面对面充分告知调查对象研究内容、目的、方法等，调查对象知情同意后，自行选择问卷星平台回答题目或者纸质问卷答题。本研究方案经南京市疾病预防控制中心伦理委员会审批通过。
1.3　质量控制
调查员经过培训后上岗。每日现场调查结束，对当日问卷进行查验核对，确保数据质量。数据整理时，剔除PMT条目选项都一致的问卷。数据录入后，抽取10%问卷进行复核，检查数据录入的准确率。
1.4　统计分析
运用SPSS 25.0软件对数据进行分析。使用χ2检验进行基于社会人口学的接种意愿单因素分析，将基于社会人口学的接种意愿单因素分析中有意义的变量、PMT各维度平均得分、知识总分共同纳入logistic回归进行多因素分析，检验水准α=0.05。
2　结果
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2.1　调查对象基本情况
本次研究共计发放问卷1 528份，收回有效问卷1 479份。1 479例调查对象中，1 426例未接种HZV，占96.42%。未接种的调查对象中385人愿意接种，占27.00%，1 041人不愿意接种，占73.00%。1426例中，男性、女性分别占37.10%、62.90%，40~49岁、50~59岁、60~69岁、≥70岁分别占14.66%、17.67%、31.28%、36.39%，小学及以下、初中、高中、专科及以上文化程度分别占26.51%、26.16%、21.67%、25.66%，非就业人员、就业人员分别占81.00%、19.00%，非职工基本医疗保险、职工基本医疗保险分别占34.64%、65.36%，家庭人均月收入<0.5万元、0.5~1万元、>1万元分别占68.02%、21.25%、10.73%。见表1。接种意愿单因素分析，性别、年龄、区域、文化程度、就业、基本医疗保险类型、家庭人均月收入、目前或过去从事医疗卫生行业、目前或过去从事疫苗相关工作、健康状况自我评估、水痘患病史、家人HZ患病史、家人水痘患病史、慢性病情况、家人HZV免疫史、流感疫苗免疫史、HZV支付意愿有统计学差异。
2.2　基于PMT的HZV接种意愿多因素分析
将疫苗接种意愿作为因变量，接种意愿单因素分析中有统计学差异的因素、保护动机因素及知识因素作为自变量纳入二元logistic回归模型进行分析。见表2。结果显示，高收入区域（OR=1.53,95%CI:1.05~2.21）、职工基本医疗保险（OR=1.52,95%CI:1.02~2.27）、家庭人均月收入>1万元（OR=2.15,95%CI:1.26~3.67）、现在或退休前从事医疗卫生行业（OR=1.86,95%CI:1.05~3.30）、健康状况自我评估好/很好（OR=3.27,95%CI:1.50~7.09）、家人HZ患病史（OR=1.93,95%CI:1.37~2.71）、流感疫苗免疫史（OR=2.53,95%CI:1.66~3.84）、HZV支付意愿>0.1万元（OR=2.49,95%CI:1.44~4.30）、感知易感性（OR=1.17,95%CI:1.02~1.34）、自我效能（OR=1.59,95%CI:1.28~1.96）为促进HZV接种意愿的影响因素。内部回报（OR=0.77,95%CI:0.65~0.92）、外部回报（OR=0.82,95%CI:0.70~0.96）、反应代价（OR=0.64,95%CI:0.52~0.77）为阻碍HZV接种意愿的影响因素。见表3。
3　讨论
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本研究结果显示，南京市≥40岁未接种HZ疫苗人群中有27.00%的人愿意接种带状疱疹疫苗。低于Wang等人在中国部分地区城市居民中调查的接种意愿率42.67% [14]，也低于张欣等人在中国6个城市调查的接种意愿率90.1%[15]和黄淑雅等人在郑州市调查的接种意愿率42.07%[16]。各地区HZ疫苗接种意愿率差异，可能与研究对象年龄、研究方法等不同有关，也可能与各地接种政策、经济水平、疫苗使用时间、宣传力度、HZ发病率等因素有关[17]。
本研究接种意愿多因素分析结果显示，基本医疗保险类型为职工基本医疗保险者接种意愿高。按照江苏省2023年6月1日施行的《江苏省医疗保障条例》，基本医疗保险包括职工基本医疗保险和城乡居民基本医疗保险两种。南京市目前疫苗接种政策是，职工基本医疗保险的参保者可通过医保卡的个人账户支付HZV费用。这可能是南京市职工基本医疗保险者接种意愿高的主要原因。上海的一项研究也表明，医保支付场景下愿意接种HZV的比例约为自费场景下的4.5倍[18]。提示医保政策是影响接种意愿的重要因素。此次研究中，反应代价平均得分高者HZV接种意愿率低。反应代价条目包括“带状疱疹疫苗价格昂贵”、“担心接种带状疱疹疫苗可能会产生副作用”、“担心接种带状疱疹疫苗会得带状疱疹”。提示接种对象对疫苗价格和疫苗安全性的担心影响接种意愿。本项目研究结果中，家庭人均月收入>1万元者和HZV支付意愿>0.1万元者接种意愿高，也提示HZV价格是影响HZV接种意愿的重要因素。目前南京市的进口重组带状疱疹疫苗需接种2剂次，每剂次疫苗价格为1598元。国产带状疱疹疫苗需接种1剂次，疫苗价格为1369元。而调查对象家庭人均月收入<0.5万元的占68.02%，不少调查对象表示HZV价格高，进口HZV价格甚至超过个人月收入，经济负担较重。建议相关部门采取医保报销、降低疫苗价格、对重点人群减免疫苗费用等免疫策略，提高HZV接种意愿。本次研究结果中，健康状况自我评估好/很好者接种意愿高于健康状况自我评估差/很差者，在调查中，一些健康状况自我评估差/很差者表示担心自己的疾病属于HZV禁忌症或者HZV加重现有病情，不愿意接种HZV。需加强HZV安全性的健康宣教，预防接种前做好健康评估工作，提高接种意愿。
现在或退休前从事医疗卫生行业者接种意愿高，可能是由于这部分人群对HZ的危害性、易感性，疫苗的安全性、有效性更加了解，所以愿意接种，需作进一步研究。家人有HZ患病史者接种意愿高，这可能是由于家人患HZ，调查对象对HZ疾病认知水平更高，更加愿意接种疫苗预防疾病。有流感疫苗免疫史者接种意愿高，这与北京市东城区一项研究结果一致[19]。可能是因为流感疫苗和带状疱疹疫苗都是非免疫规划疫苗，接种流感疫苗人群更加关注自身健康状况，对疫苗的有效性和安全性也比较认可。感知易感性得分高者接种意愿率高，这与张欣等人的研究结果一致[15]，建议今后的工作中，加强对HZ易感性的健康宣教，提高接种意愿。自我效能得分高者接种意愿率高，此次研究的自我效能条目包括“我相信接种带状疱疹疫苗是一件很容易的事”、“我有能力查询到带状疱疹疫苗的接种服务信息”、“我认为我有能力解决预约、缴费等带状疱疹疫苗接种流程中遇到的问题”等问题。HZV接种对象为≥40岁人群，这部分人群信息来源不如年轻人，一些调查对象认为预约缴费流程繁琐，接种疫苗不方便。预防接种单位可以针对HZ的接种对象特征采取更为多样且有效的方式宣传公示HZV疫苗接种服务信息，简化预约缴费流程，提高接种意愿。
综上所述，南京市的HZV接种意愿率较低。在今后的工作中，将针对不同人口学特征人群采取措施，加强HZ和HZV的健康宣教，尤其是HZ易感性和HZV安全性的健康宣传；预防接种单位可针对HZV接种对象特征，采取多种方式公示接种服务信息，优化预约缴费等流程；建议相关部门探讨HZV免疫策略，通过将HZ疫苗费用纳入医保报销范畴、重点人群减免疫苗费用、降低HZ疫苗价格等措施，减轻疫苗接种经济负担，提高接种意愿。
基金
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  • 南京市卫生科技发展专项资金项目(YKK22194)
文献
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2024年第51卷第20期
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doi: 10.20043/j.cnki.MPM.202407394
  • 接收时间：2024-07-22
  • 首发时间：2026-03-20
  • 出版时间：2024-10-25
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  • 收稿日期：2024-07-22
基金
南京市卫生科技发展专项资金项目(YKK22194)
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    南京市疾病预防控制中心，江苏 南京 210003

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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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