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Article(id=1320427660015153732, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320427658937225679, articleNumber=null, orderNo=null, doi=10.11847/zgggws1148817, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1750176000000, receivedDateStr=2025-06-18, revisedDate=1760198400000, revisedDateStr=2025-10-12, acceptedDate=1776268800000, acceptedDateStr=2026-04-16, onlineDate=1792744086506, onlineDateStr=2026-10-23, pubDate=1786291200000, pubDateStr=2026-08-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792744086506, onlineIssueDateStr=2026-10-23, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792744086506, creator=13701087609, updateTime=1792744086506, updator=13701087609, issue=Issue{id=1320427658937225679, tenantId=1146029695717560320, journalId=1319373219989389464, year='2026', volume='42', issue='8', pageStart='897', pageEnd='1024', issueExtLink='null', onlineDate='null', pubDate='1786291200000', pubDateStr='2026-08-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792744086250, creator='13701087609', updateTime=1792747993375, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1320444046678544663, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320427658937225679, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1320444046678544664, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320427658937225679, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=919, endPage=924, ext={EN=ArticleExt(id=1320427660275200582, articleId=1320427660015153732, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=Characteristics and influencing factors of parents′ hesitancy for non-immunization program vaccines in children aged 1–6 in Beijing: a survey in 2025, columnId=1320427660187120197, journalTitle=Chinese Journal of Public Health, columnName=Special Report—Evaluating the Protective Effect of Childhood Vaccination, runingTitle=null, highlight=null, articleAbstract=
Objective

To understand the degree of hesitancy among parents regarding their children′s vaccination with non-immunization program vaccines and its influencing factors, thus providing a basis for formulating targeted intervention measures.

Methods

A multi-stage stratified sampling method was used to select 4 182 parents of children aged 1-6 who accompanied their children to vaccination in 60 community health service centers in urban, suburban, and exurban areas of Beijing. The questionnaire survey was conducted with the Parent Attitudes about Childhood Vaccines (PACV) scale, and the score of the scale, the proportion of vaccine hesitancy and its influencing factors were analyzed.

Results

The median (interquartile range) of the PACV scale score was 33.33 (20.00, 43.33). The proportion of vaccine hesitancy was 13.03% (545/4 182), and the hesitancy proportions for the 15 items in the scale ranged from 6.46% to 83.62%. Multivariate logistic regression analysis revealed that parents of children with non-local household registration (OR=1.313, 95%CI: 1.072–1.607) and male parents (OR = 1.487, 95%CI: 1.240–1.783) had a higher risk of vaccine hesitancy. In contrast, parents aged 30–39 years (OR = 0.668, 95%CI: 0.529–0.843), 40–49 years (OR = 0.690, 95%CI: 0.503-0.947), and ≥50 years (OR = 0.431, 95%CI: 0.267–0.696), as well as those with an annual household income of 100 000–190 000 yuan (OR = 0.644, 95%CI: 0.521–0.797), 200 000–490 000 yuan (OR = 0.567, 95%CI: 0.440–0.730), and ≥500 000 yuan (OR = 0.578, 95%CI: 0.393–0.849), and parents who were homemakers or unemployed (OR = 0.390, 95%CI: 0.232–0.656) had a lower risk of vaccine hesitancy. The top three items in terms of the proportion of parents′ hesitation were concern about children suffering severe adverse reactions after receiving paid vaccines (83.62%), the belief that children were vaccinated with more paid vaccines than needed (73.34%), and concerns about the safety of paid vaccines (70.30%).

Conclusions

The overall proportion of vaccine hesitancy among parents of children in Beijing regarding non-immunization program vaccines is relatively low, while the popularization and education of vaccine knowledge should still be strengthened to further reduce vaccine hesitancy.

, authors=Qianli YUAN, Huai WANG, Pei GAO, Dan ZHAO, Luodan SUO, authorsList=Qianli YUAN, Huai WANG, Pei GAO, Dan ZHAO, Luodan SUO, authorCompany=null, correspAuthors=Luodan SUO, authorNote=null, correspAuthorsNote=
SUO Luodan, E-mail:
, copyrightStatement=Copyright © 2026 Chinese Journal of Public Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1320427660862403147, articleId=1320427660015153732, tenantId=1146029695717560320, journalId=1319373219989389464, language=CN, title=北京市1～6岁儿童家长非免疫规划疫苗犹豫特征及影响因素: 一项2025年现况调查, columnId=1320427660346503751, journalTitle=中国公共卫生, columnName=专题报道——儿童疫苗接种保护效果研究, runingTitle=null, highlight=null, articleAbstract=
目的

了解儿童家长对儿童非免疫规划疫苗接种的犹豫程度及其影响因素，为制定针对性干预措施提供依据。

方法

于2025年2—3月，采用多阶段分层抽样法在北京市城区、近郊及远郊区的60家社区卫生服务中心，选取陪同儿童接种疫苗的1～6岁儿童家长4 182人，使用父母对儿童疫苗接种态度（PACV）量表进行问卷调查，分析量表得分、疫苗犹豫比例及其影响因素。

结果

4 182名家长PACV量表犹豫评分中位数（四分位数间距）为33.33（20.00～43.33）分，疫苗犹豫比例为13.03%（545/4 182），量表15个条目的犹豫比例为6.46%～83.62%。多因素logistic回归分析显示，外地户籍儿童家长（OR=1.313，95%CI=1.072～1.607）、男性家长（OR=1.487，95%CI=1.240～1.783）的疫苗犹豫风险高；年龄30～39岁（OR=0.668，95%CI=0.529～0.843）、40～49岁（OR=0.690，95%CI=0.503～0.947）、≥50岁（OR=0.431，95%CI=0.267～0.696）、家庭年收入10～19万元（OR=0.644，95%CI=0.521～0.797）、20～49万元（OR=0.567，95%CI=0.440～0.730）、≥50万元（OR=0.578，95%CI=0.393～0.849）、职业为家务待业的家长（OR=0.390，95%CI=0.232～0.656）疫苗犹豫风险低。家长犹豫比例排名前3的条目依次为担忧儿童接种自费疫苗后发生严重副反应（83.62%）、认为儿童所接种的自费疫苗种类比实际需要的种类多（73.34%）、担心自费疫苗接种安全性（70.30%）。

结论

北京市儿童家长对非免疫规划疫苗接种的犹豫比例整体较低，但仍需加强疫苗知识科普宣传，以进一步降低疫苗犹豫水平。

, authors=袁千里, 王怀, 高培, 赵丹, 索罗丹*, *, authorsList=袁千里, 王怀, 高培, 赵丹, 索罗丹, authorCompany=null, correspAuthors=索罗丹, authorNote=

袁千里（1990—），主管医师，硕士，研究方向：疫苗可预防传染病防控和免疫规划

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索罗丹，E-mail：
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袁千里（1990—），主管医师，硕士，研究方向：疫苗可预防传染病防控和免疫规划

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year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=1, rfOrder=0, authorNames=null, journalName=null, refType=null, unstructuredReference=World Health Organization. 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Vaccine, 2025, 64: 127696., articleTitle=null, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1320427661063729740, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320427660015153732, xref=null, ext=[AuthorCompanyExt(id=1320427661072118349, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320427660015153732, companyId=1320427661063729740, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Institute for Immunization Prevention, Beijing Center for Disease Prevention and Control, Beijing 100013, China), AuthorCompanyExt(id=1320427661080506958, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320427660015153732, companyId=1320427661063729740, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=北京市疾病预防控制中心免疫预防所，北京 100013)])], figs=[ArticleFig(id=1320427664922489460, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320427660015153732, language=EN, label=Tab.1, caption=

Survey results of PACV items among parents of children aged 1–6 years in Beijing

, figureFileSmall=null, figureFileBig=null, tableContent=
条目PACV量表条目犹豫人数比例/%
1除了生病、过敏外，您曾经是否因为其他原因推迟为您孩子接种自费疫苗？92322.07
2除了生病、过敏外，您是否曾经因为其他原因拒绝为您孩子接种自费疫苗？46511.12
3您在多大程度上同意让您孩子按照推荐的免疫程序去进行自费疫苗接种？3568.51
4您是否认为目前儿童所接种的自费疫苗比他们实际上所需要的多？3 06773.34
5您是否认为自费疫苗预防的都是很严重的疾病？94022.48
6您是否认为对孩子来说，通过生病获得免疫力比接种自费疫苗来获得免疫力好？2 33955.93
7您是否认为儿童同时接种的自费疫苗越少越好？2 57661.60
8您是否担心您的孩子接种自费疫苗后会发生严重副反应？349783.62
9您是否担心每次的自费疫苗接种都可能不安全？2 94070.30
10您是否担心接种的自费疫苗并不能有效预防其对应的疾病？2 93470.16
11如果再生一个孩子您是否愿意让孩子完全按照免疫程序去完成有的自费疫苗接种？58213.92
12总的来说，请评价您自己对儿童自费疫苗接种有多犹豫？1 63038.98
13您信任从官方渠道获取的关于自费疫苗接种的信息吗？3969.47
14您对自费疫苗接种的担忧，能够和接种医生坦诚沟通3658.73
15综合考虑，您对接种医生的信任程度如何？2706.46
), ArticleFig(id=1320427664997986933, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320427660015153732, language=CN, label=表1, caption=

北京市1～6岁儿童家长PACV量表条目调查结果

, figureFileSmall=null, figureFileBig=null, tableContent=
条目PACV量表条目犹豫人数比例/%
1除了生病、过敏外，您曾经是否因为其他原因推迟为您孩子接种自费疫苗？92322.07
2除了生病、过敏外，您是否曾经因为其他原因拒绝为您孩子接种自费疫苗？46511.12
3您在多大程度上同意让您孩子按照推荐的免疫程序去进行自费疫苗接种？3568.51
4您是否认为目前儿童所接种的自费疫苗比他们实际上所需要的多？3 06773.34
5您是否认为自费疫苗预防的都是很严重的疾病？94022.48
6您是否认为对孩子来说，通过生病获得免疫力比接种自费疫苗来获得免疫力好？2 33955.93
7您是否认为儿童同时接种的自费疫苗越少越好？2 57661.60
8您是否担心您的孩子接种自费疫苗后会发生严重副反应？349783.62
9您是否担心每次的自费疫苗接种都可能不安全？2 94070.30
10您是否担心接种的自费疫苗并不能有效预防其对应的疾病？2 93470.16
11如果再生一个孩子您是否愿意让孩子完全按照免疫程序去完成有的自费疫苗接种？58213.92
12总的来说，请评价您自己对儿童自费疫苗接种有多犹豫？1 63038.98
13您信任从官方渠道获取的关于自费疫苗接种的信息吗？3969.47
14您对自费疫苗接种的担忧，能够和接种医生坦诚沟通3658.73
15综合考虑，您对接种医生的信任程度如何？2706.46
), ArticleFig(id=1320427665094455926, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320427660015153732, language=EN, label=Tab.2, caption=

Univariate analysis of factors influencing vaccine hesitancy

, figureFileSmall=null, figureFileBig=null, tableContent=
变量调查人数犹豫人数比例/%χ2值P值
儿童性别
　女童208429614.203.1020.07
　男童209833916.16
儿童户籍
　本市3 25245814.0813.752<0.001
　外地93017719.03
儿童居住地
　城市2 93942814.562.9640.085
　农村1 24320716.65
家中子女数
　<22 43436915.160.0030.959
　≥21 74826615.22
与儿童的关系
　父母364356515.512.3190.128
　其他监护人5397012.99
家长性别
　女性2 87438213.2925.556<0.001
　男性1 30825319.34
家长年龄/岁
　<3057412822.3030.533<0.001
　30～39273138914.24
　40～495248115.46
　≥503533710.48
文化程度
　初中及以下4126916.7510.6040.014
　高中/中专57210919.06
　大专或本科273839914.57
　硕士及以上4605812.61
家庭年收入/万元
　<101 22925220.5039.730<0.001
　10～191 62122213.70
　20～491 02212312.04
　≥503103812.26
职业
　农民2244720.9857.455<0.001
　工人/职员138621215.30
　医疗从业人员5547112.82
　公务员及企事业单位人员7008111.57
　个体经商者3085919.16
　家务待业325309.23
　退休人员138117.97
　其他54712422.67
), ArticleFig(id=1320427665186730615, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320427660015153732, language=CN, label=表2, caption=

疫苗犹豫影响因素单因素分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量调查人数犹豫人数比例/%χ2值P值
儿童性别
　女童208429614.203.1020.07
　男童209833916.16
儿童户籍
　本市3 25245814.0813.752<0.001
　外地93017719.03
儿童居住地
　城市2 93942814.562.9640.085
　农村1 24320716.65
家中子女数
　<22 43436915.160.0030.959
　≥21 74826615.22
与儿童的关系
　父母364356515.512.3190.128
　其他监护人5397012.99
家长性别
　女性2 87438213.2925.556<0.001
　男性1 30825319.34
家长年龄/岁
　<3057412822.3030.533<0.001
　30～39273138914.24
　40～495248115.46
　≥503533710.48
文化程度
　初中及以下4126916.7510.6040.014
　高中/中专57210919.06
　大专或本科273839914.57
　硕士及以上4605812.61
家庭年收入/万元
　<101 22925220.5039.730<0.001
　10～191 62122213.70
　20～491 02212312.04
　≥503103812.26
职业
　农民2244720.9857.455<0.001
　工人/职员138621215.30
　医疗从业人员5547112.82
　公务员及企事业单位人员7008111.57
　个体经商者3085919.16
　家务待业325309.23
　退休人员138117.97
　其他54712422.67
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Multivariate unconditional logistic regression analysis on factors influencing vaccine hesitancy

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因素比较组参照组β $ S_{\overline{x}} $Wald χ2值P值OR值95%CI
儿童户籍外地本市0.270.106.960.0081.3131.072～1.607
家长性别男性女性0.400.0918.39<0.0011.4871.240～1.783
家长年龄/岁30～39<30–0.400.1217.280.0010.6680.529～0.843
40～49–0.370.1611.500.0210.6900.503～0.947
≥50–0.840.245.290.4310.267～0.696
家庭年收入/万元10～19<10–0.440.1111.89<0.0010.6440.521～0.797
20～49–0.570.1325.37<0.0010.5670.440～0.730
≥50–0.550.2016.480.0050.5780.393～0.849
职业工人/职员农民–0.290.2019.240.1520.7480.503～1.112
医疗从业人员–0.320.237.810.1650.7250.460～1.141
公务员及企事业单位人员–0.430.2330.730.0650.6530.416～1.027
个体经商者–0.120.242.060.6210.8880.555～1.421
家务待业–0.940.271.93<0.0010.3900.232～0.656
退休人员–0.590.383.400.1250.5550.262～1.176
其他0.110.210.240.6141.1120.736～1.680
), ArticleFig(id=1320427665358697081, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320427660015153732, language=CN, label=表3, caption=

疫苗犹豫影响因素多因素非条件logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
因素比较组参照组β $ S_{\overline{x}} $Wald χ2值P值OR值95%CI
儿童户籍外地本市0.270.106.960.0081.3131.072～1.607
家长性别男性女性0.400.0918.39<0.0011.4871.240～1.783
家长年龄/岁30～39<30–0.400.1217.280.0010.6680.529～0.843
40～49–0.370.1611.500.0210.6900.503～0.947
≥50–0.840.245.290.4310.267～0.696
家庭年收入/万元10～19<10–0.440.1111.89<0.0010.6440.521～0.797
20～49–0.570.1325.37<0.0010.5670.440～0.730
≥50–0.550.2016.480.0050.5780.393～0.849
职业工人/职员农民–0.290.2019.240.1520.7480.503～1.112
医疗从业人员–0.320.237.810.1650.7250.460～1.141
公务员及企事业单位人员–0.430.2330.730.0650.6530.416～1.027
个体经商者–0.120.242.060.6210.8880.555～1.421
家务待业–0.940.271.93<0.0010.3900.232～0.656
退休人员–0.590.383.400.1250.5550.262～1.176
其他0.110.210.240.6141.1120.736～1.680
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北京市1～6岁儿童家长非免疫规划疫苗犹豫特征及影响因素: 一项2025年现况调查
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袁千里 , 王怀 , 高培 , 赵丹 , 索罗丹 *, *
中国公共卫生 | 专题报道——儿童疫苗接种保护效果研究 2026,42(8): 919-924
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中国公共卫生 |专题报道——儿童疫苗接种保护效果研究 2026 , 42 (8) : 919 -924
北京市1～6岁儿童家长非免疫规划疫苗犹豫特征及影响因素: 一项2025年现况调查
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袁千里, 王怀, 高培, 赵丹, 索罗丹*, *
作者信息
  • 北京市疾病预防控制中心免疫预防所，北京 100013
通讯作者:
索罗丹，E-mail：
作者简介:

袁千里（1990—），主管医师，硕士，研究方向：疫苗可预防传染病防控和免疫规划

Characteristics and influencing factors of parents′ hesitancy for non-immunization program vaccines in children aged 1–6 in Beijing: a survey in 2025
Qianli YUAN, Huai WANG, Pei GAO, Dan ZHAO, Luodan SUO
Affiliations
  • Institute for Immunization Prevention, Beijing Center for Disease Prevention and Control, Beijing 100013, China
    • Corresponding Author:
    SUO Luodan, E-mail:
出版时间: 2026-08-10 doi: 10.11847/zgggws1148817
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摘要
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目的

了解儿童家长对儿童非免疫规划疫苗接种的犹豫程度及其影响因素，为制定针对性干预措施提供依据。

方法

于2025年2—3月，采用多阶段分层抽样法在北京市城区、近郊及远郊区的60家社区卫生服务中心，选取陪同儿童接种疫苗的1～6岁儿童家长4 182人，使用父母对儿童疫苗接种态度（PACV）量表进行问卷调查，分析量表得分、疫苗犹豫比例及其影响因素。

结果

4 182名家长PACV量表犹豫评分中位数（四分位数间距）为33.33（20.00～43.33）分，疫苗犹豫比例为13.03%（545/4 182），量表15个条目的犹豫比例为6.46%～83.62%。多因素logistic回归分析显示，外地户籍儿童家长（OR=1.313，95%CI=1.072～1.607）、男性家长（OR=1.487，95%CI=1.240～1.783）的疫苗犹豫风险高；年龄30～39岁（OR=0.668，95%CI=0.529～0.843）、40～49岁（OR=0.690，95%CI=0.503～0.947）、≥50岁（OR=0.431，95%CI=0.267～0.696）、家庭年收入10～19万元（OR=0.644，95%CI=0.521～0.797）、20～49万元（OR=0.567，95%CI=0.440～0.730）、≥50万元（OR=0.578，95%CI=0.393～0.849）、职业为家务待业的家长（OR=0.390，95%CI=0.232～0.656）疫苗犹豫风险低。家长犹豫比例排名前3的条目依次为担忧儿童接种自费疫苗后发生严重副反应（83.62%）、认为儿童所接种的自费疫苗种类比实际需要的种类多（73.34%）、担心自费疫苗接种安全性（70.30%）。

结论

北京市儿童家长对非免疫规划疫苗接种的犹豫比例整体较低，但仍需加强疫苗知识科普宣传，以进一步降低疫苗犹豫水平。

非免疫规划疫苗  /  疫苗犹豫  /  预防接种  /  儿童  /  家长  /  北京市
Objective

To understand the degree of hesitancy among parents regarding their children′s vaccination with non-immunization program vaccines and its influencing factors, thus providing a basis for formulating targeted intervention measures.

Methods

A multi-stage stratified sampling method was used to select 4 182 parents of children aged 1-6 who accompanied their children to vaccination in 60 community health service centers in urban, suburban, and exurban areas of Beijing. The questionnaire survey was conducted with the Parent Attitudes about Childhood Vaccines (PACV) scale, and the score of the scale, the proportion of vaccine hesitancy and its influencing factors were analyzed.

Results

The median (interquartile range) of the PACV scale score was 33.33 (20.00, 43.33). The proportion of vaccine hesitancy was 13.03% (545/4 182), and the hesitancy proportions for the 15 items in the scale ranged from 6.46% to 83.62%. Multivariate logistic regression analysis revealed that parents of children with non-local household registration (OR=1.313, 95%CI: 1.072–1.607) and male parents (OR = 1.487, 95%CI: 1.240–1.783) had a higher risk of vaccine hesitancy. In contrast, parents aged 30–39 years (OR = 0.668, 95%CI: 0.529–0.843), 40–49 years (OR = 0.690, 95%CI: 0.503-0.947), and ≥50 years (OR = 0.431, 95%CI: 0.267–0.696), as well as those with an annual household income of 100 000–190 000 yuan (OR = 0.644, 95%CI: 0.521–0.797), 200 000–490 000 yuan (OR = 0.567, 95%CI: 0.440–0.730), and ≥500 000 yuan (OR = 0.578, 95%CI: 0.393–0.849), and parents who were homemakers or unemployed (OR = 0.390, 95%CI: 0.232–0.656) had a lower risk of vaccine hesitancy. The top three items in terms of the proportion of parents′ hesitation were concern about children suffering severe adverse reactions after receiving paid vaccines (83.62%), the belief that children were vaccinated with more paid vaccines than needed (73.34%), and concerns about the safety of paid vaccines (70.30%).

Conclusions

The overall proportion of vaccine hesitancy among parents of children in Beijing regarding non-immunization program vaccines is relatively low, while the popularization and education of vaccine knowledge should still be strengthened to further reduce vaccine hesitancy.

non-immunization program vaccines  /  vaccine hesitancy  /  vaccination  /  children  /  parents  /  Beijing
袁千里, 王怀, 高培, 赵丹, 索罗丹. 北京市1～6岁儿童家长非免疫规划疫苗犹豫特征及影响因素: 一项2025年现况调查. 中国公共卫生, 2026 , 42 (8) : 919 -924 . DOI: 10.11847/zgggws1148817
Qianli YUAN, Huai WANG, Pei GAO, Dan ZHAO, Luodan SUO. Characteristics and influencing factors of parents′ hesitancy for non-immunization program vaccines in children aged 1–6 in Beijing: a survey in 2025[J]. Chinese Journal of Public Health, 2026 , 42 (8) : 919 -924 . DOI: 10.11847/zgggws1148817
正文
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预防接种是预防传染病相关死亡、改善人群健康水平的最安全、最具成本效益且最成功的公共卫生干预措施之一[1]。非免疫规划疫苗作为免疫规划疫苗的有效补充，在扩大传染病防控范围、降低传染病发病风险等方面发挥着至关重要的作用。目前我国儿童非免疫规划疫苗接种率较低[2]。疫苗犹豫是指在接种服务可及的情况下，拒绝或延迟接种疫苗[3]。疫苗犹豫是制约提高疫苗接种率的核心挑战[4–5]。WHO 2019年将疫苗犹豫列为“全球十大公共卫生威胁之一”[6]。近年来，我国多起疫苗相关事件的发生，导致公众对疫苗的信任度下降。相比免疫规划疫苗，家长对非国家免疫规划疫苗的犹豫率更高[7]。儿童预防接种的决策主导权多掌握在家长手中，家长的疫苗犹豫已成为制约儿童疫苗接种工作推进的关键障碍[6]。了解父母对非免疫规划疫苗的犹豫现状及影响因素对优化非免疫规划疫苗接种策略、提高接种率具有重要意义。本研究于2025年2—3月对北京市4 182名1～6岁儿童家长进行问卷调查，探究其非免疫规划疫苗犹豫特征及影响因素，为制定针对性的疫苗犹豫干预策略提供数据支撑。
1　对象与方法
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1.1　对象
采用多阶段分层抽样法抽取调查对象，第1阶段在北京市城区、近郊、远郊每层各随机抽取2个区；第2阶段根据预防接种单位配合程度从选中的每个区中选取10家预防接种单位；第3阶段选取2025年2月7日—3月31日来接种单位为儿童接种疫苗的1～6岁儿童家长。纳入标准：在调查地区实际连续居住≥6个月。知情同意并自愿参与调查且对问卷无阅读理解障碍能独立回答问题者。排除标准：在调查地区居住时间<6个月、调查时中途退出、问卷完成时间<1 min、所有选项均为同一答案者。根据量表调查样本量需为条目数15～20倍的原则[8]，本研究采用中文版父母对儿童疫苗态度（Parent Attitudes about Childhood Vaccines, PACV）量表作为调查工具，该量表共包含15个条目，本研究至少需调查225人。本次调查依托于“北京市非免疫规划疫苗接种现况调查”项目现场开展，参考既往文献数据，在调查的非免疫规划疫苗中，轮状病毒疫苗接种率最低（P=6%）[2]，故将此6%作为总体接种率的估计值，样本量的确定使用设计效应（design effect, deff）系数，先估计简单随机抽样条件下所需样本量，然后乘以deff系数，得到实际抽样设计下所需样本量。取a=0.05，d=1.0%，deff=1.5，按10%失访估算，需至少调查3 600人。满足PACV量表分析所需的样本量要求。本研究共计调查4 184人，有效调查人数4 182人，有效率99.95%。本研究已经通过北京市疾病预防控制中心伦理委员会审批（编号：BJCDC2024034）。
1.2　方法
在选中的调查地点，由接受统一培训的接种单位工作人员在留观区对符合纳入排除标准的调查对象进行问卷调查。调查前由调查员详细讲解调查目的及内容，调查对象同意参加后通过手机扫描二维码进入问卷星平台，在工作人员一对一指导下填写问卷。问卷首页是知情同意的内容，选择同意的家长正式开始问卷调查。调查内容包括：（1）基本信息，包括儿童预防接种编码、性别、出生日期、户籍类型、居住地及家长性别、年龄、文化程度、职业等信息。（2）PACV量表模块，包括接种行为、疫苗安全性和有效性、总体态度3个维度。PACV量表共15个条目，条目1和2选择“是”判定为“犹豫”，选择“否”判定为“不犹豫”；条目3和条目15选0～5分判定为“犹豫”，6～7分判定为“不确定”，8～10分判定为“不犹豫”；条目4、6和7选择“完全同意或同意”，条目5、13和14选择“完全不同意或不同意”，条目8、9和10选择“非常担心或有点担心”以及条目12选择“非常犹豫或有点犹豫”判定为“犹豫”。每个条目判定为“犹豫”计2分，判定为“不犹豫”计0分；条目1～2选择“不清楚”时，按缺失值处理。条目3～15选择或判定为“不确定或不清楚”计1分。量表原始分值范围为0～30分，按照PACV量表得分线性转换规则以及疫苗犹豫阈值界定值（50分）[8–11]，判定<50分为非犹豫，≥50分为犹豫。为保证问卷质量，通过问卷星系统设置质控规则，包括限定网络IP地址为北京市，限定儿童出生年月填写范围，每个手机号仅能提交1份问卷，设置所有题目为必填且未完成问卷无法提交，设置题目选项填写范围等。
1.3　统计分析
采用 IBM SPSS Statistics 19.0对PACV量表进行信度和效度分析。由于评分不符合正态分布，采用中位数和四分位数间距对其进行统计描述。采用多变量logistic回归分析疫苗犹豫的影响因素，检验水准为双侧检验α=0.05。
2　结　果
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2.1　调查对象基本情况
被调查的4 182名家长中，男性1 308人（31.28%）、女性2 874人（68.72%）；<30、30～39、40～49、≥50岁分别为574人（13.73%）、2 731人（65.30%）、524人（12.53%）和353人（8.44%）；初中及以下、高中或中专、大专或本科、硕士及以上文化程度者分别为412人（9.85%）、572人（13.68%）、2 738人（65.47%）和460人（11.00%）；职业为农民、工人或职员、医疗从业人员、公务员及企事业单位人员、个体经商者、家务待业、退休人员以及其他职业者分别为224人（5.36%）、1 386人（33.14%）、554人（13.20%）、700人（16.74%）、308人（7.36%）、325人（7.77%）、138人（3.30%）、547人（13.08%）。被调查的4 182名儿童中，男童2 098人（50.17%），女童2 084人（49.83%）；本市户籍3 252人（77.76%），外地户籍 930人（22.24%）；2 939人（70.28%）居住在城市，1 243人（29.72%）居住在农村。
2.2　中文版PACV量表效度检验
探索性因子分析显示，PACV量表的克隆巴赫系数为0.741，凯泽–迈耶–奥尔金检验值为0.793，Bartlett's球形检验的χ2=22 644.37，P<0.001，可以进行探索性因子分析。利用主成分分析法和最大方差正交旋转提取5个公因子，特征值均>1，累计总方差贡献率为70.26%。每个条目的因子符合均>0.50，保留所有条目，结合专业知识以及实际公共卫生意义，将每个条目归类于原量表所在维度，即接种行为（条目1～2）、疫苗安全性和有效性（条目7～10）和总体态度3个维度（条目3～6和11～15）。PACV的验证性因子分析显示，拟合评价指标达标（近似误差均方根=0.056，拟合优度指数=0.979，比较拟合指数=0.970，规范拟合指数=0.968），模型拟合良好。
2.3　北京市1～6岁儿童家长PACV量表条目调查结果（表1）
1～6岁儿童家长对儿童接种非免疫规划疫苗的犹豫评分M（P25～P75）为33.33分（20.00～43.33），犹豫比例为13.03%（545/4 182）。PACV量表各条目被判定为犹豫的比例为6.46%～83.62%。家长犹豫比例排名前3的条目依次为：担忧儿童接种自费疫苗后发生严重副反应（83.62%）、认为儿童所接种的自费疫苗比实际需要接种的多（73.34%）及担心自费疫苗接种安全性（70.30%）。93.54%（3 912/4 182）的家长表示信任预防接种医生，90.53%（3 786/4 182）的家长信任从官方渠道获取的疫苗接种相关信息。
2.4　北京市1～6岁儿童家长非免疫规划疫苗犹豫影响因素分析
2.4.1　疫苗犹豫影响因素单因素分析（表2）
1～6岁儿童家长对非免疫规划疫苗的接种犹豫在不同儿童户籍、家长性别、年龄、文化程度、职业和家庭年收入方面差异均有统计学意义（均P<0.05）。
2.4.2　疫苗犹豫影响因素多因素非条件logistic回归分析（表3）
以家长是否犹豫（0=否，1=是）为因变量，以单因素分析中对疫苗犹豫有显著性影响的因素为自变量，进行多因素非条件logistic回归分析，自变量纳入方程标准为0.05，剔除标准为0.01。结果显示，外地户籍儿童家长的疫苗犹豫比例高于本市户籍儿童家长，男性家长的犹豫比例高于女性家长，而年龄≥30岁的儿童家长犹豫比例低于年龄<30岁的家长，家庭年收入≥10万元的家长犹豫比例低于家庭年收入<10万元的家长，职业为家务待业的家长犹豫比例低于职业为农民的家长。
3　讨　论
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疫苗犹豫已成为严重的全球性问题，WHO免疫战略咨询专家组针对疫苗犹豫问题的工作报告表明，超过93%的WHO成员国存在疫苗犹豫现象[12]。国内外针对疫苗犹豫的研究日趋深入，但侧重点不同，国外侧重于评估疫苗犹豫带来的实际影响，例如导致疫苗可预防传染病的暴发或流行，而国内研究多集中在疫苗安全性问题探讨以及疫苗犹豫消除方法[13]。目前，疫苗犹豫测量工具主要包括疫苗信心量表、全球疫苗信心指数和疫苗犹豫量表和PACV量表。PACV是国际上最早且应用最广泛的疫苗犹豫定量调查工具之一，已被翻译成多种语言，其信度与效度已在多个国家和地区的研究中得到充分验证，允许在不同背景下进行比较[14]。汉化版PACV量表已被应用于中国人群，并被证实可有效反映我国儿童家长的疫苗态度与犹豫水平[9–11]，但目前PACV主要用于调查家长对于国家免疫规划疫苗及新冠疫苗的犹豫情况，对于儿童接种非免疫规划疫苗犹豫的研究较少。本研究中，PACV量表总的克隆巴赫系数、凯泽–迈耶–奥尔金值以及结构效度相关指标值显示该量表具有较好的信度和效度。
本研究结果显示，北京市1～6岁儿童家长对非免疫规划疫苗的犹豫比例为13.03%，该比例低于采用同一评估工具调查的深圳市龙岗区[9]儿童非免疫规划疫苗犹豫调查结果，但高于其他地区采用相同工具调查结果（6.40%～8.83%）[15–16]。本次调查发现，外地户籍儿童家长、家长为男性、家长年龄<30岁、家庭年收入<10万元是儿童家长非免疫规划疫苗犹豫的影响因素，与既往研究结论一致[5,9,17–19]，提示应重点关注犹豫比例较高的家长群体。研究表明，通过与孕妇和新生儿父母进行有针对性的疫苗知识沟通，包括面对面交谈、发送科普短信等，是建立他们对疫苗信任的关键[20]。因此，将健康宣教时间节点前移，是减少年轻家长群体疫苗犹豫的有效干预策略。
疫苗犹豫的原因是复杂的，涉及情感、认知、文化、精神、社会和政治因素，且随环境、时间和地点变化。国内研究发现，疫苗犹豫主要原因包括：（1）疫苗安全事件。既往国内多起疫苗不安全、有效性指标不合格事件的发生，影响和伤害了家长对疫苗的接种信心，33.04%的父母在疫苗安全事件发生后1周对疫苗接种犹豫不决[21]。（2）疫苗监管模式[22]。在既往多个部门横向分段共管的监管模式下，各监管机构间协同不足，导致疫苗从生产到上市使用全链条的监管上存在薄弱环节，增加了疫苗安全风险。（3）父母对疫苗的认知偏差。社交媒体中疫苗负面新闻报道及谣言误导，加剧了公众对非免疫规划疫苗的认知偏差与接种犹豫。2019年我国出台的《中华人民共和国疫苗管理法》，明确了疫苗相关违法犯罪行为的法律责任，显著提升了我国疫苗安全管理水平，有效降低了疫苗安全事件的发生率。目前，疫苗犹豫的重要干预措施仍是健康教育[22]，但通过何种方式传递疫苗接种信息非常重要。研究表明，官方渠道对非免疫规划疫苗知识的宣传以及预防接种工作人员的专业建议，是家长选择为儿童接种非免疫规划疫苗的关键影响因素[9,23–24]。因此，建议卫生健康部门、疾病预防控制中心等权威机构通过官方途径加大疫苗知识宣传力度，及时公开疫苗接种情况及不良反应监测信息，同时利用微博、微信公众号、短视频平台等热门网络渠道普及疫苗知识，发布辟谣信息，纠正家长的认知偏差，增强其对疫苗安全性有效性的认识。综上所述，北京市1～6岁儿童家长对非免疫规划疫苗的犹豫程度整体较低，需针对疫苗犹豫比例较高的重点人群，制定针对性的健康教育措施，进而减少疫苗犹豫。
本研究存在以下局限性：（1）选择偏倚。既往国内研究发现，儿童（外）祖父母对于自费疫苗的接种积极性高于父母[25]，而本次调查对象为前往接种门诊陪同儿童接种疫苗的家长，未限定为儿童父母，可能造成疫苗犹豫情况被低估，但考虑到本次调查中≥50岁家长仅占8.44%，（外）祖父母在总调查对象中的实际占比更低，其对整体研究结论的影响有限。（2）回忆偏倚。本调查是一项回顾性横断面研究，一方面，家长在参加调查时的态度与为孩子实际接种疫苗时的态度可能存在差异；另一方面，对既往接种态度的回忆可能与真实情况产生偏差。为获取更准确的信息，后续研究可通过前瞻性队列研究的方法分析犹豫行为和态度。（3）我国非免疫规划疫苗的主要接种对象为0～6岁儿童，但本研究未纳入0～<1岁组儿童家长，可能导致调查结果在低龄儿童家长群体中的代表性不足，影响结论的完整性。

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doi: 10.11847/zgggws1148817
  • 接收时间：2025-06-18
  • 首发时间：2026-10-23
  • 出版时间：2026-08-10
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  • 收稿日期：2025-06-18
  • 修回日期：2025-10-12
  • 录用日期：2026-04-16
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    北京市疾病预防控制中心免疫预防所，北京 100013

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total species (%)		 属
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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
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