Jingjie Fan

This study aims to examine the parents' COVID-19 vaccine hesitancy after the end of the zero-COVID-19 policy in South China, and to identify the pathway of psychological distress affecting vaccine hesitancy based on the "3C" model (confidence, complacency, and convenience). A city-wide cross-sectional survey was conducted among parents of children in primary and junior middle schools from five districts of Shenzhen City, China. Information about demographic characteristics, health conditions for the children, parents' psychological distress, and COVID-19 vaccine hesitancy was collected. Multi-variable logistic and linear regression models were applied to detect potential associations. Overall, 3127 parents were included (average age: 38.331 ± 5.757 years). Among their in-school children, the uptake rate of the COVID-19 vaccine for ≥1 dose, ≥2 doses, and ≥3 doses were 98.2%, 94.9%, and 11.0%, respectively by April 2023. The overall rate of parents' vaccine hesitancy was 43.6%. Parents with anxiety (OR: 1.685, 95%CI: 1.250 ~ 2.272), depression (OR: 1.507, 95%CI: 1.105 ~ 2.054), and a high-stress level (OR: 1.162, 95%CI: 1.000 ~ 1.350) were more likely to report vaccine hesitancy. For parents' COVID-19 vaccine hesitancy, stress affected all "3C" dimensions (confidence: β = 0.099, complacency: β = 0.138, and convenience: β = 0.117, all P < .001), while depression affected two dimensions (complacency: β = 0.068, P < .001, convenience: β = 0.042, P = .021) and anxiety only affected one dimension (complacency: β = 0.074, P < .001). This study identifies a significant proportion of Chinese parents reporting COVID-19 vaccine hesitancy for their in-school children after the end of zero-COVID-19 policy. Immediate mental healthcare services and tailored health education based on the "3C" model should be provided to parents with psychological distress.

Background: The mpox (monkeypox) outbreak has been declared to be a public health emergency of international concern by the Director-General of World Health Organization in July 2022. However, evidence regarding the awareness, knowledge, and worry about mpox in the general population remains scant.Methods: A community-based survey targeting community residents was preliminarily conducted in Shenzhen, China in August 2022 by using a convenience sampling method. Information on mpox-related awareness, knowledge, and worry was collected from each participant. Binary logistic regression analyses with the stepwise procedure were applied to explore the factors associated with awareness, knowledge, and worry about mpox.Results: A total of 1028 community residents were included in the analysis (mean age: 34.70 years). Among these participants, 77.9% had ever heard of mpox, and 65.3% were aware of the global outbreak of mpox. However, only about half of them had a high level of knowledge regarding mpox (56.5%) and related symptoms (49.7%). More than one-third of them (37.1%) expressed a high level of worry about mpox. Having high knowledge levels of mpox and related symptoms were positively associated with a high level of worry (OR: 1.79, 95%CI: 1.22~2.63 for a single high knowledge level; OR: 1.98, 95%CI: 1.47~2.66 for both high knowledge levels).Conclusions: This study identified the gaps in public awareness and specific knowledge of mpox in Chinese people, providing scientific evidence for the prevention and control network of mpox at the community level. Targeted health education programs are of urgent need, which should be implemented along with psychological interventions to release public worry if necessary.