Scholarlink

Background <p>Delays in receiving vaccinations lead to higher vaccine-preventable disease risk. We quantified the prevalence and drivers of delayed uptake of fee‑based, non-Expanded Program on Immunization (non-EPI) childhood vaccines in urban China.</p> Methods <p>A multicentre clinic-based survey with an embedded discrete-choice experiment (DCE) was conducted from May to July 2024 in 15 immunisation clinics across five provincial capitals in China. Caregivers of children aged 0–6 years provided verified vaccination information, socio demographic data, scores on a 12 item Caregiver Timely Vaccination Scale, and responses to a DCEwith four attributes (price, waiting time, calendar delay, adverse event [AE] risk). Delayed vaccination was defined as receipt of at least one non-EPI dose 30 days or more after the recommended schedule.Weighted logistic regression identified correlates; mixed logit models generated marginal utilities and willingness to pay (WTP).</p> Results <p>Among 1 292 valid caregiver–child pairs, the delay prevalence was 23.7% (95%CI: 21.3–26.1). Delay risk increased with monthly household income &lt; ¥10 000 (adjusted OR: 1.24, 95% CI: 1.11–1.38), an unpleasant prior vaccination experience (1.11, 1.01–1.23) and a caregiver’s delay history (1.22, 1.10–1.36), and less likely when knowledge was adequate (0.33, 0.25–0.43). The timely scale discriminated delayed from timely caregivers (+ 1.0 mean score). In the DCE, AE risk dominated all other attributes (66.3% relative importance): lowering the stated risk from 5% to 3% increased predicted uptake by 74% points. Reducing queue time from 30&#xa0;min to 10&#xa0;min added 24 points. Caregivers were willing to pay ¥106 (≈ US $14) per 1% AE‑risk reduction but only ¥4 for a 10‑day improvement in calendar timeliness.</p> Conclusions <p>Delayed vaccination drives non-EPI under timeliness in urban China. Embedding delay metrics and the brief 3&#xa0;C screen in routine dashboards, supported by sharper AE‑risk communication and fast‑track queues, could close the gap and advance Immunization Agenda 2030 targets.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Timeliness gap in non‑EPI Childhood vaccination in urban China: a five-city study of socioeconomic determinants and caregiver preferences

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月10日

查看全文
  • Linchen Chu,
  • Kangning Sheng,
  • Jiajun Li,
  • Kan Chen,
  • Yi Zhou,
  • Hongni Wang,
  • Liuren Zhang,
  • Jing Wu,
  • Chuanxi Fu

摘要

Background

Delays in receiving vaccinations lead to higher vaccine-preventable disease risk. We quantified the prevalence and drivers of delayed uptake of fee‑based, non-Expanded Program on Immunization (non-EPI) childhood vaccines in urban China.

Methods

A multicentre clinic-based survey with an embedded discrete-choice experiment (DCE) was conducted from May to July 2024 in 15 immunisation clinics across five provincial capitals in China. Caregivers of children aged 0–6 years provided verified vaccination information, socio demographic data, scores on a 12 item Caregiver Timely Vaccination Scale, and responses to a DCEwith four attributes (price, waiting time, calendar delay, adverse event [AE] risk). Delayed vaccination was defined as receipt of at least one non-EPI dose 30 days or more after the recommended schedule.Weighted logistic regression identified correlates; mixed logit models generated marginal utilities and willingness to pay (WTP).

Results

Among 1 292 valid caregiver–child pairs, the delay prevalence was 23.7% (95%CI: 21.3–26.1). Delay risk increased with monthly household income < ¥10 000 (adjusted OR: 1.24, 95% CI: 1.11–1.38), an unpleasant prior vaccination experience (1.11, 1.01–1.23) and a caregiver’s delay history (1.22, 1.10–1.36), and less likely when knowledge was adequate (0.33, 0.25–0.43). The timely scale discriminated delayed from timely caregivers (+ 1.0 mean score). In the DCE, AE risk dominated all other attributes (66.3% relative importance): lowering the stated risk from 5% to 3% increased predicted uptake by 74% points. Reducing queue time from 30 min to 10 min added 24 points. Caregivers were willing to pay ¥106 (≈ US $14) per 1% AE‑risk reduction but only ¥4 for a 10‑day improvement in calendar timeliness.

Conclusions

Delayed vaccination drives non-EPI under timeliness in urban China. Embedding delay metrics and the brief 3 C screen in routine dashboards, supported by sharper AE‑risk communication and fast‑track queues, could close the gap and advance Immunization Agenda 2030 targets.