Coverage and Vaccine Hesitancy of Influenza Vaccination Among Reproductive-Age Women (18-49 Years Old) in China: A National Cross-Sectional Study.

Publication date: Jul 14, 2025

Background: Influenza is a significant global respiratory infection, and vaccinating reproductive-age women, particularly in densely populated countries like China, cannot be overlooked. In this study, we aimed to determine influenza vaccination coverage, vaccine hesitancy, as well as associated factors among Chinese women aged 18-49 years old. Methods: A cross-sectional survey among women aged 18-49 years was conducted in China from 15 to 30 March 2023. We collected information such as past-year influenza vaccination, demographic characteristics, health-related factors, COVID-19-related factors, and perceived susceptibility and severity of influenza. Influenza vaccine acceptance among participants who did not receive influenza vaccination in the past year was also investigated. Multivariable logistic regression analyses were employed to investigate the influencing factors of vaccine coverage and vaccine hesitancy. Results: A total of 1742 reproductive-aged women were included in the final analysis. The past-year influenza vaccine coverage among women aged 18-49 years old was only 39. 32% in China. Age ≥ 35 years (aOR = 0. 72, 95% CI: 0. 56-0. 94), renting accommodation (aOR = 0. 57, 95% CI: 0. 44-0. 75), and history of COVID-19 infection (aOR = 0. 65, 95% CI: 0. 47-0. 89) and COVID-19 vaccine hesitancy (aOR = 0. 39, 95% CI: 0. 29-0. 54) were all identified as negative correlates of influenza vaccine coverage among Chinese reproductive-aged women, while participants with a history of chronic diseases (aOR = 1. 57, 95% CI: 1. 23-2. 01) and noticeable pandemic fatigue due to COVID-19 (aOR = 1. 45, 95% CI: 1. 05-2. 00) were prone to have higher vaccination rates. Among reproductive-aged women who did not receive influenza vaccination in the past year, the hesitancy rate regarding future influenza vaccination was 31. 79%. Factors such as older age, urban residence, living with others, poor self-rated health status, absence of chronic diseases, completion of full COVID-19 vaccination, COVID-19 vaccine hesitancy, pandemic fatigue, and failure to perceive the susceptibility and severity of influenza might increase influenza vaccine hesitancy. Discussion: Overall, a lower coverage rate of influenza vaccine was notably observed among Chinese reproductive-age women, as well as the hesitancy regarding future vaccination. To effectively mitigate the impact of influenza and reduce the incidence of associated diseases, it is imperative to devise targeted intervention strategies and policies tailored to reproductive-age women.

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Concepts Keywords
China coverage
March influenza
Pandemic reproductive-age women
Vaccinating vaccination
Women vaccine hesitancy

Semantics

Type Source Name
disease MESH Influenza
disease MESH infection
disease MESH COVID-19
disease IDO susceptibility
disease IDO history
disease MESH chronic diseases
disease MESH status absence
disease IDO intervention
disease MESH respiratory infections
disease MESH morbidity
pathway REACTOME Influenza Infection
disease MESH pregnancy outcomes
disease MESH adverse birth outcomes
drug DRUGBANK Pentaerythritol tetranitrate
disease IDO quality
disease MESH uncertainty
disease MESH marital status
disease MESH anxiety
disease MESH depression
disease MESH hypertension
disease MESH dyslipidemia
disease MESH stroke
disease MESH heart disease
disease MESH osteoarthritis
disease MESH rheumatoid arthritis
pathway KEGG Rheumatoid arthritis
disease MESH osteoporosis
disease MESH asthma
pathway KEGG Asthma
disease MESH diabetes mellitus
disease MESH cancer
disease MESH Anxiety Disorder

Original Article

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