Administration of non-national immunization program vaccines for children under six in a rural county, Henan Province: Did costs matter?
This study aimed to investigate caregivers’ administration of non-National Immunization Program (NIP) vaccines in rural China, and examine health system, individual, and social determinants. A cross-sectional survey (n = 1051) was conducted from July to October in 2022 in a rural county of Henan Pro...
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Taylor & Francis Group
2025-12-01
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| Series: | Human Vaccines & Immunotherapeutics |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/21645515.2025.2454744 |
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| author | Miaomiao Yin Yuan Cao Xiaolin Xu Hanzhi Peng Yu Wang Qian Long |
| author_facet | Miaomiao Yin Yuan Cao Xiaolin Xu Hanzhi Peng Yu Wang Qian Long |
| author_sort | Miaomiao Yin |
| collection | DOAJ |
| description | This study aimed to investigate caregivers’ administration of non-National Immunization Program (NIP) vaccines in rural China, and examine health system, individual, and social determinants. A cross-sectional survey (n = 1051) was conducted from July to October in 2022 in a rural county of Henan Province. Caregivers of children under six who came to township health centers for child vaccination were interviewed. Cross-tabulation and multivariate logistic regressions were used to examine the administration rate and associated factors. Qualitative interviews were conducted with healthcare professionals (n = 4) and caregivers (Focus Group Discussions, n = 4) to understand local policies, routine practices, and caregivers’ experience with the administration of non-NIP vaccines. A framework approach was used to analyze qualitative data. Quantitative and qualitative data were integrated during the interpretation of the results. The administration rate for non-NIP vaccines remained low in rural Henan, 26.7% of children had not received any non-NIP vaccines, 43.5% had received 1–2 types, and around 30% had received 3–5 types. There were no significant differences in the administration of non-NIP vaccines between left-behind and non-left-behind children after adjusting for characteristics of children, caregivers, and households. Qualitative findings reflected that the high cost of non-NIP vaccines was a primary factor influencing caregivers’ vaccination decision. Poor communication between physicians and caregivers was another significant factor, which was caused by low retention of healthcare workers, a shortage of professionals, and insufficient financial incentives for physicians. This study enriches the evidence on non-NIP vaccination among rural children, particularly for the vulnerable group of left-behind children. |
| format | Article |
| id | doaj-art-5f430dfe800f4871bafa12cd3b828747 |
| institution | Kabale University |
| issn | 2164-5515 2164-554X |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Human Vaccines & Immunotherapeutics |
| spelling | doaj-art-5f430dfe800f4871bafa12cd3b8287472025-01-22T07:25:40ZengTaylor & Francis GroupHuman Vaccines & Immunotherapeutics2164-55152164-554X2025-12-0121110.1080/21645515.2025.2454744Administration of non-national immunization program vaccines for children under six in a rural county, Henan Province: Did costs matter?Miaomiao Yin0Yuan Cao1Xiaolin Xu2Hanzhi Peng3Yu Wang4Qian Long5Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, ChinaSchool of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaSchool of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaGlobal Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, ChinaGlobal Health Research Center, Division of Social Sciences, Duke Kunshan University, Kunshan, Jiangsu, ChinaGlobal Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, ChinaThis study aimed to investigate caregivers’ administration of non-National Immunization Program (NIP) vaccines in rural China, and examine health system, individual, and social determinants. A cross-sectional survey (n = 1051) was conducted from July to October in 2022 in a rural county of Henan Province. Caregivers of children under six who came to township health centers for child vaccination were interviewed. Cross-tabulation and multivariate logistic regressions were used to examine the administration rate and associated factors. Qualitative interviews were conducted with healthcare professionals (n = 4) and caregivers (Focus Group Discussions, n = 4) to understand local policies, routine practices, and caregivers’ experience with the administration of non-NIP vaccines. A framework approach was used to analyze qualitative data. Quantitative and qualitative data were integrated during the interpretation of the results. The administration rate for non-NIP vaccines remained low in rural Henan, 26.7% of children had not received any non-NIP vaccines, 43.5% had received 1–2 types, and around 30% had received 3–5 types. There were no significant differences in the administration of non-NIP vaccines between left-behind and non-left-behind children after adjusting for characteristics of children, caregivers, and households. Qualitative findings reflected that the high cost of non-NIP vaccines was a primary factor influencing caregivers’ vaccination decision. Poor communication between physicians and caregivers was another significant factor, which was caused by low retention of healthcare workers, a shortage of professionals, and insufficient financial incentives for physicians. This study enriches the evidence on non-NIP vaccination among rural children, particularly for the vulnerable group of left-behind children.https://www.tandfonline.com/doi/10.1080/21645515.2025.2454744Non-national immunization program vaccinesleft-behind childrenrural areaadministrationChina |
| spellingShingle | Miaomiao Yin Yuan Cao Xiaolin Xu Hanzhi Peng Yu Wang Qian Long Administration of non-national immunization program vaccines for children under six in a rural county, Henan Province: Did costs matter? Human Vaccines & Immunotherapeutics Non-national immunization program vaccines left-behind children rural area administration China |
| title | Administration of non-national immunization program vaccines for children under six in a rural county, Henan Province: Did costs matter? |
| title_full | Administration of non-national immunization program vaccines for children under six in a rural county, Henan Province: Did costs matter? |
| title_fullStr | Administration of non-national immunization program vaccines for children under six in a rural county, Henan Province: Did costs matter? |
| title_full_unstemmed | Administration of non-national immunization program vaccines for children under six in a rural county, Henan Province: Did costs matter? |
| title_short | Administration of non-national immunization program vaccines for children under six in a rural county, Henan Province: Did costs matter? |
| title_sort | administration of non national immunization program vaccines for children under six in a rural county henan province did costs matter |
| topic | Non-national immunization program vaccines left-behind children rural area administration China |
| url | https://www.tandfonline.com/doi/10.1080/21645515.2025.2454744 |
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