Psychological distress and COVID-19 vaccine hesitancy among parents of in-school children after the end of the zero-COVID-19 policy: A city-wide survey in South China
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-section...
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| Format: | Article |
| Language: | English |
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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/10.1080/21645515.2025.2538942 |
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| author | Ruiyin Zhang Fangmei Ren Yucheng Xu Jingjie Fan Wei Lin |
| author_facet | Ruiyin Zhang Fangmei Ren Yucheng Xu Jingjie Fan Wei Lin |
| author_sort | Ruiyin Zhang |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-7f093bdbd4634baa92b98ac4eccdb7f4 |
| 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-7f093bdbd4634baa92b98ac4eccdb7f42025-08-20T03:56:12ZengTaylor & Francis GroupHuman Vaccines & Immunotherapeutics2164-55152164-554X2025-12-0121110.1080/21645515.2025.2538942Psychological distress and COVID-19 vaccine hesitancy among parents of in-school children after the end of the zero-COVID-19 policy: A city-wide survey in South ChinaRuiyin Zhang0Fangmei Ren1Yucheng Xu2Jingjie Fan3Wei Lin4Department of Programme Immunization, Futian District Center for Disease Control and Prevention, Shenzhen, ChinaGushu Community Health Service Center, Affiliated Hospital Group of Guangdong Medical University Shenzhen Baoan Central Hospital (Baoan Central Hospital of Shenzhen), Shenzhen, ChinaEmergency Office, Futian District Center for Disease Control and Prevention, Shenzhen, ChinaDepartment of Preventive Healthcare, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, ChinaHospital Office, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, ChinaThis 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.https://www.tandfonline.com/doi/10.1080/21645515.2025.2538942ParentCOVID-19vaccine hesitancy“3C” modelpsychological distressin-school children |
| spellingShingle | Ruiyin Zhang Fangmei Ren Yucheng Xu Jingjie Fan Wei Lin Psychological distress and COVID-19 vaccine hesitancy among parents of in-school children after the end of the zero-COVID-19 policy: A city-wide survey in South China Human Vaccines & Immunotherapeutics Parent COVID-19 vaccine hesitancy “3C” model psychological distress in-school children |
| title | Psychological distress and COVID-19 vaccine hesitancy among parents of in-school children after the end of the zero-COVID-19 policy: A city-wide survey in South China |
| title_full | Psychological distress and COVID-19 vaccine hesitancy among parents of in-school children after the end of the zero-COVID-19 policy: A city-wide survey in South China |
| title_fullStr | Psychological distress and COVID-19 vaccine hesitancy among parents of in-school children after the end of the zero-COVID-19 policy: A city-wide survey in South China |
| title_full_unstemmed | Psychological distress and COVID-19 vaccine hesitancy among parents of in-school children after the end of the zero-COVID-19 policy: A city-wide survey in South China |
| title_short | Psychological distress and COVID-19 vaccine hesitancy among parents of in-school children after the end of the zero-COVID-19 policy: A city-wide survey in South China |
| title_sort | psychological distress and covid 19 vaccine hesitancy among parents of in school children after the end of the zero covid 19 policy a city wide survey in south china |
| topic | Parent COVID-19 vaccine hesitancy “3C” model psychological distress in-school children |
| url | https://www.tandfonline.com/doi/10.1080/21645515.2025.2538942 |
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